Good Lives for Older People…

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-By John Boley

… is the motto of a unique organisation that is changing the landscape of the aged-care sector. ACH Group is a not for profit organisation that was established a little over 60 years ago by Sir Keith Wilson in South Australia. He persuaded the Commonwealth government to provide housing for older people who could not afford it, many of them widows and/or Second World War veterans.

Today, says ACH Group chief executive Mike Rungie, “We believe in providing support, care, information, training and opportunities for older people so they can live their lives well regardless of their age.” Mike is keen not to categorise people too much into silos marked ‘pensioner’ or ‘retired’, for example, but he does explain that the target groups are generally much older than the standard retirement age. Nevertheless, among ACH Group’s aims is the provision of the means of “better health, jobs, volunteering opportunities, training, and fitness.” The organisation is not merely about providing care, then, but assisting elderly residents to achieve true quality of life in their later years.

Mike says this is not an implied criticism of the conventional model of care provision. “In fact Australian aged care systems are very good. What tends to happen is that money flows out either directly to older people or to organisations who provide services on behalf of government. Our big issue is the mismatch between the opportunities that older people are looking for and the services that are being provided.”

But demographics are changing while health care improves, with the result that people live longer and want to do something useful for longer. As Mike explains, if you ask someone in their 30s or 40s what they do, the answer is usually quite clear. If you ask someone in their 70s, 80s or 90s, the answer is often less clear.

Mike says that the issue is dynamic and no one has a definitive answer as to how to address this “large new challenge.” But ACH Group focuses clearly on improving the lives of older people in five linked areas: good lives, good health, good choice, good care and good relationships. This includes giving people opportunities to stay fit, manage their chronic conditions and receive rehabilitation when they have been in hospital. Good care, says Mike, means delivering the care required at the right time and place to suit the recipient. “There’s not much point,” he says, “in coming at three in the afternoon if the person needs to get out to a computer course they are doing every morning at nine o’clock.” Good relationships, he explains, means empowering care workers in a way that enables them to do for the recipient what the recipient wants at that time, rather than what is on a necessarily generalised job description. This is not a criticism of care workers – far from it – but a function of a traditionally rather rigid care system that does not provide care workers with enough capacity, communication and scope to respond to needs.

In fact, a recent report from the Productivity Commission – the Australian Government’s independent research and advisory body on a range of economic, social and environmental issues affecting the welfare of Australians – recommends that government support greater choice for older people, indicating that older people do like the idea of consumer directed care “where clients get control over budgets.

“The biggest challenge for us in consumer directed care was that no one knew how to do it. It entails making sure staff know what our expectations are but also “empowering” consumers to understand how to make decisions. We call that ‘consumer directed care literacy’. We think that a new client takes about a year to become confident with their accounts, their budget and what is possible. That is music to my ears, because what we are doing is being part of teaching people how to live a different lifestyle as things change.

“People coming into our more traditional aged care services are coming through assessments and referrals. But increasingly now, people are choosing us because we are starting to promote other possibilities. Consumer research has given the organisation a feel for what to provide. When we get high levels of feedback on things that people are interested in, we’ll set some of them up and test interest and effects on people.”

It is interesting to note that many of ACH Group’s clients experience some form of dementia. With an average lifespan of eight years upon diagnosis of dementia, there is still a lot of living to be done, says Mike. Recognising this, the company has taken a strategic approach to become a specialist provider of services for people living with dementia.

A Dementia Champions network was established three years ago to ensure that ACH Group’s services can support people with dementia in living as well as possible. More than sixty staff across all ACH Group services were trained to develop evidence based services, to implement service improvement programs and to act as resources to other staff in their local area. This spreads their influence and supports real change in the organisation’s services.

“By creating a highly skilled and innovative workforce in dementia care, we are able to provide individualised care for people with memory loss and adapt our services as needs change,” says Mike.

ACH Group’s commitment to developing a skilled workforce is not only limited to dementia care alone. In a partnership with the SA Department of Health and Flinders University, ACH Group is developing a Teaching Aged Care Facility at the Repatriation General Hospital to join up health and aged care services with educational initiatives. Mike says that this facility will create considerable graduate and undergraduate teaching capacity and research opportunities, as well as new opportunities for workforce attraction and retention.

“This is consistent with the directions recommended by the Productivity Commission, the Commonwealth Government Health Reforms and the directions of Health Workforce Australia,” says Mike. It is also consistent with international trends that are emerging in many countries including Scandinavia, UK, Netherlands and North America. Upon completion in 2013, the Teaching Aged Care Facility will also result in 120 new places for restorative care available to older people.

ACH Group is active in South Australia and the eastern suburbs of Melbourne, but Mike says there is no great desire to spread the net too wide. National networks of learning and innovation are in place to support the organisation’s strategic goal to changing the way people think about growing older and aged care.

Making Sense of Management

Management is the art, or science, of getting things done through people. Sounds fairly straightforward – except for the fact that people are not robots waiting to do our bidding. People have their own minds, motivations, and goals. So how do managers keep operations – and the people behind them – running as planned?

January 18, 2019, 3:30 AM AEDT