When Place Matters

Lynden Aged Care

“There’s no place like home.” This is the last line of sentiment expressed in John Howard Payne’s 1822 song, “Home Sweet Home.” A sentiment that has lived on not only in song, but in books and theatre – a socially defined ascription to a sense of place, security and indeed, belonging. Interwoven and equally important is that small part of our world – our neighbourhood, our community – that generates trust in our surroundings and the people within them.

The aged in particular need to know that their home and their neighbourhood is the safest place to be in their later years. This is confirmed in a recent report released by The National Seniors Productive Ageing Centre entitled, Neighbourhood Characteristics: Shaping the Wellbeing of Older Australians,” supporting the consensus that one’s neighbourhood plays a vital role in quality of life, general health and overall happiness.

Government funded programs such as Home Care Packages allow some freedom to “age in place,” a philosophy of aged care in Australia since the Aged Care Act 1997 was introduced as part of the Federal Government’s Structural Reform Package. The sad reality for most aged Australians is that staying within the confines of their comfort zone – their home and community – indefinitely, often becomes impossible. Ultimately, frailty, ill health or mental deterioration may dictate a change in lifestyle. The concept of “ageing in place,” however, remains consistent and is encouraged in most of Australia’s aged care facilities. Consequently, residents can remain in the same familiar environment as care needs change. It is a 21st century approach to ageing well.

Lynden Aged Care considers itself a “home away from home,” a community based organisation that offers responsive provisions to these changing care needs. It’s a facility that is close to the heart; board members have family living in the facility. “The board makes decisions that improve the lives of the residents,” says Ann Turnbull, Lynden Aged Care’s CEO. “Lynden Aged Care is a standalone facility; it’s not part of a large group. The decisions we make are right for us. There are different levels of care so we can cater to 99 per cent of conditions… Once you come in here, you’ll know that you’ll be here right to the end… we do palliative care very well.”

For 30 years, Lynden Aged Care has stood nestled in a quiet suburban street in Camberwell, Victoria. A not-for-profit 80 bed facility, Lynden Aged Care offers standard services such as basic care, high care and extra services. Basic operational costs are met by the federal government and residential fees, and individuals are assessed by the government to determine their level of care requirements. It is a growing, evolving industry.

To accommodate a growing niche in the aged care market, Lynden Aged Care is expanding its facility. A new wing will include six Independent Living Units and 20 high care beds with completion slated for 2013. ILUs are a growing trend for an ageing Australian population. It’s a shift generated by the baby boomer generation who expect more for their parents in terms of care levels – they want higher levels of service in more upscale facilities, and many are prepared to pay for it.

This shift in expectations is consistent with potential residents as well, who enter into an aged care facility at an average age of 82. They themselves expect more independence and a feeling of wellbeing from their chosen facility, while maintaining a sense of place. And they want their partners with them. Statistical predictions indicate that by 2031, the number of aged Australians still living with a partner is expected to increase by 52 per cent for those aged 75 and over.

Lynden’s ILUs will be high quality five star, two bedroom, two bathroom units with priority access to the aged care facility when required. Each unit will include a nurse call system for immediate assistance. “The units we’re building don’t cater to the typical retired couple. We anticipate that they will appeal to the 80 year olds, one of whom is probably more frail than the other and more likely to require care,” says Ann. Prior to the Aged Care Act 1997, residential aged care was a two tiered system, meaning that relocation became necessary as individual care needs dictated. Couples with different care needs were often separated, some after years of marriage. At Lynden Aged Care, “They would have priority to a fully nursed bed in the aged care facility, with the spouse still living on the same block of land,” Ann explains.

Ann suggests that the proposed federal aged care reforms and their effects on Lynden Aged Care are uncertain. “There’s not enough data to really know how [the changes] will affect us. The fact that we’re going to be adding another 20 high care beds gives us the confidence that we won’t be negatively impacted.”

The organisation acknowledges that a sense of community is valued, not only by residents, but staff as well. Ann wants Lynden Aged Care to been seen as an employer of choice. It’s expected that within 10 years aged care facility staff numbers will increase 14 per cent while demand will increase 60 per cent. Some facilities are already seeing difficulty in recruiting and retaining skilled staff, but so far at least, Lynden Aged Care appears to be the exception. “I can’t say that we have a shortage of skilled workers. I never have vacant shifts or have to call the agency for last minute staff. Shortage is not my problem,” says Ann.

Understandably so, as Lynden Aged Care offers incentives such as wages higher than the industry average. Staff has more time per day per resident which they find very rewarding – relationships with residents have time to develop and mature. Additionally, staff are encouraged to attend in-house lectures and may take courses that are offered externally. “We support our staff in upgrading their professional status,” notes Ann.

It is estimated that a million elderly Australians will have dementia by 2050. In recognition of this statistic, the Australian government is making significant investments to support those families and caregivers coping with this syndrome. A Dementia Supplement will provide $164 million in financial assistance to those receiving Home Care Packages and in residential care. It represents the first time in Australian policy that dementia has been seen as a health priority.

Although Lynden Aged Care can appropriately address all care levels for residents, “almost everyone here has dementia,” says Ann. “We can manage 95 per cent of dementia cases. We do dementia training but we’re not a dementia specific facility. We can manage people with dementia as long as their behaviours are socially acceptable.” If ever behavioural needs can’t be met, those residents are transferred to a dementia specific facility. For non-problematic dementia residents Ann assures that, “In the new building we’ll make sure that it’s designed to remind people where they are.”

All rooms at Lynden Aged Care have a garden view. The organisation recognises the intrinsic value of a garden, not only for residents but for visiting families and staff. Evidence supports the beneficial setting of a garden in aged care facilities and hospitals. Gardens foster mood improvement and reduce stress. Research also indicates that aside from ameliorating stress, gardens in aged care facilities encourage overall satisfaction with the quality of care provided and the resultant contentment with the health care provider. Says Ann, “We have a full time gardener and maintenance person on staff. They are two positions that private providers would get rid of… [but] the Board recognises the importance of gardens.”

There are current challenges to be met by any aged care organisation in Australia. Ann relates one challenge in particular that her facility is addressing. The majority of Lynden Aged Care staff is international with English as a second language. This can make communication with residents difficult, especially for the hearing impaired. To address this challenge, “We make sure the staff speak slowly and look at the resident face on. I encourage the staff to make sure that their body language says the same thing that they are trying to convey,” she says. “Residents, even those with dementia, read body language very accurately. If they can sense that the carer is being patient and kind,” that aids in communication between career and resident.

The Board members continue to be the most influential attribute to Lynden Aged Care, says Ann. “They are closely involved… they know what is important to the facility. It’s not just the bottom line. No doubt, that is one of the huge positives with Lynden Aged Care… It’s not like home, but it is the very next thing.”

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?

November 21, 2018, 3:47 AM AEDT