Mar 06, 2018

Aged Care Has Been Set Up “Around The Notion Of Guilt”

The staff are the backbone of the aged care industry. Without carers, nurses and other aged care staff, Australia’s vulnerable elderly may find themselves in a challenging and helpless situation.

In fact, quality of care can be directly correlated to the workforce knowledge and skill of their staff.

This is what Professor John Pollaers spoke about at the Quality in Aged Care conference in Sydney.

Professor Pollaers shared with the audience the emerging themes that they are testing as a part of the Aged Care Workforce Strategy Taskforce.

Aged Care is an “incredibly fragmented industry”, says Prof Pollaers.

“There are many many different parts to it. And not all the parts understand the role that the others play.”

“There’s a lot of issues that they each face which can often lead to a lot of  “siloing” in the industry and a lot of disruptions.”

“But we must remember why people are in this industry – predominantly because they care”.

“And people who look to this industry as those who care about the people that they love. So we need to remind ourselves of that when we come together for our meetings.”

One of the most poignant ideas that Prof Pollaers raises is the idea that aged care is “an industry that has been set up around the notion of guilt”

“That’s guilt over passing somebody you love into care by somebody else. The guilt of thinking it’s too big a burden to take on yourself. The guilt of ‘what happens if it goes wrong?’ and what that says about them.”

“The frustration and the anger that comes out of that guilt when it goes wrong. And of course that lands at the doorstep of the workforce.”

“As we get to understand a little bit more about that, one of the really sensitive parts of the conversation is that it took sometime in those sessions to often to acknowledge that they felt that care was a burden”

“You can imagine that people are horrified when they hear themselves say that, because who wants to ever think that care is a burden?”

“But the reality is that the access to this system, the issues you face and the difficulties of being able to makes decisions and feeling like you’re all alone managing against this large system does feel like a burden.”

The role of the aged care workforce is to “lift that burden”.

“There are a number of people who are frail, who are lonely – they are the people we must have in our minds when we make conversations. So where do we start?”

“We had to make it very clear that the [Aged Care Workforce Strategy Taskforce] is not another review. The need that this industry has for review after review is something that many have questioned”

“And what we found is that many of those reviews haven’t ended up in a conclusion or a decision that can be executed. ANd so when the Minister asked me to take this on, it was definitely not to do a workforce review and rather to develop with industry a core strategy.”

Aged Care “Call to Arms”

“We have to try focus the work around the issues of substance,” says Prof Pollaers.

“So we looked at all the reports that existed – the Senate enquiries, the report by David Tune.”

“There was an absences in a response to solving workforce issues. We have to develop a Framework to tackle this issue.”

Aged Care Workforce Strategy Taskforce found five strategic imperatives redefining the sector’s thinking;

  1. Why this aged care industry matters
  2. Industry leadership, mindset and accountability
  3. Industry workforce organisations and education (current and future)
  4. Industry attraction and retention
  5. Translating research and technology into models of care and practice.

“There needs to be a recognition, that the aged care industry needs its own code of practice,” says Prof Pollaers.

“It needs to start to define safety and quality, in a ‘living well’ contest ahead of community expectations.”

“Frankly what [aged care] do have now is a table of the industry setting the reputation of the industry. In every other industry you have the industry setting the standards and people fall short.”

Prof Pollaers says that there need not be so much negativity around standards, “a code can be written in a way that actually identifies and promotes what good looks like”

“If we want to get through the media crisis, the regulatory crisis, and being used by government from time to time, then you have to get on the front foot and start to lead this dialogue.”

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  1. I do not doubt Professor Pollaers sincerity and his desire to improve the system but there is a crisis in staffing and I doubt the capacity of the industry to confront and address the staffing problems that they are at least in part responsible for and that have developed while they have been in charge of this system.

    As a non-industry attendee at the first taskforce summit, with an interest in systems that don’t work, I thought that the branding exercise reaffirming the industry’s commitment to caring was not the best way to address a problem which required the industry to examine whether they had met this caring commitment in their staffing policies. I have studied similar situations and under strong market pressures caring readily becomes tokenised – the words becoming a substitute for the real thing. Care has slipped badly even while people still believe and loudly proclaim their commitment. This encouraged that. What was needed was a dose of reality that challenged the way they had met their responsibilities..

    What was missing at this summit was actual data about staffing and about failures in care. Staffing data in Australia is alarming and this is a crisis. This might have been followed by a discussion of what the staffing needs really are and on what data it should be based. There is international data to compare with our own. We got no data at this summit so did not even start addressing the issues that needed to be confronted realistically and honestly.

    At Aged Care Crisis we think that the only way to address this problem of tokenism is to make providers directly accountable to their local communities by having a local empowered visitors scheme working transparently with providers and local community advocacy and support groups. This should be mentored and supported by government and collect data transparently. Management would then work with suitable community members in addressing any problems. This would hold providers to their mission and pin policies to the real context of care. Community would understand providers real problems and provide support. This would be a system based on the principle of distributive justice.

    Community would be in a position to support staff and empower them so that they have more control over their work. This might then be seen as a desirable career by community members who know what it involves.


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