Putting older people at the centre

The aged care system is complicated and confusing, Rumbalara Aboriginal Co-operative executive manager of positive ageing and disability Aaron Chambers tells day one delegates at the inaugural National Aboriginal and Torres Strait Islander Ageing and Aged Care Council Conference.

At the Aboriginal community-controlled health and aged care provider – headquartered on Yorta Yorta lands in Victoria – the approach is all about taking away the administrative burden on Elders.

One area of focus has been aged care assessments.

The assessment process is “a huge issue everywhere,” Mr Chambers said. But by adopting a no-phone approach they have seen progress.

Instead of people being bounced around the system, Mr Chambers explained that workers go out to the older person, sit down with them and talk face-to-face.

This individualised approach can take time, but it is important for building trust.

It is also important to engage with Elders on their terms, and when they are ready.

Mr Chambers gave the example of when they had an Elder booked in for an aged care assessment and the staff member had to drive an hour to reach them.

“They turned up, the Elder went, ‘It’s a really nice day today, I don’t think I want to have an assessment,’ and that’s fine,” he said.

“If it was a mainstream service, I don’t think you’d get a second call back. But once people are engaged and they’re being assessed and they’re being put on to the appropriate level of funding, then we can start seeing progression.”

Then there is the issue of ensuring an Elder can access the right care.

“Programs – there’s a lot of them,” Mr Chambers said.

“It is disjointed, the reporting is an absolute headache, but we feel that it’s our responsibility to… match all of this together so it’s easy for the Elder, so they don’t have to retell their story, they don’t have to be bounced around to the 1-800 number,” he said.

“They have the conversation once. Are we perfect? No, of course not. But the idea is to have continuity of care, have it integrated so people aren’t being hand-rolled around and they can have the same people supporting them through the whole process.”

Palliative care needs to be culturally safe

Rumbalara has also been putting a lot of emphasis on culturally appropriate palliative care offerings and supporting Elders through their journey to the Dreamtime.

The Rumbalara Elders Facility is a 30-bed residential care home in Shepparton that offers full-time care and a dedicated palliative care unit for Elders and Aboriginal and Torres Strait Islander people with disabilities or special needs.

“And we can really see now over the last five years that Elders aren’t as scared coming in,” Mr Chambers said.

“We’ve highlighted it, that yes, a lot of people do come into residential aged care and that’s their final home. But it’s their home first, and by doing the appropriate planning and working with the family and making sure that Elders’ wishes are supported on their journey to the Dreamtime, it will be fascinating to see the impact across the whole community the longer that that goes on.

“For example, we had an Elder pass a couple of weeks ago. We had around 80 community members at the facility for three days.

“Being there with the Elder, being that person… with family, and I think that time is the really special part and the collective impact on that whole family of having a good death. I think it’s really powerful.”

None of this is possible without adequate funding, however, and for Mr Chambers, aged care needs should be addressed through aged care funding.

“We shouldn’t have to be shuffling around and drag from this program or drag from that program to make it work,” he said.

“Fund the community, not the program. I know that everyone says that one, but we’ve listened. The Elders in our community want a simpler system to take out the complexity, to make it easy. And that’s what we’re trying to do. As I said, not perfect, but it’s going somewhere,” Mr Chambers said.

“There is a lot of negative stuff going on about aged care at the moment, but there is also a bit of a glimmer of light.”

The Ageing Agenda is a media partner for the NATSIAACC conference. Read our coverage here.