Myth Busting in Aged Care

I had the pleasure of attending the LASA national congress recently, and I’ve summarised what I learned as follows:

1.      Longevity risk

Longevity may pose financial risks by stretching retirement savings to the limit, but it does not necessarily increase healthcare costs. On average people get sick during the last five years of life. Longevity simply delays this phenomenon. It does not compound it. The problem for healthcare budgets is not longevity per se but the bulge in baby boomers in their final five years.

2.      Consumer-driven care is not just about market efficiency

There is research to support the view that feeling in control of your life can have significant, positive physiological effects. Conversely a loss of control can increase chronic stress. Self-efficacy drives health and well-being, but learned helplessness is a major risk for older, frail, isolated people.

3.      Dementia risk can be ameliorated

There are a range of modifiable risk factors relating to dementia: cholesterol, blood pressure, education, engagement, exercise and sleep.

4.      Well-being includes seeing a meaning or purpose in one’s life

There are skills and mental habits associated with a meaningful life that can be taught. These include a sense of gratitude and mindfulness.

5.      Resilience is not just a personal characteristic

It can reside in the eco-system in which we live. Organisations can increase the resilience of their staff and clients by shaping their work cultures accordingly. This view is relatable to other research evidence on optimism being contagious among work colleagues.

6.      Performance measures can be counter-productive

A brief discussion on performance measures with a fellow attendee raised a warming light. The wrong KPI could have adverse impacts. Imagine adopting a KPI such as Net Promoter Score in healthcare. This could lead to overmedicating patients to keep them ‘happy.’

7.      The IR system is archaic but some flexibilities can be achieved

The IR system hasn’t kept pace with client-centric regulation in aged care. Award or EA-based barriers to flexibility exist in relation to minimum engagement periods, rigid part-time hours, rostering requirements and client cancellations [in home care]. There are also sham contracting risks, pressure to contain wage costs and associated challenges in attracting and retaining staff.

EA’s can be varied to some degree and individual flexibility agreements can be used to buy flexibility on a one-on-one basis. Importantly, such agreements can’t override the award but they can stipulate matters outside the award e.g. workplace location. About 15% of the aged care industry draft their own EA’s rather than adopting the industry standard.

8.      Carers don’t always care

Great staff can become desensitised to client needs. The endless repetition of mundane tasks can rob them of their empathy. This means that employers need to invest in their staff to combat this risk. A simple, relevant capability framework expressed simply can guide the investment in selection, coaching, training and development and promotion.