Home' Australian Ageing Agenda : AAA Jan-Feb 2012 Contents "We don't always see this as an ageing process but a living
process. For example, our housing residents don't see themselves
as 'ageing' or 'old' or 'older'; so it doesn't fit with them to be
saying 'positive ageing'. It's not a term they use, but one others
use about them. For them it's about positive living. So we prefer
to talk about people having a good life in their 70s, 80s and 90s,"
"Our job as an aged care provider is to explore the
opportunities to help people in their 70s, 80s and 90s to have a
good life," she says.
A GOOD LIFE
Just what defines a 'good life' has been an interesting
challenge for ACH but they have managed to narrow it down
to six key elements.
"A good life is first of all unique," says Mussared. "I make the
decisions and they're tailored to me.
"Second, it is one that I control. In research, a sense of
control has been shown to be the number one factor in quality
of life. This is what drove us in trialling consumer directed care
packages (CDCs) and it still does.
"Third is a sense of belonging and knowing where you sit
within various relationships; fourth is what we call 'contribution
and engagement', especially engagement. People need to feel
that they have credibility and influence, with relationships that
are strong and reciprocal.
"Fifth, a good life should be as healthy as it can be. Older
people are catching on that it is never too late; and that starting
to exercise, even in your nineties, is a worthwhile thing to do.
Finally," says Mussared, "there should be a sense of optimism
about the future. There are always things to learn, reflections to
make, people to meet. One lady in our research, who was in her
90s said she still sets goals - they just aren't as long range."
Despite their prodigious efforts, finding ways to deliver
services on the good life principles is still a challenge for ACH.
"We're getting better and better at the health stuff and the
goals around optimism. A whole lot of our assessment processes
have been replaced with joint goal setting; that's a very, very
"We know the healthy aspect of a good life is probably easiest
to deliver. It's the 'unique life', the personal control, and the
contribution and engagement elements - ensuring people have
roles where they can produce, participate, create -- that are
harder to deliver on.
"One thing - we need to stop care workers doing things for
older people that the person wants to do, or is capable of doing,
for themselves. They've run their own lives for 85 years and
they should be given the opportunity to keep doing it as much
as they want and encourage them to have control over the
things they want."
POLICY AND POLEMIC
Professor Hal Kendig, director of the Ageing, Work and
Health Research Unit in the Faculty of Health Sciences at the
University of Sydney and a chief investigator on the Australian
Research Council (ARC) Centre of Excellence on Population
Ageing Research (2011-2017), is a long-standing advocate of
Kendig says the ageing policy emphasis always seems to be
in terms of the care element. "But it is only a small proportion of
the older population -- only five, 10, 15 per cent - who ever need
that level of care services.
"We need more fundamental structural changes to the
way our society views ageing, with a comprehensive policy
approach taking into account much broader issues of ageing.
[...] There's a lot of evidence that the experience of ageing is
improvable but there are so many negative attitudes that are
"People can't envisage that ageing can be a good experience
and that older people can have a meaningful contribution. The
government role is crucial at the moment -- we need a whole
of government approach to ageing and it is good to see that
beginning to happen [as in New South Wales]."
Selling positive ageing
Professor of Ageing at the Centre for Research on Ageing at
Curtin University of Technology in Western Australia (WA), Gill
Lewin, is also research director at flagship WA community care
provider, Silver Chain, and immediate past president of the
Australian Association of Gerontology. She agrees it is essential
that our society learns to rethink what it means to age well.
"We need a much better understanding within the general
community about ageing and a much more positive expectation
of both the process and the times ahead.
"People think of ageing as being about frailty and
dependency; not as this wonderful time or opportunity. We've
talked about it in multiple different contexts, about needing
a public marketing campaign about the positive aspects of
ageing and how it's not to be dreaded. It is to be embraced!"
says Prof Lewin.
Kendig argues, in critique of the 2010 Intergenerational
Report that, rather than scapegoat older people, "there needs
to be an enlightened evidence-based strategy for a constructive
and responsible response to an ageing Australia. [...] We need
leadership and action to enable older people to be part of
affirming solutions and to recognise the opportunities as well as
the challenges of an ageing Australia".
NEW JOBS AND SERVICES
"In the proposed new system, there'll
be a need for people skilled in planning
and helping people systematically think
through their options and the potential
path ahead, to have a strategic plan to get
them back on track.
"There'll be more roles for life coaches
in chronic disease management. There've
been several studies positive studies
where nurses have worked with people
who have multiple co-morbidities and
have coached them in helping them
understand their disease and also in best
"Services should include specific,
intensive reablement interventions to get
back as much functioning for people as
they can -- short, sharp interventions, when
something [eg a fall, a loss] first happens
and they have the energy to tackle it."
"There will be new jobs in enabling people
to do things. So, I think there will be more
technology support to help people to get
connected virtually. There will also be more
'concierge services' -- someone who can
help with solving problems and fixing things
when they happen. When something like
the hot water system blows up, who do you
call? A concierge service you can trust will
"Other roles will involve facilitating
independence for people - navigating how
to get support will be even more challenging
in a consumer directed care environment.
"There will be a whole lot of new jobs
in sub acute care and in chronic disease
management. Another big area is preventive
health. [...] There will be new roles for
dietitians for example - they will become
more important; and more requirements for
exercise physiologists and physios."
"There'll be a huge role for volunteers, which
is really important. But we need to develop it
further so we recruit volunteers to do specific
things, to make it more task and skill-based -
not just 'volunteering'."
AAA | JANUARY -- FEBRUARY 2012 | 41
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