Home' Australian Ageing Agenda : AAA Jul-Aug 2015 Contents Australian Ageing Agenda and Aged Care Channel are taking the
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In the early days some valuable lessons learnt included slowing
down to the residents pace, staff engagement in particular during
sundowning, and residents not needing to be in bed by the time
night shift started. Feedback has been solution based and for
complex cases, small group sessions with social workers and
occupational therapists have provided ongoing support, while
with new staff a redefined selection process has been put in place
to ensure the right fit to the new model.
Planning showed a consultative approach was needed cross-
departmentally. Areas of importance included staff culture, residents'
clinical needs, medication and meal timings, appointments, and
the lifestyle program. For staff buy-in, quick wins with one or two
changes, such as extending breakfast times, showed its success. In
addition, it has been important to emphasise that person-directed
living is not a copy-paste model. It should be tailored to the specific
needs of each unit rather than a blanket approach across all sites.
Staff education on this new model of care has been very
important to gain staff buy-in and as such a training roadshow
was implemented. Promotional items such as branded choice-
dignity-wellbeing lanyards, pocket-sized flyers, staff orientation
tools and a video have aided with this. A recognition program has
recently been introduced to reward staff members who go above
and beyond in demonstrating the new model.
BENEFITS TO IMPLEMENTATION
Many of the benefits are highlighted above and continue to
evolve as the model matures. There has also been no increase in
staffing or costs in comparison to the previous person-centred
model. Instead, schedules and rosters have been adjusted
around each unit's daily workloads depending on their
While person-centred care is well-known, we felt that model
was still institutional and needed to be challenged. The result
has been person directed living with individualised choice,
dignity and wellbeing for its care recipients. Its success
• Tasks and to-do lists eliminated
• Residents rise, shower and eat breakfast when they choose to
• Bed sensors (where applicable) alert staff to resident movements
• Partnerships with each resident centered on their preferences
• Specific staff assigned to certain neighbourhoods to
• Catering introduced flexible breakfast times including a late sitting
• Subsequently, lunch, dinner and supper times have been expanded
• Cleaning staff no longer vacuum in the early morning, but at
times best suited to the residents.
• Laundry pick-up and delivery occurs later in the day
• Allied health activities such as physio, hydro and diversional
therapies tailored later in the day and focus more on
• More flexible hairdressing, dental and doctor's appointments
• Revised medication timings that required partnership with
doctors and the pharmacy
• In dementia units, a reduction in non-reportable elder abuse
incidents, and a reduction in physical aggression incidents
towards staff have been reported
• For staff, improved inter-disciplinary team involvement, reduced
stress levels coupled with increased confidence
• Family members have also embraced person-directed living,
leading to increased compliments and reduced stress for them
moving forward will rely on regular evaluation, feedback,
continuous improvement, ongoing staff education and a
cohesive interdisciplinary team. n
Dr Alasdair MacDonald is general manager business innovation
and quality at Montefiore.
www.australianageingagenda.com.au | 37
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