Home' Australian Ageing Agenda : AAA Mar-Apl 2013 Contents an opportunity. With their core business
experience in planning and delivering
seniors housing with shared facilities,
lateral thinking retirement village
operators might find interesting niche
roles to play as developers, consultants,
facilitators and managers. So might aged
Certainly this model hasn't escaped
the nimble thinking of Trish Noakes,
founder and director of Just Better Care, a
community care business named the 10th
fastest growing franchise in the country
last year by Business Review Weekly.
For Noakes, small and niche makes
just better sense when it comes to aged
support services in the future.
"One of the biggest problems is social
isolation," says Noakes. "Families are
working and not living close by to older
relatives, so many people are just sitting
home alone for large periods of time.
"Do we need to hang onto a four
bedroom house? Some of us will start to
think about this and think that they could
live with their mates and share, with less
reliance on the family."
With the move to consumer directed
care, which formally begins for all new home
care packages on 1 July this year, Noakes
expects to see the start of some big changes.
"We're going to see all sorts of models.
If three or four or five people all have an
EACH package, they might want to get
together in one person's home or find
another functional building they can live
in; then they can rent out their houses
and combine their resources.
"They don't have to go into 60 bed
homes; they can buddy up and combine
the packages. And if one person is
having a better day, they can make a cup
of tea for the others. Everyone would
have each other."
Noakes says she is keen on "setting
up some really niche arrangements and
seeing how they take".
"Once you start getting a few of these
examples up and being talked about,
I think we will have more and more
conversations about what we really
want," she says.
COMMUNAL IN COMMUNITY
Tamar Krebs, founder and managing
director of Group Homes Australia (GHA),
has already broken new ground. Late last
year she opened her first group home
specifically for people with dementia in
St Ives, in Sydney's upper north shore. A
large, traditional home in a leafy setting
that's been renovated and adapted
for purpose, it can accommodate a
maximum of six people, cared for by two
What makes group homes different,
says Krebs, is that they allow people to
stay living in their neighbourhood, single
or in couples, remaining connected with
all their familiar networks and activities.
"The residents all get up at different
times and have different daily routines,"
says Krebs. "The model can cope with that.
And residents can still go to their local
grocery store and the same hairdresser
they have been seeing for years."
"Of our first three residents, two of
them have lived in St Ives for 50 to 60
years and the other one is from [nearby
suburb] Lindfield. This is familiar to them
- the type of house, the street, the local
landmarks and shops and railway stations."
Krebs has another group home under
construction now, this one designed and
built for purpose to house 10 people.
Krebs has deliberately kicked off with the
two different approaches to understand
the different considerations involved
and see how they compare. She says in
many established locations, the challenge
of finding suitable land or demolition
opportunities for new homes means
renovation of existing properties will be
the only real option.
"Another reason we did the renovated
model was to test the scenario where
an older person might come to us and
say, I'm 80, I am a widow, I have several
friends in a similar situation and we'd like
to live together; can you turn my house
into a group home?" she says.
MAKING IT WORK
While the group home model is new to
the aged care landscape in Australia, it is
well established in countries such as the
Netherlands, Denmark and Japan; and it's
growing in popularity in the United States
with establishments like English Rose Suites
in Minnesota where Krebs gained much
essential advice and inspiration for GHA.
"In Australia we have group homes in
the community for children and young
people with severe disability. So why do we
warehouse and institutionalise older people,
after all their years of independence and
contributions, and for such a comparatively
short period of time?" asks Krebs.
"In dementia, quality of life is
paramount to people flourishing and
research shows that people flourish in
small, home-like environments."
Krebs admits she has had to be "a
little bit more creative on the investment
side", and also with staff training. The
'homemakers' are certificate three and
four trained for dementia specific care
with RNs on a drop-in basis. Each home
has a 'homemaker mentor' who ensures all
the 'jobs' get done.
"We've had to reprogram most of the
carers from being task-focused. There is no
'should' or 'have to' here. Homemakers need
to get to know residents and what triggers
and engages them; then work with them
daily to make it happen safely," she says.
"[My banker] said you don't fit inside a
box but he went and researched it from
the perspective of the State Environment
Planning Policy [for seniors or people
with a disability] perspective and he
came back and said he gets it. Banks
are already lending to group homes for
people with a disability."
Other organisations see opportunities
from increasing their investment in
health care services for older people. As
governments struggle to get more for
less from ailing healthcare budgets, many
services traditionally provided by the
acute care sector are opening up for aged
care service providers. The language is all
about linkages, collaborations, efficiencies
and value for money.
Residents of Group Homes Australia's first group home have a kitchen
garden for herbs.
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