Home' Australian Ageing Agenda : AAA Nov-Dec 2016 Contents Frontline view
Aged care from all angles
When managers shift their
focus away from tasks, and give
staff the opportunity to shift as
well, it's quite remarkable what
can be achieved, Di Adamson
tells Darragh O'Keeffe.
Sometimes all it takes is one
small change and the culture
in an aged care facility can be
transformed, says Di Adamson.
For 15 years, Adamson has
been working with frontline managers in
residential care to "create environments
where people love coming to work."
She points to one manager who
introduced a "learning circle" at the end
"The nurses and care workers would
get together to talk about what they
learned that day; what triggers in a
resident they identified, what they did to
make a difference in someone's life, and
what they could share around that."
The sessions weren't about clinical
handover, Adamson hastens to add, but
rather an opportunity to reflect on the
personal insights staff had gained that shift.
The manager reported that, over time,
the interpersonal, communication and
problem solving skills of the staff had
dramatically improved, says Adamson.
"Because what so often happens in
residential aged care is that I am working
with one resident and I learn something,
but it's not passed on, whereas those
meetings gave everyone an opportunity to
learn the lessons."
INVOLVING STAFF IS KEY
Underpinning Adamson's approach is
an underlying belief that frontline staff,
from senior nurses to care workers,
need to be authentically engaged in the
change management process -- whether
it's getting their input to how a facility
will adopt reablement to rolling out a new
model of care.
"I truly believe that when staff have
the opportunity to contribute at this level
and to think like this they are perfectly
capable of it," she says.
And it should start right at the
recruitment stage, Adamson argues.
"Typically someone comes for an
interview and they are given a list of tasks
they'll have to perform and we ask about
their experience and capability.
"But we should also be talking to them
about the depth of the role: that they will
be walking with people on the last journey
of their life. We should be asking how they
feel about that, how they feel about our
organisational values and how they can
make a difference to our residents' lives."
The focus must be on engaging people
in the true meaning of their work, yet
aged care has typically been defined by
completing tasks, Adamson argues.
"Everywhere I go, I hear managers
complain that their frontline staff are 'too
focused on tasks' and won't get behind
their person-centred approach. But the
managers have been walking around for
years handing out the tasks -- they hold
staff accountable based on the completion
"This needs to change at management
level. We can't just expect the people on
the floor to do it differently if management
isn't doing it differently," she says.
FOCUS ON TASKS
AT OUR PERIL
In fact, Adamson argues that the shift away
from focusing on tasks is critical if facilities
are to truly adopt more person-centred
and consumer directed approaches, as
envisaged under the reforms.
"That's going to be our greatest risk;
that we lose the intent of these changes
when we become focused on the process
and implementation rather than on
the result in terms of outcomes for the
But she acknowledges that for many
facility managers, just keeping on top of
the latest changes is a huge challenge.
"Until they have a day to step outside
their daily practice, to look back in with a
different view, it's an absolute struggle. Yet
once the managers shift, once they speak
differently and give staff the opportunity
to shift as well, then it's quite remarkable
what can be achieved," she says.
'IT'S BEEN A GIFT'
Adamson speaks from firsthand
experience -- having started her career
as a nurse she was fast-tracked into
management and then leadership roles in
both aged and acute care.
"I was always fascinated with how to
create a culture where people love coming
to work," she says.
After several roles as director of
nursing and CEO at public and private
hospitals, Adamson ventured into training
and consulting in aged care back in 2001.
"What became my speciality was
not the clinical stuff but rather the
complex communication, leadership and
relationships in the workplace," she says.
"I feel it's been a gift," Adamson says of
her career in the sector.
"The people who work in aged care
are just heart and soul; they already care
deeply about what they do, all I do is fine
tune that so they get better results. It's a
privilege to be out there doing it." n
54 | NOVEMBER -- DECEMBER 2016 | AAA
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