Home' Australian Ageing Agenda : AAA May-Jun 2017 Contents We asked four industry figures:
Changes driven by how seniors wish to live
A focus on an individual’s preferences and enablement
will shape the future of residential aged care. The biggest
change in our sector is, and will continue to be, an emphasis
on how people wish to live their life.
This change in paradigm is the key to meaningful ageing.
At Churches of Christ in Queensland, our positive
wellbeing model of care is underpinned by a comprehensive
understanding of the residents’ personal preferences.
We have seen in community care a focus on preference-
driven care and in residential aged care, I think the same
pattern will occur.
Over the next decade, clients will have greater autonomy
to determine where money and resources are delivered for
Listening to and delivering on people’s wishes is a
direction we have already committed to and one I see being
In economic terms, it’s transitioning scarce resources away
from government and provider decision-makers and into
the hands of the consumer who will be more responsible for
directing that funding. And they will do a better job of it.
The most exciting transformation will be a change in
culture. A move away from aged care based on a medical
model to a focus on people living life to the full.
Changes in our language may be subtle but they can be
significant. Questions will be asked differently. Where once
we might refer to “the bloke with the
hip replacement in bed 27” now we
might ask: what can we do for our
client who is a retired pilot or avid
The industry needs to ask: how
can we make the rest of your life
enjoyable, comfortable and abundant?
A continuing challenge will be maintaining our workforce.
Strong changes in recruitment need to take place.
Working in aged care has historically been dismissed
as less attractive than a fast-paced hospital setting. A key
change for our industry is understanding and embracing the
social benefits of work and making a positive difference to
No longer can task-related responses be definitive criteria
for employment. Yes, you will still need to know how to
change a bed or clean a room, but the focus must be on the
person first, not the task.
This purpose and passion is what we need to get right in
our workforce culture.
The future in caring and supporting older people must
include maintaining, and even building, capabilities and
potential, not simply managing decline. n
Bryan Mason is director of seniors and supported
living at Churches of Christ in Queensland.
Reforms raise questions around ownership
Instead of asking what the aged care
sector will look like in a decade,
perhaps a better re-framing of the
question is: what do we want it to
The policy focus in recent years
has been driven by a relatively
unquestioned belief by stakeholders that competition and
less government regulation will create the aged care system
Australia wants in terms of access and quality. Missing
from this discussion is the shape of the industr y that will
emerge from the current reforms; that is, the average size
of facilities, size of provider organisations and the mix of
ownership across the sector.
These structural elements, particularly ownership, have
in a large number of international studies been found
to have an impact on access to and quality of care. The
literature suggests a higher quality system will result
from a predominately not-for-profit industr y. Research
also suggests that the larger the number of beds in a
residential aged care facility the lower the quality of care
Historically, the majority of residential aged care places
in Australia have been operated by not-for-profit providers.
While this is still true, the percentage of all residential
aged care places operated by for-profit providers has
increased from 27 per cent of all in 2001 to 38 per cent by
2015. Demand for places and the move to a competitive
marketplace is expected to enable for-profits to expand
much faster than not-for-profits. This could result in for-
profit providers dominating the industr y.
For-profit providers tend to build larger facilities and are
located primarily in metropolitan locations, suggesting market
failure in this industr y outside major population areas.
Consequently a preference for a deregulated competition-
based system to guide future growth may give rise to
an undesirable two-tier sector: a market-based one for
metropolitan Australia and a government regulated one,
reliant on not-for-profit providers, for the rest of the countr y.
Although the preferred mix of for-profit and not-for-
profit providers has been a keen topic for debate in other
countries, there has been ver y little recent discussion on
this issue in Australia.
So the question facing Australians is: will we be
comfortable and satisfied, in terms of access and quality,
with a residential aged care sector where the majority of
providers operate on a for-profit basis?
We need to have this discussion now to determine if we
have the correct policies in place to create the residential
aged care sector we want by 2030. n
Richard Baldwin is an honorary associate at the
Faculty of Health, University of Technology, Sydney.
Given the unfolding reforms and the growth
in community care, what will residential
aged care look like in a decade?
20 | MAY–JUNE2017
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