The Royal Commission into Aged Care Quality and Safety provides an important opportunity to review how we support older people and the extent to which this reflects community expectations.
It is also an opportunity to not only identify poor practices but also those individuals and organisations demonstrating leadership through innovative practices which are promoting quality dementia care and improved quality of life.
There are many challenges which the work of the Royal Commission will need to consider as part of their remit. The capacity of the aged care sector and its workforce to deliver quality support and care will be a focus of its work and the recently released Aged Care Workforce Strategy has highlighted how multifaceted this issue is.
Improving leadership and the culture this creates within an organisation needs to be a critical consideration in how support and care can improve, with the focus being on relationships rather than tasks. Having a culture where workers can continue to learn and people living with dementia and their families and carers are considered to be central to the provision of services can have a profound effect on their quality of life and care.
While the training of staff is important, it is the leadership and culture of an organisation which can enable this knowledge to be translated into practice. In what has historically been a regulation and compliance driven industry the challenge will be how to ensure the focus of the Royal Commission does not unintentionally lead to a further emphasis on this approach.
There are thousands of aged care staff in Australia already providing high quality support and care and their professionalism, compassion, empathy and dignity have a significant impact on those they support.
However with an estimated 436,000 Australians living with dementia, and that number expected to rise to more than 1.1 million within the next 40 years, there needs to be a change in how people living with dementia are treated within the industry.
With 70 per cent of people living with dementia residing in the community and at least 50 per cent of those in residential aged care having a diagnosis of dementia, the Royal Commission’s Terms of Reference appropriately highlight that dementia must truly become core business for the aged care sector.
As the peak body for people living with dementia, their families and carers, Dementia Australia offers support and educational services as well as information. Many of our own suggestions for the Terms of Reference have been included and we look forward to seeing its recommendations for bringing change that improves not just the support and care, but quality of life of not just those living with dementia in aged care but all who receive this care.
Our research and experience has shown that putting the person living with dementia at the very heart of service design and development is the key to providing high quality care. Local needs must be considered too – strong local leadership and consultation that includes managers, staff, customers and their families is needed to better understand how to create a service that responds to their specific needs.
The Royal Commission will hopefully provide an important opportunity to look in detail at both what works and what does not work in the current aged care system so that sound recommendations can be developed for the future.
The new, independent, Aged Care Quality and Safety Commission should also provide a more integrated approach to promoting quality across residential and community aged care.
While formal dementia education programs help to improve practical care and can lead to increased knowledge, they do not necessarily translate into changed practice.
Creating learning experiences that provide an insight into what it is like to live with dementia – such as the Virtual Dementia ExperienceTM and the Educational Dementia Immersive Experience (EDIE) workshop developed by Dementia Australia – are more likely to affect participants’ attitudes and behaviours (Doube & McGuire 2015).
Staff commitment, service innovation and quality supports do exist, but the direct experience of people living with dementia suggests that service excellence is inconsistent across the broader aged care sector.
If we are going to have an aged care industry that meets and hopefully exceeds our expectations of what it means to lead a good life for those living with dementia and indeed ourselves as we all grow older we need to focus on capacity building through promoting strong leadership and learning cultures .