Tuesday, April 30, 2013

CHART - National Aged Care Conference, Canberra.

The Cooperative for Healthy Ageing Research and Teaching (CHART) at the University of Canberra held its inaugural National Aged CareConference on Friday, 19 April 2013.
The keynote speaker was Professor Lynn Chenoweth from the University of Technology Sydney.  Lynn is the Professor of Aged & Extended Care Nursing in the Faculty of Nursing, Midwifery and Health at UTS.  Professor Chenoweth spoke about creating caring cultures for older people within the health and residential aged care systems. 

The percentage of Australians aged over 65 has been increasing since the 1980s, and while some disease rates are falling, the prevalence of mental health and neurological conditions is rising.  This increase in neurodegenerative disorders is resulting in an increase in health spending, as these conditions are the most expensive to manage.  In fact, health care costs across all conditions are rising faster than general economic growth. 

There are challenges at the system, organisational and direct care levels which contribute to lack of safety, poor care coordination and care of chronic conditions, treatment errors and adequate transition care in hospital discharge.  Professor Chenoweth spoke about the need to have the right care, at the right time, in right place, with right provider – a concept that can be achieved through the philosophy of person-centred care.
 
An alignment with person centred care requires that staff are appropriate educated and trained, information is shared between all stakeholders, and that processes are regularly reviewed.  Professor Chenoweth then discussed three projects that demonstrated the benefits of person centred care – the CADRES Study, the EN-ABLE Project and the PerCEN Study.  These studies demonstrated that adoption of a person centred care model resulted in an increase in the quality of care and patient wellness scores, a decrease in patient agitation, fewer incidences of falls and injuries and a more positive emotional response to care.

This idea of adopting a more person-centred approach to the delivery of care was further developed by Fritz Quero, a PhD student at the University of Canberra who spoke about a project to introduce a homelike philosophy of care at a Calvary Retirement Community facility.  This model of care focuses on creating an environment which is able to incorporate the “rituals, routines and personal touches” that residents associated with their own homes into a residential aged care facility.

Fritz discussed the importance of language, and how the facility doesn’t have wings, but “households”, not dementia units, but “memory support households”.  The homelike philosophy of care is about deinstitutionalising residential aged care, promoting shared decision making and emphasising living well, rather than just waiting to die. 

Residents’ rooms and common areas in the Calvary facility were transformed by personal touches and household furniture.  Residents were able to choose the colour of paint on the walls, and the nurses’ station has been infused into the household – it blends into the living room, rather than being a separate area.  As Fritz discussed, implementation of this philosophy of care required consideration of the systems, procedures, and processes already in place.  In addition, it required consultation with the residents and training with staff to help them adapt to a new way of delivering care. 

While there have been some teething issues, such as the lack of understanding of the duty of care from non-clinical staff, and misunderstandings of clinical governance responsibilities, the majority of outcomes have been positive, as Fritz discussed.  Both clinical and non-clinical staff members understood and have become more involved in delivering this model of care.  Residents are more empowered, having been given the opportunity to participate in their own treatment and determine the timing of their care.  There has been a marked decrease in complaints, and an increase in satisfaction with overall care. 

The projects discussed by Lyn Chenoweth and Fritz Quero demonstrated the positive benefits, for both staff and consumers, that can be derived from a more respectful, person-centred approach to the delivery of care.  

Heather McGowan
HIP Project Officer

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