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Challenge beliefs around ageing to create organisational change

Stereotypes of ageing impact the attitudes and behaviour of both aged care staff and residents, and challenging these can be a way to create culture change within organisations, says an academic.

Associate Professor Lee-Fay Low, from the University of Sydney’s Faculty of Health Science, encouraged the audience at the Future of Ageing conference on Monday to challenge stereotypes of older people and take responsibility for change within their own organisations.

Stereotypes of older people and ageing impacted resident’s self-perception and behaviour, and influence how others, such as aged care staff, expected them to behave. Together, these affected how aged care operated, said Associate Professor Low.

Associate Professor Lee-Fay Low (Photo: Jarra Joseph-McGrath)

Associate Professor Lee-Fay Low (Photo: Jarra Joseph-McGrath)

The environment of residential aged care, as a structured and formalised institution, “full of red tape, paperwork and hierarchy” also placed expectations on behaviour, she said.

A “good” resident was expected to not make a fuss, participate in activities, be happy and accept help. Similarly, staff were expected to fit in with others, offer help and be satisfied.

These expectations of behaviour were further strengthened by the fact that both residents and care staff had little power over the routine, meals, relationships and the environment within facilities, she said.

The repercussions of this were that residents often felt a loss of identity. “They feel loss of control and they struggle to maintain their independence,” she said.

However, Associate Professor Low said there was room for individuals to take responsibility to begin to facilitate cultural change within facilities.

Speaking to Australian Ageing Agenda after her presentation, she said there had been a lag between the rhetoric of change and the reality of good quality care.

“My message is that we all need to act – even if we think the system is against us, the aged care system, the policies, procedures… we need to individually take responsibility and make changes,” she said.

The first step to achieving culture change was reflecting on attitudes and perceptions of ageing, which allowed for scope to see how things could be done differently. “If we change how we see older people, if we try to look beyond the stereotype, we see them as having potential. We see how they can be assets,” she said.

Cultural change also meant giving power, control, choice and responsibility to both staff and residents, she said.

Shift the power dynamic in facilities would provide scope for residents to act as volunteers within their own facility, or contribute to making the facility work better, such as sitting on an interview panel when recruiting staff.

Associate Professor Low said one method to building strong relationships was through goal-setting, which encouraged older people to think positively about the future and themselves.

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6 Responses to Challenge beliefs around ageing to create organisational change

  1. Cheryl March 16, 2016 at 7:37 pm #

    Hear you! About time. Residents have been overlooked. They need empowerment and for us to look at ability not disability. I have been encouraging table setting and clearing, folding laundry washing wiping down dining chair seats weekly. I know this is small but I want to grow the tasks that are meaningful and empowering. The residents have a food focus group and make their own menus. We work for the residents in their own home and yet we take everything away

  2. Steve Zanon March 16, 2016 at 8:51 pm #

    This is a good article that explains why a low margin business model forces high standardisation of operational processes which means that residents accept a loss of control which results in a loss of identity. Deregulation of ‘above the line’ value added services will change this for the better.

  3. Jo Cleary March 17, 2016 at 2:40 pm #

    When assisting facilities to innovate the dining experience, I ask “what can the residents do?” Often, there is a barrage of responses concerning risk – they will burn/electrocute/ poison/infect themselves and/or others, etc.

    I also ask the question “what do the innovators do?”. (I used to ask “What would Donald do” but that got a bit scary).

    While facilities are pretty good at meeting the regulatory requirements and satisfying the stakeholders around compliance, the resident ends up down the pecking order of influence. Customer-centric care gets overshadowwed with the 40+ functional stakeholders that primarily thwart the vision of the organisation.

    Innovators take an outside-in approach. They view the situation through the eyes of the resident. They find a way to achieve a quality outcome for the resident while managing the risk and meeting their regulatory requirements. This helps close the chasm between the competing priorities and stakeholders.

    A huge opportunity I see is to take residents on the digital transformation journey with you. While not all, many will be up for it if given the opportunity. Wouldn’t that be a game changer?

  4. Brenton March 18, 2016 at 11:02 am #

    Innovators never shy away from risk. They embrace it. Never throughout history has substantial and significant innovation occurred without people stepping outside their comfort zone and into the unknown. We should never be the masters but always the servants and is this respect models of care must be driven by consumers themselves.

    This is not about ‘value adding’ for those people that can afford it but it is about embracing alternatives that fundamentally uphold human rights and dignity. If residential care facilities are supposedly ‘homelike’ environments then why can’t residents lock their doors, why cant they eat the food they want to eat, why cant they have kettle’s, toasters, microwaves, fridges etc?

    I don’t know too many people who would accept those conditions if they were applied to their own home environments? Fulfilling duty of care and upholding human rights are not diametrically opposed as many would lead us to believe. Duty of care was primarily established to protect the consumer however it is now used to legitimise coercion and control. People supposedly have rights contained within a Charter, however these rights are not upheld and they are not enforced. What use is a ‘right to take risk’ when you are never provided with any opportunity to actually take the risk in the first place. Life begins where our comfort zone ends and it is time that the Aged Care sector started to move outside of its comfort zone in order to allow older people to live with the dignity and respect they deserve.

  5. L.Hocking March 21, 2016 at 1:16 pm #

    I think we need to be careful about assuming all residences are the same. Certainly I know residents who have a fridge, kettle etc in their room and are able to offer their visitors drinks etc as well as serve themselves when they choose. My relative also carries a key so that her room can be locked when she chooses. While we still have a way to go we have made enormous progress and still moving in the right direction.
    Facilities do not have any choice but to be good at the regulatory requirements if they want to be funded. Finding the balance is the challenge.

  6. J. Baker March 22, 2016 at 11:09 am #

    I have read all the reply’s as well as the report and agree with them all, I work in an organisation that encourages residents to be independent and occupied as well as recognised as individuals who can add value to any supported living environment. I think many providers are afraid that if they encourage independence too much their funding will be affected, leaving less funds to care for those who are dependent for all their care needs. It’s a catch 22, your damned if you do and damed if tou don’t. If the Government would support innovation with funding as they do with ACFI I believe you would see more providers encouraging rather than discouraging independence in residential aged care. Instead of being afraid of litigation related to ‘risky behavious’ let’s encourage our elders to continue being a vibrant human being enjoying life to the full, and maybe teaching us to let go and enjoy being a part of their lives.

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