The future shape of aged care?

Edited by Janelle Ward

The founder and chief executive of NewDirection Care, Natasha Chadwick, is the 2019 Telstra Australian Business Woman of the Year. She is on a mission to reshape the way older Australians and those living with dementia are cared for when they need to move into residential accommodation.

In her acceptance speech, Ms Chadwick said: “The questions that the Australian community need to ask itself are: do we still think its okay to segregate someone who is living with dementia from other people in a secure environment – to criminalise someone who is living with a brain injury or brain disease? If you had a loved one in this situation, it’s not what you would want for them. Winning this award will shine a spotlight on my mission at NewDirection Care for radical change across all aged care.”

In this edited Q&A she did with Inside Ageing, Ms Chadwick explains her vision, the result and the hurdles she had to overcome.

Q. What does winning this award mean for you?
The win means a lot as it recognises what we have done to improve the lives of the people who live in our inclusive micro-town. It also demonstrates that change and innovation, while not easy, is achievable even in the current environment.

This award also provides me with an additional platform to promote the good work we do in aged care and bring light to the fact that we still have some way to go. As a society, we need to rethink the way that both aged and dementia care is delivered, so that older Australians and people living with dementia can continue to live meaningful lives beyond their diagnosis or move to residential aged care.

What has been your motivation?
It was simply from the desire to change the way we care for elderly members of society and those living with dementia. I had been growing increasingly frustrated with the traditional institutional model of care, which is segregated and task driven and doesn’t treat residents as individuals.

They have little or no independence and are forced into regimented schedules of waking, dressing, eating and sleeping. This is simply not the way to live.

There hadn’t been significant innovations in the industry for decades. No other industry would tolerate such inertia, yet aged care is much more important because we are dealing with people’s lives.

My desire to do something radically different was reinforced by research coming out of universities and Alzheimer’s organisations around the world that revealed that the traditional way of doing things is, frankly, not helpful and that people living with Alzheimer’s can thrive when given their freedom and independence.

They do well when they have some control over their lives, are part of a community and live in familiar, home-like surroundings. Understanding this, channelled my thoughts into the best ways of making all of this happen.

Do you think the current aged care funding model supports innovation and opportunity for fresh thinking?
I think we are getting there. Certainly, within the last couple of years, there have been some encouraging signs coming from the Federal Government.  For example, in 2017 it was announced that $34 million in funding grants was to be made available to start-ups and organisations working on innovative services within the aged care space, especially those with dementia care as a key focus.

The grants were awarded to 42 projects and will cover them until June 2019.  Now, what I don’t know at the present time is whether there will be a new round of funding in the pipeline to further support innovative programs.

Australian Government expenditure on aged care was $18.1 billion in 2017–18 and is expected to increase to $22.2 billion by 2021–22, according to the Royal Commission into Aged Care Quality and Safety. The funding is made up of operational funding to support day-to-day services and capital financing to support the construction of new residential aged care facilities and the refurbishment of existing facilities. However, what I would like to see is ring-fenced funding for innovation across the entire aged care sector.

How is your facility different?
It is worlds apart from traditional aged care with its one-size-fits-all approach. Our residents are treated as individuals, not one of a crowd. There are no regimented eating times, shower times, visiting times or other fixed points in the day or week that can threaten a person’s autonomy.  

We respect the right of individuals to make their own decisions. Within each home [which accommodates seven people], residents can even choose to help with the preparation of meals, all of which are enjoyed family-style …

In traditional institutions, life seems to stop for residents once they enter the facilities … Among the other key differences are the ‘house companions’, who wear everyday clothes, not uniforms, and who provide assistance and support, operating around residents not dictating to them.

What have been the biggest hurdles in launching this concept?
There are a couple that spring to mind. The first is that there really hasn’t been a lot of support from within the industry. There are some people who have been and remain incredibly supportive of everything we are trying to do and are interested in our model of care. But then there are others who want us to fail, because success is proof that the industry itself has to change and not operate the way it has always done. 

I suppose this shouldn’t come as a surprise. There are always going to be people who are resistant to change, no matter what industry you work in, because it is too much effort for them to break the status quo.

The other hurdle I want to mention is that to make our small-scale living concept work, we needed to radically rethink and reinvent the staff model, which is very task-focused. We had to break away from it completely, which we did by inventing the multi-skilled role of the ‘house companion’. 

Our ‘house companions’ support residents as part of the family unit of each home and help with daily activities as needed. This was also a challenge initially because staff applying for positions had no reference points as the role hadn’t previously existed. However, we have devised a demanding assessment process and a five-week induction program to train them.

Do you think female leaders in aged care face unique challenges?
Yes, I do, but in my opinion they are not specific to this industry. They are exactly the same challenges that female business leaders experience in many work environments. Among the biggest challenges are the difficulty in finding enough time to build a business because of family commitments and problems sourcing financing because women are sometimes not taken seriously. The misconception persists that only males can make effective business leaders. I often hear stories of women attending trade shows and being overlooked by potential business partners or clients who assumed that a man standing at the booth was the person in charge. And, even though we live in a so-called enlightened age, earning respect in male-dominated industries can still be a struggle.

Other challenges exist because women can be their own worst enemies. This is due to several factors, from a lack of confidence and not speaking up to a fear of failure and downplaying accomplishments because of concerns of being seen as boastful. There is also the problem of imposter syndrome, that no matter how great their achievements, some women feel they don’t deserve them.

Do you think Natasha Chadwick’s aged care and dementia care model is the way of the future? Do you think sufficient funds are set aside for research into the best care models?

• YourLifeChoices has no association with any aged-care organisation but believes it is important to report on developments – or lack of them – in the sector.

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