7^th Annual MARC Symposium

Reforming Ageing and Aged Care: Pathways to success

Event Summary

The Melbourne Ageing Research Collaboration (MARC) held its 7th Annual Symposium in September in an online format. Focusing on pathways to success for reforming ageing and aged care, the event attracted 158 attendees, including older people and carers, researchers, healthcare staff, advocacy groups and government representatives.

Attendees were treated to presentations from a range of disciplines, which highlighted examples of reforming the aged care sector to improve the experiences of older people, families and carers. MARC Director Debra O’Connor opened the Symposium by welcoming the attendees and presenters, and thanking the J.O. & J.R. Wicking Trust, the Victorian Department of Health and MARC partners for their ongoing support. She also introduced Professor Briony Dow who chaired the symposium.

View the highlights of the the 7th Annual MARC Symposium

Day 1 – Wednesday 15 September 2021

Day 1 was launched by the Hon. Greg Hunt, the Federal Minister for Health and Aged Care. Minister Hunt briefly discussed the findings of the Royal Commission into Aged Care Quality and Safety and the government’s plan for reform.

Our first presenter, Dr Carrie Hayter, a consultant for disability, aged care and health care agencies, focused on the importance of a human rights approach for ageing and aged care reform. Dr Hayter explored the history of Australia’s Aged Care system, highlighting a feeling of ‘Groundhog Day’ caused by the slow changes over time from an ongoing lack of choice and human rights in aged care policies. She suggested we might look to Scotland for an example of how aged care can use a human rights approach. Best practice models included “PANEL” (Participation, Accountability, Non-Discrimination and Equality, Empowerment and Legality) and “FAIR” (Facts, Analyse rights, Identify responsibilities, Review actions). However, most importantly, improving choice in aged care requires the input of older people and their carers.

Our second speaker, Dr Jennifer Hewitt, a physiotherapist from the University of Sydney, highlighted the limited funding for preventative healthcare, re-ablement and wellness in the current aged care model. She discussed findings from the SUNBEAM trial investigating an individualised, supervised strength and balance exercise program in residential aged care. This program resulted in reduced falls and improved physical performance of residents as well as in significant cost savings and practice change. Dr Hewitt also discussed how this program has received federal funding for implementation in residential aged care facilities impacted by COVID outbreaks. Her work showed how a new model for re-ablement in any reform can improve wellbeing for older people.

The experience of caring for a person with dementia can be rewarding but also at times extremely challenging. In the final presentation of Day 1, international speaker Dr Karen Harrison-Dening from Dementia UK presented on the role of the UK “Admiral Nurses”, who are specialist nurses that provide holistic support and coordinated care for the person living with dementia, their families and care staff. They integrate the complex attributes of the dementia trajectory, from prevention, diagnosis, management, and care, to the end of life. As a result, they act as support pillars and ensure positive outcomes for everyone involved in the dementia journey. Again, this presentation highlighted an example that could be included in any reform in Australia.

Day 2 – Friday 17 September 2021

The Hon. Luke Donnellan, Victorian Minister for Disability, Ageing and Carers, launched Day 2 of the Symposium. Minister Donnellan congratulated MARC on its event and the importance of its work, citing the relevance of the event theme in light of the Royal Commission into Aged Care and Safety and the impact of COVID-19.

For Stephen Grech, the first speaker, visiting his parents in residential aged care during COVID-19 was extremely difficult. Challenges included navigating visitor booking systems, limited availability of technology and negotiating complex window visits where a resident is on one side and a visitor on the other. This had a profound effect on his parents’ mental health who were experiencing prolonged isolation during the lockdown. Stephen, from Doing Business Better, provided his thoughts about applying business process principles, tools and techniques to improve the experience of residents, family and friends during COVID-19. A key component of these principles is to communicate, engage and involve the stakeholders, particularly residents and their families, to develop new processes that support everyone. Management and leadership are critical components of driving this change.

The second speaker of Day 2, Dr Sandra Iuliano from the University of Melbourne, shared that 68% of Australian aged care residents are malnourished or at risk of malnourishment. This can lead to negative health and wellbeing outcomes, including lower quality of life, impaired immune function, and increased tiredness. Sandra’s research found that improving food quality, specifically protein and calcium reduces the risk of falls, fractures and malnutrition in older adults living in residential aged care. Dr Iuliano also highlighted that nutrition is much more than calorie counting and nutritional intake. It is also about enjoyment and choice. In reforming nutrition and food in aged care, models of care need to include for example culturally appropriate meal options, opportunities for residents to make decisions about what to eat, better facility designs to foster family-style mealtimes, and ensuring that staff have enough time to support residents during meals.

Another challenging area requiring reform relates to the links and transitions between health and aged care systems in Australia. When residents in aged care become acutely unwell, they may need to be transferred to hospital for treatment. However, this process can be complex. Our third speaker, Dr Ellen Burkett from the Princess Alexandra Hospital in Queensland, is the clinical lead of the CARE-PACT project (Comprehensive Aged Residents Emergency Partners in Assessment Care and Treatment), a program designed to collaborate with residential aged care facilities and GPs to provide a centralised contact for clinical support, resources and education when residents become acutely unwell. Early results from the CARE-PACT study demonstrated the success of centralisation, with a significant reduction of unnecessary emergency presentations and hospital inpatient admissions. This project is being expanded, for example, through the development of educational resources for clinicians and guidance on how to interact with patients with dementia presenting at the emergency department.

At the end of Day 2, MARC Director Debra O’Connor made the closing remarks, highlighting the diverse range of pathways to success that were discussed during the event. A consistent theme amongst the presentations was the need to involve key stakeholders in the improvement processes, including older people and their families. Co-design and co-development are central principles of MARC and will continue to guide the collaboration’s contributions to the care of older people in Australia.