Building better Aged Care systems
Mike Rungie specialises in the intersection between good lives and aged care. He is a member of a number of boards and committees including ACFA, Every Age Counts, Global Centre for Modern Ageing and GAP Productive Ageing Committee. In this artlicle publised in Aged care INsite, he pleads for the Gornment o give us just one of the 124 recommendations arising from the Royal Commission, Recommendation 55(d)
Not surprising that the aged care mandarins are arguing about who should run the aged care show. Because there is no obvious winner that could take these 124 Royal Commission recommendations and turn them into something that will improve the lives of frail modern elders. And that’s what we’re after.
We don’t mind the lofty ideals in the first few recommendations. But mostly it’s the dozens of recommendations after that has us despairing for today’s and tomorrow’s modern elders.
Problem is they are all about fixing a broken system. And it’s hard to imagine that, even fixed, the current system would actually improve people’s lives.
Don’t try and tell us that small institutions will be that much better than big ones, and that tougher oversight will make home care packages imagine better lives for people. And, there are so many recommendations covering so many areas, that we are left feeling like whoever’s running the show will never pull it off, and what they do pull off will be way too complicated and expensive… and maybe not even that different.
Let’s not fall for the providers’ rhetoric either, that it’s all about more staff and more money… when it’s my dog and my daughter who used to cook a special lunch once a week and the familiarities all around me that I’m missing. And if I’m bored, lonely and disoriented that doesn’t mean I want to spend my day with more staff.
Our favourite recommendation… in fact the only one we think is likely to take us somewhere remotely in the direction of really improving modern elders’ lives is Recommendation 55(d), “prioritise research that involves co-design with older people, their families and the aged care workforce”.
This would have to be real co-design, not consultation after older people and their families have been socialised into aged care thinking. Co-design that first asks about people’s lives, interrogates what they want to keep or change, invents solutions with older people and clever product developers, tests these with older people, and insists on a range of new prototypes that we can all learn from.
Let’s not assume that we can imagine what a new co-designed aged care system will be. With a leadership with no lived experience it will be no better that what we have now.
Remember the wounding of older people started 20 years earlier in people’s lives, and every bad thing done to them makes it more acceptable to do the next. If you want to stop the abuse, stop the process that makes them abusable.
We know aged care has to be sustainable but not by screwing efficiencies out of a strained system, rather by building capacities of communities and older people, by offering them products and services they like and want to learn to use and pay for, by hunting for efficiencies of approach not just the hopelessly over-sold efficiencies of scale.
So, Royal Commission, keep it simple. Ditch the lot and give us Recommendation 55(d). Resource the building of co-design capacity locally all over Australia. Fund new prototypes. Grow us all in the co-design culture. Start tomorrow. Let us have some fun for a change. And join a broader movement towards productive ageing and against ageism, accepting that current aged care might be kind, but it’s also ageist and will never get us there.