Episode 39 – Royal Commission and the Aged Care Crisis in Australia

This week’s episode of our baby boomer show is all about the healthcare crisis in Australia – particularly in the aged care sector and people with disabilities. The Royal Commission is being called to look at the quality of care provided in residential and home aged care to older Australians. It will also cover the challenges of providing quality care to young Australians with disabilities living in residential aged care settings. Our panelists – Wayne Bucklar, Dr. Drew Dwyer, Bronwyn Williams, Brian Hiselwood, and Amanda Lambros – are here to voice out their concerns and opinions on the rising issues concerning the Royal Commission and the aged care system.

Transcript

Wayne Bucklar:  It’s that time again, it’s Boomsday Prepping. Your regular weekly look of what’s happening for Baby Boomers and as usual, we’re joined by a panel. With me today is Brian Hinselwood, Amanda Lambros, Bronwyn William and Glenn Capelli is absent today. He’s taken leave to go off and pursue other things. This week, we are joined as always by my co-host Dr. Drew Dwyer. My name is Wayne Bucklar and Dr Drew, lead us off. Is there a crisis in aged care? Is this inquiry really required?

Dr Drew Dwyer: Thank you Wayne. Hello everybody, thank you for tuning in today. Today’s podcast is going to be specific and specific to the issue that’s going on in Australia at the moment and a specific issue I think Baby Boomers need to get themselves attuned to and I’m sure they’re all going to have a say about it as our panel will today. But I’m talking about, we’re going to talk about the aged care crisis. The Royal Commission in Australia that’s been called on the aged care crisis and the general thoughts about where we sit as a panel of Boomers and Boomer experts about what should be done here. I’m going to kick the ball off and I can warn everybody, there may be some contentious subjects raised but our panel are all used to each other now so I think we can have these conversations. Really at the end of the day, let’s begin with the Royal Commission and watch your thoughts on it. For me, too far too late. I don’t believe it’s going to change much we’ve had that many investigations, parliamentary inquiries, done many research, there’s so much data in this. Are we flogging a dead horse and are we going in the wrong direction again? Because for me, it requires immediate action as a national crisis in our society and something that just requires the Prime Minister and the ministers to get on with the job and do it and get it done and have actually society face the facts and truth. I’ll move to Brian. Brian, what’s your point on the Royal Commission?

Brian Hinselwood: My immediate thoughts on the Royal Commission are that like most royal commissions we seem to have, at the end of the Commission or whatever it’s called, almost nothing will change. Everybody will be told how badly they’re doing, everybody will be put on various television programmes and made to look silly and embarrassed and everything else and at the end of the day, almost nothing will happen because in my opinion, this is a segment of society that is so big. It’s like the banking inquiry, they actually can’t touch them. They can tell them off and they could say how they could improve.

Dr Drew: Oh yes, it’s a billion dollar industry.

Brian: Yes and I don’t think and I think you’re right. I mean if the prime minister and the minister responsible were to get off their extremely well played back sides and do something maybe something would happen but they won’t. They won’t. They want with the television news reporters to do their job for them. I’m just despaired that anything will be done at all.

Dr Drew: Yeah, good. And the fact is, if you are just listening and not understanding, there’s a royal commission being called into the Australian aged care system for abuse and neglect and a whole range of issues. I myself as a gerontologist will be making a number of reports on it and putting my submission to the Commission but seventy eight million dollars has been set aside of coffers from the taxpayer over probably a two-year period which we as a panel believe will outcome nothing. For me, it’s about ripping the scab off a sore so that they can basically put a band-aid back over the top of it to cover it up. Amanda, what’s your thought here?

Amanda Lambros: I think, unfortunately, by the time it’s actually looked into which is happening right now, it’s usually about two years too late. And I kind of have to second what Brian said and it’s two years too late, they’re going to spend what did you just say 78 million dollars?

Dr Drew: Correct.

Amanda: Of taxpayers money on this and the outcome is going to be like slap on the wrist, “You guys pull your heads in, try to do a little bit better. We’re not going to be paying you any more than we currently pay you. We’re not going to give you any more training than we currently give you but just do a better job, okay? Everyone good? Great, thanks. Bye.” That’s really what’s going to happen

Dr Drew: It’s a sad indictment on the way we’ve structured our system, our political system, our society and I just feel let down as someone who’s devoted their life, a majority part of my life in this area to make change because I stepped out of the actual physical act of nursing in it for a while to move to the education to change and into leadership and so I can tell you some days you just hit your head against a wall and break into tears because you feel like you’re getting nowhere in this monstrous system that is broken and defunct. Bronwyn how do you feel about the Royal Commission?

Bronwyn Williams: As I’m sitting here listening to you all, I was thinking and I can’t remember his name, the senator who was calling for the disability sector should also be included in the Royal Commission aged care because the two overlap and this often people with disabilities go into aged care at quite young age in a nursing home situation because there’s nowhere else for them to go and it reminded me of when I used to work in the disability sector as a teacher and in those days and I think there still are special schools where the children were put, in a sense, put away from, there was no integration.

Dr Drew: Yeah, we institutionalized disability.

Bron: We’ve institutionalized disability, we institutionalize the age so it’s the sense of if we can put them away outside of the normal theme of things, a normal way that we look, we actually can forget that they’re there.

Dr Drew: Yeah. But Bronwyn can I just interrupt for a minute, I want to go back because this is what I’ve researched. Institutionalization or the deinstitutionalization of care itself, back in the 90s went through this its own investigation and its outcome – the reform of aged care. Now I send very strong messages through the epidemiology, through the knowledge of evidence – institutionalization will never be avoided for the simple fact that at some point for some people, there is no other option but for them to enter a institutionalized care system. The problem with it is the type of care we give or the model of care we put into those institutions. Now we have moved progressively into a better space, let me tell you, from someone who’s worked in it back in the 80s to someone who works in the 2000s. We still have about 4,000 plus people, young people in aged care institutes but there are organizations who’ve been developed like young care who are institutionalized of course but specialize in young people to get them out of nursing homes. But again, poor funding, they have to raise their own money, they have to do that themselves. There is a large component of all of this argument that says for me ‘back to society.’ Society needs to reflect on itself. You can’t have your cake and eat it too.

Bron: So that was actually the point I was trying to make Drew, was that it’s the fact that like I’m  not saying that we don’t have institutions or that they do not perform a valuable function. That’s one of the downsides of institutions and institutionalization is that it’s a ‘set and forget’ lot of situation.

Dr Drew: Yes.

Bron: Where society, and this is what you were saying, we need to look at our ourselves as a society because it’s a systemic issue. Our society says if we can put away from us the things that are not normal, the things that are not pleasant, the things that we don’t want to deal with and whether that’s someone who has a disability or someone who has got to that point in their life where they’re not able to look after themselves because of their age, we can somehow sense we can just forget about them and leave it to somebody else to deal with.

Dr Drew: Well I mean they’re trying to de-socialize it by pushing people to community services but I can assure you one thing because I work in both there is some of the care in the  community services is appalling because of the neglect and isolation and as a society, everyone’s trying to build this social model which is okay by me to a point but there is a medical model that sits in the center of the core of all human beings. They get sick, they need help with their health and their wellness and let me go past the nursing now, just in what people would consider the science of Nursing. Let’s go to the science of emotional support, mental health and well-being and connection and I’ll leave it to Amanda to make a comment there about older people and the space around social connection, well-being and isolation.

Amanda:  Well I think one of the biggest problems is that transitioning from normal regular life into an aged-care facility is what exactly that – it’s a transition. And so we know that as people transition, they’re more likely to isolate instead of participate so if anything these, these institutions really should have opportunities for them to participate as much as possible and having said that you actually need staff who encourage them to participate so if the training for the staff is not there all of a sudden what you do and in this is legitimate fear and I know anecdotally I’ve heard this from family and friends who have put relatives into institutions, is that they’re terrified that as soon as they put them in that their mind is going to just go downhill from there and that they won’t be able to recover and they’ll just end up, it’s like the first step into basically the grave.

Dr Drew: And it’s a very quick spiral, downward spiral to end of life when you feel terrible about yourself. Brian, let me ask you let’s stay on the subject of staff because I’ve raised this issue in the social media in the public space this week, I’m not getting a bunch of response because I know that it’s a contentious issue that no one wants to talk about for the sheer fact you may be called out for some particular reason, we’ll discuss in a moment. But Brian you’re in your 70s and I’m gonna put it on you. You’ve fallen down, you’ve hurt yourself, you don’t have the family support, you’re quite happy to go into a nursing home because there’s one around the corner that you think you might like and I’m hypothesizing Brian, but what do you expect to find in the people and the staff that would be in that home to meet, greet and share every day now of your life with you as a man in his 70s who needs support and help?

Brian: Look, I think you touched on it a little earlier Drew when you were talking about yourself going into one of these places and sitting down on the bed with people or holding their hand or cuddling them or whatever, I think what I think would happen and what I’m pretty sure it doesn’t happen is that somebody would take an interest in what I’ve done with my life to get to this point.

Dr Drew: Touché

Brian: I’ve been an actor. I’ve been in films. I’ve been on stage, blah blah whatever I’ve done. I support a little … I would like for somebody to take some time to find out who I am. The fact that I’m in there and I might be incontinent, I might be in the early stages of dementia or whatever. It is kind of beside the point, I would still want somebody to be attentive to me as a person not just in the nursing which I would expect anyway.

Dr Drew: Let me just interrupt you there. I want to interrupt there and I’m going to go to Bron next. I want everyone to understand very clearly, nurses focus on this issue. It is core to what the nurse does. Unfortunately nurses are still seen with this white veil wearing, stoic, bandage  applying nasty and it’s just a horrible space that nursing needs to move itself away from in aged care because we’re missing this core component. So much of what Brian’s talking about is in the literature and yet at the moment it is not being implemented and I’m going to switch to Bron because Bron I know has been a pastoral worker in nursing homes and then I’m going go to Amanda because I believe we are missing the mapping and the connection between what is good nursing care and what is good person-centered care and not only how do we reach it and I’ll tell you how we reach it. We reach it through the staff and the people that have been asked or volunteering or putting and committing themselves to this work. My point at the moment is we probably for too long have been choosing and allowing the wrong type of people to come into aged care. There’s the question I asked Bronwyn.

Bron: Yeah. Look, I’d agree with that. I’ve had a role, just six months roll in aged care as a Salvation Army chaplain and I often got comments about how well I connected with people, people were sorry when I was leaving and all I felt I did was be myself and talk to people as people which is in the end, is all we want. That’s what Brian is saying, you want someone who’s going to connect with you, listen to your stories, find out a little bit about you and certainly as a chaplain, that was part and parcel of my role. But I know that just even reflecting on some of the other stuff that were in the particular facility where I was, yeah, you had to question not because they were bad people.

Dr Drew: I will tell what’s is about Bronwyn. It’s about culture, religion, background, connection,

training and competency because I want to make it very clear, this is not about being white for me. It’s not nothing about color of skin because I work with some of the most beautiful Indian, Filipino, Chinese, ex-nurses who are mothers, who are well trained well into this and do an amazing job. Yet I work with many culturally diverse people and white anglo-saxon people, very few of them because they won’t come for the crap pay we pay but who just cannot connect with these elderly people. It’s just a job, they go, they wash, they clean, they bathe, they walk in, they vacuum, they do their bits and pieces, they walk out. I mean it’s a shame because person-centeredness is the language everyone grows out and it has a very big different meaning when you are challenged as a person who is diverse yourself. different perhaps. It’s it’s a same for me being a male and a nurse to want to be in a close intimate trusting relationship with someone. People look at you and think you’re queer, there’s something wrong with you, you’re weird but they just don’t get it. I just like being ‘me’ in those environments and it’s what I am. For me, it’s a calling. I’m naturally connected to it and I love that space because it makes me happy. Amanda, you probably have something to say about this but I want to make it very clear – this is a cultural issue in the care of our vulnerable, frail and older people because we have to be mindful of the fact to go back, many of these older people have never met culturally diverse people and not had much to do with them because of where they have grown up in Australian society.

Amanda: Yeah and I think that’s a big thing that actually needs to be taken into consideration is that it’s not that it’s anti or racism or anything like that. It’s the way in which they grew up and if you think back to one of our first podcasts almost was about emotional intelligence and it’s how how these elderly who are currently in these institutions actually have they developed that emotional intelligence? Are they open to new experiences? And honest-to-god at 85 years old, when I may be partially suffering from dementia, the last thing on earth I’m thinking about is “Now I’ve got to be nice to this lady who’s trying to do something for me and I don’t understand a word she’s saying yet I’m meant to be there helping her out.” And you hear this from these elderly people over and over again.

Dr Drew: Absolutely.

Amanda: And I know my grandparents were in one and I’d go and visit regularly and the comment from one of my grandfathers was “What the hell! I don’t even understand these people.”

Dr Drew: Yeah, and my grandma was the same. My grandma at 94, and she had her favorite carers and I can tell you some of her favorite carers were extremely culturally diverse to her. One of them was a black male from the Sudan but he had the most beautiful, caring personality and he really paid attention to Nan when he walked in that room. He made the whole 15 minutes he was in there all about her but others, she would say “God, I don’t understand that one. She makes it very hard to get along with her.” She’s over 94, you’d think “Yeah, you poor old bugger. Why should you be put in a place of having to emotionally, intelligently have to get along with someone because they’re providing you a service?”

Amanda: But I also see the flipside that you really have to look at, it’s like “If you’re only going to pay me, I don’t know, $14 an hour, okay $18 an hour,  I’m going to go in, I’m going to do my job. It’s a bare minimum requirements that I need to do and I’m going to go out.”

Dr Drew:  Oh this is a classic because I can tell you because I brought the training. They wanted to go in and wash, clean, bathe, they want him to go in and look for observations to manage behavior, incontinence, wounds, skin integrity, balanced meals, feeding, hydration, nutrition, hydration, up their personality, then look for behaviors then document them, record it and do the ACFI, the funding instrument. We just load these people with so many burdens and layers of an onion where they should be looking at the roses and smelling, care and getting on with care and part of that is because we’ve removed the governance of nursing and I say this specifically because you don’t need a lot of them. But the nurses on their ongoing journey, train teach, mentor and take care of the onion layers so that the care workers can connect and smell the roses. Brian, do you have a thought on this? About what we’re talking about?

Brian: Yeah, look I do. It’s interesting isn’t it? When you talk about people earning $18 an hour or whatever the going rate is. Earlier on Drew you mentioned 78 million dollars, is that the cost of having the inquiry?

Dr Drew: Correct. That’s the budget they’re putting aside for it.

Amanda: Isn’t that crazy?

Brian: I’m just thinking if they were to put that 78 million dollars into the training of these people,  they’re still spending the same taxpayer dollar, surely they get a lot.

Dr Drew: My thought exactly. Put 78 million dollars into the funding of nurses, let me tell you. And nurses will try and train and educate and mentor them.

Brian: Yeah. But again, employing nurses if you’ve had and I don’t know what the ratio is but if you hired two nurses for every 25 patients, 25 people – would it make a huge difference? I suspect it might.

Dr Drew: It would. The ratio system is, I mean there is empirical data, but they say it won’t change anything but that’s a whole other debate. The fact is that when we look at nursing in the space of nursing it’s about the holistic view and the principles of clinical governance for nurses. The core fundamentals around these people have to be maintained. Nurses are very skilled in doing so and they don’t they don’t have to be the instrument of bedside care to do it. They will lead, mentor and teach these skills into care workers. The fact is it’s highly over-regulated, highly bureaucratic and we’re removing the core essence of what we do. I would love my own home because I would get rid of all the bullshit called accreditation but we actually need accreditation to a point because it keeps everyone honest for the general public. It’s a dichotomy of getting lost in the language and the trees. At the end of the day, I believe very clearly that we need far much more training and standards and education, far better pay. But again, goes back to what Bron had said about society. Society needs to understand if we need and desire these things, it’s going to cost us money. So I put it out there in this panel, do we really, really with this crisis hitting the scene at the moment need to give half a billion dollars to a Barrier Reef Marine Institute so that they can do whatever they choose to do about the marine part now? I’m hypothesizing but there’s half a billion dollars that could be shoved across to aged care and community services. Do we really need to be giving money overseas to a humanitarian organization? That is we have no control over that money and where it’s going when we are in the crisis here in this country when it comes to helping our frail and vulnerable who built this country. We really need to get our priorities right in this country and society needs to own it instead of the bleeding heart jumping forward and bleeding their hearts out over somebody in another country, before we are allowing our own people to suffer – it’s not right.

Brian: It does seem a bit ridiculous to me that we spend and I have no idea what the figures are, but billions of dollars trying to help people overseas which I think it’s all very noble and grand.

Dr Drew: Yes, of course.

Brian: But as you say we’ve got people here suffering equally badly as the people overseas and we’re doing very little to help them. And I think somewhere along the line there should be a balance, let’s get a little bit sorted first and then let’s help everybody else.

Dr Drew: Amanda?

Amanda:  I totally agree with that. I think there’s so much money being wasted on like this commission and not necessarily well I think it’s wasted on the Commission because I really don’t see that there’s going to be much of a to do at the end of it. But when the money is going overseas and stuff, I understand it’s not wasting the money but it’s like there’s so much.

Dr Drew: It’s not prioritizing it.

Amanda:   Not at all. Especially not when you watch programs like that and you see the impact that it has on these elderly and not only on the elderly but the families who have no other choice but to put their families, their relatives into these places. And unfortunately, unless you’re going to a private facility that does pay their staff much better but you’re also needing to be able to save up that money to be able to go into that private facility

Dr Dew: Absolutely. They’re going to lose their home in the journey anyway. Their life-saving asset, the only asset built as a society to pass on their legacy to their children. I mean yes, these are emotional issues but it takes emotional intelligence. One of the things that peeves me is the simple fact that Medicare is a function and a system given into the Australian society that everyone takes advantage of and I’ll give you some clear data and I’m sure the AMA and the Medicare people won’t like this going into the public domain. But in a hospital bed in general, their hospital bed will receive over a thousand dollars a day for that hospital bed just to occupy the bed from Medicare. A nursing home has to spend probably 70% of its time trying to justify $200 a day to fill a gap in the care of an older person. And I can guarantee you very clearly in there, I know and everyone who knows as much as I do about the system will tell you – many of the elderly are sitting bed blocked in hospitals because they can’t get the care they need. We should be at least saying to the Australian taxpayer “Listen, we’re going to take those bed numbers, those bed figures, we’re going to give five or eight hundred dollars, five hundred dollars a day to a nursing home to enable that nursing home to transition that older person into the nursing home for three to six months. Get them well, get them up, get them mobile, get them back into the community independent and living a life and give them the money to transition or to respite or to enable or rehabilitate the older person who needs help instead of sitting them in a hospital bed wasting away without the proper care and the focus on their aging issues.” It’s just the whole thing is just a frustration. Amanda?

Amanda: Absolutely. And I think unfortunately, I really feel kind of as part of the younger generation is that that middle generation is really – they’re stuck with their hands tied behind their back because “We can’t leave our jobs and take care of mom and dad full-time because we need our jobs to be able to afford our house. And mom and dad, maybe they were farmers, maybe they don’t have much money saved up.” So like you said they’re going to end up losing whatever savings they have and their house or whatever to be in maybe one of the better facilities but sometimes you don’t have an option of the better facilities, depending on the level of illness that they actually have that they need to go into that. Exactly. So it’s just I think it’s this horrible horrible slippery slope and people recognize it but it’s such a taboo subject that people don’t even want to talk about it. Everyone recognizes it, everyone knows it’s going on,  no one really wants to talk about the dirtiness of it.

Dr Drew: And for Baby Boomers which our show is designed for, I really ask you all as listening to us and week after week. If you do and listen to our subject matter, this is the true guts of what we face as older people. At some point down line in your life, you will need to come to the emotional adjustment of you’re in need of care and it’s going to cost you probably your life savings to get it. So as Boomers, what can we say to Baby Boomers listening today around their planning and all of the subjects we do talk about as a panel over the last 40 odd shows? What do we say to Boomers? Because my clear message always is and I know it pisses people off, but it’s emotional intelligence, it’s planning, it’s knowing yourself and setting yourself up so you can age well. You’re still going to die, you’re still all going out the door the same as everybody else and my very clear message to Bomers is “Pay attention now, right in the middle of this crisis and this Royal Commission because we are and the Boomers are the largest population to have a say over this and they need to put the pressure on the government now.” Brian?

Brian: Drew, can I just ask you given your association with this market, if I can use that terminology?

Dr Drew: It’s a market.

Brian: Do the same sort of things happen to the same degree overseas in let’s say the UK?

Dr Drew: Yes.

Brian: The United States, Canada?

Dr Drew: Very clearly Brian, it’s a yes. So the UK is experiencing exactly the same as Australia at the moment. They are shutting down nursing homes for abuse, neglect and poor care. However, the NHS has its own issues so it’s a sponsored NHS system. Canada has its own issues. Canada has a free healthcare system, Amanda can talk about that.

Amanda: Bet we also have the private. It’s that same thing, it’s like if you have no money and you have nothing saved up and you’re actually really need major medical care, you’re going to go into one of the facilities that it really is one foot into the grave.

Dr Drew: Yep.

Amanda: But if you have the money to be able to go in, there’s some places that I’d really would love to already live there, that they’re just stunning.

Dr Drew: Yeah, it’s the same in America. I mean I go into a nurse you have an America, 500-600 beds, big monsters – the care is wonderful. It’s a Medicaid system that sponsors and funds a different way. However, if you’ve got money in America and you can afford your own retirement the right way, oh my god go to Florida. Some of those retirement villages are absolutely amazing.

Amanda: Yep.

Dr Drew: And Australia is the same. There are beautiful homes.

Brian: Yes. It’s the same.

Bron: When you were just saying, comparing other countries, I went to something that a friend from the US just posted on Facebook, just a little bit off track but her friend died in this recent flooding that’s come out of the hurricane that’s been over there. Because she’s a mental health patient and she was being transported in the back of a cop car, handcuffed in the car and was swept away and so she died. She wasn’t a criminal but that’s how they treat these people. I think there’s this whole sense for me about other than this, that we have to come to grips with as a society if someone is different to us. Like we’ve talked a lot about diversity and inclusion, a lot of it is just lip service.  Actually when we can start to see someone who is even remotely, tiny a little bit different to us in that they are a different gender, a different age, different skin color, if we can start to see them as a person like us then we have a chance to rectify some of these huge issues that we have and whether we’re spending money overseas with humanitarian aid or whether we’re spending it in our own country, it’s about seeing people as people with dignity and we need to address. But my siblings and I are addressing this with my mum, we are now at the stage where she’s having a palliative care assessment in the next few days, still living at home but we know that she’s maybe got up to three months, maybe six months lived and we’re having to look at this and it’s raising all of those issues that you said Drew about an understanding to have the conversations with my sons because I want to have an open conversation with my boys.

Dr Drew: Prior preparation prevents a piss-poor performance Bron.

Bron: All of those things. But I think the biggest lesson for my brother and sister and I has been to see my mother not just as our mother but as Ruth, the person that she is who has her own thoughts, her own ideas, her own wants and we’re trying to do our best as difficult as that is.

Dr Drew: I think this is a challenge in the age care crisis because I often say I vouch my mandate and mission and my agenda is nursing because for me it is a lived massive area of science that is not understood well enough but nurses have their own fault in that. But as far as humans, we can’t fight darkness or beat darkness with more darkness. We’ve got to do it with light. And I’m one of the clear people, I mean those who don’t know, never seen me in person, I’m over seven foot tall, I’m a very big person,  people can take me the wrong way. My diversity is in your face, I can assure you but I know the core of my human heart and my human being is and I can challenge many people in this area. I’ve been nursing, caring, loving and respecting human beings for a long time in war zones, in hospitals, in nursing homes and I know I have a gift and the gift for me as a human being is to see another human being and I love and cherish their individuality whether as some people see it as rude or abrupt or whatever – I don’t care. You know the fact is for me, I just don’t like assholes. But you can be a person and still have your little idiosyncrasies we may need to learn to love and respect and ignore. In the race of humanity, it is like a race. Some people running down that straight will get ahead of others, some people on the curve will fall back behind but we need to understand very clearly that it is a race – humanity is a race and it’s a continuous race. But you’re right Bron, we’ve got to start focusing on humanity and people again and all I hear at the moment is everyone wanting their indifference noticed before somebody else’s. And in an aged-care scenario, we really have to everyone whole society step back and go “All of these people in aged care, the one common thing they all have is they are aging. They’re our elderly and they’re our older people.” And I’m not grouping them or homogenizing them, I’m just saying as a group of aging people, they are human beings and then you have to cut through into their individuality. It’s going to be hard to meet their needs if we keep putting the wrong people in the care of servant behavior serving these people’s needs. Brian?

Brian: Yeah, look it’s hard to argue against any of this. I just as I said earlier, if I had to go into one of those places, I would like to think that the staff would take notice of me, a person, as an individual. And I’m sure that’s all pretty much all anybody wants and then of course they need to be fed and maybe to be cleaned and whatever. But I mean basically they want to have people notice them as people like I’m whatever age I am at the moment. Bron was talking about her mother is over 90 years old.

Dr Drew: I’ll just interrupt while Brian’s having a cough there, to assure everybody the interesting factor around what Brian’s talking about is if you step into the system and you wanted to pull it apart as this Royal Commission will do, you will notice that we systematically have assessments and processes and data collection that focuses on the person. This has been a discussion in aged care for well over 30 years let me tell you. This has had the Amanda Lambroses, as the Drew Dwyers, the Rhonda Nays, the expert – we have reviewed this, researched it, translated it, evidence-based. It is sitting there and this is the annoyance is we’re not doing it and we’re not doing anything about it. It’s so bloody frustrating as a person who is so passionate about it because again, we have to go to the point of who is being asked to pick up this knowledge and transform it into care? And everytime I raise it, I get told “You’re a bigot. You’re a racist. You’re a bully. You’re a homophobe. You’re a this, you are a that. I go “Please this is about who are the people that come in to be the servant leaders in care.” Because that itself is a challenge to go in and give care to another human being and put them first and to find out who they are and give them what they want. On a good day, it can be a challenge. We have to own, educate and teach emotional intelligence, communication, ethics, love, respect. I often say, Bron and Amanda, I often say when I’m overseas working with particular Asian nurses who I love the fact that people say “Why do you do that Drew?” “Because I don’t have to teach them how to care. They know how to care. It’s in their culture, it’s in their upbringing, it’s in them.” I have to teach them the science and the stuff behind the care, the systems and processes. I can’t teach somebody to care for somebody. It has to be in that person. Go ahead back Brian.

Brian: Look, I was just about to mention Bron’s mother who is in her 90s and whatever she’s done in her life and I honestly have no idea what she has done in her life, have children and living in the country. But it would be nice for somebody in whatever facility she’s in to actually talk to her about what did she do when she was 20. What did she do when she was 30-40-50 whatever? Because I don’t know, she might have had the most wonderfully adventurous life. She might have traveled to a thousand different countries and spoken four languages – I have no idea. But people don’t take the time and I’m not sure that you can afford, the country can afford to have people sit in various facilities and just talk to people.

Dr Drew: I think we can afford it Brian, that’s the point. I think Australia can afford it, we’re just not applying it and it’s an insult to what we had actually set up. As I said before, I can assure everyone listening these systems are in place, this knowledge is well-known, it’s about implementing what we know is the best practice. It’s not being done by everybody, it’s being done by few but not being done by the many and I can assure you, I’m going to put a cast  on social media this week about it and I’m going to take the challenge. I know it will cost me and my reputation but I’m really at the point of being over it because it brings sadness to me as a person who is passionate about it. It shits me to tears that I have to go in and try and lead or force or motivate people to do something that is well known in the literature, well structured in the training, in the competencies and everything – it is there. You only have to pick it up and read it but it’s not transferred over into practice and I don’t know why. You could point the finger all day of blame but I would rather not do that, I would rather just put the solution on the floor.

Brian: We have spent, I don’t know  whether it has been 45 minutes, 50 minutes whinging and complaining about this whole system and with justification. But within the system, there must be an awful lot of people who are really, really good.

Dr Drew: There are.

Brian: Who really do care and really do the right or try to do the right thing.

Dr Drew: There are Brian but you are up against many other issues within the system so it’s been going off for a long time. All I can say is yeah, we’re having a whinge, we’re a panel, we’re at a discussion, a media discussion so it’s always good to get all these things on the table. But at the end of the day is and I send this message in my social media, it’s not all bad. There are some wonderful places doing some wonderful work and I don’t see systematic abuse and neglect. I don’t see it and I work in many many different facilities in many states in Australia. What I do see is individualized issues and problems. They are systematic in that home and that service and they very much can be noted down to individuals. The problem is, you can’t address these as a leader through transaction and transformation because someone is liable to turn and accuse you of bullying, harassment, abuse yourself. And so therefore, the leaders that we need to be espoused fail to engage. They just get on and do what they have to do to the best of their practice and it’s almost like “Get me out of here in the eight hours so I don’t have a trip, a slip and a fall and that I can go home, know that I did a good job and I did the best I could do.” Amanda?

Amanda: I think for me, one of the biggest things is that even though there are great people in the system, the system currently is broken. It’s broken and I think everyone’s really well aware of it and a lot needs to happen and I think there’s brilliant people such as yourself and myself and a ton of other fabulous people out there who are able to help and train and educate and we have the research and the science behind us.

Dr Drew: Yes.

Amanda: Use it and instead of throwing 78 million dollars in just trying to figure out what the problem is, it’s like hire the people who already have researched what the problem is.

Dr Drew: Absolutely.

Amanda: And implement the solution focused outcomes for the staff so we’re not in this situation in the first place.

Dr Drew: Yeah. Look I’ll say something on that before we go to Bron and that is I can tell you and I know this very clearly and I’ll be honest and I know it cops me a couple of lashings, 50 lashings with the whip but these people who do it much like me, we are always very mindful but the problem is you need to give these particular people power and no one likes anyone with any power. And those who have got the power, are using that power very poorly. Governance is a major issue because clinical leadership is a major issue and you can’t have governance without it. It means espoused leaders have to be well-trained to do that job well but nobody likes authoritarian systems and yet they are silently acting in one. So yet again, that massive confusion is somebody take a hot needle and stab me in the eye with it because that’s the only answer I’ve got. Bron?

Bron: Oh well I won’t stab you in the eye with a hot needle. Look, yeah we can sound like we’re having a whinge but I think we’ve just got to keep talking about it.

Dr Drew: Yeah, I agree.

Bron: Because we we do feel frustrated, like that’s the whole thing about ‘stab me in the eye with a hot needle’ is we feel so frustrated that we can’t change anything because it’s a system, it’s a systematic change that is needed but systems are made up of people and systems only exist because people allow them to exist. And so it has to be that the little voices just having to keep being spoken out, expressed, saying “This is not right. We can do this better.” Because we could look at, and I have looked at, a variety of different things and you look and go “Oh we’ve got so much further to go.”

Dr Drew: Yeah.

Bron: But if you look at where we’ve come from, we have made change and we’ve made change in the aged care and the care of our aged in our society. We have a long way to go but we just have to keep looking at, not only looking to where we want to go but looking back at where we’ve come from and go “Okay we’ve made these strides, we’ve got this far. Let’s keep going, let’s keep talking about it.” Because otherwise, we will stop and we will be frustrated and we won’t do anything.

Dr Drew: Yeah. The cracks open up and more people fall through them, I’m afraid.

Bron: That’s right.

Dr Drew: And I think we have to be challenged and strong enough and emotionally intelligent enough as a Boomer population and older generation yet young enough to still make change. We have to be strong enough to take the debate on Bron. I think the debate needs to be taken on and people need to be able to be challenged, need to be listened and people need to learn to listen. People need to accept that race I was talking about, some people get forward and win for the next hundred meters, some people end up falling back as they go around a corner. But we need to listen and communicate and talk because I know as an expert in it and being in the system a long time and that is I could get rid of half the BS if I was given a home and I could just specifically focus on choosing the right people and leaving those people alone to do what they know and what they are espoused to do what’s right for the people they care for. Because it will be, in the end of the day, a reflection on them on how they care for the people they’re serving.  Amanda?

Amanda: I totally agree with you.

Dr Drew: It’s bizarre. Let people who want to care be governed in care. And I can tell you, they’ll do their job and they’ll do it well.

Brian: Drew, sorry Amanda, it is one of the problems the fact that this particular industry in Australia is almost exclusively privately owned?

Dr Drew: No, it’s not.

Brian: The owners are driven by profit rather than care.

Dr Drew: No, that’s part of the issue Brian if you look at the whole tapestry of it. I think the most of the problems we are experiencing in aged care at the moment and community services is the culture of the people that work within the business. If the value systems are not aligned or in synergy, you have different people with a different value system guiding and leading other people. So it’s really about for me I teach this in a model of leadership in aged care, values leadership is about understanding the values of the key stakeholders in that one service. Mapping and finding the synergies that connect those values together, finding the values that are important, finding the values that are not. Some of the values that are important that others will need to remain and we have to train and transform people to espouse those values because something as simple as making money is important. Now most people don’t value that, but of course if business isn’t making some money, the business is not sustainable. So at some point, people have to share that value. But there different value between a manager, a carer, a nurse and the person who receives care who’s paying that money, you know what I mean? So we need to map those values in, find the shared values, then of course you have to have a transactional leadership space where it has policy, procedure, flowchart, form and tool because we have to follow guidelines built by society. Otherwise, people get upset that things are not safe and measured and that’s the society we built. But then when we find a problem with the difference between value and system, it should then take transformational leadership to train, teach, educate, lead and mentor people out and across to the shared value. Continuous improvement, customer service – I mean there’s so much literature here Brian. I’ve got bloody degrees and PhDs in it and as I said, it’s hot needles in my eyes because the moment people like me start speaking or wanting to change, I come up against the egos of the dickheads in the system that don’t share your value and that’s basically what it is. They think they know better and I can assure you and I’ll make the bold statement, many of the leaders – espoused leaders apparently – are too busy navel gazing at their own mandate and their own job and their tenure and their big jobs to worry about this. And that’s the sad fact, so systematically again, you’re pulling it down. It’s like a whole branch of a virus. But anyway, we’re going to end our session out with one message each for all the Baby Boomers in regards to the age care crisis and how it’s affecting you. Ad I’ll go to Amanda first, a message for our Boomer listeners?

Amanda: I’m going to say as much as we doom and gloom it, there are some really great positive people and places out there and I think when you spot them, if you do see them, kind of praise them for the job they’re doing because it’s a really hard job in very difficult situations. And in the grand majority of times, they’re being underpaid so when you do see a shining light, kind of acknowledge them.

Dr Drew: Yep, Brian?

Brian: Yeah, I think that’s a very good thing that Amanda has just said about praising the people that are trying to do the job. I mean if I have one last thought on it, it would be as an older person, to try and stay out of these places for as long as possible.

Dr Drew: How about you Bron?

Bron: Look, I think it comes back to something I say so often, it’s about living intentionally. Not burying your head in the sand and so hoping all of this will go away by the time you get there because I think that we as people we tend to do that. We think “Oh I hope somebody else will fix it.” It’s actually part of our deal to let’s leave intentionally and with emotional intelligence as you like to say.

Dr Drew: That’s right. And my message for everybody listening is this: Entering aging and the last and third stage of your life particularly that end stage for the whole family and everyone around you as an individual is a place and a space for making tough love decisions. Do your research, investigate, find the service, the system and the process that best maps and suits you and when you pick that service, you be loud and proud and acknowledge and connect and build a partnership that people offering you that service and you hold them accountable for what they’re doing. But have some compassion and love for the entire system as Amanda says that there is some good there, lots of good there. As Brian says, ‘Do what you like to stay away from it.’ But even in your own home, in your community, you’re still going to need something, I can guarantee you.

Brian: Yes.

Bron: Yep.

Dr Drew: As I said, it’s tough love time. Be smart, be honest and be transparent with yourself and you’ll make the right decisions. The losers in the game, the rogue people – they won’t last long if we start investigating them and cutting them out of the system. It’s pretty much that simple for me. So thank you everybody for tuning in. Thank you panel for turning up. Happy aging.

Wayne: Well that was Boomsday Prepping. You’ve heard from our panel Dr Drew Dwyer, Amanda Lambros, Brian Hinselwood and Bron Williams, and we’ve been talking about the crisis in healthcare. If you’re a Baby Boomer, this is something that affects you. Thank you for paying attention and do remember you too can be an activist. Just because you’re a Baby Boomer, it doesn’t mean you have to sit back quietly and not say anything. I’d like to think I’m gray and I vote but I don’t care much about fishing. My name is Wayne Bucklar, you’re listening to Boomsday Prepping – the Baby Boomer show.

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