To provide aged care in regional Australia, we need to change infrastructure and attitudes. The challenges are unique and often not discussed in the media.
True values-based, person-centred care relies on:
· Integrity in the strategy and governance – especially with greater oversight for existing plans and a stronger focus on planning for the future to accommodate diversity, volume and geography
· Empowering the workforce that delivers aged care – from a regional perspective, this means attracting talent with incentives and decent pay rates, and considering impacts like the current housing affordability crisis
· Embedding quality and compliance – not only does this mean meeting the Quality Assurance Standards at an individual centre or provider level, it means addressing the lack of access to centres and services often encountered regional Australia
· Creating person-centred care on floor level – to change a culture or to train a staff means creating space for these activities to occur. It also means encouraging providers to spend budget on embracing change, which can’t happen if the supply is so low, staff can’t find the time away from the day to day to do so
· Make use of digital technology – the more regional Australia connects with digital technology and the more it’s role in the life of aged care workers and care recipients alike, the greater ability we have to increase access to services, especially in the planning stages.
Providing aged care in regional Australia relies on boots-on-the-ground work. And translating what we learn as we do it into useful data to make a case for a change in the future.
To provide aged care in regional Australia, smaller centres need to focus on big picture marketing and community education. Here’s how.
Making regional care jobs more attractive
Aged care provision in regional Australia is constrained by the local workforce. Attracting care professionals to regional areas is a tricky equation at the best of times.
Now, the difficulties have intensified.
The frontline aged care workers were emotionally and physically drained by Covid. The work levels were difficult to manage. This means people that may have previously considered work in the sector are reticent and existing workers have faced burn out, shifted to part time or even retired from the industry.
Economic problems also play a part. Regional NSW especially is in the grips of a housing crisis. Rents are high, pushing more and more workers out from regional centres towards long commutes from further outlying regions. Inflation has increased the cost of living, leaving even less money for rent or mortgage. And while house prices may drop, the phenomenal gains within regional Australia during the pandemic means rents and house prices are still much higher than they were in 2019. RBA rate rises may contain and reduce prices slightly, but they also make banks nervous. That means while house prices may be on small downward trends, the buying power of potential mortgage holders is dropping significantly.
To make a case for someone to work in aged care in a regional town, there has to be:
· Higher wages to offset cost of living, better relocation packages, and regular performance incentives
· Investment in training and study allowances to upskill workers and provide career mobility within organisations to take advantage of that training
· A focus on lifestyle and sharing not only the job information but selling the place, the culture and the lifestyle of the individual towns, online and off
· Cross promotional work outside of aged care to let future regional workers know their kids can go to school and day care
· Practical steps to work with industries outside the sector so partners can find work and/or can create work via freelancing and/or small business.
Invest in health education
Forget the brochure in the GP’s waiting room. If we want to shift the needle on the uptake of early intervention programs, we need to look for opportunities to talk to the public. It also means overcoming objections, proper consultation at the grassroots level, and transparency.
Part of providing aged care services in regional Australia is that potential clients come too late to the aged care system. Instead of accessing as a preparedness and preventative measure, most regional recipients of care-related services are in their latter stages of dependency.
This is a reactive, emotionally and psychologically damaging, and potentially costly way to view service provision. It reduces an individual’s chance of staying at home or even in their town by a significant degree because of waiting lists and supply issues.
How do we relieve the pressure on stressed and strained services by connecting people to in-home care services earlier?
· Promote community-care models. With the rise of co-living in Europe and USA, and the increased interest in tiny house culture and sandwich generation living here in Australia, we can show that the stoic “I don’t want to be a burden, so I do everything myself” model of the past is outdated. Potential exists to show the impact that community care models can have on individual outcomes
· Transparency. Allow people to investigate the impact an in-home care nurse or private nurse can make on their overall well-being through case studies, information and tangible demonstrations. It also means embracing discussion about the reinvention of Australian aged care through the Royal Commission and Quality Assurance standards
· Seeking opportunities to speak to the public in regional areas, especially with local champions at the helm. People on the coast and the bush want you to front up and be available for their questions. They’re also reluctant to trust polished services from the city that know all the right things to say. Investing in relationships in key cities like Moruya, Ballarat, Toowoomba or Port Augusta will do a lot more for community support and trust than an online webinar held in a Sydney or Melbourne office by some unknown.
Promote diversity in regional health
We know that regional health faces challenges in attracting talent. But it’s not only cost or lifestyle that is creating the barriers. Country towns sometimes do themselves a disservice by behaving in a way that is insular. It can make it difficult for people to feel as though they are welcome.
This is especially true in healthcare.
Diversity opens the door to:
· Better community reflection and representation, which leads to better health outcomes in marginalised groups. The more people see themselves reflected in the staff and the policy, the more likely they are to engage
· More innovation through additional lived experience through a cultural lens and bringing knowledge from overseas, within community practice and/or preventing too narrow a focus on solutions and outcomes. That leads to good policy development
· More opportunities to attract high-quality talent to the industry. Diversity and inclusion training to ensure groups that may have concerns about moving to regional towns from overseas or groups such as LGBTQIA+ and Aboriginal or Torres Strait Islander peoples feel safe, welcome and included
· More university graduates choosing regional placements. Let’s show that barriers young people commonly encounter, such as homeownership, employment, partnership and creating a home, may be lower than in urban centres. All while highlighting regional destination culture, technology and diversity as proof that lifestyle won’t be sacrificed by choosing to live regionally.
Embrace technology and telehealth
There is a lot to be said for working smarter instead of harder with the use of technology. We may not be able to bring specialist services to a town full time. But we can utilise telehealth to create greater availability of appointments. Perhaps there is only one aged care provider in a regional centre that can provide in-home care. But does that really mean the worker should spend the majority of their work time in a car? Or that we cannot educate aged care workers and clients alike on ways to automate and reinvent the labour involved?
Part of embracing technology to provide regional care services includes:
· Choosing ExSitu to help you create values-based, person-centred care plans for aged care, palliative care, mental health and more
· Making use of Umps for well-being monitoring via personal alarm pendants and other in-home monitoring technology
· Embracing Hayylo, a client communication software that connects clients and families to admin teams and removes repetitive tasks
· Utilise online communities to offset the social isolation often felt by ageing Australians, like the work by BCR Communities
· Promoting the resources provided by Carers NSW, Relationships Australia and Cota.
Providing aged care in regional Australia is an enormous project. One that won’t be solved with funding alone. However, the more we all take ownership of reinventing regional Australia through technology, diversity, community engagement, education and awareness, and opportunities, the greater the chance of positive change.