clinical focus
30 years. It’s been a hard move. Thanks for
taking the time out to talk to us. It helps to
talk about it.”
Staff members and residents have also
noticed social adjustments among residents
and staff had improved. One staff member
reported, “We are seeing some residents
who were isolating themselves in their
rooms now participating in activities.”
CASE STUDY
Easing the transition
Providing
mental health
services in
residential
aged care.
By Tim Lamb
I
t is often challenging for older adults
to make the transition into aged care.
Many new residents experience grief as
they leave behind their homes, spouses
and possessions. Being placed into an
unfamiliar environment with new people
can lead to social isolation. Anxiety and
depression rates are also higher in aged
care residents than the general population.
Consequently, many residents
need somebody to listen to them and
understand their situation. In 2015,
the Caring for Residents of Aged Care
program was created by Change Futures
to provide a service to assist with these
issues. Originally, the program was
delivered to St Vincent’s Aged Care in
Brisbane’s north side. Since February 2017,
the program has spread across 15 different
facilities and has been delivered to more
than 500 residents.
Julie Aganoff, program founder and
executive director of Change Futures,
explains that there is a strong need for their
services in residential aged care.
“We originally started working in
residential aged care as we knew that
residents could not access Medicare
rebates for psychological services and
very few could afford to pay the full fee
28 agedcareinsite.com.au
for a psychologist to visit them in the
facility,” Aganoff says.
“Given the needs of this very frail and
very old client group, we saw this as a big
gap in service delivery, so we decided to
do something about it. We worked for
free for 18 months before we were able
to attract funding for this service.”
The Caring for Residents of Aged Care
program offers both individual and group
therapy to residents. The type of therapy
is tailored to the cognitive capacity and
medical needs of the resident. Cognitive
behaviour therapy is the gold standard
for treatment for depression and anxiety,
but this approach needs good cognitive
capacity. Reminiscence therapy is valuable
for those with some loss of capacity as
long‑term memory tends to remain intact
for longer with people with dementia.
This approach is also used in the groups
as it helps build social connection among
the residents.
OUTCOMES
The Caring for Residents of Aged Care
program has resulted in positive outcomes
for aged care residents. Clinically
significant reductions in psychological
distress, anxiety and depression have been
found, with one resident saying, “I always
feel so much better when you have been.”
Many staff members have observed
an increase in mood among residents.
One staff member reported, “I am seeing
residents smile – I haven’t seen this for a
long time.”
The program has also led to clinically
significant improvements in life satisfaction.
One new resident and client of the program
commented: “We were at that house for
Deidre* is an 87-year-old living at
St Vincent’s Care Services. She has always
had a positive attitude towards life and
has no history of mental health issues.
However, she was recently diagnosed
with Alzheimer’s disease, and became
concerned about her decline in mood in
the afternoon, memory and cognition.
Deidre attended a weekly conversation
group run by Change Futures combined
with one-on-one counselling sessions that
were focused on reminiscence therapy.
She has reported that the group sessions
allow her to feel valued in sharing her many
stories. Regarding her counselling sessions,
Deidre has reported a reduction in
psychological distress: “It’s so good for me
to talk to you because it makes me think,
makes me remember and that’s good for
my brain. Thank you.”
FUTURE OF CHANGE FUTURES
Change Futures supervises approximately
20 provisional psychologists each year.
In addition to the Caring for Residents
of Aged Care program, Change Futures
offers generalist psychological services as
well as specialist services for Indigenous
populations, refugees, people with
disabilities and carers.
Aganoff hopes that funding will be
increasingly available for this program to
enable access to more residents of aged
care facilities.
“It is wonderful that the Commonwealth
government has recognised the mental
health needs of vulnerable older people
and is responding to address this issue,”
she says.
“We have had tremendous support
from the Brisbane North Primary Health
Network and St Vincent’s care services to
deliver this program. So far more than 500
residents have benefitted. We would like to
see every resident have access to mental
health support as they face the challenges
of this final stage of life.” ■
* Name changed
Tim Lamb is a research officer for the
Change Futures psychology clinic.