Aged Care Insite Issue 111 | Feb-March 2019 | Página 23

industry & reform in December 2016, and I think they saw the video, and it’s a very challenging and important piece of work. It’s difficult to gauge how many organisations actually saw the material that was sent out by the department, because it went in various locations, and there was no implementation strategy attached. So it was good fortune that Helping Hand as an aged care provider had some contact with Relationships Australia, South Australia. Relationships Australia provides support to forgotten Australians, the stolen generation and child migrants, and in casual conversation, it emerged that there was a real need to do some work in this area, so a partnership formed between the two organisations which provided a powerful base for more work. What kind of specific things does your organisation do in that community? What we’ve undertaken to do – in what is still quite a short-term project, and we’re hoping that more work can be done in this space and that more funding can be applied – is to start talking directly with forgotten Australians about what their needs are and how they want aged care providers to respond to their needs. So we really embarked on a very significant consultation and co-design project with forgotten Australians in South Australia to see what their needs and issues were, and as a result a variety of things have happened, which is terrific. What are their needs, and what can aged care providers do to make these people more comfortable in care? The big difference for forgotten Australians is that other individuals want choice, independence and care as part of their aged care service provision, but forgotten Australians were actually abused in institutional settings, and by instruments of the state, voluntary organisations and churches. So, while other older individuals may well have had experiences of trauma, they won’t necessarily have come about as a result of this systemic failure of institutions and government. That’s important to understand, and a point of distinction for this group, and why their needs for maintaining choice, control, dignity and independence are so amplified, and that’s really underpinned their responses to us. They want to be assured that their voices will be heard, because as children their voices weren’t heard, and that’s really a critical issue. So, yes, the implications have been vast for many of them, and lifelong, because you’re shaped by trauma experienced as a child. It’s not something that leaves you. And people have had varied outcomes, but by and large, there is real limitations on people’s trust in authority structures. There’s a great deal of reticence around the medical profession. Any authority structures, actually, have been structures which in their experience caused them harm, so understandably when you come into a more regulated system again, and where medical authority and power are dominant, that’s going to trigger and raise a variety of concerns. It covers not just physical set-up and access, but things like if you’ve experienced sexual abuse, it may influence whether or not you can cope with certain practices or the gender of your carer. If you’ve been exposed to terrible food as a child, there will be certain things that you will never eat. Or if you had no possessions, or they were taken from you, what possessions you do have may have an elevated importance. It also extends to things like not necessarily having the same network of family and supporters around you, because children were removed from those contexts, so they were often very likely to be more isolated and not have advocates and family members who were there to care for them. So all of those things add up to a real fear of going into an aged care setting and being exposed and vulnerable. As a result of some of these things you’ve learned, are you and this group now actively engaging with aged care providers? Are they listening and shaping their ideas in how they set up these facilities with a view to the forgotten Australians? These are early days, but Helping Hand has managed, with the guidance of some terrific forgotten Australians, to create a policy statement for the organisation, which can act as a starting point for other providers to say, “How do we want to formally recognise the needs of this particular group of people, and how might we respond to it?” So our executive has actually approved that, and we’re in the process of getting the policy statement published, and it will become a publicly available document. We did share this information with other providers at the LASA Conference recently, and we also held a forum for other aged care providers in South Australia to update them on our work, and we’ve been delighted with the response from some of the other providers who are really interested in what we’ve been doing, and are looking forward to our work which we will be sharing publicly. So it does set up a situation where others can start saying, “Well, how are we recognising this group, and what care are we going to consider providing, and how might we approach working with them to provide the best possible care and assurances of wellbeing into the future?” We’re quite optimistic, but we would be very enthusiastic to be able to continue this work. There’s a lot that needs to be done in developing a better understanding of how to care for older people in a variety of settings, whether it’s residential or home-based care. An approach to trauma-informed care is something we’re very keen to develop more, along with good screening tools, and a variety of other methods to help us identify and respond to the group. Is there any government help, or engagement with government? Are they seeing this as a priority issue? Government has expressed interest in it, and we have been able to share information about the project, but we do need to emphasise that, at this point, Helping Hand has been able to do this To be honest, I don’t think the aged care sector particularly picked up on this issue. work because of philanthropic funds, and at this stage we’ve been dependent on that for engaging in this work. We are looking and working hard with government to see what other opportunities there are to fund this work. Fortunately, Flinders University in South Australia has also just attracted some research funds in their health department, and they’ll be doing some more work on literature searches and research in relation to screening tools. So there is growing interest in this work, and we’re hopeful that we will get a wider range of support into the future. ■ agedcareinsite.com.au 21