clinical focus
Aci: in your article, you detail the challenges specialist mental health services may face in being effective for the older population. Where do these issues stem from? MB: They stem from the [ need ] to firstly identify older people who have mental health issues. [ We must ensure we ] are able to identify those people, have them come forward, and deal with some of the stigma related to mental health. Our older population tends to have the traditional stigmas around mental health – that it’ s shameful – but if we can have services, workers with the right skills [ and the right ] approach, and have media [ show ] that it’ s OK to talk about mental health issues, we may be able to have people come forward and ensure that they’ re comfortable with saying they have a mental health issue.
The service providers and the staff within those services need to have the correct approach, so the older person feels comfortable talking about what’ s happening. With the project we did in Hobart, the staff there did form relationships with the people, or had existing relationships with them, so the older person and the clients felt comfortable talking about those issues.
Better together
Strong relationships between care workers and clients lead to exceptional results in a program designed to fight functional decline.
Maree Bernoth interviewed by Dallas Bastian
A participatory care model out of Hobart was the focus of recent research that delved into job satisfaction for care workers and functional decline in older people.
The study evaluates a program to prevent functional decline of older, community-dwelling people, called Staying Active-Staying Independent.
Study lead Dr Maree Bernoth, from the School of Nursing, Midwifery and Indigenous Health at Charles Sturt University, says the evaluation gives older people and community support staff the opportunity to share their experiences from the program.
In this interview with Aged Care Insite, Bernoth details the main messages participants raised during interviews and a focus group, the important elements of the relationship between the caregiver and receiver, and some of the areas of the program that can be expanded. in that study, you evaluate a program designed to prevent functional decline of older community-dwelling people, called staying Active – staying independent. What does this program involve and what did the evaluation cover? We’ ve done a number of evaluations. We’ ve done some qualitative work and identified what the meaning was for the clients and the staff. We’ ve also done some quantitative evaluations. The quantitative evaluations will be in future papers, but we’ ve published two lots of papers about the qualitative aspects of the program. The Hobart District Nursing Service received funding through Health Workforce Australia to look at a different approach to assessing clients’ needs and keeping them functional. It’ s related to the consumer-directed care we’ re working towards right now. What the Hobart District Nursing Service did was educate the staff, firstly, teaching the care workers the new approach, empowering them to do assessments on their clients, and also to support those clients as they went through the program that was identified as suitable for them.
The care workers went out and spoke to the clients. Instead of assessing them from a nursing perspective, they asked the clients what was most important for them. The clients identified issues that weren’ t obvious [ including around mental health ]. Then the care workers, in conjunction with an allied health professional and a registered nurse, worked to implement a program that was suitable for that person. The outcomes were just amazing. There were good [ results ] for the staff and for the care workers. There were positives for the clients, and for the communities involved. It was a terrific program and something that can be replicated throughout the country.
As you mentioned, you conducted in-depth interviews with older people receiving care and a focus group with seven community support workers. What were some of the key points this process raised? What all of the clients revealed or acknowledged to us was that the approach the care workers took was essential; it was very much accepted by the clients and enabled them to reveal their deepest needs. That was based on the relationships that had been built between the care workers and the clients. While we’ re talking about customer-directed care, if we’ re going to identify the needs of the client, the relationship and communication between the person doing the assessing and the client are [ critical ] so the
34 agedcareinsite. com. au