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Making ‘healthy normal’ in aged care requires mindset change

Southern Cross Care has seen a 54 per cent reduction in fractures as it rolls out reablement, reports Jackie Keast in the final installment of AAA’s series showcasing how leading providers have embedded wellness approaches.

For the past two years Southern Cross Care SA/NT has been rolling out its organisation-wide reablement approach to reverse its clients’ decline and bring about healthy outcomes. It’s involved a complete re-think of how staff work, and the organisation’s policies and procedures.

But another challenge has been a lack of confidence among clients, as many don’t believe that they can make functional gains, said Jo Boylan, the provider’s director or operations.

“We have to build self-efficacy through good health literacy; to say actually you can still gain good muscle mass at your age, and you can prevent falls,” Ms Boylan told AAA ahead of her presentation at the upcoming Active Ageing Conference 2016.

Staff have been using a technique called appreciative inquiry, where they encourage clients to reflect on a time in the past when they felt healthy and energised. Drawing on these positive memories, they work together on how the client could make steps towards regaining that function.

When a new client first enters an SCC service, they’re measured on the frailty spectrum and from there staff assists them to improve their outcomes. Key areas include building muscle, core strength, nutrition and social engagement, and preventing causative factors of decline.

Ms Boylan said SCC’s approach was anchored in the conviction it was a universal human right to have the potential to improve health and wellbeing. “It is possible to make healthy normal… It is possible to reverse frailty,” she said.

Jo Boylan

Changing mindsets

At the organisational level, Ms Boylan said embedding reablement required a whole of system approach, ensuring that policies, procedures, staff and environment all supported healthy outcomes for its clients.

“Making healthy normal has to be a mindset change,” she said.

SCC has worked on this over a two-year rollout period. In the past year, it has re-written procedures and established early-intervention working parties in its sites. These parties monitor and quickly identify when decline occurs, and work out how it can be reversed. The provider is also in the process of establishing data collection and evaluation tools, said Ms Boylan.

The organisation invested in staff education and the development of guidelines around health literacy and healthy ageing. It was also currently in the process of reviewing job descriptions and appraisals to better reflect a healthy ageing approach.

To build its focus on physical activity, SCC was also installing gyms across residential sites, and had re-skilled members of lifestyle staff in a Certificate III in Personal Training.

Ms Boylan said it planned to allow community access to these gyms, where it will operate the Council of the Ageing’s Strength for Life fitness program for over 50s.

While the roll out of the approach was not yet fully complete, Ms Boylan said it had already seen a 54 per cent reduction in fractures across residential sites.

The Active Ageing Conference 2016, hosted by Australian Ageing Agenda, takes place on 4 August at Swissotel, Sydney

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