Leadership in Aged Care

Similarly in the residential aged care sector where the majority of residents have dementia, many new facilities do not adhere to the well-established design principles for people with dementia. Interestingly, this research found that active involvement of aged care nurse managers in the design process was associated with better design outcomes. A barrier for leaders in both sectors is the increased cost of appropriate design, but such design is associated with better outcomes and may reduce the risk of acute confusion, falls, and injuries such as hip fractures. It needs leaders with the right vision to ensure that such designs are regarded as being mainstream.

Another feature of leadership in the aged care workforce is the importance of middle management in hospitals, residential aged care facilities and community aged care programs. In each of these settings middle managers are responsible for the organisation of the care of 30 or more older people and a similar number of staff. Effective middle managers need to have mastered a complex mix of knowledge and skills related to ageing, dementia and other aspects of aged care, and general management as well as having the right attitudes towards older people and staff.

A recent review of aged care middle management leadership found that strong, effective leadership is critical in improving job satisfaction, workforce retention, care quality, patient outcomes, and reducing the associated costs. The review noted that, "the essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility." But it was noted that this couldn't develop effectively in isolation as "successful leadership and management outcomes depend on coherent and good organisational leadership."

However, there is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. It is a challenge for employers to find staff with adequate knowledge, skills and experience. Too often a person without adequate aged care or managerial experience is appointed due to the lack of better alternatives. Aged care is not as popular as working in other health and welfare sectors and so it suffers from lack of competition in job applications.

The way forward is to systematically develop middle management leadership skills in aged care. In the context of a research project funded by the Australian Research Council and led by Associate Professor Jeon from the University of Sydney, an Aged Care Clinical Leaderships Quality Framework was developed and validated using a Delphi survey and consultations from a National Aged Care Clinical Leadership Consortium comprising of representatives from key government and non government organisations, aged and community care, industry and consumer and professional bodies.

The framework comprises eight key components, which have subsequently been used to guide the development of the Clinical Leadership in Aged Care program. Working in partnership with Baptist Community Services NSW and ACT, the program is well underway and its results are yet to be reported.

There are many challenges ahead for Australian aged care leaders but perhaps most importantly it is the mainstream political, public service and business leaders that need to get a better understanding of what needs to be done and to ensure that it happens properly and with some urgency.