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Leadership in Aged Care

By Brian Draper and Yun-Hee Jeon - posted Tuesday, 1 November 2011

It will require good leadership for Australia to become a successfully ageing society. Over the next twenty years, due to the baby-boomer generation, the number of Australians aged 65 years and over is projected to nearly double from around 3.2 million to approximately 6.2 million people.

This is testament to increased life expectancy from the good nutrition, living conditions, social stability and health care in Australia; but there will also be the accompanying age-related chronic health conditions, including dementia and other degenerative disorders such as macular degeneration, Parkinson's disease and osteoarthritis.

According to Access Economics, the number of people with dementia is expected to more than double from around a quarter of a million Australians in 2010 to over 590,000 by 2030.


The impact of this demographic change upon the community and residential aged care system will be immense, as indicated in the recent Productivity Commission Inquiry Report, 'Caring for Older Australians'. Similar challenges will be experienced in hospitals that are already having difficulties treating older people with dementia and other causes of confusion.

To meet these challenges effectively will require leadership at many levels within the system – from those responsible for ensuring that system capacity is able to keep up with the demands of the expanding ageing population; executive level management responsible for putting organisational leadership to ensure strong workforce is in place for quality and safe care; and to middle managers responsible for ensuring that their individual units are functioning efficiently, effectively, and utilising 'best practice'.

There are already concerns that leaders in Australia are not adequately addressing aged care issues. Although we await the Government's response to the Productivity Commission Inquiry, concerns about the organisation and co-ordination of the aged care system have been repeatedly expressed in various reports over the last decade, such as the 2004 Hogan review, without significant change being enacted. Certainly there are enlightened leaders within aged care, but the concern is that aged care issues are not being adequately addressed by leaders within the mainstream.

Poor workforce planning is also an issue. Aged care is heavily reliant on adequate numbers of well-trained staff for optimal performance in the health, community, and residential sectors. There are, however, already well-documented deficiencies in the aged care workforce and it is not just numbers; it is also skills within the workforce and the fact that the workforce itself is an ageing one. The issue is certainly not being ignored by leaders, but the response to date has been piecemeal and inadequate to address not only the current deficiencies but also the projected increased demands over the next 20 years.

It is not clear whether mainstream leaders understand that the business model of obtaining efficiencies in an industry by staff reductions compensated for by technological improvements does not work in aged care.

For the foreseeable future, new technology is not going to replace the interpersonal skills of dedicated professional health, welfare and other community workers. Instead, new technology such as the robot seal Millie used in dementia care will assist staff in providing higher quality care.


So if the ageing population is going to double in the next 20 years, the workforce will need to double just to remain on par with the current struggling situation.

There is also a lack of adequate mainstream appreciation that aged care environments need to be better designed for an ageing population. Even the places that you might think would be most likely to be user friendly for older people are deficient.

Hospitals are poorly designed for older people despite around 50% of patients being over 65 years of age. Many hospital environments have long been known to increase confusion in patients, particularly those with dementia and sensory deficits, and yet very little has been done to systemically improve hospital design. Indeed it was only earlier this year that the world's first 'elder-friendly' acute hospital, the Royal Jubilee Patient Care Centre, was opened on Vancouver Island.

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About the Authors

Brian Draper is a Conjoint Professor at the Academic Department for Old Age Psychiatry, Prince of Wales Hospital Randwick & School of Psychiatry, University of NSW.

Associate Professor, Sydney Nursing School, University of Sydney.

Other articles by these Authors

All articles by Brian Draper
All articles by Yun-Hee Jeon

Creative Commons LicenseThis work is licensed under a Creative Commons License.

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