{ "version": "1.0.0", "segments": [ { "speaker": "Mel", "startTime": "2.72", "endTime": "26.535", "body": "Over a couple of months, he really settled. And in the end, it was a safe place for him. It was the best place for him to be. And for me to feel he was well cared for and felt safe. I knew he really loved it there. One day when I took him out, all he wanted to do was go back there. And I knew the right decision had been made." }, { "speaker": "Tracy Parish", "startTime": "33.43", "endTime": "50.225", "body": "It's no secret we're all getting older. So how can we age well? What happens when living at home is no longer possible? In this episode, we're delving into life in residential aged care homes and exploring how research and new care approaches are making a positive difference." }, { "speaker": "Tracy Parish", "startTime": "50.625", "endTime": "87.98", "body": "Welcome to Help! I'm Ageing, a podcast from the National Centre for Healthy Ageing, Australia's leading healthy ageing research centre tackling the big questions we face as we get older. We'll be talking with researchers and people of living experience sharing real stories, real evidence, real insights with you. We'll discover new ways of thinking and find out how data and science can help you have a healthier future. With Australia's population rapidly ageing, the time has never been more pressing to shine a light on what's possible when research, health care, and living experience collide. But how can we age well?" }, { "speaker": "Tracy Parish", "startTime": "87.98", "endTime": "90.78", "body": "Well, let's find out. But firstly, who are we? Taya?" }, { "speaker": "Taya Collyer", "startTime": "90.78", "endTime": "99.585", "body": "Who am I, Tracy? I don't know some mornings. I'm the lead biostatistician at the National Centre for Healthy Ageing, and that means I do the stats." }, { "speaker": "Tracy Parish", "startTime": "100.225", "endTime": "107.185", "body": "Well, I'm a journalist, Olympic broadcaster turned medical research communicator, and now a podcaster. Over to you, Taya." }, { "speaker": "Taya Collyer", "startTime": "107.28", "endTime": "145.92", "body": "Well, Tracy, today we are going inside the world of residential aged care, which is a place that some Australians know a lot about, and some Australians know what they maybe see on TV or read in the paper, and other Australians probably know nothing. So a really exciting discussion today, and we're learning how research can play a part in making a positive difference for residents and their families and also the workforce who are supporting them. And we're lucky today that our special guest is Professor Helen Rawson, a registered nurse and deputy head of Monash's School of Nursing and Midwifery and a lead researcher on some Living Lab projects at the National Centre for Healthy Ageing." }, { "speaker": "Taya Collyer", "startTime": "145.92", "endTime": "146.8", "body": "Welcome, Helen." }, { "speaker": "Helen Rawson", "startTime": "146.8", "endTime": "148.72", "body": "Hi. Thank you very much. Thank you for having me." }, { "speaker": "Tracy Parish", "startTime": "149.05501", "endTime": "165.31001", "body": "It's great to have you on board, Helen. It's a big question facing many Australians, isn't it, and their families when living at home is no longer possible as they age. Let's unpack that. Particularly, let's start with we talk about aged care and we talk about residential aged care, but they're very different." }, { "speaker": "Helen Rawson", "startTime": "165.87001", "endTime": "193.56999", "body": "Yes, they all come under the broad umbrella of aged care. So, people can receive aged care in the community, in their homes, and indeed that's where the majority of people who are receiving aged care, they're doing so in their homes. And we do know that the best place to stay is always in your home, with family, in the community where you've lived, some people have grown up in that community, and that's where they can have supports coming into their homes to make people stay there as long as possible." }, { "speaker": "Taya Collyer", "startTime": "193.56999", "endTime": "195.41", "body": "Right, and what kind of supports are we talking about?" }, { "speaker": "Helen Rawson", "startTime": "195.41", "endTime": "214.66", "body": "The supports could range from helping with cleaning, helping with cooking, gardening, to having someone coming to help with those hygiene needs, helping someone shower in the morning, getting dressed, etc. Or if people may have, you know, they may have wounds or anything like that, that they have those dressed and attended to at home." }, { "speaker": "Tracy Parish", "startTime": "214.66", "endTime": "243.97", "body": "Okay. And today we're focusing particularly on residential aged care. From what I can see, there's what I call the early adopters, so there's people that realise that moving into a residential aged care home may suit their lifestyle and also be a benefit for them to have live a healthier life. And there's the others that are perhaps a little bit more resistant and think, and you do hear of some people who say, I want to stay at home at all costs regardless. And then their families have to sort of try and tackle that. You've seen both cases I'm sure." }, { "speaker": "Helen Rawson", "startTime": "243.97", "endTime": "295.355", "body": "Yes, I have and I think there's a couple of things with that because it's only a small proportion of people, I think it's just over six percent of people who are receiving aged care are doing so in a residential aged care home. Right. And the decisions to move into a residential aged care home may differ from one person to the next. But what we are seeing that people are staying home longer, so by the time with the supports in place that they need, so by the time they do have to move into residential aged care, it's because those supports they're having at home, which includes family support or sometimes known as informal carer support, which is absolutely critical in this sector, they're no longer able to provide that support to keep that person well enough to stay there. So that may mean that the person needs to go into residential aged care where they can receive 24-hour care." }, { "speaker": "Helen Rawson", "startTime": "295.755", "endTime": "352.825", "body": "And that sometimes the decision could be, it could be someone has fallen at home and they've realised that the supports now needed is they need to be somewhere where they need that support 24 hours, where there are nurses there, care workers, etc. It could be that someone's been living with dementia and being supported at home, but now they need a more a place that really is suited to their life stage now, whether it's being in a memory support unit, etc, which is in residential aged care. So, there's a myriad of reasons why people may need to go in, but it also takes into consideration what is best for the older person, and I really want to stress here, working with them as much as possible to understand what is best for them, and then of course the people who support them, how can I actually continue providing that care and doing so well? Because we want to ensure that the person receiving care is receiving absolutely top care." }, { "speaker": "Tracy Parish", "startTime": "352.985", "endTime": "372.885", "body": "What about family who are listening right now who have no experience with residential aged care, for example, and they've got mum and dad or they've got somebody else who's a loved one, doesn't necessarily have to be a parent, and they're trying to decide whether it's the right thing. When you said it could be the right decision for their health, how do they know that? Who helps them make that decision?" }, { "speaker": "Helen Rawson", "startTime": "372.885", "endTime": "435.91498", "body": "So they're on various places and they could be working with their GP, which is usually the first port of call for all of us in terms of our care and whatever health supports we need in the community. Discussing with their GP and the older person, what the needs are and then is that still able to be supported at home, they could be speaking to some of the advocacy groups as well, so you've got OPAN is one of the groups, there's carers all these sort of places that support carers as well, and sometimes for some people, well for a lot of people actually, their encounter with aged care is because when it's needed. For a lot of people it's not something that everyone knows about, and more so again when it's residential aged care, it's when that's needed. And sometimes you may have a family member who is in hospital, who have to go to hospital for whatever reason, and then it's at that stage when they may have information from social workers and the supports from the hospital, they say we think that the care needs now are at a stage where they may be better supported in residential aged care." }, { "speaker": "Taya Collyer", "startTime": "435.91498", "endTime": "458.875", "body": "Right, and it might also have little or nothing to do with the older person themselves. What I'm thinking of here are issues of carer burnout. Absolutely. Or the death of a spouse. Yep. If someone's, if someone's spouse has been that crucial support at home providing meals and and providing that support, and then that person becomes ill or burns out, that can be the tipping point, right?" }, { "speaker": "Taya Collyer", "startTime": "458.875", "endTime": "464.395", "body": "So it might be a deterioration in the health or independence of an older person, or it could be related to their ..." }, { "speaker": "Helen Rawson", "startTime": "464.395", "endTime": "500.59", "body": "Definitely, related to the care that the person provides, the informal carer. And for the aged care sector as I'll call it, whether it's residential or in the community, the work of informal carers is absolutely paramount, and they do a lot. And we know you've used the term carer burden, that's real. Yeah. And for, you know, because some carers may feel I have to do this care. Yeah. They've done a great job thus far but the person might be needing more, but they feel they have to do this care. And sometimes that leads people to, you know, feeling guilty to, because they feel as if well I've defeated, you know. I'm letting them down. Absolutely letting that person down." }, { "speaker": "Helen Rawson", "startTime": "500.75", "endTime": "523.885", "body": "And it's also about working with that person as healthcare professionals to understand you have done the best by them, and actually them being in residential aged care is actually the best as well. So there are two groups to be looked after here. The older person receiving care and if there are informal carers involved, and informal carers could be family or close friends etc, supporting them as well." }, { "speaker": "Tracy Parish", "startTime": "524.605", "endTime": "531.58", "body": "Let's hear a story that happens in so many families when they all think someone else can look after mum or dad." }, { "speaker": "Mel", "startTime": "532.54", "endTime": "572.245", "body": "The family dynamics were very challenging, particularly when two of the family members felt that I should have looked after him at home and I had sort of minimal support from another family member, that placing him into aged care was the best thing. Their understanding of dementia, there was three brothers, their understanding that he (Dad) was just gonna get better. Surely you can look after him. And then it wasn't till when he settled and everything was, Dad was much happier and that they said that was the best thing you could have done for him. And I said, yes." }, { "speaker": "Tracy Parish", "startTime": "573.365", "endTime": "593.86", "body": "Well, we've painted a positive picture. I guess we do have to tackle the issue of stigma because COVID-19 changed everything in terms of people's perceptions at that time of residential aged care. And then since then we've had the Royal Commission into Aged Care. It's something you're very passionate about. How do we change people's perception?" }, { "speaker": "Helen Rawson", "startTime": "594.66504", "endTime": "640.76", "body": "Podcasts like this is one example. Because as I said before, for a lot of people, they don't know anything about aged care or residential aged care until they have to engage with it or something happens and it hits the media. And we do know in the media that a good news story may not get there, but something that's a crisis point or negative will do. So, and not to say that some of the things that were said was not correct, but there's also a whole lot more going on in residential aged care homes in terms of the ultimate goal of supporting people needing care, and that's coming from family members, the staff themselves, visitors, you know volunteers, there's another group we need to talk about, and that always does not get highlighted, so there are both sides." }, { "speaker": "Tracy Parish", "startTime": "640.76", "endTime": "676.05", "body": "And of course this was a time when not only families couldn't go in there but visitors and other things, it was very much relying on the staff. Yes. Later on, I want to talk about loss. But nothing could have been more confronting than that time where the staff on the front line in these residential aged care were seeing loss after loss after loss. Did we lose a generation of carers, of people in that field? Or did you find that didn't, that the workforce stayed pretty, pretty, I don't want to use the word strong, but you know, they stayed in it." }, { "speaker": "Helen Rawson", "startTime": "676.05", "endTime": "705.37", "body": "And look, from my experience, no, we did not lose a lot. Because we need to think about why are people working with older people in the aged care space, in residential aged care space? I know from my personal experience with staff, but also from my research, they want to do that work. They really want to support and care. And so that's a focus. So no, they are there. There are some people who've left, a lot of that staff from my experience, they're there, they're working and wanting to do that work well." }, { "speaker": "Helen Rawson", "startTime": "705.37", "endTime": "739.73004", "body": "And I think that was probably upsetting for me to see when I went back to work from the staff perspective, and we used to talk about this in the staff room, just don't look at the media, which is difficult because they were seeing a lot of negative stories coming out and but they're thinking but we're here, we wanted to work. People were working long, really long shifts and if, but what I saw from my experience, team bonds were there, a lot of them were stronger because they realised that they needed to, you know, work together to support each other because it was such a difficult time. Mhmm." }, { "speaker": "Tracy Parish", "startTime": "739.73004", "endTime": "745.77496", "body": "It's something we really have to recognise because so many people owe those staff so much." }, { "speaker": "Taya Collyer", "startTime": "745.77496", "endTime": "754.015", "body": "Yes. And let's stay with the workforce. So, enlighten us, Helen. Who is working in a residential aged care home? What are the various roles?" }, { "speaker": "Helen Rawson", "startTime": "754.015", "endTime": "774.425", "body": "So, look, in Australia, some information from the Australian Institute of Health and Welfare, which this institute have a lot of data about health, a lot of things to do with health more broadly in Australia. From their work, they've got about 500, just under 550,000 workers working in the aged care space." }, { "speaker": "Taya Collyer", "startTime": "774.425", "endTime": "775.385", "body": "Wow, in Australia." }, { "speaker": "Helen Rawson", "startTime": "775.385", "endTime": "776.10504", "body": "In Australia." }, { "speaker": "Taya Collyer", "startTime": "776.10504", "endTime": "777.065", "body": "More than half a million workers." }, { "speaker": "Helen Rawson", "startTime": "777.065", "endTime": "791.94", "body": "Yes, 75 percent of them are what we call direct care workers. So they are the workers that are involved in providing that direct care. So it would be nurses, care workers, allied health professionals such as physiotherapists, occupational therapists, etcetera." }, { "speaker": "Taya Collyer", "startTime": "791.94", "endTime": "799.54", "body": "Yeah, swallowing is a big deal, right? Yes, I'm pretty ignorant, but I have seen Maggie Beers show on the ABC, there's a lot of swallowing." }, { "speaker": "Helen Rawson", "startTime": "800.98", "endTime": "805.195", "body": "Yes, because if you think if you have problems swallowing that will impact your ability to eat and take in nutrition." }, { "speaker": "Taya Collyer", "startTime": "805.195", "endTime": "805.67505", "body": "Yeah, okay." }, { "speaker": "Helen Rawson", "startTime": "805.67505", "endTime": "821.91003", "body": "Of course other people work in residential aged care homes. You've got people in reception, and all of these are very important roles. People in catering, they may be in maintenance, they may be office workers, and also people working in lifestyle and all those sort of supportive roles." }, { "speaker": "Tracy Parish", "startTime": "821.91003", "endTime": "823.19", "body": "And those in social activity." }, { "speaker": "Helen Rawson", "startTime": "823.19", "endTime": "824.47003", "body": "That's what we call lifestyle yes." }, { "speaker": "Tracy Parish", "startTime": "824.47003", "endTime": "837.915", "body": "Yeah. They're amazing. Yes. Because they may ... they take it from being absolutely boring to being able to create something and getting to know the residents and obviously create just some joy, really." }, { "speaker": "Helen Rawson", "startTime": "837.915", "endTime": "839.275", "body": "Yes. Absolutely." }, { "speaker": "Taya Collyer", "startTime": "839.755", "endTime": "861.445", "body": "It might look boring to you, Tracy. I've got two kids under four, and I tell you what, sitting in a chair all day or doing nothing all day, having someone attend to my needs, that sounds like the best thing that could possibly happen to me. But you did just mention that the importance of knowing them, of knowing the resident. And, Helen, in our discussions, that's something you've repeatedly come back to. Can you talk to us about why that's so important?" }, { "speaker": "Helen Rawson", "startTime": "862.565", "endTime": "870.79004", "body": "Well, it's so important because, obviously, it's the residents and the research we've done. This is what they wanted to be ... people wanted to be referred to living in residential aged care homes as residents." }, { "speaker": "Taya Collyer", "startTime": "870.79004", "endTime": "872.55", "body": "So you asked them, what should we call you?" }, { "speaker": "Helen Rawson", "startTime": "872.55", "endTime": "878.47003", "body": "Yes. Because people said, are you a consumer? Terms sort of older person, older adult, lots of different words." }, { "speaker": "Taya Collyer", "startTime": "878.47003", "endTime": "879.27", "body": "Think they loved that." }, { "speaker": "Helen Rawson", "startTime": "879.27", "endTime": "881.19", "body": "And they did not like consumer, of course." }, { "speaker": "Tracy Parish", "startTime": "882.07", "endTime": "883.03", "body": "I bet they didn't like consumer." }, { "speaker": "Helen Rawson", "startTime": "883.03", "endTime": "914.07996", "body": "And they said, we are residents and this is our home. So when you think of although it's obviously communal living, it's a community in there and there are a number of different people in there. And as a direct care worker, I'll look at that space. As a direct care worker you know the person that's in front of you. If you think in a hospital, if somebody is cognitively able to tell you what's going on with them, that's great, but in a residential aged care setting, they are living there, so they're not going to be discharged somewhere else." }, { "speaker": "Helen Rawson", "startTime": "914.405", "endTime": "989.77", "body": "This is their home, they're living there long term. Also, they may have cognitive deficits. So they may not be able to tell you, actually my favourite football team I followed all my life, my father followed it and that person before, was St Kilda football club. And just having, just knowing that little bit of information about someone can be so important. Let's say it was the football and they like watching the football, ensuring that if there are matches they can see it. If it's the grand final and that team is playing, making a big deal about it. If somebody really enjoys knitting, for example, in their world or they enjoy dancing or singing, you can tailor those great activities that they like to do, what is uniquely them into their care. And people with dementia, various stages of dementia who are in residential aged care, one of the things they often remember is the past. Like a long way back. So you'll see musicals from the 40s and 50s playing a lot, and they're all singing along. They love all the war songs, you know, from World War two is something that you noticed. That's something that younger people coming in as workforce need to sort of understand because they might even know what those songs are. Or the significance of them." }, { "speaker": "Helen Rawson", "startTime": "989.77", "endTime": "1031.5349", "body": "Yep. And that's why it is so important to get to know the resident from their perspective and if they're not able to tell you that's why it's important to work with their family or significant other. It's just simple things like food, know, do they like sugar in their tea, do they like having banana custard for example. We know the things that they like so that you can tailor to their needs. Absolutely. So you're not sitting there thinking, oh well we've given them tea and they're not drinking it. Well that's because, well, they don't like tea, they actually like coffee, or they like tea with sugar or with that, you know, those sort of nuances. And that also, whilst it might be like just having tea, that also has an impact on their nutrition, their hydration." }, { "speaker": "Taya Collyer", "startTime": "1032.8949", "endTime": "1038.975", "body": "Hydration is key. I mean, my research is mostly about acute care settings in the hospital, but hydration is (important) Yeah." }, { "speaker": "Tracy Parish", "startTime": "1040.49", "endTime": "1051.61", "body": "Okay. And of course, when we look at the staff that are there, they come from all different backgrounds. Is that something they're taught? Is that something in their training about thinking about the resident?" }, { "speaker": "Helen Rawson", "startTime": "1051.77", "endTime": "1069.8", "body": "So I can speak from a registered nurse perspective obviously we have that training as a registered nurse for critical thinking decision making etc. And the role of the registered nurse in residential aged care homes, as I said before in the statistics it's about 17 percent of them, they have that critical leadership role." }, { "speaker": "Taya Collyer", "startTime": "1070.28", "endTime": "1081.8", "body": "Can you say more about that? Because I've just realised, I've heard, I've seen headlines about nurse ratios, but I actually have no idea. Why is it so important that we have registered nurses in residential aged care?" }, { "speaker": "Helen Rawson", "startTime": "1081.8", "endTime": "1155.2699", "body": "Because of that real critical thinking and decision making that nurses are trained for. So we know that International Nurses Day on May 12 the theme for 2026 (was), Our Nurses, Our Future Empowered, Nurses Save Lives. And that really highlights the critical role that nurses have in the care of communities, wherever that may be, because of the training that they undertake, because of the experiences that they have, because of their ability to lead teams, because of their ability to, the nurses are that first line of you know identifying there may be a problem, escalating problems. More so in a residential aged care setting because they're the ones coordinating that care because obviously we don't have doctors on-site, we might not have a dietitian on-site etc. So it's the nurse really leading those teams I've never seen the stats I told you about the care worker numbers. They're the majority of that direct care workers who don't have that training. It's about the nurse, registered nurse being able to ensure that the team is doing what is needed to support the care and wellbeing of residents." }, { "speaker": "Tracy Parish", "startTime": "1155.27", "endTime": "1157.43", "body": "And to not make it feel like a hospital." }, { "speaker": "Helen Rawson", "startTime": "1157.43", "endTime": "1170.885", "body": "Well, absolutely because it's not a hospital. No. So it's absolutely not a hospital. So that's why all these different roles are so important, including you talked about those people who do the lifestyle activities, some people call them diversional therapists, etc." }, { "speaker": "Taya Collyer", "startTime": "1170.885", "endTime": "1201.795", "body": "Can we loop back? You mentioned earlier the importance of perhaps working with a resident's family to understand them. I wonder, I know people are out there listening, and what they want are Helen's top tips for families who might be assisting someone to enter a residential aged care home, either during a crisis of some kind or not. What do you see families really do well? What are the things that they perhaps don't realise they could do?" }, { "speaker": "Helen Rawson", "startTime": "1201.795", "endTime": "1258.145", "body": "So from my experience with families, they feel- sometimes they feel as if they have to hand over, you're handing over the care of your loved one if it's a parent or whoever it is to this other group, but it's really not understanding that they can work with them in that care, which is so important. So I think and it's important for families to understand the staff welcome that, welcome you telling us you know, what are the likes and dislikes of the person. Again I'm going to say working with the person as well if they're older person, and how can we support their care needs. And we welcome families asking questions, telling us what they will like, but equally from a staff perspective, it's also educating families about if your loved one has a diagnosis of dementia, this disease goes through a trajectory, and what could be coming up. So really understanding that is important." }, { "speaker": "Tracy Parish", "startTime": "1258.41", "endTime": "1271.77", "body": "Sometimes you've talked about how that trajectory of decline surprises families. How people go into a home and may decline, and they think, well, they were doing okay at home. How do you deal with that?" }, { "speaker": "Helen Rawson", "startTime": "1273.205", "endTime": "1313.5349", "body": "Oh, that's and I think it's understanding. We know that's, we know that's normalised thinking. They're not critical of the place because they may see that when my mother was living with me and I was looking after them, she was doing this. She was walking around, etcetera. Since she's been in here, I've seen that she's changed, she's not walking around as much. And that could be a number of reasons and one of them likely is the disease trajectory is changing. So it's really about talking to families about this is what the care is and working with them to show them how that care works from day to day, and also alerting them to how the trajectory of the disease could change, and when those changes are happening, communicating those with families." }, { "speaker": "Taya Collyer", "startTime": "1313.5349", "endTime": "1319.8099", "body": "Right, so preparing them for what might be down the track, but then also involving them that." }, { "speaker": "Helen Rawson", "startTime": "1319.8099", "endTime": "1320.21", "body": "Absolutely." }, { "speaker": "Taya Collyer", "startTime": "1321.4099", "endTime": "1323.57", "body": "Wow, that's really crucial work." }, { "speaker": "Helen Rawson", "startTime": "1323.57", "endTime": "1333.0751", "body": "Yes, absolutely. And so how care should be, even if you're in a hospital, you know, it's people are, people sometimes call older people, you know, they're vulnerable." }, { "speaker": "Taya Collyer", "startTime": "1333.0751", "endTime": "1335.555", "body": "Yes, we do that in research all the time, full disclosure." }, { "speaker": "Helen Rawson", "startTime": "1335.555", "endTime": "1354.3301", "body": "Yes, and I don't like that term. I think systems and conditions make them vulnerable. And I think it's for us to ensure that we reduce that vulnerability by you know being open speaking with them, speaking with their families, understanding them, knowing them, which is so important." }, { "speaker": "Tracy Parish", "startTime": "1354.745", "endTime": "1361.545", "body": "And it's very confronting to be put in that vulnerable category because you're talking about that you don't like. The age category as well." }, { "speaker": "Helen Rawson", "startTime": "1361.545", "endTime": "1361.785", "body": "Yes." }, { "speaker": "Tracy Parish", "startTime": "1361.785", "endTime": "1381.34", "body": "I was just reading the other day, which shocked me. At 65, you can now access government funding to a certain level or be assessed to go into a residential aged care or some other care package. And of course, for some of us, not disclosing, but I'm not there yet. But I just went, wow. It's not that far over the hill." }, { "speaker": "Tracy Parish", "startTime": "1381.34", "endTime": "1383.5", "body": "Mhmm. That is really confronting. Yeah." }, { "speaker": "Helen Rawson", "startTime": "1384.62", "endTime": "1413.38", "body": "And it is for some people but if you think about it, of course, in the, in sort of high income countries, WHO standards, an older person is defined as, they use broadly terms 60 and older because in some low and middle income countries, that 60 is the age reflecting differences in life expectancy. In Australia for example and other similar countries, it's 65 and over. But when you think about that over, it could be 40, 50 years." }, { "speaker": "Taya Collyer", "startTime": "1413.38", "endTime": "1414.26", "body": "That's a long time." }, { "speaker": "Tracy Parish", "startTime": "1414.26", "endTime": "1428.385", "body": "Yes. Let's touch on cultural differences. Which ties into that a bit because all cultures. look, think about older people in different ways, don't they? Including your own. Yes. You've talked about that, and that was a motivation. Tell us about that." }, { "speaker": "Helen Rawson", "startTime": "1428.63", "endTime": "1459.5099", "body": "So look, in my cultural background, my family are from the Caribbean, the West Indies, and they migrated to England, and I was born in England. But I do have that cultural context. And for me older people, they're revered. They are the custodians of the past, the histories, they're respected. And this is a driver for me with working with older people and aged care because I wanted to be, it's just a respect that you know, I feel that they are owed." }, { "speaker": "Helen Rawson", "startTime": "1459.51", "endTime": "1507.605", "body": "And for some cultures that's what they think. And you find that may come out in some of the workers as well. Sometimes they may refer to someone as aunt or uncle and I always try to say to them, now, talk to them about how they would like to be referred, but using those terminologies is because of respect, and I think that's so important, and particularly in the Australian context, we are a very multicultural society. It's about just over a third of people 65 years and older, so in that older person's bracket, they are from a different culture and language back, they're born in another country, and a number of those are from a different culture and language background. And an interesting thing that happens sometimes when people get older, and particularly with dementia, even though they may have had fluency with the English language, but dementia, they don't have that anymore." }, { "speaker": "Helen Rawson", "startTime": "1508.1", "endTime": "1542.73", "body": "Some research that I was doing, I was in a residential aged care home and there was a man from Croatia, if I remember that correctly, and he used to come in and visit his father every day at lunchtime, and I asked him about that, it was part of the work that we were doing. He said, I just wanted to make sure that my dad had somebody to talk to every day. And he said, I just don't understand it, you know, when he moved to this country, he did really well, and he used to speak English really well, and now he just doesn't seem to know the words anymore. It's about working with his staff and he said that he shared common words with his staff and they've got it written down and all that sort of thing." }, { "speaker": "Tracy Parish", "startTime": "1542.73", "endTime": "1583.1849", "body": "That's so important to understand the cultural context. Also culturally different, there's a great study that was also done by NCHA and it was about older people having to go into respite care and they found Italian, they worked with Italians, Greeks and I think there was Chinese-based backgrounds. But particularly the cases of people from Italian and Greek background stick with me, and they just would not allow their parent to go into respite care. And if they did, they wanted to be there with them 24-7 , which of course wasn't respite for the carer, but they just said it's just not culturally right for them." }, { "speaker": "Helen Rawson", "startTime": "1583.1849", "endTime": "1628.47", "body": "That's right. And from my cultural background as well, it's not, it's not the norm that you would put someone into residential aged care but my mum was in residential aged care before she recently died and we know that it was the best place for her to be. She was at a stage, she had dementia that then accelerated and she needed to be there for safety, for wellbeing and she actually was amazing in there, the staff were as well. But sometimes you need to, and that's an important point when you're trying to work with families, you have to sometimes get behind, you know that guilt they may feel about putting someone residential aged care, but also from a cultural perspective, it's not what we do. And is it that, but we know that cultures are changing and people are changing as well." }, { "speaker": "Taya Collyer", "startTime": "1628.47", "endTime": "1648.8699", "body": "Right, and so the decision to move into residential aged care, that's tied up with very with really serious ideas about our identity, about what's appropriate, about who we are as a family. That's complexity on complexity. Heavy stuff." }, { "speaker": "Helen Rawson", "startTime": "1648.87", "endTime": "1649.3499", "body": "Mhmm." }, { "speaker": "Tracy Parish", "startTime": "1649.5099", "endTime": "1660.095", "body": "And does that also reflect how we recruit people now for the for that sector? Do we need to look at having people from broader cultural backgrounds?" }, { "speaker": "Helen Rawson", "startTime": "1660.095", "endTime": "1687.58", "body": "I think we need to have people from all backgrounds. Culture, language, depending on the place it could be religious groups as well but also all the diversities that we've got around that we live with so well. We need to ensure that we've got those people in providing care because these will be the people who are also receiving care. And being able to be supported by someone, whatever context that may be, is very powerful." }, { "speaker": "Tracy Parish", "startTime": "1688.915", "endTime": "1741.39", "body": "I mean you started this journey way back at 16, which I think we do want to hear about. But how do you attract somebody? You know, if you're speaking to someone, how do you talk to a 16 or 17-year-old and say, have a think about it on a Saturday afternoon job? Yes. Well, that's how I started. You know, in England, it was my Saturday job and a lot of my friends were working in the high street shops. And I got a job, a friend of mine was working in a residential aged care home. It was called a nursing home then. And she had a job and I didn't understand that she was working in what's called the domestic side where she was doing cleaning of the place. So I just, she said, oh just write, I'm sure you'll get a job. So I wrote to the head nurse as it was then, and was called matron at the time. And yes, as a 16-year-old that was my job working with older people. So I was in high school and I loved it because it taught me so much." }, { "speaker": "Helen Rawson", "startTime": "1741.815", "endTime": "1776.7649", "body": "It taught me teamwork. It taught me how to talk to an older person that was not a family member. It taught me respect. It taught me so much and then obviously when I went to do my nursing degree I still continued working there in my holidays. And for me I just, and when I see that I always think about we should be doing more and we should be doing better to care for older people for a number of reasons, but also we're all getting older and I want to make sure that the care that's being provided if I ever need it when I'm at that stage is absolutely appropriate and phenomenal." }, { "speaker": "Tracy Parish", "startTime": "1777.245", "endTime": "1785.0", "body": "Think how the young people could really help with things like the iPads and the tech in there. Oh definitely. Showing older people like what is your password again?" }, { "speaker": "Helen Rawson", "startTime": "1787.64", "endTime": "1842.98", "body": "Yes, where I'm on the board and a number of aged care providers have this, they have engagement with schools high schools with students coming into residential aged care homes and another home that I did some research with and the nurse in charge was very innovative in things that she did. She understood the importance of let's you know knowing the resident and it was Year 10 students, they had a history project. She thought right, what we can get the Year 10 students to do is to map out what's the history of the older person. We will get the information about that person to support our care and then the students had to use that history and I think for their project align it to what was going on in a global or an Australian context at that stage. And the residents for the research that the residents, they loved it when the students used to come in every Wednesday afternoon and it was two students worked with an older person and they loved coming in and sitting and talking to them." }, { "speaker": "Helen Rawson", "startTime": "1842.98", "endTime": "1855.9401", "body": "Some places have kindergartens programs. I know where I'm on the board we have a you know, some people have mother and baby programs. So it's a number of things. That intergenerational connection is so important for both sides." }, { "speaker": "Tracy Parish", "startTime": "1856.875", "endTime": "1876.1799", "body": "Earlier I said we would talk about loss because I don't think you can think about residential aged care without at least acknowledging that. As a 16- or 17-year-old , obviously that was something you had to to deal with and you still deal with. How much does that impact a staff member?" }, { "speaker": "Helen Rawson", "startTime": "1876.2599", "endTime": "1938.32", "body": "Oh, that's a really great question and it does have an impact on staff because unlike being in a hospital where a patient comes in and depending on whether they may be there for three, four, five days they go home. In Residential Aged Care it's the people's home and they live there. And most people who leave, the resident, most permanent residents who leave Residential Aged Care, they do so through death. If you think about the staff, the staff have got a very intimate relationship with these residents and their families who was coming in to visit them and over a period of time as well. So you get to know them, you connect with them, you connect with their families and then they die. And if you think, because of the work, it could be I could have been on two days off, and when I've come back that person's gone. Not only are they gone but that connection with the family. So that's a real, real thing and staff do feel grief. And I'm a senior researcher at the moment and some research where we're looking at staff grief." }, { "speaker": "Tracy Parish", "startTime": "1938.3201", "endTime": "1939.76", "body": "Is it through Monash University?" }, { "speaker": "Helen Rawson", "startTime": "1939.76", "endTime": "1968.03", "body": "It is at Monash University. Staff grief in residential aged care homes. And this piece of work, we wanted to co-design something with the different levels of staff. And we also worked with managers as well to talk about this because organisations need to support their staff. And the staff talked about of course a lot of organisations have their employee assistance program if you want to talk to someone. But what our staff said was we want to talk to somebody who understand what we're going through." }, { "speaker": "Taya Collyer", "startTime": "1968.03", "endTime": "1971.15", "body": "Yeah, is beyond a generic like I'm having a tough day." }, { "speaker": "Helen Rawson", "startTime": "1971.15", "endTime": "1995.62", "body": "Absolutely. And because you know, you and I may know that resident together, so that person's gone and it's okay for us to discuss it. So that's some work we're doing because really recognising that staff do feel that loss and they need to be supportive. If you're thinking about staff wellbeing and you know the staff are very critical in residential aged care homes. We want to look after them and that's a part of that." }, { "speaker": "Helen Rawson", "startTime": "1995.62", "endTime": "2008.895", "body": "And most so well the managers if you think of the, you know that pivotal role that registered nurses have, they're supporting their staff and what they talked about who's supporting us. So that's so important because staff do grieve." }, { "speaker": "Tracy Parish", "startTime": "2008.895", "endTime": "2012.655", "body": "That loss when a resident goes, is there no training at the moment?" }, { "speaker": "Helen Rawson", "startTime": "2013.99", "endTime": "2050.51", "body": "Would be individual, whatever organisations do. So the work that we're doing, that's what we're actually wanting, we're working with staff to develop. And we've actually pilot tested it and doing a bit more work. It's for a program that each organisation themselves can use to adapt and facilitate themselves because sometimes it's difficult to bring someone in, some places may bring a counselor in, but they don't do that all the time. But part of that training is also talking to people about loss and grief because just because you know that the person people you're working with will be dying at some point, it doesn't make it any easier." }, { "speaker": "Taya Collyer", "startTime": "2050.91", "endTime": "2061.795", "body": "You've mentioned volunteers quite a number of times, Helen, and I think it might be nice to to finish up our discussion with that group. And spoiler alert, Taya has a music background." }, { "speaker": "Tracy Parish", "startTime": "2062.195", "endTime": "2064.035", "body": "I've never seen it." }, { "speaker": "Taya Collyer", "startTime": "2064.035", "endTime": "2074.98", "body": "And when I was doing my undergraduate, we would often, we'd be performing all over the place. And I've often wondered as an adult, like, could I roll in and, you know, should I be trying to help out?" }, { "speaker": "Tracy Parish", "startTime": "2075.46", "endTime": "2076.34", "body": "With your guitar." }, { "speaker": "Taya Collyer", "startTime": "2076.34", "endTime": "2094.995", "body": "Would it be interesting? And I think a lot of people my age in our in the midlife are often wondering to ourselves, like, could I improve? Could I help? How could I help? So can you tell us what are volunteers doing, and and is it encouraged or discouraged for randos such as myself to reach out?" }, { "speaker": "Helen Rawson", "startTime": "2095.4749", "endTime": "2096.9949", "body": "In a word, please reach out." }, { "speaker": "Helen Rawson", "startTime": "2098.355", "endTime": "2140.35", "body": "Volunteers are critical and pivotal in this sector with older people, in particular in residential aged care homes. A real reliance of volunteers and what we've experienced that, a reduction in volunteers post- COVID when you're streamlining who allowed in and out, etcetera. But volunteers do a wealth of work and in a number of places they have music programs, so please if that music is with your voice or an instrument, if you go into a residential aged care home and just say I'm interested in volunteering, these are the skills that I have. Of course, there are all the checks that need to be put in place even for volunteers, but they welcome that." }, { "speaker": "Helen Rawson", "startTime": "2140.43", "endTime": "2142.19", "body": "So what are volunteers doing?" }, { "speaker": "Helen Rawson", "startTime": "2142.27", "endTime": "2162.7002", "body": "Volunteers, they may be doing, they may be reading with someone, not everyone can have a visitor. Yes. Not everyone may have a family member to see them. Right. So they may be going in and you know, I'm assigned to see Sarah Jane or Sarah Jones for example, so I'll be the visitor for this person I'll and come in and maybe see them once a week or twice a week." }, { "speaker": "Helen Rawson", "startTime": "2162.78", "endTime": "2192.1702", "body": "They may be doing exercise, sometimes people have little exercise classes, and for some people you can still do exercise even if you're just sitting in your chair and not physically mobile to move around. There's music activities, there's gardening activities for people, there are volunteers who may drive the if the organization have a bus to take people to places. There may be volunteers who help with meals. There's a number of things that people can do. Volunteers who help with organising the volunteer group." }, { "speaker": "Helen Rawson", "startTime": "2193.4502", "endTime": "2208.145", "body": "You know so there's a number of things. A lot of places have cafes, volunteers. There's a number of roles for volunteers. So I would encourage you, anyone else, if you feel you could spare an hour or two a week, whatever it is, please contact a residential aged care home." }, { "speaker": "Taya Collyer", "startTime": "2208.145", "endTime": "2213.025", "body": "Yes. Listeners, if you can read a book, if you can read a book, you're in." }, { "speaker": "Helen Rawson", "startTime": "2213.265", "endTime": "2222.45", "body": "Well, it's even more than reading a book. If you can talk to someone. Uh-huh. And particularly we've talked about the culture and language diversity. You, you know, I speak French, for example." }, { "speaker": "Helen Rawson", "startTime": "2222.53", "endTime": "2226.05", "body": "I'm happy to talk with anybody else if you've got who speak French, you know, that sort of thing. It's very important." }, { "speaker": "Tracy Parish", "startTime": "2227.5698", "endTime": "2242.5552", "body": "And I think that's a perfect way to finish because I think all three of us are very good talkers, and we could and we could go on for some time. Yeah. It's just amazing to actually work with you today on just extracting those wonderful memories, but also those terrific tips for families." }, { "speaker": "Tracy Parish", "startTime": "2242.5552", "endTime": "2250.61", "body": "And we're really so thrilled to have you as part of our podcast, Professor Helen Rawson. Taya, to you as always. Thank you." }, { "speaker": "Helen Rawson", "startTime": "2250.61", "endTime": "2253.33", "body": "Thanks, Tracy. And thanks for having me. Appreciate that." }, { "speaker": "Tracy Parish", "startTime": "2253.33", "endTime": "2263.5251", "body": "Thank you. Well, today, we highlighted an issue that many of us could face as we age. What happens when living at home is no longer possible? Well, we hope it helped. Thanks for listening." }, { "speaker": "Tracy Parish", "startTime": "2263.5251", "endTime": "2285.32", "body": "This podcast from the National Centre for Healthy Ageing is proudly driving innovation and transforming health and care through research so we can all lead healthier lives as we age, especially those most vulnerable. There's that word. Want to know more? Check out our website at ncha.org.au. If you like this episode, please tell your friends, your family, your colleagues, obviously." }, { "speaker": "Tracy Parish", "startTime": "2285.4", "endTime": "2286.2798", "body": "Dog owners." }, { "speaker": "Taya Collyer", "startTime": "2287.0", "endTime": "2291.975", "body": "If you've got any musical friends there. Bandmates. If you're walking your dog, you're at the dog park." }, { "speaker": "Tracy Parish", "startTime": "2292.135", "endTime": "2310.07", "body": "Seriously, just share it everywhere. The more, the merrier. The more people we can reach, the greater impact the research can have in helping people age well. There's still so much more to talk about, so join us next time for more real stories, real evidence, real insights about healthy ageing. Tune in wherever you listen to your podcasts." }, { "speaker": "Tracy Parish", "startTime": "2315.75", "endTime": "2329.8252", "body": "This podcast was recorded on the land of the Boon Wurrung Bunurrung people of the Kulin nations. We pay our respects to elders past and present and extend that respect to any aboriginal and Torres Strait Islander people listening today." } ] }