Trish has over 30 years’ experience in successfully providing community care services. Starting with a nursing career, she established her own nursing employing agency Noakes Nursing Services, helped Wesley Mission grow its extensive community services, and in 2007 started “Just Better Care” offering the whole range of required home care services.

She began her talk emphasising that we must all share in the future care of our elderly. It will affect everybody either through having to care for an ageing relative or looking after ourselves. Our life expectancy is rising. If you are now in your 60’s you can expect to reach the 90s. Some people will live in residential care but the majority will expect to live at home.

There are many other situations arising in our community which need caring support. For example Trish cited the circumstances of an elderly mother who throughout her whole life has been caring for her two children both suffering from cerebral palsy. As the mother is now in her 70s she is finding it difficult to cope. Also, she is worried about what will happen to her children when she is no longer alive.

One most noticeable trend today is how we isolate elderly people from the rest of the community, leaving them in silo environments. Yet people aged 70 years + already represent about 10% of the total population. By 2050 it will equal 20%, more than 6 million people. Our healthcare and aged related expenditure will consume 40% of total government outlays. How will society pay for this?

The aim is for the elderly to: ‘live longer and live better’ by residing in their own homes, supported by home care services, which users need and can purchase. In The US, UK and Europe there has already been a direct move away from providers of services deciding what services are available to a Consumer Directed Care (CDC) approach.

To achieve this in Australia we will have to change our approach from giving services to allowing the elderly to decide what services they need, and then responding by providing the appropriate supportive services. This is what the elderly will want, and it is has a positive effect. Empowered users will be healthier, happier and hence more capable and independent, resulting in lower demand for services.

To achieve this will require major reforms, leaving behind a system of ratios and waiting lists, to providing more choice in services. The reality is when people are given choices the majority are moderate in their demands. Some service operators will be unable to provide the services needed.  A lot of unnecessary red tap exists which must be reduced to achieve progress. Finally, we must integrate our elderly into the mainstream of life.

A major community care initiative occurred in July this year with the launch of the National Disability Insurance Scheme starting in selected regions namely;  the Hunter in NSW, Geelong and Barwon in Victoria and South Australia (children) and Tasmania (teens). It received bi-partisan political support. 

Individualised plans are developed setting out goals and aspirations for disability services and products that will be funded by DisabilityCare Australia, and other supports a person requires. Currently the scheme is underfunded with $15 billion allocated but $25 billion is needed. More work is needed to develop and refine the details of support services required, availability of services and administration.

Trish concluded by challenging all of us now to discuss and review key community care issues recognising,  

• Inadequate Government funding for aged care.
• Shortage of beds, suitably trained staff and health care facilities to adequately meet rising demands.
• Implementing more necessary reforms.
• The need to integrate the elderly into our everyday communities.
• Querying what will be the elderly outlook for quality of life in the next 10-20 years.
• Asking how can we equip ourselves to effectively cope with these challenges?
• Assessing how we can possibly pay for services in a user pays environment and finally
• Evaluating how affordable are these consumer driven demands to us as a society and as a country.

Question and Answers Session 

Q1. Issues of the efficiency and red tape must be constraining? Yes, especially with government funding, charity communities, the annual accreditation process, equity entitlement issues. There is a lot of administrative work done of a repetitive and non-significant nature which you would think could be avoided without any adverse outcomes.

Q3. How do you plan for the future? Management and planning has to be closely linked to your staff working in the field. People on the ground are the eyes and ears about what is going on, the aids needed, the services provided and generate the information about what’s going on. Financial records are necessary, trends analysed and ideas generated about ways to affect improvements, etc.

Q4. In a suburban church how do you find the gaps of community needs? Talk amongst your community congregation and with your local council.

Q5.What other countries have a suitable role model for a holistic approach that Australia emulate?  UK, Holland (Housing) and other European countries