Wellness advice

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna Land.

00:00:22 Kate
Hello, I’m your host, Kate Holland. Thanks for listening to another episode of Age Old Problems, New Aged Care. Today we’re talking about social isolation. And many of us would have heard about the loneliness epidemic, which peaked during COVID times.

00:00:34 Kate
Despite our almost constant connection to devices, many of us feel disconnected in real life. And for older people, social isolation is almost commonplace. According to aged care research and industry innovation, around one in five older Australians are socially isolated. Reasons include the social, economic and health changes that commonly occur later in life. And these often result in a decline in the quality and quantity of social relationships. And the reality is that being socially isolated or disconnected from community can be really bad for a person’s health, even if that person doesn’t feel lonely.

00:01:05 Kate
Maria Chabrel is Group Manager, My Life and Social Connections at Helping Hand, and she’s joined me today to help pinpoint some of the risk factors and some of the available remedies for social isolation. Welcome Maria.

00:01:15 Maria
Thank you.

00:01:16 Kate
And also joining us is Tony Barrillo and he is a Commonwealth Home Support Programme client and he can talk to us about how social connections have benefited his life. Welcome Tony.

00:01:25 Tony
Thank you. Very glad to be here.

00:01:27 Kate
We’ll start with you Maria. Can you please explain your role at Helping Hand? What is it that you do?

00:01:31 Maria
So my role is to lead a team that are delivering services to older people and the combination of services that is social work. So we have social work within our profile, but we also have people working within social connections. So they deliver group programs and also one-on-one social connections as well.

00:01:49 Kate
Beautiful. How long have you been with the organisation?

00:01:51 Maria
I’ve been twice. First time around, four years. Second time around, this is 2 1/2 years now.

00:01:56 Kate
One in five Australians, that’s quite a lot of people feeling socially isolated, isn’t it? How does that impact them and what’s something that you observe about this?

00:02:03 Maria
So the most recent data, we’re looking at 30% of people over the age of 60 experiencing social isolation.
Part of the barrier as well is that people don’t recognise when they are experiencing social isolation. It tends to happen very, very slowly.

00:02:17 Maria
What can happen is that there is a loss. So they were experiencing loss in the family. It could be a partner, could be friends. The social network becomes a lot smaller. It happens very slowly. That’s a risk factor for them.

00:02:29 Maria
We’re also looking at the ease of connecting with community isn’t quite there. So they used to be able to drive, so perhaps they can’t drive anymore. So getting to a place that they would be able to connect now has become difficult. You now need to think every step before that happens. So sometimes that becomes too hard in amongst everything else that’s happening in someone’s life.

00:02:50 Maria
Health can decline. Getting up in the morning and preparing for an outing can take a little bit longer or it can take more time. So it’s easier for someone to say, I’m not going to do that today.

00:03:01 Maria
So that happens once a month, it can happen then once a fortnight, once a week, two or three times a week. And before you know it, someone’s experiencing that social isolation.

00:03:09 Kate
And I remember speaking earlier this year to someone who deals with hearing loss too, which would be one of those health things. They mentioned that if people delay improving their hearing, it can make them more nervous in social situations, they end up retreating. So there are lots of small steps that can make a really big impact, aren’t there? So what impact can social isolation have on an older person’s health and wellbeing?

00:03:28 Maria
So it can decline someone’s quality of life and that’s a big broad term to describe someone’s mental wellbeing and the feeling of connection. We experience positive hormones going through our bodies when we laugh, when we connect, that’s absent when we’re socially isolated. So we don’t have that natural fix that can support us in that as our social networks decrease, we’re also increasing our vulnerability. So there’s less eyes on us, there’s less support, there’s less understanding of what we’re experiencing and going through. So what happens is then we’re more open to scams, we’re more open to abuse and neglect from others because we don’t have that village that is supporting us that we would normally have if we had those broader social networks.

00:04:13 Kate
Yes, if you’re more constantly in conversation with people, then you’re checking in and sharing experiences, aren’t you?

00:04:18 Maria
And it also is a really good trigger for cognitive decline too. So if you’re having those regular conversations, someone can go, “oh, you’re becoming a little bit forgetful, have you gone and spoken to your doctor?” Things like that. There are those checks and balances that happen very naturally in our relationships that we take for granted that don’t happen or that needed to be manufactured in an environment where we’re noticing a social isolation.

00:04:38 Kate
Sure. And energetically, people generally feed off each other’s energy, don’t you? You have more activity, you might talk to someone like Tony and he’s doing some wonderful things and you get inspired and you want to do more. But the more you retreat to yourself, it can become more and more of almost habitual to not go out, can’t it?

00:04:53 Maria
Can be, but there’s also a really close relationship between the physical health and mental health. We can argue that one comes before the other, but there is such an interconnectedness. And a lot of the times when we’re feeling lonely, there’s been a lead up to when we recognise that we feel lonely. And before we recognise that, we look around and we’re alone, and generally we stop seeing our doctor as well and we stop seeing our dentist, and so all of that starts to decline before we even know it.

00:05:23 Kate
So who is eligible for Social Connections Programs through aged care providers such as Helping Hand? And if someone was interested in tapping into one of these programs, how do they go about getting started?

00:05:33 Maria
So we have funding – so providers have funding from the Commonwealth Home Support Programme and also from the Support at Home Program, so there is an ability to tap into that level of funding. So what people can do is either contact My Aged Care or they can contact us and we have a navigator service that can provide that walk alongside service to support people to connect with My Aged Care to get the relevant funding in order to connect with our programs.

00:05:58 Kate
Excellent. We’ll make sure that we have links for those websites and phone numbers, et cetera, in our show notes. So what’s Helping Hands’ approach to building social connections and what kind of programs do we offer?

00:06:08 Maria
So our programs are very much client driven, so we do have a base of programs that are tried and tested – we do know that clients enjoy a game of bingo, so we try and do that. But what we tend to do is we collect a lot of feedback from clients around what they would love to see happen in their programs and then challenge a little bit, considering that we’re sitting from a social isolation perspective: what did you like to do that you would love to do again? And so our most successful groups at the moment are the Lunch Out and About groups where “we used to go to this cafe all the time” – great, let’s create a group that we can do that once a week. And they’re our most successful groups at the moment. We started with one, we now have two and we’re about to create a third. So we allow our people to direct the development of the program and we evaluate the success of that program and asking clients what they would like to see happen. So that’s our approach from a program design perspective.

00:07:04 Kate
It seems like you love what you do. What is it that you love most about it?

00:07:08 Maria
I like to remain connected with outcomes that we’re trying to achieve. So I love hearing the stories around, we had a Christmas party last year and someone connected with a lifelong friend from school that they hadn’t seen in 60 years, and yep, job done! That’s exactly what we’re looking for, and that connection has thrived. We’re creating connections between people who are attending groups that now have friendships and they’re educating each other.

00:07:31 Maria
So there’s hobbies that are being shared amongst the group attendees that wouldn’t have happened if we didn’t have these groups. There are contacts now happening outside of the groups. There are phone calls happening on a regular basis that weren’t happening before. So it’s the beginning of that village network that we’re building slowly and the group just happens to be the catalyst for that.

00:07:53 Kate
That’s so great. And that sharing of hobbies, I mean, you read articles all the time about how all of us should try and learn a new skill each year, and so if that means people are sharing ideas and sharing hobbies, they’re going to keep on being stimulated all the time, aren’t they?

00:08:04 Maria
Absolutely.

00:08:04 Kate
Now, Tony, turning to you, what does feeling connected mean to you? How important is it for you to feel connected to other people?

00:08:11 Tony
Well, I look forward to those two hours when I go on Tuesday.

00:08:15 Kate
And what do you do when you go in on a Tuesday?

00:08:17 Tony
Sometimes we watch videos, we watch a documentary. Last week we watched the old story of the Ford and the Alden, which was very interesting because I worked at Alden for 28 years. And I look forward because since I’ve been there, I think it’s about two years now, I made so many friends. And we have a joke, we talk about this, about that.

00:08:40 Tony
We play balls, we play bingo, they always organize something. So we had a BBQ a couple of times already at the park. and the Christmas lunch last year, we already booked for this year. And I really look forward because all these people, more or less all on the same age bracket, and we talk about so many things. And I really look forward to go there every Tuesday for those two hours, because to me it’s something different, you know, getting out of the house and also meeting people and doing things for two hours.

00:09:13 Kate
What made you make the decision to find out about it? Were you starting to feel lonely or noticing you weren’t going out much?

00:09:19 Tony
Getting older, you never know what’s around the corner, you never know what happens. It did happen, so I fell from the step ladder and I broke my femur so I had to have a hip replacement. I’m still lucky that I can drive and it doesn’t really bother me but, I said down the road, if something happens and I can’t do the things that I’m doing now, so I would need help. So that’s why I registered.

00:09:41 Kate
And is this a men’s own group is it?

00:09:43 Tony
Yeah, men’s own group.

00:09:44 Kate
And do you meet people from all sorts of backgrounds? Have they all got different stories?

00:09:48 Tony
Yes. I met Rob, which he was a guitar player, and he played even Channel Ten ABC, and we talk about, the old days, and he comes from Crystal Brook, and he tells all the stories of when he was young. And I grew up in a farm, so I know all about that. I really enjoy it because I’ve met so many different people. Some they left, some they come back. Two or three they left, they’re not turning up anymore. But still, knowing them, it was good.

00:10:18 Kate
You can see how much you enjoy it. What would you say to somebody else who’s a bit unsure, a bit nervous about starting something like this?

00:10:24 Tony
It’s a way of going out and meeting other people. We have a good laugh every Tuesday, everybody gets into it.

00:10:31 Kate
What do you think the spin-off effects have been in your life? Do you think it has made you happier and more rewarded in general?

00:10:36 Tony
I always like to talk to people or meet people, we interact and we talk. We know each other in here and been the same people for nearly two years. You know, it’s like going to school, to a class and you make friends, it’s like the same thing.

00:10:51 Kate
Well, that’s beautiful. Now, before we wrap Maria, what’s the key? Any piece of advice that you’d like someone who’s listening to this episode to take away?

00:10:58 Tony
Get out. Get out and have fun.

00:11:00 Maria
There you go. Get out and have fun. Absolutely.

00:11:02 Maria
But for me, it’s don’t wait until it’s too late. We do match like-minded people to groups. We are currently in a significant development phase where we’ve had, and Tony, you’ve experienced this, where we’ve had the same groups over the last couple of years.

00:11:17 Maria
There’s going to be quite a significant injection of brand new groups coming in 2026. Some things with IT where we’re connecting people to devices so they can connect with families overseas. Looking at photos and connecting with family and friends, we provide that. They can bring their devices and we can actually show them how to use their own device rather than a device they’re unfamiliar with.

00:11:37 Maria
We’re looking at museum visits, we’re looking at things that people weren’t doing before and we’re matching people who express a particular interest and hobby, matching them with those groups so those conversations ignite really easily without having to be very hard work.

00:11:52 Maria
I guess my advice would be don’t wait until it’s too late, bring your friends along and it just supports our wellbeing.

00:11:59 Kate
And tell other people about it.

00:12:00 Maria
Absolutely.

00:12:02 Tony
Well, last year we did the calendar. Everybody brought photos in and they did a calendar for us with all the photos and then we went to visit the Adelaide Gyro, which was very, very interesting. And everybody came that day, even if it was raining, but we all went and we had fun.

00:12:20 Maria
And it was the calendars that actually created that outcome where two people were sitting next to each other and didn’t realise that they were school friends because they saw the photos.

00:12:30 Tony
Well, I met this friend of mine, which we went to school together.

00:12:35 Maria
Oh, was it you? Oh, there you go.

00:12:37 Tony
He’s two years younger than me. And then he went to Switzerland and I went to France. After, I would say nearly 20 years, we met each other here in Australia.

00:12:50 Kate
There you go, connections lead to connections, hey.

00:12:51 Tony
And we’re from the same village, same area, really. We’re only about three kilometres away from each other when we used to be young.

00:12:58 Kate
That’s wonderful. Oh, look, thank you so much. I think you’ve both presented very good argument for getting involved in all of this, and it’s been lovely to talk to you and in person.

00:13:05 Maria
Thank you.

00:13:06 Tony
It’s a pleasure.

00:09:17 Kate
For more information on Helping Hand and their services, please head to helpinghand.org.au or call Helping Hand directly on 1300 653 600.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:22 Kate
Hello, I’m your host Kate Holland. In this episode we’re going to learn more about allied health, and in particular, occupational therapy or OT as lots of people seem to call it. It seems to be an area of health that’s quite unfamiliar to many as well, but not to this episode’s guest Amanda Bailey, because she is Occupational Therapy Manager in Home Care at Helping Hand. Thanks for joining me.

00:00:43 Amanda
Thank you for having me.

00:00:44 Kate
Now OT sits under allied health, so I’m just wondering can you start by describing what allied health actually is. And I think Helping Hand has its own allied health team doesn’t it, maybe you can describe some of the things that Helping Hand offers?

00:00:54 Amanda
Yes, Helping Hand has a broad allied health team, so we have exercise physiologists, physiotherapists, occupational therapists, social workers, podiatrists, there’s even dieticians and speech pathologists and I think that covers everybody. We have nursing as well, but they don’t usually fall under the branch of allied health, that’s a bit more medical. But still, all part of the package, and all part of the things that Helping Hand offers.

00:01:22 Kate
And they’re all sourced through Helping Hand as well aren’t they?

00:01:23 Amanda
Yes. So we have all of those disciplines working for Helping Hand in home care, and I know that we also work across the residential sites as well with those disciplines.

00:01:32 Kate
So people are getting to see people that are part of Helping Hand team which must be very reassuring as they come to their homes.

00:01:38 Amanda
Yes, it’s really nice that we can have people that are from Helping Hand, to understand policies and procedures bigger than Helping Hand as well, so up to the more government levels. And make sure that when we make, when we get a referral, that we know who the coordinator is of the person, we know that little bit more about them. And we might get to see them a few times, so it’s bit about relationship building as well. More than just, you just pop in pop out, and then you go on. You can see people for several years.

00:02:00 Amanda
We just had a client this week who requested a specific occupational therapist that they’ve seen for about six or seven years now, said that ‘no I don’t want another team member, I want to see that person again’; so it just shows that relationship building is really important.

00:02:18 Kate
So how do people know that allied health is there, and that there are certain services that might help them reach their personal goals? As I said, allied health is not necessarily a description people know quite closely, so do you inform them that there are these things out there and what might align to their particular goals?

00:02:33 Amanda
So it comes back to the admission team, and so then the Home Care Package Coordinators or the Client Engagement Officers, or there’s a few other roles, but the ones who service the Commonwealth Home Support Package clients. And so they will talk through what the client’s needs are, and then they might be able to say ‘oh yes that sounds like something that an OT can help with’ or ‘that might be more physio or speech pathology’, whichever discipline that it relates to. And then it also comes back to when the client has had that very first assessment from the government assessors, they might put in referrals to say ‘you need an occupational therapist’. So it’s quite broad, but we don’t see someone without a referral. So they need to kind of already know what we are before we see them, which can be a bit tricky.

00:03:20 Kate
Yeah I was going to say, in my mind, you might see a physio because you want to be able to walk your dog, or maybe a exercise physiologist might help you get better at watering the garden – but an OT, not everybody knows what that is. So maybe you could tell us how you became an OT and what an OT actually does.

00:03:34 Amanda
So I became an OT when I was looking to change from my nursing background. I was just wanting something that wasn’t quite the same shift work, still wanted to help people, and one day I woke up and thought ‘hmm, OT, I could do that, I’ve got a rough idea of what they do’, and then a few months later I was at uni studying my four year degree to become an OT! So it just sort of progressed quite quickly there, I didn’t have much time to change my mind I guess. I’ve always thought it was the best choice that I’ve made, I’m really happy that I’ve become an OT.

00:04:02 Kate
How long have you been doing that for now?

00:04:03 Amanda
So I’ve been with Helping Hand now for a bit over three years, and then maybe four or five years before that, and then including my nursing and I was also a carer in residential care beforehand – I’ve been in for around 20-odd years now, so seen all sorts of bits and pieces over the years. And all of those roles have really complemented each other, to be able to look at the bigger picture and get to know people.

00:04:24 Kate
So what are some of the reasons that people would typically seek out help from an OT?

00:04:27 Amanda
One thing that I always try to explain to people is the word occupation in occupational therapy is what occupies your time during the day. So it’s not a workplace thing, ’cause sometimes people will say to me ‘oh I’m retired I don’t need an occupational therapist’, or sometimes people will answer the phone during our visit and they’ll say ‘I’ve got the occupational health and safety girl here with me’. It’s like – no it’s not quite like that! It’s what occupies your time during the day – so everything from getting out of bed, getting dressed, walking the dog, making something to eat – anything that occupies your time. Hobbies, sewing, doing a puzzle, socialising with family, getting out and about – it really covers so much.

00:05:11 Kate
So you are assisting them to be able to live a meaningful life doing those things that they want to keep doing.

00:05:15 Amanda
Absolutely. So that’s why we really need to, when we meet somebody, work out what their needs are. So part of what an occupational therapist does is we look at the person, we look at the occupation that they want to do, and then we also need to look at the environment that they’re doing it in. So if you have become less mobile and you can’t walk up and down stairs as easily now, but you live in a home that has several steps – what can we do to help make that safer, so you can achieve living at home for as long as possible and still doing the things that you enjoy.

00:05:52 Amanda
Sometimes people say ‘I don’t want to grab rail that means I’m giving up’, it’s like – no, it’s something that’s helping keep you safe. And if this rail stops you having a fall, and possibly having a significant injury such as fracturing your hip, or anything else – or then sometimes you might be then fearful of having a fall, and start withdrawing from doing the things that you enjoy doing – that rail isn’t really taking away from your independence is actually probably increasing your independence. So sometimes just reframing, or helping people just really look at how they see some of these assistive technologies, is a big part of what we do.

00:06:25 Kate
I know it sounds like a small thing, but I’ll never forget in England, it was a very long time ago, I met a lady over there – and they package everything in England, like to the hilt, with plastic. And she could barely open anything, and even jars and things like that were really frustrating for her. Do you help with little things like that which sounds small but are actually pretty big?

00:06:40 Amanda
Yes. So like I said, we cover anything that occupies your day. So we’ve got small kitchen aids that can even be as simple as, you know, the little like ring pulls on a tin of tuna, or like dog food cans, things like that. It’s really hard to actually open those if you have something like arthritis, or anything that’s limiting the function in your hands. And so, we’ve got devices where people are able to open those cans again. And so we have people that’ll be like ‘oh I’m able to feed my dog still, or my cat still’. And yes they could have someone come in and help feed the cat, but it’s just nice to be able to not have to ask for someone to open that jar, or open that bottle for them. It just gives them the extra little bit of independence.

00:07:16 Kate
Absolutely, that’s important. So if someone’s coming to see you for the very first time, what are the sort of things you would run through with them as they get started?

00:07:25 Amanda
So we always just start with a bit of an initial assessment and it’s really just to get to know the person – what their home environment’s like, the sort of things that they do during the day, ’cause sometimes people will say ‘oh I don’t know what I need to tell me, what you can do for me’. It’s like, well, I need to know more about you so I can make those suggestions. And I always explain to people that anything I suggest is a recommendation – it’s not that you have to do it, it’s just these are some ideas based on my clinical judgement. But you’re the expert in yourself and your body, and you might have tried some of these things before, or I’m not going to tell you have to change everything in your life. I had several people tell me that before I came, they knew that OTs often tell people to remove rugs ’cause they’re tripping hazards, and so they went and hid all their rugs before I turned up. And I’m like ‘oh thank you for sharing that with me, but even if I recommended you remove them, it’s still your choice, you just need to understand there’s a risk in having rugs.’ And quite often if a rug is large and heavy and not sliding around when you step on it, the edges aren’t curling up, it’s not really an unsafe thing, it’s just something that you want in the house.

00:08:30 Kate
So I mentioned, none of us really want to admit that we’re not capable of things. Do you have to sometimes tease out of people their needs?

00:08:38 Amanda
Yes, so quite often during that first visit, it’s a bit of relationship building and rapport building as well so I’ll have some people who, when we first talked with them, ‘oh no no, I’m fine with that. I’m fine with that. No worries there.’ And then after you talk a little bit more, they’ll happen to just mention something and you’ll be like ‘oh, are you sure that that you’re alright with that?’ If there’s something I can help you with, and then maybe just explain some of the interventions we might put in place. For example, the little steps over the tracking of the door to get in and out the house. That might be a trip hazard. Your walker might have got caught on there, or just might have stumbled cause it was a bit dark and you didn’t see it. And so I can talk about maybe a little small ramp to go there could just make life a little bit easier and without that relationship building and having those conversations. People just be like, I don’t know. I’m fine with everything. You don’t need to be here, which is sometimes what people say as well.

00:09:32 Kate
Are there common questions that people seem to ask about accessing both OT but allied health in general?

00:09:39 Amanda
I don’t know if there’s really any common questions. It’s more just understanding what we do and sometimes just clarifying that like, ‘oh, my friend got told this a few years ago from an OT. Is that true?’ And it’s like, well, that might have suited them. But legislation’s changed now or that’s not really quite what an OT would do, or maybe that suited their individual situation, but it’s not what you need.

00:10:03 Kate
It needs to be personalised doesn’t it.

00:10:05 Amanda
That’s right, it’s very personalised. If it wasn’t a personalised thing, anyone could do this and just throw 3 or 4 pieces of common equipment at you and be like ‘OK, see you, bye.’ And that’s, you know, not everyone needs those pieces of equipment, so let’s, you know, step back and work out what you need to support you.

00:10:18 Kate
People want to know how this can be funded. Have you got some information about that for us?

00:10:23 Amanda
So allied health services can be funded through someone’s Home Care Package, or through the Commonwealth Home Support Programme. Just with the Commonwealth Home Support Programme. They will need to have the My Aged Care codes in place. And if they don’t have them, they can just ask for them. Usually there’s just a bit of a phone call to My Aged Care.

00:10:39 Kate
So if someone was listening to this today and they wanted to, you want them to know one piece of advice about accessing allied health services or understanding what OT is and how they might utilise it. What would that piece of information be?

00:10:52 Amanda
So if they already with Helping Hand, I’d recommend that they have a chat with their coordinator or whoever a contact person is a helping hand, or even just to call Helping Hand and say ‘I’m having these problems. Is there somebody that can help me?’ Because the people who work at Helping Hand will be able to say, ‘Oh yes, that sounds like it might be an occupational therapist or that might be a speech pathologist, or maybe that’s a physio’ and direct them to the right referrals rather than just being stuck at, ‘I don’t know where to ask’ because sometimes just knowing who to ask the questions to is the biggest barrier, because we all have questions in ourselves, but not everybody knows the answers to the questions we have, so just being able to ask that right person. So I think that would be my advice.

00:11:33 Kate
And we will make sure that we have links to phone numbers and websites and all of those bits and pieces in the show notes for this episode, and I really appreciate you coming on and sharing your expertise.

00:11:42 Amanda
Thank you so much for having me.

00:11:43 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au. You can also call their home care number 1300 444 663.

00:12:04 Kate
Please remember you understand your needs better than anyone. Take the time to contact one of our friendly team to find out how we can help.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:23 Kate
Hello I’m your host, Kate Holland. And I’m so glad you’re listening to this episode of Age Old Problems: New Aged Care, as it’s a really important one about advanced care planning. So this means planning for the future care of you or your loved one in line with personal wishes and desires. Not always an easy thing to bring up, this kind of planning is a very valuable thing to discuss with family. Joining me to discuss this topic is Zara Freeman, who’s a Palliative Care Nurse with Helping Hand, and it’s a subject that she’s very passionate about. Welcome Zara.

00:00:50 Zara
Thank you so much.

00:00:51 Kate
So firstly, for people that have no idea – and I myself knew what an advance care directive was, but didn’t know there was a umbrella term, advanced care planning – can you explain what that is?

00:01:00 Zara
So basically advanced care planning is just sharing about a person’s healthcare and how they would like to live their life. So how they’d like to live their life now, and into the future. So it’s about looking at if their health deteriorates, what type of care that they would like, where they would like to live, and what things are important to them. It’s a really important process and it’s also a fun and exciting process and gives people a lot of agency for their health.

00:01:30 Kate
So what’s your role in supporting residents and their families in this process of advanced care planning?

00:01:35 Zara
My role is that when a resident enters our residential care home, we like to get together with the family and the resident in the early stages of their admission and just to have a comfortable, friendly chat with them about what their care needs are and what they would like into the future. And this can either be the starting of discussions around completing advance care directive. Or for those residents that have a cognition deficit, we also complete another form which is called my life decisions, which is the same as an advance care directive, but it’s for residents that need supported decision making.

00:02:16 Kate
So what is an advance care directive? I don’t think everyone knows what that is.

00:02:19 Zara
Yeah, sure. So an advance care directive is a legal form. It’s actually for people over the age of 18. Anyone can have an advance care directive, so if you haven’t got one and you’re over the age of 18 would be really good for you to start one. And basically what it is, it just records your wishes and your values and also your present and future healthcare. So it’s what would you like now and what would you like into the future if something should happen to you.

00:02:47 Kate
Now I remember this coming up with my father in law and we thought we should have this discussion and everybody got very strange about it. But actually when we started the discussion, it was quite a healthy thing because as you say, particularly as you age – although life is unpredictable and, you know, I’m not quite aged care yet, but I do have one myself – it is about making decisions around what might happen if you can’t make decisions for yourself, if your health deteriorates significantly, that sort of thing, doesn’t it? And it can include things like if you were going to make funeral planning, the sort of elements that you might want to include in that.

00:03:18 Zara
Exactly, exactly the form is a fantastic form, it’s really easy to fill out. You can basically download it online through SA Health. But the important thing to acknowledge is that even though it is an easy form to fill out, it can be confronting for some people to talk about their life, thinking about their life and what things they would like in the future. And sometimes people may not be speaking about it to other family members as well. So you may think that, you know you want to speak to your dad about it or any loved one about it, but they might not want to talk to you about it. So it could also be that you have a chat about it with your friend as well. You don’t have to be the substitute decision maker to have these discussions. It can be an initial discussion with just a family or just a loved one and you could talk about it down the beach or at the park. It can just be a relaxed conversation. It doesn’t need to be scary or intense.

00:04:15 Kate
So you mentioned a substitute decision maker. What is that?

00:04:18 Zara
Yeah, so substitute decision maker is the person who we’re doing the advance care directive form, who they would like to be their decision maker. So it’s their legal decision maker. So in the event that the person that has the advance care directive, that they may become unwell, may not be able to make their own decisions, they can appoint the substitute decision maker to make decisions on their behalf. So either you can have one substitute decision maker, you could have two or three or four. But it’s really important to have someone that you trust and that you’re looking through their eyes and stepping into the shoes of the person the advance care directive is for, and that’s the most important thing – that you’re acknowledging their wishes and you’re following through and honouring that.

00:05:06 Kate
So you mentioned that the person you discuss a directive with doesn’t necessarily have to be the substitute decision maker, but would it make more sense if you did do it with them, because they’re gonna be the ones making those decisions on your behalf?

00:05:16 Zara
Exactly. So sometimes with the advance care directive, you might wanna have lots of different discussions with lots of different people, so maybe that you may start initial discussions with your friends and people that you love. And then when you have an idea about what you want, then you may make it more formalised and then start discussing with your substitute decision maker. I think the really interesting thing that I found in my job is that some family members think that they are definitely going to be the substitute decision makers because they’re the people that have been most involved in their mum and dad’s care, and sometimes they’re actually not, so that can be a really interesting family dynamic issue that we need to work through. But it’s an amazing, wonderful process, because not only do the substitute decision makers learn things about their mum and dad, that they’ve never ever known before, which is so beautiful, but it also gives them such an honest space that they can really value and work through what their mum or dad would want and just honour their wishes. And it’s a really beautiful thing to do and it’s quite humbling as well for the whole family.

00:06:26 Kate
So what are the sort of wishes that come into this? Obviously there’s things like if your health deteriorates. But as I mentioned with my own, it might be things like having music playing at your funeral. Is it that spectrum of things?

00:06:36 Zara
The form start off with ‘What are your values and your wishes’ so that can be anything like: I’d like to get my hair done every week, or I’d like to have makeup on, or make sure I wear high heels, or it can be anything that is important to that person. It could be that I want my dog with me all the time. So you’ve got all those beautiful soft things that make us to be human, so that’s the first thing. And through all those values and wishes what your main focus is that you’re looking at is quality of life and what makes up someone’s quality of life. So for me I could say if I was in a wheelchair I wouldn’t want any treatment. But you Kate may say, oh if I’m in a wheelchair, that’s fine. I can still continue my life. So it’s really, really important to look at what people’s quality of life is and what that means to them. So really delving in to that does take time, and it can take hours and hours to work out what people’s quality of life means to them, because we never think about these things.

00:07:36 Zara
From there – which is such an honour and a beautiful conversation to have – but then we then delve into, once the resident and once the person and the community starts feeling comfortable, then we can go into things that may be a little bit challenging, talking about what healthcare they would like. That could be things like if they were in a car accident, would they want to be in intensive care? Would they want resuscitation if they deteriorate, what type of healthcare they would like? So at Helping Hand what we do is we talk about how they are presenting when they arrive on admission. And we go through the whole journey of their life with us, which is such an honour all the way up until past their death, into the memorial service we have, so that when residents in our facility start the pathway of their new life with us, they understand exactly the healthcare they want, the healthcare they don’t want. And then of course, that gives them agency to understand the quality of life they want and then the quality of life and care we’re giving them.

00:08:42 Kate
You mentioned that you have to sometimes work with a family dynamic when the decision maker isn’t necessarily the person that they imagined it to be. Is this why a plan like this is so important? Because when you do reach a point here, for lack of a better word, the decision is there by the individual, and the family are not left maybe in conflict about that.

00:09:00 Zara
Yes, exactly. And it’s really, really important for the family to be all on the same page because you may have a brother or sister who may have never spoken for ten years, or have different ideas about what’s good for their mum or dad. It’s a wonderful time for the family to either be connected or share an understanding that they’re there for their mum and dad and it’s about their mum and dad. It’s not about them and that they are just valuing exactly what their mum or dad want and it gives them peace of mind. And of course it gives the resident or anyone out in the community peace of mind that people are gonna follow their wishes.

00:09:40 Kate
So this is a legal document, an advance care directive. Does this mean people have to then go and get it signed off by a lawyer?

00:09:45 Zara
So what we do here at Helping Hand, and what you can do out in the community as well, is all you need is a Justice of the Peace to sign. So we have our own Justice of the Peace here. And she will come in and sign it with the resident and the family, the substitute decision makers. And if you’re out in the community, you definitely just need to go to a Justice of the Peace and get that signed. I think the most important thing – because we do receive quite a few advance care directives that people have done out in the community – I think it’s really important that you write as much as you can in the advance care directive, even if you do extra pages.

00:10:22 Kate
It’s a downloadable document, isn’t it?

00:10:23 Zara
It’s a downloadable document, yes, and you just type in the browser advance care directive and it’ll come up. All you need to do is print it off. And I would always suggest go to somewhere beautiful that you love, like a park and just sit and relax, have a nice picnic, but just enjoy yourself and just get it started. Just start talking about it. You don’t need to do it all in one hit. I think people think it’s a form. It needs to be filled out. It’s a question and answer. It’s certainly not. It’s about your whole life and what’s important.

00:10:54 Kate
It’s about living the best life you can, right throughout your life.

00:10:58 Zara
Exactly. Living your best life. Living the life you want. Some things you’ll say. Yes, I OK. I will do that, or I won’t do that. But it really gives you that knowledge and that power to live how you wanna live, not how other people want you to live.

00:11:15 Kate
That’s beautiful. Now we often end the episode with, like, one piece of advice that you’d like people to take away with them. I think you’ve probably just given it. Don’t be scared of the process. Sure. And find a nice place to do it, would that be right?

00:11:24 Zara
Yeah, I would say don’t be afraid to do it. And you have to be over 18 years old. But I think if we all can just do it, get it done and then not only is it valuable that you have a document at the end, but you have created a beautiful relationship with a person you’ve done it with.

00:11:41 Kate
That’s great. Well, I think you would be a wonderful person to talk to about this stuff. So thank you so much for explaining that to us today.

00:11:45 Zara
No worries. Thanks a lot, Kate.

00:11:54 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.

00:12:10 Kate
Please remember – you understand your needs better than anyone. Take the time to contact one of our friendly team to find out how we can help.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:22 Kate
Hello and thank you for listening to Age Old Problems: New Aged Care. I’m your host, Kate Holland. In this episode, we’re discussing grief and bereavement. What they are, some of the ways that people can respond to loss, and how you can support yourself or a loved one through the process. No one should ever feel alone. There are places that you can go to for help and people that you can speak to and at Helping Hand one of those people is Paul Hodgson, the Coordinating Chaplain. He joins me to share his wisdom on the topic. Welcome, Paul.

00:00:48 Paul
Thank you, Kate.

00:00:49 Kate
So can you start by telling us about your role at Helping Hand?

00:00:51 Paul
So as you said I am the Helping Hand Coordinating Chaplain. What that role entails is offering and providing support for residents in our residential care homes with regards to their social and emotional wellbeing and to, where appropriate, offering specifically spiritual care and support. And what that looks like is offering the opportunity for residents to talk about whatever is going on for them in their world at that moment. Whether that’s something that’s troubling them, or worrying them or they’re experiencing anxiety, or it might be that they have had a fantastic weekend and want to talk about catching up with their family or some happy or joyous experience that they had.

00:01:38 Kate
So even though your title has the word ‘chaplain’, it’s important that people can get support from you that doesn’t have to be in the religious space.

00:01:46 Paul
Sometimes it is more spiritual, like the big questions of life and purpose and hope and that sort of thing. But no, that’s right. It’s around whatever the starting point for the person is, what’s right in front of you? What’s going on in your world? What are you reflecting on? What are your emotions right now? And sometimes simply to be heard, to have those emotions and feelings validated can make a huge difference to the sense of well being for that person.

00:02:12 Kate
So one of the conversations you must deal with a bit working in aged care is around grief and bereavement, and I believe these terms refer to two different things.

00:02:22 Paul
My understanding, or my own personal definition, would be the so that grief is the emotional, cognitive, and even physiological response to change. Even when change that we experience is positive, we still can have the grief response and incorporate those different aspects of who we are. Most often, we associate grief with the difficult and challenging emotions to do with loss and loss can come in so many different shapes and forms.

00:02:55 Paul
Bereavement is, in my understanding, probably in reference specifically to the sense of loss and grief and even the societal and cultural norms around the processes that we go through when someone close to us dies. So bereavement might be a, you know, a narrow, thin edge of a much bigger topic that grief is.

00:03:17 Kate
You mentioned physiological reactions. I found that quite interesting, looking into this idea of grief and bereavement. There are some quite common responses that people have when they’re grieving and they’re not all in the mind, are they?

00:03:29 Paul
Well, no, that’s right. And grief isn’t one emotion or one experience. So our brain will react and respond with different chemicals that give us physiological responses. So we literally feel it in our body, not just as an emotion or a feeling.

00:03:47 Kate
So when someone is starting to go through this process, I guess in conversations with them you might pick that they’re starting to feel some of these feelings or even experience it physically. I mean, I’ve read things even like almost gastrointestinal kind of responses can be there. Do you try and talk to them about the fact that these are quite normal? Because I think when you’re already grieving something, you can start to worry that you’re too sad or you’re grieving in the wrong way, which there is no wrong way is there.

00:04:14 Paul
There’s no right or wrong way to grieve, apart from perhaps the decision to not grieve or to try to push it away. Grief isn’t bad or negative. Grief isn’t something to be avoided. If we can grief it’s a necessary response for us. In fact, one of the quotes that I think it’s quite helpful for me: grief is the price you pay for love. So if you love anyone ever at any point, then it’s likely that you’ll experience grief. We all want to love. We all want to be loved. But when we lose someone that we love, in particular, grief is the price you pay for that love. And I would want to couch with the people that I talk with, who would have experienced loss and or change and are going through a grief process, is where appropriate to try to normalise it and to encourage people to understand and then embrace the process. We do experience emotions and feelings that are the ones that we would probably choose not to have, that are difficult and challenging emotions.

00:05:23 Paul
Not only is grief not a negative or a bad thing or something to be avoided, I would suggest that it’s actually a helpful and healthy thing that can lead us to a point where ultimately instead of those hard to have, or negative feelings that we don’t like – sadness, separation, you know, those sorts of things – that ultimately it can lead us to peace, to acceptance and ultimately even to hope.

00:05:47 Paul
Because grief is often linked to love, going through the grief process can help us to live on in the new normal – whatever normal means – so grief isn’t about just getting over the loss that we’ve had. It is about the adapting, adjusting and finding a new life beyond our loss that still incorporates the love for the person who is no longer with us, and I think it enhances our memory and honouring of them if we grieve well.

00:06:15 Kate
So do you have suggestions for things that might help people through that grieving process?

00:06:20 Paul
Don’t do it on your own. It’s important to recognise that sometimes there are needs to be on your own for personal processing, but not to hide away, and that can be a really difficult thing because sometimes people will have their ideas about how you should grieve. We’ve already acknowledged that grief is personal and unique to each individual who’s experienced it, not just the circumstances of it, but our experience and response to it. And so sometimes we need to find people who are going to be helpful for us that they will just listen. They won’t want to urge us to hurry or rush through it or just get over it or hasn’t it been long enough now or you should be further down the track than you are? Those sorts of thoughts or comments that others offer and sometimes in our self talk we will tell ourselves can we really unhelpful and unhealthy.

00:07:14 Kate
Paul what are some of the things that people can do to take care of themselves as they go through the grieving process?

00:07:19 Paul
It might sound really simple and basic, but it is really helpful and vital to focus on things like looking after yourself physically. Eating well, getting good sleep, not dropping off any exercise, even if that’s simply going for a 20 minute walk. You know, our physiology and our emotions are all interconnected, so to go for a walk and allow our unconsciousness to work on what it’s working on and dealing with our emotions is a really helpful thing and also not to deny yourself the opportunity to do things that you enjoy. Sometimes you always say, oh, you know, I’ve lost my loved one, I’m not allowed to be happy or to have positive and enjoyable experiences. In fact, it’s the reverse. We need to be filling our buckets at that time more than any other time. And so whether it’s gardening, or spending time with the pets, or going off and seeing a good movie, or things like that. It’s important to continue to intentionally build those positive experiences into our life to give us the emotional capacity to be resilient and deal with the aspects of grief that are hard.

00:08:21 Kate
So what services does Helping Hand have to support residents and clients with grief and bereavement?

00:08:27 Paul
Certainly the chaplains that we have across all of our metropolitan care homes and some of our country sites now too are available to support residents who are experiencing grief and loss and their families. But we also have social workers and other staff who will be able to be specifically involved to help and support. In my experience, what I’ve noticed is that our care staff, our lifestyle staff who get to know people and spend time with our residents on a day to day basis, they’re very aware when a resident has gone through some sort of grief or loss experience, and are genuinely and sincerely caring, compassionate and sympathetic. They mightn’t always have time to sit for a long period of time, but I think the community that is Helping Hand that surrounds our residents is caring and responsive to people in care in grief and loss, generally not just the people that you can call in who are sort of more the people you’d expect to be able to be offering their supports and services.

00:09:25 Paul
With our home care clients, there are grief and loss groups run by social workers where people who have experienced those things can come together in a safe space and be supported, to become a support group for each other and to receive the direction of input from professional people and social work.

00:10:13 Paul
And most if not all, of our care homes also offer support groups specifically for family members and loved ones of residents who might be living with dementia. And the journey of loved ones and family members of those who have dementia is a journey with grief. Those groups bring people together who can talk about their unique aspects. The grieving before the person has actually died. Their sense of ‘I’m grieving, but others don’t get it. They’re going: well, your mum’s still alive, why are you grieving? Why are you sad?’ But of course, the experience of those closest is well, it’s not the one that I used to have. She’s not the same person exactly that I used to know. She’s still in there somewhere. That’s sort of the support group to be able to reflect on those issues and for people to share their stories and go, oh, that person gets what I’m going through because they’re facing the same sort of thing is a really valuable thing that is offered by Helping Hand as well.

00:10:51 Kate
I was thinking too, do you deal when people have come from living at home for most of their life and then they move into a residential care home, for example. Do you sometimes have to help them through grieving the life that they’ve left behind to now be in this new phase of life?

00:11:06 Paul
One of the things I hope I always address when I meet somebody who’s just moved into one of our care homes is to acknowledge with them that they’ve been through a big change. And I said earlier on that grief is our response to change, and there are people who come in to live in their care homes even where they have recognised it’s the best decision for them – it’s a big challenge. And so yes, there is a grief response to what they’ve lost, and they’re looking forward to things that are now available to them that weren’t previously. Family members also go through the whole range of emotions. Am I doing the right thing? Am I letting my mum and dad down? Am I being a bad son or daughter because we’ve made this decision? And so ideally to be able to support them and say that you’ve made the best possible decision for your loved one. But there is a change, you know, in the way that you’ll see them and interact with them, so there’s definitely grief associated with that change.

00:12:02 Kate
So can families make arrangements to talk with you as well? Not just the residents?

00:12:05 Paul
Yeah, we’re definitely available for that. We try to provide information in the information pack as each new resident arrives, that describes what chaplaincy services are for the residents, but also for the family members. That’s not just when they first arrive, but potentially as the different changes that happen as the resident stays with us over those remaining years of their life. There are other aspects of grief that will become a normal part of that journey as well. There are ways that Helping Hand can assist in directing people to support, which includes a long list of a whole range of different resources that people can reach out to and access themselves, including some that are available online, if that’s easy for people rather than thinking about talking to somebody, face to face, and they are also 24/7. So if it’s a crisis too, that there is support available.

00:12:58 Kate
And we will make sure that we include a list of all of those available services on the show notes for this podcast. Paul, if you were going to give one piece of advice about grief and bereavement that you’d like listeners to take away from this episode, what would that be?

00:13:11 Paul
Grief isn’t a bad or negative thing. It will not be an easy thing, but it’s necessary. It’s probably unavoidable. It’s personal, and it’s about helping us to live with peace, acceptance and hope on the other side of the loss that we have experienced.

00:13:30 Kate
Thank you so much, Paul. It’s been a really great discussion.

00:13:32 Paul
Thank you.

00:13:37 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:22 Kate
Hello I’m your host, Kate Holland. Did you know that at home nursing services are available via Home Care Packages? This means you can skip a trip to the GP and have plenty of services delivered at home instead. In this episode of Age Old Problems: New Aged Care, I’m joined by Jess Bryant, Clinical Manager with Helping Hand who is highly knowledgeable on what’s available to whom and how to access it. Welcome Jess.

00:00:43 Jess
Hi.

00:00:44 Kate
So Jess tell me about your role at Helping Hand. What does that involve?

00:00:46 Jess
I’m the Clinical Manager for Home Care Services, and that involves looking after all the nursing services for home care clients.

00:00:51 Kate
So those nursing services include at home nursing services as well, don’t they?

00:00:58 Jess
Yes.

00:00:59 Kate
Are you able to tell me a little bit about the areas in which Helping Hand offers at home nursing services?

00:01:04 Jess
So our nurses come out to your home, and they can assist you with things like wound care, medication assistance, whether that just be from prompting to actual administration, insulin administration and diabetes management, continence assessments, assessments to help get dementia supplements through their packages, we do skin checks, general wellbeing – which can involve your blood pressure monitoring, pulse, and all those types of things that you would normally go to the doctor for – we can do them at home to prevent you having to go that extra trip to the doctor.

00:01:34 Kate
They sound like excellent services. So who is eligible to receive these services?

00:01:40 Jess
So any client that’s on a Home Care Package with Helping Hand, any Commonwealth Home Support Programme participants, and the general public can pay a fee for service as well.

00:01:50 Kate
So do you find that many people are aware that at home nursing services are available to them?

00:01:56 Jess
No, I don’t believe many of our clients are either. Our Home Care Coordinators will actually liaise with us to refer them through to nursing services.

00:02:05 Kate
The services that are given to people, do they then liaise with their GP as well? Is there kind of a crossover between the two?

00:02:07 Jess
Yep. So if it’s anything like wound care, medication management, the nursing team can also assist with that. We can come out to the doctor with the clients, or we can just phone them or email them to let them know what we require to help their clients stay in their home longer.

00:02:23 Kate
And unlike some other organisations, the nursing staff that work with clients at Helping Hand, they are all Helping Hand staff themselves, aren’t they?

00:02:30 Jess
Yes, we have a team of nurses across metro, Whyalla, Port Pirie and Clare, and they’re all Helping Hand employees.

00:02:37 Kate
Obviously people will still have their own GP. Are the services that are provided through the nurses, is that information then coordinated and sent through to their GP?

00:02:44 Jess
Yes. So we will email through to GPs, call GPs, or sometimes go with clients to their GP. This is so that we can have that continuity of care for our clients.

00:02:54 Kate
So when you have a first appointment with a client, what would you generally run through with them when they’re going to start accessing these services?

00:02:59 Jess
So we would go in and we would do an initial assessment, depending on the service type, you know could be a medication assessment, or a skin assessment if it’s a wound, and, you know, many other types of assessments that we have. We introduce ourselves, we go through what they would like out of their care, what their goals are, and then we work with them to achieve those goals.

00:03:17 Kate
Will they have a continuity of nursing staff coming to them? Do they have someone allocated to them or does that change?

00:03:23 Jess
Yep, in metro we have a small team of nurses that you will generally get, either one or two or three of the same nurses. Obviously that can change when staff have leave, but you will see the same faces and hear the same names when we’re coming out to see you.

00:03:36 Kate
Yeah, which would make people feel very comfortable, I’m sure. What are some of the other benefits of having Helping Hand come to you and having it at home as opposed to having to go out to a GP?

00:03:45 Jess
You don’t have to run around and make times to get appointments, or lifts if you’re not able to drive. We come out to see you and we can talk with the GP so that we still get that continuity of care. If we think you need to see the GP, we do refer you in to the GP as well. So it’s just easier.

00:04:05 Kate
So I’m sure you have lots of good examples of things that you’ve offered, but do you have a particular story that stands out where you’ve helped a family in a way that perhaps they would not have expected that they could have improved through at home nursing?

00:04:13 Jess
Yeah. So we see a lot of carer stress as nurses when we’re going in, whether it be husbands or children of, you know, their mother – looking after them, helping them with simple tasks, just feeling like it’s too much for them. So we had a particular lady who her daughter was looking after her. A lot of carer stress happening. We discussed with the daughter around, you know, what is it that’s causing you this stress and how can we help? And we found out that it was just the medication that she was having a lot of issue with about making sure it was correct, making sure it was the right time, making sure she was there for her mum. So we offered nursing support. We did a medication assessment. We spoke with the GP, got the list of medications and set that up to do twice daily medication so the daughter could actually just go in and be a daughter and not have to go in and worry about medications and managing this for mum as well.

00:05:01 Kate
So it’s not always actually medical help on the person, it’s also providing support. I’m guessing that maybe some people don’t know that nurses actually have this broader skill set, and sort of permission to do what they can do, would that be right?

00:05:13 Jess
Yeah. So the GP’s will tell us exactly what they’re needing for their client once we set a goal plan up, and then we just work with them and we feedback to them if there’s anything that’s outside of the norm for the client.

00:05:24 Kate
So what changes are on the way for nursing? I get the impression that some things are changing. Where do you see it heading in the future, particularly nursing at home?

00:05:34 Jess
So nursing with the new Support At Home that’s coming through will be growing. There’s a big clinical aspect on there, where Helping Hand are currently looking at getting AINs, which Assistant in Nursing, so it will be an upskilled worker that can do basic nursing skills, to be able to streamline the process and minimise wait times. We’re also looking at getting more involved in the palliative care area because there is grants that are coming through for Support At Home, and that will be helping to keep people in their homes longer, which is what the community is telling us that they need.

00:06:09 Kate
And Support At Home, that’s a government initiative?

00:06:11 Jess
Yes.

00:06:12 Kate
And the information of that is continuing to roll out.

00:06:13 Jess
Yes.

00:06:14 Kate
So would you suggest for people to find out more about that, or just to keep on top of it, to visit both the Helping Hand website and perhaps the government websites?

00:06:22 Jess
Definitely. We’re getting new news every day.

00:06:24 Kate
we’ll make sure we have links to that as well. And obviously if people would prefer to talk to somebody, they can call Helping Hand and get information from a person?

00:06:29 Jess
Yep.

00:06:31 Kate
For somebody who is thinking about getting at home nursing, what would be a piece of advice that you would give them? What would be their starting point, and what would be the key reason you’d suggest they might pick it up?

00:06:40 Jess
If you’ve got any concerns around your health, if you are wanting to promote your health and stay at home longer, we can come out and just assist you in those things that you might normally go to the doctor for, or that you know families can sometimes say that you know you shouldn’t be at home anymore. But we can actually help stabilise things and keep you at home for that little bit longer than what the normal trajectory might have been.

00:07:02 Kate
So obviously, if somebody has an issue arise, they would call their GP and try and make an appointment. Is it the same sort of thing? If they have something that suddenly appears and they need help, can they then contact their at home nursing staff to come and attend to them?

00:07:11 Jess
Yep. So anyone with a Home Care Package can contact their coordinator, request to have nursing in place. The coordinator will then send a referral through and we will call to contact you, make an appointment, set that up. If we have a Commonwealth Home Support Programme client, they can get the codes from My Aged Care and then they can contact Helping Hand and we can set them up for a visit as soon as possible as well.
00:07:38 Kate
Sounds incredibly beneficial and I think I would like home nursing to come to my house so I didn’t have to try and get in the queue for an appointment too! Thank you so much for talking to us about it.

00:07:50 Jess
Thank you.

00:07:51 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600./s

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:22 Kate
Hello and welcome to another episode of Age Old Problems: New Aged Care. I’m your host, Kate Holland. Did you know that it’s estimated that in Australia there are more than 433,000 people living with dementia? So with this knowledge at hand, we’ve decided to devote three episodes to understanding it better. And this one’s the first.

00:00:40 Kate
Dementia is not a normal part of getting older. Instead, it’s a broad term that describes a collection of symptoms caused by disorders affecting the brain. And while everyone’s experience is unique, there are some early warning signs that you can look out for. Joining me to help you understand all of this a bit better is Tanya McIver, who is Group Manager of Residential Services at Helping Hand. Welcome Tanya.

00:01:00 Tanya
Thank you Kate.

00:01:01 Kate
So can you start by telling me a little bit about your role at Helping Hand. What does that involve?

00:01:05 Tanya
My background is clinical and a registered nurse, and currently I oversee and support four of our residential aged care homes at Helping Hand. And that’s supporting them with their clinical care, operational care, family and staff care.

00:01:18 Kate
Great. So how does that tie into understanding dementia? Can you talk me through your background and your experience in working with people with dementia?

00:01:25 Tanya
Sure. I was at university and worked as a carer while I was doing my registered nurse training. I moved into acute for a while, but always had an absolute love and passion for delivering respectful, dignified care to our older Australians, so I’ve been back in aged care for over 20 years, managing homes, and am very passionate about supporting staff involvement to ensure that there’s respect and dignity at all times.

00:01:49 Kate
And you did mention to me before we started this, you were drawn to work in aged care and with other people, why was that?

00:01:54 Tanya
The older people have created this country that we live in, and people deserve care, and they deserve the absolute best care after all the work that they’ve done to create this beautiful place that we live in. Staff need to respect, understand, and then make sure that we’re giving them the best experience possible in aged care, which is their final home.

00:02:15 Kate
So dementia, which unfortunately does impact a lot of people. So it’s not just one disease. How can you define dementia and what are some of the diseases that are linked with it?

00:02:23 Tanya
So there are a lot of different variants of dementia. There’s some that are diagnosed as part of another condition, like a Parkinson’s can lead to a dementia. There’s different parts of the brain that can be impacted which develop like a frontal lobe dementia, which will give different signs and symptoms. So there’s lots of early signs that people will pick up at home across that variety of disease diagnoses.

00:02:46 Kate
So is that why it appears quite differently in different people because of the condition leading towards it?

00:02:51 Tanya
It does. Because of different areas of the brain that it can affect, because different parts of our brain control different parts of our emotion, personality and behaviours. So there are different ways that signs and symptoms can come, and also people are individuals. So it impacts individuals differently and sometimes because of their life experience and lived experience, it will impact someone differently.

00:03:13 Kate
The differences aside and what leads to it aside, what are some of the common early signs of dementia that people might be able to look out for?

00:03:20 Tanya
You see, there’s the forgetting things, but it’s not just where’s my car keys. It’s actually. I don’t know where my bathroom is. I’m at my front door and I haven’t just forgotten my keys. I’m not sure if I know where my car is, so there’s the small forgetful things. People can also become very repetitive, so you might start to see someone ask the same thing over and over again, and no matter how many times you give the answer, that person is not able to retain it. Real changes in routine, often people are awake a lot at night, so that can change. And there’s also the fear of security, so people might go out their front door and not be sure where they are, so that’s when safety becomes a concern. And changes in someone’s personality, you might start to look and go, well, that’s just not like mum. She doesn’t do that. So things that are really out of character. It’s sort of a myth that it’s just, I’ll just start to forget things – there’s some critical personality changes that might start to get you worried that something’s going on.

00:04:18 Kate
I have heard, actually through personal experience, that not being able to deal with basic numbers and things like that, is that another indicator?

00:04:23 Tanya
Definitely. Something that’s always been familiar to a person, and you just forget your sequencing, so things no longer make sense and, you know, I’ve looked after people who are, say, school teachers that no longer can process putting prose and language together. Mathematicians, doctors, that just lose those real basic things that have been part of their life, and that has been what makes them who they are.

00:04:50 Kate
Can you sense their frustration with that?

00:04:52 Tanya
The early signs of dementia, and living with dementia early in life, is incredibly frustrating. Because you have moments of absolute clarity where you think, ‘what on earth am I doing?’ and that’s confronting and embarrassing for some people, especially people that have had very high pride in what they do. It can become very embarrassing trying to understand why you’re doing what you’re doing.

00:05:15 Kate
It must be a bit frightening for them if they start to be suspicious that this is something that’s becoming a problem. And then for family members, if they start to detect some things like these, where’s the best place for them to turn for help or advice? If they’re suspicious that maybe some of this forgetting is a bit more significant than the rest of us losing our keys, which we all do?

00:05:33 Tanya
Yes, there’s some really good starting points. Often people find that if they’ve got a family GP, it’s a really good place to start, because if you’ve got that relationship, they will also support understanding. There’s organisations such as Dementia Support Australia, there’s dementia hotlines that you can call. There are really great external supports, and also your own friends and family. So it’s, you know, opening up and just saying, look, I think this is what’s happening and asking for help. But absolutely the first starting point is your GP.

00:06:05 Kate
Great. Well, we’ll make sure we put some links in the show notes for Dementia Australia, etcetera. So people know where to turn to. What about broaching the recognition of these signs with the loved one that you think might be behaving differently than you’ve seen before? How’s what’s the best way to broach that?

00:06:18 Tanya
Again, it’s very individual. Some people will be really open to it. A diagnosis of dementia is absolutely life changing. And if the person’s living with dementia, their ability to process that may be very varied, so it’s gauging where they’re at as far as coping, and at that point, sometimes the real care has to go to the caregivers themselves to support them with it. Because sometimes you have to explain over and over again, so it’s not just saying on one occasion you’ve got dementia. It may be a daily and hourly recurrence of that person having no insight into that diagnosis.

00:06:59 Kate
What about anger or frustration that you’re saying to somebody you think this might be the situation? Do some people push back and just not want to hear it?

00:07:05 Tanya
Absolutely, because it is confronting and it’s uncomfortable to think that you might have that. Plus in the early stages, you know, you do come in and out of understanding. So when you are able to process it, it’s really scary. When you’re not able to process it, you don’t understand why people are saying that to you. That’s when you could become quite upset and agitated about it, and that’s not fun.

00:07:27 Kate
You don’t want to see your loved one upset. But am I right in thinking that the earlier that you address this situation, the better?

00:07:34 Tanya
Yeah, absolutely. If possible, that is the best way to get the help. There are medications in very early stages and that’s why it’s important to get that medical support from a GP who may then refer on to a geriatrician who specialises, so there are people that specialise in looking after people with dementia. So the sooner you can get to it, the better. And it also allows you to start changing your environment at home to support. So if you start to understand and get help for the symptoms, you may be able to then change your environment to support their wellbeing even longer.

00:08:06 Kate
And those support lines you talked about before, do they also provide support and advice for the carer as they’re trying to deal with this?

00:08:11 Tanya
Yes, there’s incredible support for carers because it’s a 24 hour job when you start caring for someone. So places like Dementia Support Australia have incredible hotlines. They have a whole series of training and podcasts and courses that you can actually do, that will support you to understand what’s happening, and give you some tips and some help, and also keep showing you different places to go for that help, and also allows you to connect with the community that’s going through the same thing as you are.

00:08:41 Kate
Which is really, really helpful, isn’t it, when you can relate – because not everybody can understand if they’re not going through it themselves. So is it possible for people living with dementia to remain at home?

00:08:52 Tanya
Yes, for a period of time, it absolutely can be. And there there’s ways of supporting that to happen. It may be decluttering your home, it may be putting some signage up, using different colours, ensuring familiar items are around, getting some help, bringing people in to help you, some home care so that you can have a break yourself. Because home is such a familiar environment, so if someone can stay at home for a longer period of time, it’s just so important. So there are people that can come in and do that, so home care is a great way to bring carers in if that helps out, because there may be times where the person living with dementia is now struggling to even sequence a shower, so you bring someone in to do that and get support for the caregiver as well.

00:09:38 Kate
But the familiarity for them living at home, that’s very reassuring, isn’t.

00:09:42 Tanya
Oh it is. It’s all the familiar things. It’s where the memories are. It’s, you know, where the photos are. That may help them orientate themselves to time and place again. And all those familiar items that are really important.

00:09:54 Kate
Now I imagine the answer to this question is varied, because we’ve already talked about the fact that everyone experiences this differently. But how long can people with dementia, or people living with dementia, usually stay at home?

00:10:04 Tanya
Totally varied. It depends on what signs and symptoms become more prevalent, when safety becomes an issue, that’s usually the trick. The two real triggers to have to come into care are safety of the person living with dementia, or carer fatigue for the person caring for someone with dementia. When someone is at risk of leaving the home in the middle of the night and getting lost, it’s time to think about do we need a more secure environment? If someone’s unable to even get the just general personal care and they’re at risk of other things like infection or skin breakdown, it’s really time to think about coming into care. Home services are great, but ultimately we have to look after the people looking after people with dementia as well. And if it gets to the point, you know, sometimes we call it the breaking point or the crisis point. It’s important to know that there’s incredible services available that can pick your loved one up, like residential aged care, and bring them into a safe place to land.

00:11:05 Kate
Now we’re going to do a whole other episode about residential aged care and why that’s very beneficial for both the person who’s living with dementia and their family. But before we wrap this one, if someone was going to reflect on listening to this episode, what would be sort of key advice or key things you’d like them to remember? Maybe in terms of what they should really look out for, and how they should broach it with a loved one if they think that maybe there’s some signs happening?

00:11:29 Tanya
The most important thing to remember is you know your person the best. You are gonna pick up the signs sooner than anyone else, because of your relationship with your person. That is really hard to do, but there’s so many services to help and the sooner you can open up, discuss it, bring that help in the sooner you’ll actually feel you can get the support and wrap around that person and give them all the care and support that they need.

00:11:53 Kate
That’s great. That’s a really good insight and understanding and while we know that it is going to affect people differently, there are some really key things people can look out for there. So thank you so much for joining us, and we’ll speak to you again soon.

00:12:04 Tanya
Thanks, Kate.

00:12:11 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.