a. Using video to explore happiness in residential aged care
Mikkol Macabali, Dr Lisa Williams, Dr Michal Boyd (presenting)
Background: It is well known that the population is ageing. Life expectancy has steadily increased over the last century and as people age they often become more frail and require 24-hour care in Residential Aged Care (RAC) facilities. Little is known about the older persons’ experience in RAC, and particularly about what adds meaning to their lives. In this project we utilised digital stories to involve older people living in RAC as co-researchers to explore what gives life meaning from their perspective. We explored the effectiveness of digital stories with participants to gain a first-hand view of what promotes living well in RAC.
Methods: Four older people living in RAC volunteered to participate in this digital story project. Data was collected through a semi-structured interviews conducted by a student researcher. Participants were asked to reflect on what gave them meaning and promoted happiness in the past and presently. The interviews were transcribed and thematic analysis completed under the supervision of two experienced researchers. Still and moving images were collected and edited into the final video.
Results: Participants provided insight on how to live well as one ages. They shared stories about social connection with other residents, and emphasised the importance of making the most out of their situation together. One participant even suggested a building design to promote resident interaction. There was evidence of reciprocal learning, with the student researcher involving participants in the videography and editing, and participants influencing the student’s self-awareness of ageist attitudes and preconceptions.
Conclusion: Digital story-telling is one way to explore the life experience of older people living in RAC’s. The co-researcher relationship created authentic interactions and offered a creative method to capture participant experiences. The resulting digital stories can also be used to promote an appreciation of older people as valued members of the wider community.
b. What happens when a community development approach is applied to a residential aged care facility, to engage with its local community and attract them inside?
In 2018 Southern Cross Care NSW (SCC) aged care services approached The GroundSwell Project and their partner The Caring at End of Life Research team from Western Sydney University (WSU) to collaborate and create a unique wellbeing program for residents in two SCC facilities.
Taking a 10K diameter around two SCC aged care facilities, a community development worker was employed to develop awareness, opportunities and programs with residents, staff and the local community that encourage social capacity building. Questions were raised of the impact a Cd approach would make in developing connected and engaged aged-care environments, improving death literacy and developing strategies and a service model to duplicate process in other facilities.
Western society’s obsession with youth and productivity separates and categorizes “old” and “ageing” as unattractive and useless. Part of the preliminary research findings of the WSU team identified residents feeling worthless, isolated and depressed. The invitation to share responsibility in end of life care shifts the expectation and frustration in the medical model to a collaborative social model which everyone can take part in shaping. Forging collaborative programs with a whole of community/ network centred approach enables intergenerational engagement, acceptance of our shared experience in life and death and acknowledges seniors as valuable contributors.
De-institutionalizing the mentality and behavior of those within the facility was the starting point. Appreciative Inquiry and Enabling approaches to existing practices were used to raise awareness and help build a reflective and reimagining of facility life, including the duality of “workplace” and “home”.
This presentation shares discoveries and insights realized since embarking on this project and learning what it takes to spear head an aged care facility - steeped in organizational and workplace cultural practices - into a socially engaged environment where meaningful connections determine service delivery; dramatically shifting care workers’ focus from task driven (things) to relational (person centred).
c. Gaps in health and social care provision at the end of life: Opportunities for compassionate communities
Robinson, J. (presenting),¹ ² Gott, M.,¹ Moeke-Maxwell, T.,¹ Frey, R.,¹ Moyes, K.¹ Old, A.,² Raphael, D.,¹ Williams, L.¹ and Njo, H.¹
School of Nursing, University of Auckland, New Zealand¹
Auckland District Health Board, Auckland, New Zealand²
A public health approach to end of life care which focuses on harm prevention and risk reduction for people with life limiting illness has the potential to improve health and well-being at the end of life. A public health lens will be used to explore opportunities to collaborate, connect and partner with communities to better support those living with dying, caring and bereavement in Aotearoa, New Zealand.
To identify gaps in health and social care in the last year of life from the perspectives of bereaved families and consider how these could be addressed by partnering and collaborating with communities to reduce the harms associated with dying, caring and bereavement.
An adapted version of the Views of Informal Carers – Evaluation of Services (VOICES) questionnaire was used to survey 3,932 bereaved families about their experiences of health and social services in the last three months of life.
Nearly half the respondents reported inadequate support from health and social services, 10% received no support at all. Key themes identified from the analysis of open response questions included 1) a lack of social connection for both the ill person and their carer; 2) family/whānau feeling alone in the caring role; and 3) family/whānau experiencing barriers to caring for the sick person in the way they wanted, particularly in hospital and aged care settings.
This study identifies substantial gaps in service access for people with palliative care needs. We will explore how these gaps could be addressed by adopting a public health lens to developing compassionate communities. Our analysis will inform approaches adopted by the tertiary provider who participated in the study to improve end of life care for their patient population, as well as ways to support non-service based responses.