Descriptions and comparisons between Long Term Care (LTC) systems often focus on system characteristics, rather than the ability to meet the needs of older people with declines in intrinsic capacity and functional abilities. Person-centred analysis of the match between care and need requires appropriate tools to collect and compare data across different countries, populations, and care settings.

 

This workshop will take participants through an analysis of the LTC available to people in their communities, considering six different dimensions (the 6As)

1. Availability – what types of care services exist?

2. Approachability – can people get access to services?

3. Adequacy – do the services meet people’s needs?

4. Acceptability – is care appropriate, safe and non-judgemental?

5. Affordability – how much does care cost, and who pays?

6. Accountability – what checks are in place to ensure quality and safety.

 

Each dimension is considered against a standard vignette that describes declining intrinsic capacity and increasing care needs for a “typical” older person over 8 years of their later life. In this narrative, the person transitions from being mostly independent in daily activities to requiring assistance with most tasks. Vignettes can be a useful tool for collecting standardised person-centred data by setting a fixed profile of needs and assessing care access, use and outcomes relating to those needs. Importantly, since the scenario is longitudinal, the vignette also requires consideration of anticipated needs as people age as well as current needs. The aim is to fit LTC within the WHO healthy framework where it has roles in maintaining intrinsic capacity and abilities (prevention) as well as in providing support to help people keep doing what they need and want to do.

 

The standard vignette was prepared based on analysis of data from the WHO Global Studies of Ageing, to reflect different sets of disabilities that are common in later life. The vignettes were developed by teams from ILC Singapore and ILC Australia, and are adaptable to different settings using set parameters. The 6As were refined by the ILC Global Alliance through a Delphi process.

 

In this workshop, participants will:

• unpack the six dimensions of care (6As) and understand how they relate to the needs of older people.

• adapt the standard vignette to their own country setting, considering health, demographic and government functions.

• apply the 6A interview schedule to define and describe their systems of care in relation to the needs of older people, relating to the vignette and the change in the person’s needs over time.

• identify examples of best practice, policy and practice gaps, and opportunities to improve care systems.

 

Prepared examples of LTC systems and services will be presented from Australia, Singapore, and South Africa. Participants will be guided in working through the vignettes and framework to describe and assess LTC in their own settings. It is expected that by the end of the workshop participants will have tools and techniques for assessing and describing LTC supports for their own communities against the needs of older people. They will also have an opportunity to compare and contrast LTC approaches across different countries.

 

Duration: 60 minutes

Emeritus Professor Julie Byles

Co-President, ILC Global Alliance | Director, ILC Australia

Emeritus Professor Julie Byles AO BMed PhD FAAHMS, is an Honorary Professor at the University of Newcastle in Australia. Julie has held local, national, and international roles in the International Clinical Epidemiology Network, the International Gerontology and Geriatrics Association, the International Longevity Centre Global Alliance (currently co-President), and has worked with the World Health Organization in various advisory roles. Julie is a Fellow and Life Member of the Australian Association of Gerontology,and was National President from 2011-2013. She is also a Fellow of the Australian Academy of Health and Medical Science. She is the Chair of the Hunter Ageing Alliance which strives to improve local conditions for older people with a focus on their participation, housing, health and social care.

Professor Julie Byles is an internationally renowned researcher on aging and health systems. As a clinical epidemiologist, Julie’s interests are in risk determination, health assessment, other health care evaluation, and measurement of health outcomes. As a Gerontologist her interests in ageing include the role of health and long term care services, preventive activities, and treatments in maintaining quality of life for older people. She is currently serving on the Lancet Commission for Long-term Care.

 

Ms Susana Concordo Harding

Senior Director, International Longevity Centre Singapore, Tsao Foundation

Susana has more than 23 years work experience in the ageing sector, with specialisation in policy advocacy and programme/service development. She also works on research projects, and her interests are ageing and gender and its intersectionality, caregiving, financial security, community resilience, active and successful ageing, long term care, empowerment, and community development. She is also the Honorary Treasurer of the Board of Directors at Centre for Seniors, a non-profit, Social Service Agency that is dedicated to helping seniors to remain meaningfully engage in work and in life, as well as Council Member of the Gerontological Society of Singapore. Last year, she was awarded the Prof Gary Andrews International Fellow by the Australian Association of Gerontology (AAG) and recently awarded, Ageing Asia Global Ageing Trailblazer at its 13th Eldercare Innovation Awards 2025.

 

Prof. Rayne Stroebel is a prominent figure in care innovation for older persons and people living with dementia in South Africa. He is the founder and Managing Director of GERATEC, a pioneering organisation dedicated to enhancing the quality of life for older individuals through relationship-directed support. As the regional coordinator for The Eden Alternative South Africa, Dr. Stroebel has trained over 3,000 caregivers, promoting relationship-directed support and care models. He holds a PhD in Dementia Studies from the University of Stirling and is an Executive Member of the International Longevity Centre South Africa. His work emphasises holistic, culturally sensitive approaches to ageing and dementia care, which is reflected in his blog, www.mindsmatter.co.za.