Greg Shaw, International Federation on Ageing, Canada
Graeme Prior, Hall & Prior Aged Care, Australia
Vipan Nikore, Homecare Hub, Canada
Conny Helder, tanteLouise, The Netherlands
In the context of the lives of current and future generations of older people and the coronavirus pandemic, this moderated symposium will focus on the need for systemic and technical innovation in long-term care to respond to the needs of an ageing global population.
Older people aspire to well-being and respect regardless of declines in physical and mental capacity. Long-term-care systems are meant to enable older people, who experience significant declines in capacity, to receive care and support in an environment that enables them to do what they have reason to value. The rights of older people, their fundamental freedoms and dignity, are human rights.
These aspirations are rarely the reality for older people. The impact of population ageing is often viewed as a social and economic burden, and issues of older people while being acknowledged by government in well meaning statements such as ‘we must do better for seniors’ do not translate to effective policy.
The decades long debate on sustainable and responsive long-term care models will be a primary driver of intergovernmental dialogue in this action area of the UN Decade of Healthy Ageing (2021-2030). The principles of integration, non-fragmentation, and person-centredness are foundational to the World Health Organization (WHO) supporting countries to develop long-term care programmes. Three approaches have been identified in the WHO mandate namely:
- establishing the foundations necessary for provision of long-term care as part of universal health coverage;
- building and maintaining a sustainable and appropriately trained workforce and supporting unpaid caregivers; and
- ensuring the quality of long-term care.
The disproportionate impact of COVID-19 on older people has ignited a new conversation and started to galvanise communities, civil society, and others around long-term care.
In this session, thought leaders in the field of long-term care from Canada, Australia, and the Netherlands will articulate what it means to innovate, to challenge the status quo, and advocate for positive change in a sector that seems to be driven by cost effectiveness rather than the person, caregivers, and their family.
Presenter #1, Graeme Prior
Australia’s long term care system is in the midst of a once in a generation change.
In March 2021, concluding 30 months of inquiry, the report of Australia’s first ever Royal Commission into Aged Care Quality and Safety was released. This pivotal paper sets the agenda for aged care reform in Australia over the next decade.
The Commissioners outlined a vision for long term care in Australia where care and services are delivered based on resident need and driven by deregulated market forces.
In May 2021, the Australian Commonwealth Government, the funder and regulator of care in Australia released its response. The Commonwealth supported 126 of the 148 recommendations, 12 are still under consideration and 6 have been rejected. The response demonstrated a genuine commitment of the Commonwealth to introduce structural reform into the sector. Central to this response is a commitment of an additional ~$15US per resident per day in funding, to be introduced over the next 12 months. This funding is hoped to achieve two pivotal goals – improvements in the standards of care provided to residents and attraction of suitably qualified staff to deliver this care.
Australia has the foundations of a world class, resident focused long term care model. The required reforms to realize the Royal Commissioners vision will require significant reform and innovation.
Presenter #2,Vipan Nikore
Principles to drive innovation in older adults
In recent years healthcare innovations have been developed and implemented at a faster pace than previous years. Unfortunately, these innovations have not been routinely embedded into practice nor translated into improved outcomes for older adults. People do not typically point to our work with older adults as the model for innovation within healthcare.
This paradigm needs to be flipped. It is imperative we drive new innovation and translate recent advancements into our systems for older adults. Older adults deserve more dignity, care, and respect than what society has given them thus far. Further, our ageing population is one of the fastest growing demographics, an incredibly complex patient populations, and comprise the group of patients that make up the highest costs in our health systems.
Keys principles to drive innovation in older adults are:
- Define metrics to measure related to quality, experience, and cost
- Focus on personalization and allowing choice for older adults
- Allow for creativity by funding alternative models of care
- Focus on speed by removing barriers and bureaucracy in the system
- Understand what types of failure to tolerate and what types not to
- Share data and care models transparently
- Never lose sight of quality & safety
- Focus on low and middle income countries to avoid widening the equity gap
Presenter #3, Cony Helder
Preparing for new realities
TanteLouise (the Netherlands) started out a new ecosystem to improve quality of life for people with dementia with a new vision on long- term care and home care.
This resulted in astonishing results: residents regain their personality and autonomy, are active, enjoying life in general and maintain their own activities of daily life. Residents sleep better and medication has been reduced dramatically. A significant increase in quality of life, mobility and self-reliance has been proven, including an increase in life expectancy of + 1 year in comparison with practice as usual.
These experiences are transformed into a stimulating day-care center program for people with moderate to severe dementia and their caregivers. The aim is to reach a 30-50% reduction of long-term admittance. Frail persons with dementia are te be equipped to stay in a home environment in their own community and still receive the level of care of the active ageing program in the nursing home Monitoring technology will be used for multi-disciplinary interventions, if necessary to stabilize the situation at home.
TanteLouise incorporates a steady flow of innovations to give more possibilities to improve productivity and measure, monitor and understand the process of ageing and dementia in particular. Extra attention is given to primary and secondary prevention.