Linda Justin has held a variety of senior management roles in health and human services, in the NGO, public and private sectors. Linda has worked to achieve operational excellence through collaboration and innovative thinking, placing client/customer quality practice and service at the centre of an organisation. She has worked with Boards, executives, and front-line staff for organizational transformation both culturally and operationally. Linda has worked with several national and international health organizations’ and policy committees. Linda is enrolled in a PhD programme at UTS. Her PhD Title is “Who do you say I am? Language, Culture and their intersection with Quality and Safety in Aged Care”. Linda is a casual lecturer at UTS, Board Member for Hammondcare a leading Australian dementia specific care provider and is also an external adviser to St Vincent’s Healthcare and a member of the We-Thrive collaboration with Prof. Kirsten Corazzini and Michael Lepore.
Who do you say I am? Language, Culture and their intersection with Quality and Safety in Aged Care.
Linda Justin, University of Technology Sydney, Australia
Joanne Travaglia and Deborah Debono, University of Technology Sydney, Australia
Aged Care in Australia is at an inflection point following with completion of the Royal Commission into Aged Care Quality and Safety (ACRC) which has highlighted and cited many failings, loss of dignity and abuse within the nations aged care services, during the 28 months of deliberations where they interviewed 641 witnesses and received 10,564 public submissions. In the foreword to their Interim Report, A shocking Tale of Neglect the ACRC has stated that:
“As a nation, Australia has drifted into an ageist mindset that undervalues older people and limits their possibilities, Sadly, this failure to properly value and engage with older people as equal partners in our future has extended to our apparent indifference to aged care services. Left out of sight and out of mind, these important services are floundering. They are fragmented, unsupported and underfunded. With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring.” (ACRC, 2018, P1).
Whilst the powers of a Royal Commission of broad and far-reaching, their remit is largely forensic. An alternative methodology to understand these complex issues is to use Bourdieu’s concepts of field and symbolic violence. Bourdieu’s concept ‘field’ had been used to understand complex issues such as patient safety, organisational change in the public sector, education and many other aspects.
The are a multiplicity of terms used in our health and social care policy – Patient, Customer, Client, Consumer, Resident or Care Recipient. Clearly, from these definitions we can see how the potential misalignment between expectations of the stakeholders involved, Government, Provider, Family and Older Person. The push to deregulation has shifted both policy and market dynamics, since the enactment of the Aged Care Act when the new terminology of Residential Aged Care Facilities caused a ’blurring of the distinction Nursing Homes and Hostel under new terminology of ‘Ageing in Place’. This is further compounded, by language and a multiplicity of terms, which undergird various practice-models. These terms and their application to practice, this research paper will contend have had ramifications for society and providers with regards to culture and practice and have contributed to institutional ageism and quality failures.
This paper will report on the findings of a PhD study which utilized a mixed methods approach, interviewed International Aged Care CEO’s and Leaders with deep knowledge of the sector, policy and practice models. Utilising a Bourdesian lens to understand and reframe this complex landscape from an alternative perspective and report findings from the research. Bourdieu provides an interesting and alternate lens for complex policy issues and suggests an interesting link for us to consider how language and terms in use contribute to ageism and quality failures from a sociological perspective which detracts from the inherent dignity and the human rights of older people. Because ‘if the culture we walk past, is the culture we accept’, and language drives culture and behaviour within organisations, is this perhaps the missing link to the intersectionality of culture and enterprise quality for Aged Care service provision?