Core themes of living and dying well explored: ARIIA Day 2 highlights

Published on 8 July 2024

Petrea King (L) and Uncle Boe Rambaldini delivered a pair of emotion-fuelled speeches at the ARIIA Conference. 

On a jam-packed Friday, Day 2 of ARIIA’s 2024 conference, Facing the Future, started with two impactful speeches; the first by Associate Professor Uncle Boe Rambaldini, Bundjulung Elder, the second by Petrea King, Founder & CEO, Quest For Life. 

Uncle Boe delivered an emotion-fuelled talk that recounted his personal history, and that of Aboriginal and Torres Strait Islander people. He said they are still the most disadvantaged, vulnerable and marginalised on this continent despite the Government’s Closing the Gap initiative. 

“It started with a small number of targets and then it increased to have this holistic approach to improve the quality of lives of Aboriginal people so we can take our place in society. We’re still a long mile from there. The gap is not closing… in fact, I think it’s widening,” he said.

He said we – as a society – need to look at the past and find out what we’ve been doing wrong.

“That’s what it’s all about; having a good understanding of each other. That way my people can live well, they can age well and they can die well. Our country is important to us. If we’re born on country, where we come from, it strengthens the area if we die on country,” he added. 

Ms King also spoke of understanding, including understanding grief, trauma and despair. Like Uncle Boe, her personal trauma, which at one stage saw her say, “This is too hard, this ageing well, living well and dying well”.

While working as a naturopath, Ms King asked those who came to her for help, “What is it that stands in the way of you finding peace?” and this led to her development of the four Cs:

  • To regain control over our response to life
  • A commitment to living; a deep reverence for life
  • A sense of challenge
  • A sense of connection: to people, to Country, to our first nature

The four Cs underpin her work through Quest For Life, a recovery-oriented program that doesn’t fit the mould of traditional aged care.

“We’re going to have to come up with some really creative ways of caring for people,” she urged the crowd. 

“And I hope you will think about your own life and how you take good care of your physical mental, emotional and spiritual well-being. Because the greatest gift you can give to yourself, your family, your workplace or the planet is the gift of your own good, physical, mental, emotional and spiritual well-being.”

Grant recipients take to the stage

ARIIA has funded 62 projects since 2021, putting almost $17 million into aged care research.  Eight successful grantees shared updates on Friday, with a focus on workforce support and technology.

Evan Hill, CEO, Meals on Wheels Queensland, explained how their research saw program participants and volunteers partnered up for regular lunches to discuss how they’re feeling and if there are concerns with social isolation or loneliness. 

At face value, Mr Hill said there wasn’t a significant difference between the control and intervention groups. However, by removing anyone who didn’t have isolation or loneliness reported in their baseline test, positive results were revealed in their final tests.

“Those classified as lonely in the intervention group showed a score of plus one. For those rated as highly lonely, they scored positive two. Those that were most socially isolated or lonely benefited the most.” 

Volunteers with aged care or healthcare backgrounds thrived in the program, too. From here, Meals on Wheels Queensland will onboard residents using the De Jong questionnaire, strengthen pairings and look to recruit a dedicated volunteer team for social engagement.

BCR Communities also touched on the findings from their program that delivered a Regional Provider Blueprint based on their values-based care program. 

The project aimed to test how a values-driven culture could operationalise care processes to support human rights. This included clearly documenting care client values so the service provider can align their actions to them. As a result, clear and transparent processes can be created to navigate any potential conflict between dignity of risk and duty of care. 

Heather Marciano, CEO, BCR Communities, said there are challenges, “What is safe is up to the interpretation of the person doing the audits.” However, by professionalising care management and developing processes and policies to help advocate for residents, they can provide a more respectful and rights-based model of care. 

Dying well – Reshaping end of life systems

With a conference theme including Dying well, Dr Helena Williams, Executive Medical Director, Silverchain, kicked off a Friday afternoon session on end of life care. 

As a home care provider, she said Silverchain sits in no-man’s land and their services are only funded for last-minute care when it’s too late. 

“We need clinical leadership and building the skills to have the hard conversations. We have to be getting culturally appropriate advance care directives in place for everyone […] and be proactive in identifying the need for palliative care even if that’s not what they’re referred for,” She said.

Dr Williams added that many health professionals are trained in helping people get better, and to always try another method, rather than acknowledging someone is dying. More health practitioner confidence in providing or referring someone to palliative care is needed as over 90% of residents dying in RAC would benefit from a palliative care approach. 

“We do need to normalise these discussions […] particularly the hospital, non-palliative care professions to prepare their patients,” she said.

From a policy perspective, Kate Swetenham, Director of Nursing, End of Life, SA Health, said most policies are actually reactive rather than proactive. Having clinical staff involved in policy research and development would help, she added. 

So too would better communication around what’s available as it would reduce the burden from “a lot of unrecognised palliative care need” in the sector. 

“Language is always something that trips people up. […] It’s not just end of life care for the very last few days; it is longer term. People are prepared to have the conversations but often we feel the need to protect them and keep them in the dark for longer,” Ms Swetenham said. 

aged care
aged care workforce
aged care sector
business leaders
aged care providers
facing the future
Petrea King
Uncle Boe Rambaldini
cultural inclusion