The wonder of aged care could be a surprising recruitment strategy

Written by Mike Baird, HammondCare CEO, for Hello Leaders Summer – Autumn 2024 Edition

The key factor in Australia’s care sector is the people who work in it. Without these wonderful people, the sector would quite frankly crumble. So why is it hard to give them the attention and focus they deserve? Why are we holding back?

In the last few years, we have seen a Royal Commission (resulting in 148 recommendations), a pandemic (where residential aged care was among the hardest hit), a barrage of reforms (30 just in the last financial year), an unprecedented workforce crisis and sustained financial pressures.

In some ways, people in the sector are feeling battered and bruised, and that can be discouraging. It’s hard to be creative about building a workforce when there’s been so much to deal with.

But I think it’s time to lift our eyes and start looking to the future.

There is much to be positive about: aged care workers’ wages are increasing, the Aged Care Taskforce is looking at reforms to improve funding and sustainability, and the new independent pricing authority will be reviewing the cost of quality care.

All of these will help when hope has been hard to see on the horizon.

What’s more, I think we have a secret weapon that perhaps we don’t talk about enough when it comes to attracting people into our sector – wonder.

That’s a word I use to describe the sense of real meaning and purpose that comes from working in this hard but profoundly beautiful space.

We already have the most amazing people doing the most incredible jobs. Both my daughters now work as carers in disability, and I couldn’t be more proud.

I’m touched on a regular basis when I see the dedication of my team members, just like the home care worker who walked miles to see a client after a car breakdown or the residential team who set up a mock workplace for a retired office manager, now living with dementia.

They are special people, doing one of the most important and rewarding jobs around.

We need to share their stories so that the world knows how truly wonderful it is to serve those who have reached their last years.

Here’s an example. At a recent gathering of leaders at HammondCare, we heard an incredibly moving story about the most challenging of care situations, and its impact on both the patient and the care team.

It centred on a palliative patient we’ll call Jim. Jim was an older gentleman living with some severe mental health issues as well as dementia. On top of that, he had a fungating cancer on his face that had not only seen the removal of his nose, but covered his eyes and mouth and prevented him from eating easily. It was – to say the least – an incredibly confronting presentation.

Jim had previously lived in a care home with support from the NDIS but as his illness developed, he ended up in hospital, where he essentially stayed for 18 months.

No one wanted him.

Care teams assessed him and shook their heads – his case was too complex, his needs too challenging, and his appearance and behaviour too confronting for other residents or patients, especially those living with dementia.

Our care team leader actually said to me, “If we don’t take this gentleman, he’s going to die in the hospital bed and that was the main reason we thought, ‘We have to take him.’ He is exactly the kind of gentleman we need to care for.”

Over the three months he had left to live, Jim’s life was transformed. Despite feeling nervous, and worrying about failing him, the team quickly built rapport and spent time in meaningful engagement with Jim. They discovered he loved gospel music, and the team would sing along while he listened. He even went outside in the garden and he agreed to have a shower – two of the things he’d mostly stopped doing – because they had built that trust and relationship with him.

Due to his appearance, Jim had arrived with his hands over his face, and he didn’t like people looking at or talking to him. When he passed away a few months later, he’d completely stopped doing that, and died holding a carer’s hand.

Afterwards, despite the challenges, the whole team said they would definitely care for someone like Jim again – it was so rewarding, and it made them proud of the impact they can have.

This is why our teams do what they do – and as leaders, we have to make sure they have the space and the opportunity to do it.

That’s something that has emerged from some HammondCare led research published recently by The Gerontologist (the journal of the Gerontological Society of America).

Titled ‘Being Present and Meaningful Engagement for Aged Care Residents Living With Dementia: A Mixed-Methods Evaluation of Australian Care Worker’s Experiences’ and led by The Dementia Centre’s Professor John Swinton, the research found that the number one reason that care workers enjoyed their roles was the opportunity to “be present” with residents and meaningfully engage with them.

That’s it right there – wonder.

It’s powerful, and it’s what makes our teams tick.

If we don’t allow them to experience it – because of barriers such as staff shortages, competing demands of the role, and time-pressure – we end up not only with poor care practices and resident outcomes, but with inevitable churn in our workforces.

But it’s one thing to celebrate the wonder of the role; it’s another thing to make the practical changes that will allow people to choose it.

If we are going to find and retain the number of people we need to maintain this kind of quality care, then we need to think outside the square.

We talk about an hourglass approach – attracting young workers by incentivising pathways into aged care and keeping workers longer who don’t want to retire.

At the younger end of the hourglass, there are scattered programs where high school students gain some form of experience to get them familiarised with the care sector. 

We have hopes of seeing more schemes like this taking place all over Australia, with young people developing skills they’ll need for a great career in the aged care environment but also having their eyes open to the beauty and wonder of caring for our elders.

But the older end of the hourglass faces serious hurdles.

Even though one in five retirees would consider re-entering the workforce — a valuable group of people with a lifetime of skills and experience — there are several barriers for them to negotiate.

Apart from ageism and sometimes a need to upskill, especially digitally, the biggest ones are the pension and superannuation rules.

There can be significant confusion regarding how much money pensioners can earn before they lose pension entitlements but, broadly speaking, for every dollar earned over the income threshold (which itself varies) a pensioner loses 50c of their fortnightly pension.

With pension income also taxable, many question why they should bother working.

Working ‘too much’ over consecutive fortnights means the pension is quickly reduced, however, reinstating the pension is never as quick.

On top of this, medication subsidies can be lost, and partner pensions may also be reduced or lost.

Given that the aged care sector is crying out for workers, while also facing an upcoming tsunami of demand, I believe it’s high time we make it easier for older workers to step back in from retirement. 

One solution could be to exempt employment income completely for aged care workers (and other sectors that have a critical workforce shortage) from the age pension income test.

This would mean that pensioners with limited wealth can work without losing their pension, and without a reporting burden (although taxation would still apply as normal).

It would be great if we could harness the wisdom, experience and empathy of our older workers who would still like to earn an income, and I think we should do everything we can to make it worth their while and this becomes even more important as the population ages.

We’ll all benefit one day from getting aged care right today – and what a wonder that will be.