Building people centred lives

A paucity of informal networks and advocates to witness and act on behalf of older people is a critical factor which impacts their safety, security, confidence and level of vulnerability.

We are living in a pandemic which has changed the lives of many and a spotlight has been shone on the effect of forced social isolation on the health and wellbeing of people – the very isolation that older Australians and people with disability experience every day, writes Meredith Coote.

Meredith Coote

We are aware that up to 14 per cent of older people are also likely to experience elder abuse in Australia and that coronavirus has increased this risk with the impact of social isolation. Covid19 and the increased reporting of abuse and neglect highlights a longstanding critical epidemic impacting our communities – loneliness, social isolation and lack of human connection.

It is proven that social isolation can shorten a person’s life. US researcher Professor Julianne Holt-Lunstad looked at the protective effects of social relationships on morbidity and mortality, and showed in a 2010 study that people with strong social relationships are 50 per cent less likely to die prematurely than people with weaker relationships. Being around others is a key to survival, added resources are gained, social capital is built, there is protection from undue influence. Social relationships can provide collective safety and support, access to resources and support decision making.

Safety in numbers

A paucity of informal networks and advocates to witness and act on behalf of older people is a critical factor which impacts their safety, security, confidence and level of vulnerability.  This was demonstrated in these recently reported cases: invisibility and dependence are significant risk factors. Natural supports provide the backup, security, friendship, compassion and love which paid support cannot. One very close friend can do so much to increase a person’s sense of belonging, reduce loneliness, isolation and increase personal security. One person raising the alarm that something isn’t right, can be all that is required to increase someone’s safety.

If there is only a single support in someone’s life, whether informal, formal, paid or unpaid, we have witnessed the harmful outcomes which can occur as risks increase and line of sight is diminished. Abuse is most often perpetrated by trusted people who are close to the person – this can be family and friends and unfortunately, in some cases, support workers.

When individuals rely exclusively on paid professionals for their support and relationships, a substantial gap in their lives can occur and a person is rendered more vulnerable. These paid supports are essential but must be provided in a manner that intentionally increases the maintenance and development of other relationships and connections. Paid supports should supplement, complement, create and enhance freely given support where it exists, not replace it.

The role of formal supports, provided through CHSP and Home Care packages, are fundamental in providing care, support and improved health and wellbeing to people living at home. With the consumer at the centre, a support team of case managers, therapists and support workers should assist to build their capacity and sense of security, provide assistance with clinical needs, personal care and basic daily activities which enable people to live as independently as possible and to live the life they choose.

The focus of these supports needs to also consider not merely what’s the matter with someone, but importantly, what matters to them. A priority should be identified in every support and care plan for services which develop the natural safeguards of older people, facilitate engagement of relationships and community connections and intentionally build and strengthen circles of support at each and every opportunity.

Reimagining care and support

Supports delivered should start the day, the ignition switch for what’s to come. The shopping task becomes a regular reconnection of a consumer to the markets they used to frequent, familiar smells, food and people, the gardening activity is an opportunity to meet and engage with the neighbours, even if sitting in the sun, directing tasks is all that is possible, this develops a critical local safeguard.

Developing this rhythm of life and social presence cultivates familiarity, dialogue and relationships. These activities reimagined will both reduce social isolation and increase safety and security at home. People need to feel that they are connected, reconnected, belong and that their support prompts meaningful participation in their community. This can be accomplished more easily with a diverse support team from their local area, each with a different purpose, skill set, strength, qualification and potentially different personality for the support functions they provide. Local people, potentially sourced specifically to meet specific needs, already linked to community will create natural safeguards as both intentional and incidental relationships and connections will follow.

The support provided to people, whatever age or circumstance needs to ensure that the magic in relationships thrive and remain meaningful. The sector needs to support people to build people centred lives, one connection at a time.

This movement will take collective action, working intentionally to shift practice, reducing the risk of isolation and improving the quality of life for older people.

*Meredith Coote is the General Manager of Government, Sector and Policy at Mable and has had over 35 years experience in the sector, across Disability and Aged Care, with specific depth of expertise in Guardianship, Financial Management and supported decision making. She is also, a wife, mother, daughter, friend, colleague and carer of a gorgeous young woman with psychosocial needs.

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