Aged Care - Big and Small - Both are Beautiful

A recent influx of private providers into the aged-care industry and the introduction of government reforms are creating a competitive and challenging environment, writes Lisa Rees, from aged care provider, Benetas.

Anglicare Australia’s 13th State of the Family report, Paying Attention, launched during Anti-Poverty Week (13 to 19 October 2013) explores how Anglicare Australia agencies respond in new ways to the needs of their clients. Benetas, a Not for Profit aged care provider in Victoria, is a member of the Anglicare network.

The following (edited) essay, by Lisa Rees, Benetas Customer Experience and Partnerships Manager, explores the strategies a growing organisation uses to keep true to its values and its community among the shifts and increasingly big business of aged care.

Recently a colleague made a throw-away comment: ‘Anyone can do aged care … so what makes us different?’

Those familiar with the sector and its complexities will agree that it is a stretch to say ‘anyone can do aged care’. However what my colleague was getting at is that aged care is becoming big business.

A recent influx of private providers into the industry and the introduction of government reforms are creating a competitive and challenging environment. The trend towards larger organisations and greater accountability—seen across many sectors—is edging out smaller providers.

At the same time Australia is facing an enormous increase in the number of people aged 85 and over with baby boomer children who want the very best for their parents. They’re often willing to pay for and be ‘wowed’ by extra services like spas, state-of-the-art gyms, concierges and more.

These changes are turning the sector on its head.

With aged care an attractive opportunity for big business, we should be taking a hard look at our sector: exactly what are we offering and being offered? How does a large organisation continue to enact a meaningful purpose? What are the values and what kind of advocacy can the large organisation provide for older people? Are there investments into local community programs? Or does the pressure of managing complex corporate finances take a greater toll on connections with community among larger organisations compared to smaller-scale service organisations?

Benetas is certainly a very large organisation and its primary business is aged care. While this means keeping a firm grip on sustainable operations, the leadership team and staff at Benetas are mindful of the organisation’s origins, its long history with the community and its purpose. This is to ensure that all older people, regardless of their circumstances, enjoy a positive experience of ageing.

Benetas’ ability to communicate with and advocate for older Australians, more broadly than those who are our immediate clients, is critical to fulfilling its purpose.

Benetas is well connected. It has long-established, strong links with one of Australia’s largest archdioceses, and has been supporting older people since 1948. This places the organisation in a unique position to address pressing issues for older Australians.

Modest beginnings of initially one home for 27 older women in the eastern suburbs of Melbourne reflect the mission to respond to immediate need. Like many Not for Profits with similar beginnings, it provided an invaluable service to the local community.

Rapid growth for Benetas and others in the aged-care sector followed.

In 65 years Benetas expanded from providing housing for 27 to a suite of aged-care services for more than 4,000 older Victorians each year. We grew along with our community and the sector. The mission to provide quality aged-care services to all Victorians was borne along on this growth.

There’s a perception that larger organisations struggle to be ‘as close’ as smaller groups can be to the community they are serving. However larger organisations often have funding arrangements and the capacity for policy planning or initiating collaborative work that helps bring about immediate and wider social change.

Many large organisations such as those in the Anglicare network will have arms of the business ‘on the ground’. Their staff and volunteers may already be trusted in the community and empowered to take responsive action. In an ideal world they feed information back to higher levels of the organisation about what’s happening. But, this is not an effective or sustainable model for discovering what our communities need or want.

Benetas was in this position and needed a better approach for engaging with its community. We needed to connect with older Australians and their families, and really listen, especially if we were to fulfil our purpose of ensuring a positive experience of ageing for all older people, not just our own clients.

In 2009 Benetas embarked on a Research and Advocacy Agenda working with other not-for-profits, tertiary institutions and community groups, individuals and of course older people and their families.

Under the Research and Advocacy Agenda Benetas uses its considerable community connections to talk with people and engage with them as consumers. Benetas can advocate about issues concerning older people and strategies for a more ‘age-friendly’ society.

Respect in an ageing society was the first research project conducted with Deakin University and aimed not only to understand attitudes towards older Australians among different generations, but also how the idea of respect, or lack of it, has an effect on the quality of life and wellbeing of older people.

Findings from such research projects flow in multiple directions: they inform changes within Benetas; they are fed back to government and the multi-national aged-care industry through conferences and seminars; and they are shared with academics and health professionals through journal publication. Benetas also uses the information to encourage debate within the media as well as shift attitudes towards older people and ageing in the minds of the public.

Large organisations can listen to small voices and this listening does not always have to occur in a formal or research setting to influence larger outcomes. Some of the most powerful changes can occur when people with capacity and influence use casual encounters to listen, notice and act.

It was just such a moment in conversation with older women at an aged-care residence that prompted Benetas CEO Sandra Hills to begin a landmark investigation resulting in Women at work: the voices of older women examining the working lives of women in Australia and the implications for social inclusion later in life.

Hills recalls a conversation with people at Broughton Hall, a Benetas residential aged-care facility:

I was talking to a resident who told me how happy she was to see women in such great jobs…While she’d never had the chance herself, she was quite inspired by the fact that younger women today had the ability to do this. A number of women were now listening to the conversation and they were really keen to tell their story.

Benetas has used its place as one of the large faith-based aged-care providers in Australia to examine another little understood aspect of ageing: spirituality.

Benetas recognises that ageing can be a time of spiritual growth and renewal, a time when people are facing some of life’s biggest challenges. In a recent study Finding the way: a theology of ageing Reverend Canon Dr Stephen Ames investigated spirituality in older people and what constitutes a positive experience of ageing.

A team of pastoral care practitioners are also an integral part of the Benetas workforce. The role of team members is more wide-ranging than the traditional role of chaplain and they continue to reach out beyond the immediate Benetas community, working closely with clergy and representatives from local faith-based groups. Their focus is supporting people in times of grief and loss and through existential questions of meaning for them and their families. But they are there for just as many ‘ups’ like moments of clarity and birthdays, as well as the ‘downs’ along the way.

Benetas is not unique in providing pastoral care, in identifying and sharing best practice or participating in research about ageing well in the community. Neither is Benetas alone in combining a Not for Profit operation with a sustainable aged-care business.

Many similar groups in Australia are successful and growing rapidly, yet continue to undertake meaningful and innovative work beyond their day-to-day services or immediate clients. The challenge for all of us is to respond to the changing shape of aged care now and in the future.

The next few years are a critical period for larger not-for-profit and faith-based organisations such as Benetas to work closely with our smaller counterparts to continue this vital engagement with communities. To do so we must make the most of mutually beneficial partnerships with organisations big and small. This is especially so as strong competitive and consumer forces coalesce in the aged-care sector if we are to avoid losing sight of our purpose and our pastoral capacity, and if we are to avoid service being skewed towards only those consumers who want, and are willing to pay for, the best of everything.

Consultation and cooperation, strengthening the links between purpose and programs, lead to healthy relationships between organisations and their community. This approach keeps the organisation on track and ensures innovative, responsive services—even some that pre-empt community need—continue to evolve in ways that are mindful of vision, mission and values.

As the number of older people increase in the community and the shape of aged care changes we must take time to step back and consider where we stand: to make the most of the big and the small of it.

About the author: Lisa Rees is the Customer Experience and Partnerships Manager with Benetas, one of the largest Not for Profit aged care providers in Victoria. She has over eight years experience across publishing, journalism, marketing, communications and fundraising. Rees is the chair of the Leading Aged Services Australia Vic Marketing and Communications Network and was responsible for creating the Hardship Fund for Benetas clients facing difficult times.