TACKLING AGED CARE MENTAL HEALTH & SOCIAL ISOLATION CONFERENCE
MELBOURNE 13 NOVEMBER 2018
In West Australian Noongar language, I say “Kaya wangju” – hello and welcome.
I acknowledge the traditional custodians of the land on which we’re meeting, the Wurundjeri people, and pay my respects to Elders past and present.
Thank you for your warm welcome to this most important and timely conference.
I would also like to acknowledge:
· Toby Dawson (Conference Chairman and Foundation Manager of the Illawarra Retirement Trust);
· Veronica Jamison (State Manager, Leading Age Services Australia (LASA), Victoria and Tasmania);
· Geoff Rowe (CEO of Aged & Disability Advocacy Australia); and
· Distinguished guests from the fields of aged care and mental health from across Australia.
I begin my remarks today with a question.
Can you remember the last time you stood in a line at the bank, in a queue at the post office, or sat waiting for an eternity in the doctor’s surgery?
You’ve probably muttered ‘hurry up’ to yourself – but have you ever thought why it was taking so long?
The answer is often that the reason for the holdup is that the person being served is having the only conversation – the only contact –they’ll have that day.
This is loneliness – this is the manifestation of social isolation.
These people are hungry – hungry for companionship.
When I first started doorknocking as a politician, I would meet people who would hang on to my hand for as long as they possibly could.
Their contact with people was negligible. So many people like this have withdrawn into themselves.
Being at home is the only place they can find security – so they never leave the house.
This isolation and loneliness has a spiralling effect that is detrimental to their health.
And if they have a mental health condition, it’s exaggerated even further.
Social isolation and loneliness is a profound challenge in aged care.
I’ve made the point before that there are aged care facilities in this country where up to 40 per cent of residents do not receive an external visitor for the whole 365 days of the year.
What you may not know, is that I have now found my first aged care facility where 100 per cent of residents – that’s every one of them – never has a visitor – not just for a year, but ever.
What an indictment. What a tragedy.
There’s a song by Three Dog Night – a Sixties group that many people of my vintage will remember.
It’s called “One” and I this is the opening line:
“One is the loneliest number that you’ll ever do…”
Of course, you don’t have to be on your own to be lonely. You can feel lonely in a crowd.
But that Three Dog Night line has always stuck with me as underlining the impact of loneliness and social isolation.
Another haunting quote comes from the much-revered Mother Teresa:
“The most terrible poverty is loneliness, and the feeling of being unloved.” End of quote.
Loneliness is a very real problem for so many - particularly for our senior Australians – and leads to problematic health outcomes for those who become chronically lonely.
The statistics are compelling.
Up to a third of older Australians aged over 75 report experiencing loneliness.
For seven to nine per cent of these, such isolation is severe.
It is estimated that almost 40 per cent of all permanent aged care residents are living with mild to moderate depression – a figure potentially correlating with the number of aged care residents not receiving visitors.
Community-based organisations, governments and individuals provide a very broad range of supports, informal and formal.
But still people fall through the cracks.
Mental illness in the older population is more than the experience of loneliness, sadness or grief.
It is often the result of an accumulation of multiple physical, social and emotional risk factors.
These issues lead to persistent negative thoughts and can become self-reinforcing – limiting a person’s ability to participate in, or benefit from, activities that might otherwise promote wellbeing.
People shut themselves off.
They shut others out.
And then they shut down.
Untreated, conditions like depression can increase the risk of, and accelerate physical and cognitive decline, including dementia.
This can lead to increased flow-on costs associated with higher care needs in residential aged care homes, as well as greater reliance on medication and potentially more hospitalisation.
This helps neither the individual nor the system.
It doesn’t have to be like this. The Waverton Hub is one mutual support model that is building a real sense of social connectedness.
It’s a local community support and friendship group – a self-run organisation of residents of Waverton, Wollstonecraft and neighbouring areas in Sydney.
It is an outstanding example of how communities can support senior Australians and combat social isolation.
I’ve seen first-hand the warmth and camaraderie of the Waverton Hub – and I recently announced a grant of $42,000 to support it sharing its success.
Already, more than 30 communities have expressed interest in the Hub model and this grant will help the founders share their expertise widely and encourage the development of new hubs.
The model has also attracted international interest, with a number of seniors’ communities in New Zealand indicating their intention to apply the model locally.
The Waverton Hub has been going for five years.
Members run it - they look out for each other, and they connect their colleagues to the services they need.
Waverton works – and I think we can all be excited to see this unique model replicated in other sites around Australia and overseas.
The Hub’s philosophy aligns strongly with the aims of our Government’s More Choices For A Longer Life package, part of the Budget’s $5 billion boost for aged care over the next four years.
Giving our seniors more choice, more certainty and supporting projects to help keep them connected with their communities is a top priority.
We recognise the importance of positive mental health for senior Australians and are committed to reducing experiences of loneliness and social isolation.
We are tackling the issue on a number of fronts – including improving mental health and dementia services, increasing the focus on aged care quality and safety and, of course, setting up the aged care Royal Commission.
We are paying particular attention to mental health nursing for older people at risk of isolation within our communities, through an additional $20 million in funding in this year’s Budget.
This includes a two-year pilot in two Primary Health Network areas – one at the Nepean in the Blue Mountains, the other in South Perth – that will be managed by the Australian College of Mental Health Nurses.
A total of 19 Networks sought to be part of the pilot, which is an indication of the scope of the issue, and also their commitment to doing something about it.
The pilot’s focus is not on offering treatment for mental illness, but on ways of socially connecting people who are assessed by their doctor as having - or being at high risk of - mental health and health conditions that are associated with social isolation or loneliness.
Alongside this initiative, a record new Budget investment of $82.5 million over four years aims to improve mental health services in residential aged care.
Overseen by the nation’s 31 Primary Health Networks, a priority is commissioning psychological therapy services for people who have fallen outside the system.
People who have traditionally experienced difficulty accessing services funded through the Medicare Benefits Schedule (MBS).
The PHNs will work with local mental health and aged care providers to design and continuously improve regional models of care.
When it’s fully implemented – from 2021–22 – this program will support 35,000 people who are living with mental illness in aged care facilities, each year.
Across our cities and towns, thousands of national Community Visitors Scheme volunteers are also working to help combat loneliness and social isolation.
Sustaining the mental and physical health of senior Australians is the aim of the new $22.9 million Move It Aus Better Ageing sports program, too.
We know that being healthy, active and engaged is important for our bodies and our minds – and we are already seeing the success of innovative sports for older people, such as walking soccer.
Being involved in teams reduces the risk of social isolation by improving community connections.
The Move It Aus program is currently seeking national and local organisations and not-for-profit aged care providers, to apply for grants of up to $2 million, to develop new programs.
The mental health and wellbeing of our older Australians will be a key focus of the Royal Commission as it addresses the quality of care provided in residential and home aged care.
As the Prime Minister has said: All of us – not just those who work in the aged care space, not just their residents, their loved ones and their families – need to prepare for what could be brutal revelations during this comprehensive inquiry.
The Royal Commission will provide a critical platform for people’s stories and experiences.
Our Government will not shy away from what emerges.
The Royal Commission is a vital step for Australia to determine the full extent of the issues in aged care and to understand how we can meet the challenges and the opportunities of delivering quality, sustainable services.
At the same time, we recognise the great work – selfless, compassionate and professional – that is being delivered in aged care right around the country.
The vast majority of Australia’s aged care services and their dedicated staff deliver outstanding care – and we should never lose sight of that fact.
Our responsibility – and one of the Royal Commission’s tasks – is to ensure there are no exceptions, now and in the future.
A key task of the Royal Commission will be to help build a national culture of respect for ageing and senior Australians.
A culture that ensures that people are treated with dignity and receive the care they deserve.
As the Royal Commission goes about its critical work, our unprecedented aged care reform program will continue at full pace, reforms that are making a real, on-the-ground difference.
We are bringing together aged care regulation, compliance and complaints through a new independent Aged Care Quality and Safety Commission that will open its doors on 1 January next year.
The Commission will be funded with almost $300 million over four years, including an additional $48 million to intensify quality compliance.
It will also provide a single point of contact for all aged care providers, residents, their carers and loved ones, regardinig quality of care and services.
This will give the more than 1.3 million senior Australians who receive some form of aged care increased confidence in aged care regulation.
With more than 436,000 Australians now living with dementia, managing, preventing and curing the condition has been a national priority since 2015.
That year, the National Framework for Action on Dementia was launched and the 5-year, $200 million Boosting Dementia Research initiative began.
Three years in, this has helped make Australia a world leader in many aspects of dementia research.
In July this year, we also launched the new $38 million Australian Dementia Network (ADNet), to turbocharge the quest to find cures and better manage dementia.
The $34 million Dementia and Aged Care Services research and development program is are also yielding exciting innovations.
The Moving Pictures project is producing 15 new films in an online and app format, in five languages - Mandarin, Cantonese, Hindi, Tamil and Arabic.
This aims to help cut through social isolation among these cultural groups, leading to earlier dementia diagnosis and better outcomes.
Recently, I launched is the Speak My Language radio network, which will bring thousands of members of multicultural communities together.
Aged care information and more than 1,000 people’s stories are being broadcast live and podcast, to promote ageing well, in languages they understand and are comfortable with.
The project is engaging people with 160 bilingual aged care facilitators and ethnic radio programs across New South Wales, Queensland, Victoria, Tasmania and the Australian Capital Territory.
As well, we now have a new blueprint for preparing the aged care workforce of the future.
It will guide the sector to rapidly grow Australia’s professional aged care workforce, which is estimated to require three times as many workers – almost one million – by 2050.
It is designed to help the sector shift attitudes to caring careers, and enhance the quality of life of senior Australians.
Already, we have established a committee to reform national training qualifications for the aged care sector.
It will drive collaboration across vocational training, higher education and industry to address the challenges faced by the ageing population.
We recognise that the care needs of senior Australians are growing increasingly complex, with a high incidence of multiple chronic conditions, including dementia, and changing community expectations.
These initiatives serve to remind us that many of the aged care challenges of today – as great as they are – also present great opportunities to continue to build an aged care system that is the envy of the world.
I trust you can see from my remarks today that our Government takes the issues of loneliness and social isolation among Australians very seriously indeed.
We are confronting the challenges at a number of levels and I am confident we are beginning to make significant progress.
We are committed to working together to develop practical, evidence-based policy that will make a difference to people’s lives.
Our senior Australians deserve nothing less. They may be nearing the end of their life’s journey – but I want to assure them that they are not alone on that journey.
It is encouraging to see a conference such as this that is not just providing information on issues around older people’s mental health – but also working to address them.
I wish you all well for the conference and I look forward to the outcomes of your deliberations.