Quality of Life – the ATSI Flexi

I was interested to hear a talk presented by the Quality Agency recently on their discovery that the compliance rate of residential care services was above 95% in meeting the aged care standards.

But what was more interesting were their observations about Quality of Life as assessed by consumers living in residential care.

When the Quality Agency staff asked a consumer if they felt they received quality care, overwhelmingly the person responded with a yes. Staff appeared to know what to do, care support met the person’s physical needs and the meals were of a good standard.

Consumers gave a different response however when they were asked how they felt their quality of life was. The majority of people stated their quality of life was low. This is concerning, as we would assume that if a person’s physical needs are met by trained staff who have their concerns at heart, then an individual would feel their quality of life is good – but obviously it is not.

Why not?

I guess it goes back to thinking about what makes our life worth living – family and friends around, speaking the language of our preference, having the ability to go where we want, when we want and having a purpose in life – even if that is just getting the kids off to school every day or going to work. We have purpose and goals.

But what does someone in a residential facility have, separated from the rest of the community, away from their family and friends and perhaps with nothing to occupy their time in a meaningful way? What if the care staff are unable to communicate with the older person in their preferred language? What if the older person can’t make themselves understood? There needs to be a way to provide care in a manner that also supports quality of life, and in some remote Aboriginal and Torres Strait Islander communities, there is.

The Commonwealth Government has funded Aboriginal and Torres Strait Islander Flexible Aged Care (ATSI Flexi) programs which, as the name suggests, offer a more flexible way of providing care support to the frail aged living on remote communities. The model allows communities to direct the way care is provided to aged consumers, so where the community has appropriate housing and family support for older people, the service may operate more as a day respite service, supporting the family and consumer. Where there is a need for on-going overnight support, the Flex may operate as a 24/7 service.

The benefit of an ATSI Flexi service is that there is more scope to meet both the cultural and individual requirements of the consumer base, which sometimes differ from the mainstream model.

An example of this is often seen in sleeping arrangements. In mainstream residential care, individuals value their privacy and there is a preference for private rooms. Conversely, many indigenous people in remote areas prefer a shared room as this aligns more closely with societal norms for them. Many ATSI Flexi buildings have been developed in consultation with the community, with guidance provided by Elders on placement of the buildings, layouts and room requirements. Some centres have local artwork adorning the walls.

The ATSI Flexi model promotes the concept of Cultural Safety and allows older Aboriginal and Torres Strait Islander people to remain close to their family and traditional lands, allowing them to continue practicing their culture and supports the preferences of the individual in how they want to sleep, foods they prefer to eat and activities they want to engage in. Many of the ATSI Flex’s are an extension of the community and employ local staff, allowing the older person to speak their own language and supporting the person to engage with other aspects of their community such as the art centre, women’s centre and Rangers programs.

This emphasis on community assists an older person living in an ATSI Flexi centre, or attending the service regularly, to feel a part of their community, to feel connected with the world around them and to continue to contribute to their society. Although the care and support offered by many ATSI Flexi services differs from mainstream expectations, I expect that many older people from remote communities would argue that the benefits of living on country and being supported in their own community, by their own people, continuing to engage in cultural activities, to go fishing or hunting with family or friends equals quality of life.

So how can you support quality of life for your client base?

You may not have an ATSI Flexible program and like many remote services you may have limited resources, but this shouldn’t stop you from finding out from individuals what makes life worth living for them – just ask them. Find out what makes them happy and if it is within your abilities and scope, then maybe today you can make someone’s day!