The essence of a "Community Hub"
Importantly, nursing homes are only one part of a community hub. A hub is the centre of something that extends across the community, coordinating and supporting every facet in managing the ageing process. It should make each of us a participant and helper as we age. There should be no age limits.
Involvement in hub activities should extend from schools and through universities, as that is where attitudes form, as well as to the very old. From helping, our roles gradually change to being helped when we need it, but still being focused on the needs of others.
Continued constructive activity and involvement in society and its activities are the keys to healthy ageing, both physically and mentally. We are "who we are" because of what we do in society. When we stop doing and contributing we cease to "be someone". Its easy to turn an older person into a "has been". Both elderly people living alone and nursing home residents should be "involved" in life so that they are still "someone".
Life in many of our aged facilities seems to be less than optimal. Our nursing homes have been the subject of criticism for years. Too many are living isolated lives at home and, unless we are careful, the new policy to care for them at home could make this worse. There are allegations about the way retirement villages get their money. As a community we need to be there to see what is happening and to help.
The objective
The intention is to develop a cooperative venture where parties are on the same page, with all of the information, all focused on doing something constructive together, all dependent on one another.
We don't want participants at each others throats, or community regulators walking around policing, looking for misconduct. They should all be focused on a common purpose. They will be collecting information for everyone to look at and discuss and will be contributing thoughts and ideas. Trust and trustworthiness are essential in a sector like this. Care suffers when participants don't trust one another.
By making for-profit and not-for-profit services part of a wider community enterprise we bring both back into the community and out of the cultural silo that they are increasingly now both a part of. Those providers who are serving the community will not have anything to fear, and will gain help and support. Those that maintain a silo mentality will find themselves out in the cold and will have a tough time if they don't sort themselves and their community values out. The community must be in a position to act and make the market work.
Summary of this page
This page outlines the sort of community aged care hub that I am suggesting and suggests ways of getting there. It gives some background and describes the relationship to the proposals made by Professor Maddocks (Big challenge requires bold thinking: Maddocks). It examines the government’s requirements for community partnerships in health care and concludes that there are major difficulties in implementing them successfully. These would be resolved by the proposed hub. The page examines the Harper review of competition policy and shows that the proposal addresses many of the problems where Harper is cautious about the possible adverse consequences of increased commercial competition in aged care because of its vulnerability.
Implementation would begin by creating interested groups in local communities who would soon form a central organisation to coordinate activities. They would start talking to governments and providers and liaising with other community groups. They would form a partnership with government bodies who would have a supervisory and educational role.
The local organisations and their central body would coordinate, supervise and support all aged care activities in each community. They would play a pivotal role in complaints handling, oversight of care, monitoring of standards, the collection of data, data interpretation and data dissemination. They would do so in the interests of the community and its members. The Aged Care Quality Agency (ACQA) would focus on education and work through the local hubs in assessing compliance, standards of care and in evaluating the success of their programs.
The local and central hub would become an effective customer because they would know exactly what was happening in their community and would become the organisation that advised and worked with potential residents and their families. They would be represented on the approved provider process and would ultimately be able to exert a veto. Local communities would have input into the imposition of sanctions and could not be forced to accept the ownership or operation of any aged care facility by a group or individual whom they felt could not be trusted to provide the sort of service they wanted.
The sliders on this page give a brief overview of what a community aged care hub would do. Most link to pages dealing with each issue in greater depth.
Conclusion
In this section I have proposed changes to the aged care system that turn it from a centrally managed and controlled market dominated and controlled system into a locally organised, managed and integrated one in which the community would have an important and controlling but cooperative role. It is intended to restore humanity and empathy to the sector and control the excesses of the market so protecting the vulnerable.
To illustrate the difference between the system we are currently developing and what is proposed here I have placed a table comparing the failures and benefits of the government's Aged Care Sector Roadmap with where the Road that this proposed Community Aged Care Hub would take us. It is on my Inside Aged Care website and summarises what is intended..
Learn more: see The Aged Care Roadmap
