catholic health australia health matters matters/2018... · pictured below is his eminence cardinal...

C A T H O L I C H E A L T H A U S T R A L I A

Health mattersI S S U E 8 8 / S U M M E R 2 0 1 8 / 2 0 1 9cha.org.au

Prof Josephine Forbes’ mission to disrupt the impact of diabetes

Nursing & Midwifery Symposium highlights

Research confirms

pastoral care

critical

Addiction – how should the Church

respond?

Exercise curbs disability in old age, so start now!

@HMHealthMatters

In this edition of Health Matters, Catholic Health Australia shines a spotlight on innovation and research as the enablers of improvement of care services. Medical breakthroughs, new technologies and continuing clinical research position Catholic providers at the forefront of Australia’s health and aged care sector.

I also offer that, whilst there are many factors that make our services effective, I wish to highlight two that support Catholic providers of care to be innovative and able to constantly improve.

Firstly, as not-for-profit services, our objective is not distorted by the need to keep shareholders happy and to achieve greater financial returns year on year. Admittedly, we can only continue to offer care if services are viable and sustainable, but our measure of success is not financial. Rather it is in terms of how many people can we care for? How can we ensure access to quality health care and aged care for those who are disadvantaged and underserved? Our ‘for purpose’ character facilitates our work in the healing ministry of Christ.

Secondly, Catholic care services together form the largest provider grouping of health and aged care services in the world. This scale supports opportunities for shared learning producing improved outcomes for those we care for. In support, a meeting was held this month in Rome for those the Dicastery for Promotion of Integral Human Development is inviting to join what will become the inaugural Health Commission advising the Dicastery. Pictured below is His Eminence Cardinal Turkson with myself to his left and some of the Dicastery team and some of the other people to be invited to join the Commission.

Australian Dr Alex Wodak also presented at the International Health Conference in Rome on 1 December. I encourage you to read Dr Wodak’s presentation which is shared with you in this edition of Health Matters, along with the many articles highlighting innovation and research across Catholic care services.

God Bless, Suzanne Greenwood / Editor

Suzanne Greenwood CHA Chief Executive Officer

Spotlight on innovation and research

by

Catholic hospitals and aged care services have a very long and proud tradition of providing excellent, person-centered care. Continuing to do so in the modern context requires our healing ministry to be agile, responsive and forward-focused.

International Health Conference, Rome

HEALTH MATTERS

EDITOR’S DESK

EDITOR’S DESK / Spotlight on innovation and research

COVER STORY

02 / Diabetes research could reset life-forecast for teens

FEATURE STORY

06 / How should the Church respond to addictions

10 / A little drug called exercise changing cancer care

AGED CARE

14 / Mercy – a showcase for innovation in aged care

AGED CARE INDIGENOUS

16 / Caring for First Nations Elders

NURSING & MIDWIFERY SYMPOSIUM

20 / Nursing & Midwifery Symposium highlights

22 / Q&A with Matiu Bush

26 / Shark Tank – The winners

28 / Nurses – the heartbeat of hospitals

SECTOR SPEAKS

30 / Cabrini Centre For Innovation Two Years into our Innovation Journey

32 / A priestly vision to serve the underprivileged

35 / Best practice community health and wellness for older Australians

38 / Practical action against Modern Slavery and Human Trafficking

40 / The Catholic Hospital: Understanding the Patient’s Experience

AROUND THE NETWORK

46 / This is my story: Life histories come alive with digital biographies

48 / Pasta necklaces fit for royalty

MISSION

50 / What are the benefits of Pastoral Care to hospital patients and aged care residents?

54 / An Ethical Dilemma?

57 / Largest study of its kind in Australia

60 / Formation more critical than ever

REFLECTION

62 / Loneliness and Aging

64 / Christmas Reflection

Editor / Suzanne Greenwood

Designer / Karrissa Armstrong

Advertising Opportunities email [email protected]

National Office Level 2, Favier House 51 Cooyong St, Braddon, ACT, 2612 phone 02 6203 2777 email [email protected]

www.cha.org.au @chaaustralia /CatholicHealthAustralia

Contents

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ACN 167 751 537 / ABN 30 351 500 103 / ISSN 1443-3532

Health Matters is published quarterly by Catholic Health Australia

The views expressed in articles written by external contributors are those of the authors and do not necessarily reflect the views of CHA

“You are never too old, too sick or too disabled to benefit from exercise.”– Dr Tim Henwood

01

CATHOLIC HEALTH AUSTRALIA

CONTENTS

02

HEALTH MATTERS

COVER STORY

There is no debating that diabetes is a pressing global health challenge, a pandemic, with a third of patients with diabetes developing cardiovascular and kidney disease. The World Health Organisation estimates around 450 million people globally, 1.2 million adult Australians, suffer from diabetes, with the number increasing every year.

A recent discovery that kidney disease starts much earlier than previously appreciated inspired Professor Josephine Forbes’ latest quest.

Her research is focussed on young people, aged 10-15 or 15-25 with diabetes, to see if they already have evidence of kidney disease, and the best time to intervene.

“We’re particularly interested in the function of ‘cell power stations’ which are called mitochondria. We know that young people have evidence of dysfunction in these cell power stations but we may be able to detect this even earlier to start treatment to prevent kidney disease.”

The kidneys are highly metabolic organs rich in mitochondria. They contain vast numbers of mitochondria to synthesise fuel (adenosine triphosphate (ATP)), for their normal function. In diabetes, the delivery of metabolic products such as fatty acids and oxygen, which are essential for ATP production in mitochondria, are altered. Diabetes also changes the fuel sources chosen to meet ATP production, resulting in increased oxygen consumption, which contributes to a lack of oxygen (hypoxia) in the kidneys.

Kerie Hull / CHA

Diabetes research could reset life-forecast for teens by

Celebrated researcher, Professor Josephine Forbes is on a mission to disrupt the impact of diabetes on kidney and heart health, intervening as early as possible. This work at Mater Research has the potential to change the lives of thousands of Australian children living with diabetes now and into the future. Prof Forbes shares her progress.

Professor Josephine Forbes is a Program Leader of the

Chronic Disease Biology and Care research theme at Mater and a National Health

and Medical Research Council (NHMRC) Senior

Research Fellow.

Josephine leads the Glycation and Diabetes Complications Research Group at Mater Research

with a team of 10 researchers.

Josephine is the author of over 160 scientific publications with her

research currently focused on diabetes and its’

complications.

At a glance

03


COVER STORY

“We suggest that the diabetic environment and inherited factors that underlie abnormalities in mitochondrial function synergistically drive the development and progression of diabetic kidney disease,” Professor Forbes says.

“We believe that young people may already have evidence of dysfunction in these power plants, and if they do, there is a therapy we are looking to use which is in Iate stage clinical trials for other treatments. We are investigating this younger age group to verify the treatment options in regards to dosages and how often and when we give it.

“Comparing the two different age groups will show us how early we can start the therapy. We know at 15-25 individuals have the dysfunction but we may be able to see this in 10-15 year olds and start treatment earlier to prevent progression.

“At least 30-40 per cent of these patients will get kidney or cardiovascular disease which shortens their life. They may end up on dialysis, have an early heart attack, lose their feet or go blind and we really want to do something about it. It really impacts so many things. This research is trying to take the bull by the horns and prevent it developing in the first place.”

Forbes has a partnership with a biotech company and is working her way meticulously through the regulatory regime. She says Mater has a unique centre dedicated to adolescents, between the ages of 15-25, which is her prime interest group. “We are very confident we can change the quality of life for these teens with Diabetes.”

For her dedication to the cause Prof Forbes has been awarded the prestigious TJ Neale award by the Australia and New Zealand Society of Nephrology (ANZSN), nominated by Director of Nephrology at Royal North Shore Hospital in Sydney, Prof Carol Pollock.

“Prof Forbes has made a truly outstanding contribution globally to understanding the pathogenesis of diabetic nephropathy, as well as developing a research program to better understand issues in the diabetic milieu relevant to glycaemic control, one of the major risk factors for diabetic kidney disease,” says Prof Pollock.

The award is made annually to a clinician or scientist who is deemed to have made the most outstanding contribution to nephrological science. It also recognised her outstanding contribution to diabetic kidney disease complemented by her mentorship of others and involvement with the greater renal and diabetes communities both in Australia and globally.

“I enjoy training people, it’s my way of giving back. I also deeply value a multi-disciplinary approach because we can do this better together, ”Prof Forbes says.

“At least 30-40 per cent of diabetic patients will get kidney or cardiovascular disease.” – Professor Josephine Forbes

From the very start she has worked alongside physicians and would not have it any other way. She says dovetailing science and medicine is critical in understanding where the therapies will be most useful.

Prof Pollock is not alone in her admiration of Prof Forbes’ dedication and achievement. She has been a rising star for more than a decade honoured with the Commonwealth Health Minister’s Award for Excellence in Medical Research, the Research Prize for Women in Science Technology Engineering and Maths at the World Science Festival in 2016 and the Excellence in Life Sciences Award from ‘Women in Technology’ in Queensland in 2014. She has previously received other high accolades including an NHMRC excellence award (2010), a Victorian Young Tall Poppy Award (2009), a Millennium Award for type 1 diabetes (DARP, 2007) and a young researcher award from the International Diabetes Federation (2002).

Professor Forbes says humbly that she is only as good as her team and enjoys the greatest rewards from mentorship and driving a multidisciplinary approach to creatively solving challenges from discovery to commercialisation. “I have had terrific support from Mater Research and collaborations with colleagues across Australia and overseas.

SO WHAT IS NEXT FOR PROFESSOR FORBES?

Here’s the kicker… not only is she on the way to preventing kidney and cardiovascular disease for those with Diabetes Type 1 and 2, she hopes to prevent Type 1 Diabetes before it starts.

“We have a very promising compound that may prevent Type 1 Diabetes. Through ‘Trial Net’ and other natural history data we will be able to identify at risk populations and prevent onset. We are in venture capital territory so its not talked about widely, however is very exciting.”

With these two therapies, Professor Forbes is on the way to changing the lives of millions of children and adults. She says tackling prevention of kidney disease amongst both Type 1 and Type 2 Diabetes groups is where the greatest impact lies.

If Professor Forbes has her way, one day soon diabetes will no longer hold the crown for the leading cause of chronic kidney disease and end-stage renal disease.

Prof Forbes has made a truly outstanding contribution globally to understanding the pathogenesis of diabetic nephropathy.

04

HEALTH MATTERS

COVER STORY

Prof Forbes would like to acknowledge the funding bodies who have supported her research including Kidney Health Australia, Diabetes Australia, the Juvenile Diabetes Research foundation, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) USA and the National Health and Medical Research Council (NHMRC) and of course Mater Research.

Thank you 05


COVER STORY

How should the Church respond to addictions

Virtually all cultures in history have used psychoactive drugs. One of the few objects nomadic Indigenous Australians carried from one camp to the next was so-called ‘bush tobacco’ or ‘pituri’, containing the psychoactive ingredient nicotine which reduces heat loss when sleeping semi naked in the desert.

Australia’s first drug laws banned the smoking of opium in the mid 19th Century. The only people who smoked opium in Australia at the time were Chinese. These racist laws were clearly directed against Chinese people who had been attracted to Australia by the search for gold. Similar laws were passed at the same time and for the same reason in California, US and British Columbia, Canada. Racism had a lot to do with the development of global drug prohibition in the 20th Century.

International Conference.Drugs and Addictions: An Obstacle to Integral Human Development

Dr Alex Wodak AMby

Dr Alex Wodak AM

“A 21st Century Church offers guidance to communities struggling with dysfunctional drug policies.”– Dr Alex Wodak

The Phenomenon of Drugs constitutes a worrisome problem in the world today and requires serious study and action. Pope Francis has on several occasions emphasized that the scourge of drug-trafficking, which favours violence and sows the seeds of suffering and death, requires of society an act of courage. At the International Conference focussed on drugs and addictions Dr Alex Wodak participated in an important roundtable discussing ‘The Commitment of the Church in the Battle Against Addictions: Best Practices, Oceania’. He shares his address.

06

HEALTH MATTERS

FEATURE STORY

Dr Alex Wodak participates in the Roundtable at the International Conference in Rome

THE ORIGINS OF DRUG DIVISIONS

Drug use can have benefits but also can cause considerable harm. Sometimes policy intended to reduce harm causes even more harm than the drugs themselves. As the late Kofi Annan, former UN Secretary General, said ‘We believe that the global war on drugs is now causing more harm than drug abuse itself.’ Separating drug-related and policy-related harms is often very difficult.

More than a century ago, the international community began an experiment of dividing psychoactive drugs into a small legal group and a much larger illegal group. There was no pharmacological, scientific, public health or public policy reason for this division. Why drugs were divided like this is still a mystery. But once the decision was made, the system took on a life of its own with widely adopted international treaties and a network of international organisations established to develop, implement and monitor drug control policy.

It is now increasingly clear that this experiment has failed abjectly.

Helen Clark, the former New Zealand Prime Minister, and Administrator of the United Nations Development Programme recently noted:

“there is a clear and growing consensus: around the world, the so-called ‘war on drugs’ is failing.

Some $100 billion a year is spent fighting the war, yet drug use increases every year.

Illegal drug markets have expanded relentlessly to meet this growing demand, with opium and coca production rising respectively by 130% and 34% between 2009 and 2018.

The number of drug-related deaths continues to reach new peaks, with 450,000 drug use-related deaths in 2015 alone. Much of this rise is driven by the North American opioid overdose crisis, with total overdose deaths in the United States reaching a record 72,000 people in 2017. This is more than the total number of U.S. soldiers who died in the Vietnan War.

Punitive drug law enforcement is fuelling mass incarceration and prison overcrowding, with one in five of the world’s 10 million prisoners now incarcerated for drug offences, mostly for minor, nonviolent drug possession. This proportion is even greater for women, reaching over 50% in several Latin American countries and over 80% in Thailand.

07


FEATURE STORY

Furthermore, drug market-related violence has spiralled to unprecedented levels. In Mexico alone, there have been up to 250,000 killings and 32,000 disappearances since 2006. This horrific level of bloodshed is compounded by illegal state actions where, at its extremes, the war on drugs is providing political cover for some of the most egregious human rights abuses taking place anywhere on the planet.

Thousands have been executed for drug offences over the past decade and, according to several human rights groups, up to 12,000 people have been killed extra-judicially in horrific drug war operations in the Philippines since 2016.

Rather than eradicating drugs, prohibition is empowering and enriching organised crime groups.”

The problems caused by the failed policy of drug prohibition are even more severe in drug producing and trafficking low and middle-income countries than they are in the rich world. Over the last half century, the $400 billion global illicit drug market has expanded greatly and become much more dangerous. The street price of illicit drugs has dropped substantially and continues to fall. Deaths, disease, crime, corruption and violence related to illicit drugs have increased substantially. In Australia, there were 6 heroin overdose deaths in 1964. In the next 33 years, the rate of heroin overdose deaths increased 55 times.

The time has come when the abject failure of global drug prohibition can no longer be denied. It is time to think about the realistic options available: options that must be politically acceptable but also have to be economically realistic. As Gramsci has said ‘the old is dead but the new is not yet born’.

The threshold step required is to re-define currently illicit drugs as primarily a health and social issue. There always will be a place for law enforcement but it should be a subsidiary role. Second, drug treatment must be expanded and improved until it reaches the same high standards as the rest of the healthcare system. Third, penalties against the possession of personal quantities of currently illicit drugs should be scrapped. Fourth, notwithstanding the political and logistical obstacles to achieving this, as much of the drug market as possible must be regulated. Fifth, opportunities for our young people must be improved so that they can look forward to their future with optimism.

PUNITIVE POLICY NOT THE PANACEA

Identifying benefits from punishing people for the use or possession of personal quantities of currently illicit drugs is challenging. However the unintended negative consequences for ‘offenders’ are often severe and may include damage to relationships, employment and accommodation. Usually drug use after the punishment continues unchanged. Punishing people for the possession of small quantities of currently illicit drugs consumes significant resources. It is also unfair for people with majority drug preferences to punish people with minority drug preferences absent harm to others.

Many will regard this package of reforms as unachievable. I accept that in prospect this package may seem impossible but I suggest that in retrospect many will see these reforms were inevitable. We have been through similar experiences many times before including the fall of the seemingly impregnable system of apartheid in South Africa or the fall of communism in the USSR and its satellites.

As Francis Hodgson Burnett said in “A Secret Garden”:

“At first people refuse to believe that a strange new thing can be done, then they begin to hope it can be done, then they see it can be done – then it is done and all the world wonders why it was not done centuries ago.”

Many of the listed proposals are now considered acceptable. The most contentious is the recommendation to regulate as much of the drug market as possible while recognizing that it can never be fully regulated. Methadone treatment and needle syringe programs are now each provided in more than 80 countries. Drug Consumption Rooms and Heroin-Assisted-Treatment are now each available in almost a dozen countries. Last month Canada became the first G7 country to start regulating recreational cannabis. This month Michigan became the tenth US state to commit to regulating recreational cannabis.

The measures I have just listed all regulate parts of the drug market. More importantly, they reduce harm substantially. We know what needs to be done to reduce problems due to currently illicit drugs and drug policy. But we are prevented from moving ahead by fear, especially the fear of unknown political consequences.

The health, social and economic cost of the legal drugs, tobacco and alcohol, dwarf the problems caused by illicit drugs yet are virtually ignored. Smoking causes more deaths than all other drugs combined. Up to two of every three long term smokers will die from a smoking related cause. There were 100 million deaths from smoking in the world in the last 100 years with another one billion deaths from smoking likely in the next 100 years. The development of an efficient vaping device 15 years ago now allows the world to dramatically reduce deaths and disease from smoking. Likewise, snus, a moist oral form of tobacco popular among Swedish men for decades, allows people to continue enjoying nicotine without the toxic effects of tobacco combustion. Again with tobacco, we know what needs to be done to reduce harm from smoking and oral smokeless tobacco but we do not yet know how to ensure the adoption of effective policies to reduce harm. Harm reduction always faces fierce opposition.

It’s much the same story with alcohol, the cause of much serious health, social and economic harm around the world. Effective ways of reducing alcohol-related harm have been known for decades. But an all powerful drinks industry prevents governments adopting effective reforms such as modestly increasing price or restricting availability.

08

HEALTH MATTERS

FEATURE STORY

The time has come when the abject failure of global drug prohibition can no longer be denied.

WHAT IS THE ROLE OF THE CHURCH IN THESE DEBATES?

In my view, the Church has a very important role to play in providing leadership to the community in a difficult debate.

You will all know these magical words from Matthew:

‘For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’

Surely a 21st Century Jesus would also offer help to the mentally ill and to those struggling with severe alcohol and drug problems. So too should a 21st Century Church offer guidance to communities struggling with dysfunctional drug policies.

In the 1960s I was a medical student at St Vincent’s Hospital in Melbourne. The Religious Sisters of Charity, responsible for this hospital, encouraged a commitment to the alcohol and drug field. It is a long and complicated story. But this commitment had a substantial national impact. It also ended up influencing me to work in the alcohol and drug field. It is the reason I am here today.

Things that can’t go on forever don’t. The international drug control system causes more harm than it does good. It is time that countries were encouraged to develop their own responses, based on their own situation but guided by a paramount desire to reduce harm while protecting human rights.

Dr Alex Wodak AM is Emeritus Consultant at St Vincent’s

Hospital, Sydney.

President of the Australian Drug Law Reform Foundation,

and Director of Australia21.

Dr Alex Wodak AM

09


FEATURE STORY

Elisabeth Tarica / Australian Catholic University

Attitudes to treating cancer, what it takes to give people their best chance at survival and improve their quality of life are changing thanks to the work of Associate Professor Cormie and her team at ACU’s Mary MacKillop Institute for Health Research.

Gone are the days of gently cocooning cancer patients in cotton wool – when rest and relaxation was an essential and endorsed part of care.

A little drug called exercise – generic name: physical activity – has kicked that old-fashioned idea to the kerb as it continues to deliver incredible results, reduce nasty treatment side-effects and improve people’s overall feeling of wellbeing.

Also known by other brand names such as walking, jogging, swimming and lifting weights, prescribed exercise is giving back quality of life to many who saw no hope in cancer’s ravage and destruction.

“We are talking about a dramatic change in how cancer is treated,” Associate Professor Cormie said. “The original thought that we have to protect the patient and encourage rest has been completely turned on its head. Exercise is now a critical component of cancer care with evidence showing that withholding it from cancer patients is harmful.”

These are not statements Associate Professor Cormie makes lightly.

As the lead author of the Clinical Oncology Society of Australia (COSA) position statement on exercise and cancer care, Professor Cormie led the world-first campaign for exercise to be embedded as part of cancer treatment.

Her push is backed by a significant body of research as well as the medical might of Australia’s leading cancer experts and organisations.

A little drug called exercise changing cancer careby

Prue Cormie is a woman on a mission. A mission, backed by fierce determination and steely passion, to improve the lives of millions of cancer patients around the world by turning cancer care on its head.

“If the benefits of exercise could be turned into a pill – it would be touted as a breakthrough in cancer treatment.” – Prue Cormie

10

HEALTH MATTERS

FEATURE STORY

Associate Professor Cormie says exercise is now a critical component of cancer care

“The original thought that we have to protect the patient and encourage rest has been completely turned on its head.” – Prue Cormie

By highlighting the role of exercise alongside surgery, chemotherapy and radiation, it calls for all cancer patients to be prescribed exercise as a standard part of cancer care.

The move is supported by 25 influential health and cancer organisations including Cancer Council Australia. And doors in Canberra have creaked open as health ministers and policy advisors start to take notice.

EXERCISE AS MEDICINE

Surely, if there is an excuse to give that spin class a miss, it’s being diagnosed with cancer.

However, when new mum Nicole Cooper, 33, was given the devastating news that she had an aggressive and terminal form of bowel cancer, she wasn’t expecting what came next.

Her oncologist prescribed exercise alongside potent chemotherapy.

“He said let’s do the chemo and I want you in the gym every day,” Ms Cooper said.

Originally identified in the liver, the disease had aggressively spread to her bowel. She was told there was nothing more that could be done apart from palliative chemotherapy treatment.

Her oncologist offered some hope when he was willing to put her on an aggressive chemotherapy regime on the small chance that it could shrink the tumours enough to allow him to operate.

“He said ‘we want to prepare you to take the maximum amount of drug you can get into your body, and the only thing in your control is exercise’,” Ms Cooper said.

She had to be in optimum condition to handle the demanding program. So, in between bouts of chemotherapy, exercise she did.

It was a lifesaver.

The chemotherapy killed off all but one of the liver tumours.

“I started with a non-operable, life-ending cancer and that’s changed radically for me,” she said. “A year later, I am in remission, having taken just as much exercise as I have chemotherapy.”

Associate Professor Cormie is buoyed by Nicole’s story but says she is not alone in reporting such good news.

“If the benefits of exercise could be turned into a pill – it would be touted as a breakthrough in cancer treatment,” she said. “It would be demanded by patients, prescribed by every cancer specialist and subsidised by government.”

The EX-MED Cancer program is that pill.

Associate Professor Cormie was instrumental in launching the Australian first EX-MED Cancer program, an exercise program for cancer patients designed to help with the side effects of treatment, increase quality of life and potentially improve the chances of survival.

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FEATURE STORY

Working with exercise physiologists in local fitness centres and exercise clinics, the program delivers a personalised exercise prescription to complement traditional treatment.

“We have about 20 new patients referred every week and we’ve been overwhelmed by the amount of amazing feedback from patients and health professionals,” she said. “Our vision is to have EX-MED Cancer implemented nationally so as many cancer patients as possible can access this effective medicine.”

Cancer affects one in two Australians, with one diagnosed every four minutes.

Yet only one in 10 of those diagnosed will exercise enough during and after their treatment. But every one of those patients would benefit from exercise.

COSA’s position statement on exercise for cancer patients is a drastic shift from current practice in Australia, as most cancer specialists still don’t specifically prescribe exercise as treatment, despite being aware of its benefits.

Associate Professor Cormie said cancer and its treatment can have a devastating effect on people’s lives, causing serious health issues that compromise their physical and mental wellbeing.

Cancer patients who exercise regularly experience fewer and less severe side effects from treatments. Patients with breast, colorectal and prostate cancer also have a lower relative risk of cancer recurrence and a lower relative risk of dying from their cancer.

WHAT EXACTLY SHOULD BE PRESCRIBED?

Exercise specialists can prescribe exercise in a similar way that doctors prescribe medications; by knowing how cancer impacts our health and understanding how certain exercises improve the structure and function of the body’s systems.

The COSA position statement recommends people with cancer progress towards doing two to three resistance sessions a week (such as weights) and embark on at least 150 minutes of moderate aerobic exercise, or 75 minutes of vigorous aerobic exercise (such as walking, jogging, cycling or swimming). However, noting that these levels will be unattainable for some patients, the statement specifies that an individualised approach is required.

It builds on a significant body of evidence about the positive impact exercise has on cancer – with ACU research showing the risk of dying may be reduced by nearly half with regular brisk walking and lifting moderate weights.

Associate Professor Cormie led the review of more than 100 studies published in the American Journal of Epidemiology that found mortality rates among those who regularly exercised fell 28 to 44 per cent.

Finding her niche and leading the paradigm shift Prue Cormie has found her niche in exercise medicine. Driven by a fascination about the way exercise changes our bodies, she is leading the paradigm shift in cancer care.

“What drives me is the potential to have such an impact on patients’ lives and to do research that not only has the power to change practice worldwide but influence the care that people get in one of the darkest times of their lives,” she said.

“I have always wanted to do research and figure out how to get people back to being well and living the best life possible. I saw the biggest opportunity in cancer as it affects so many people and exercise has the potential to dramatically change these patient’s lives.”

She recounts a story when a patient told her he was glad he had cancer.

“It completely floored me. When I asked him why he said being involved in this exercise program had changed his life. We hear it all the time… the impact that we have on people’s lives is massive and it’s not just about cancer.

“It makes this work super rewarding and is incredibly inspiring for our team. That’s the impact exercise can have. It is extremely motivating and the reason I love what I do.”

“Cancer affects one in two Australians, with one diagnosed every four minutes.Yet only one in 10 of those diagnosed will exercise enough during and after their treatment. But every one of those patients would benefit from exercise.” – Prue Cormie

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HEALTH MATTERS

FEATURE STORY

OUR ENDURING COMMITMENT TO END OF LIFE CAREMONDAY, 11 FEBRUARY 2019

C AT H O L I C H E A LT H AU S T R A L I A

Australian Catholic University, Fitzroy, MelbourneDaniel Mannix Building, Room 702

$120 FULL DAY | $65 HALF DAY | Refreshments included

For over 180 years, our services in Australia have served people with a life-limiting illness through a commitment to excellence in end of life care. This reflects our healthcare tradition of nearly 2,000 years which seeks out those who are vulnerable in any way and responds to them through compassion and accompaniment with the best skills and knowledge available. In this, our ethic of care aligns with the long tradition of Hippocratic medicine. In this seminar, we will explore this commitment to excellence in end of life care, its manifestations nationally and internationally, what it looks like in Victoria in the advent of the ‘Voluntary Assisted Dying Act’, and how we can continue to commit courageously to excellence in end of life care.

Who should attend?

Health, aged care and social services organisation executives, clinicians, managers, mission leaders, ethicists and pastoral practitioners; clergy, parish pastoral associates, academics, nursing and other health and care professionals.

Arrive 9.30am10.00am – 12.30pm

MORNING SESSION (MORNING TEA ON ARRIVAL)

Our Ethic of Care Endures: Setting the scene1. Learnings from the international perspective – Dr Carol Taylor2. The Australian context – Dr Dan Fleming, Group Manager Ethics & Formation, St Vincent’s Health AustraliaAccompanied by a panel of experts featuring:• A/Prof Bernadette Tobin, Director – Plunket Centre for Health Ethics• Dr Nigel Zimmermann, Associate Director of Church Policy, Australian Catholic University • Donna Filippich, Legal Counsel, St Vincent’s Hospital, Melbourne

LUNCH BREAK

1.30pm – 4.00pm AFTERNOON SESSION

How our Model of Care Endures Today1. Palliative Care report – Dr Ellen Marks, General Manager of Advocacy & Inclusion at One Door Mental Health2. Communicating our continued commitment to care – Mark Green, National Director of Mission, Calvary HealthcareAccompanied by a panel of Experts featuring:• Stephen Lyons, End of Life Communications Manager, Calvary Healthcare • Kathy Bowlen, General Manager, Media & Communications, St Vincent’s Hospital, Melbourne • Zoe Austin-Crowe, Senior Policy Advisor and Project Manager, Health Issues Centre3. Final observations, next steps – A/Prof Natasha Michael, Director of Palliative Medicine, Cabrini Health

www.cha.org.au

FOR SEMINAR ENQUIRIES PLEASE CONTACT: Susan Sullivan [email protected] | Annette Panzera [email protected] | Emma Hoban [email protected]

Mercy Place Albury

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HEALTH MATTERS

AGED CARE

“We listened to the people we care for and their families to develop improvement ideas,” Mercy Health Group Chief Executive Officer Adjunct Professor Stephen Cornelissen says.

Mercy Place Edgewater in Western Australia was the pilot site for this new approach to residential aged care, an outlook that aims to promote independence, choice and relationship development by creating familiar home spaces. The sense of community that was created at Mercy Place Edgewater was considered such a success that Mercy Health has introduced the concept across two more homes, with more to follow.

The purpose-built Mercy Place Ballarat welcomed its first residents in September this year, while Mercy Place Albury has been redeveloped to incorporate the concept and is now home to 24 small household residents. Work is also underway to develop Mercy Place Montrose and Mercy Place Mount St Joseph’s in Young to accommodate this community-centred approach to aged care.

“Research and resident feedback tells us that people, no matter what stage in life they are at, need to be connected to the community to flourish,” Adj Prof Cornelissen says. “Each of our homes that have introduced this new concept feature households that accommodate a small group of residents, who live together as a community within the larger Mercy Place community.”

Each household has its own front door entry, kitchen, living area and outdoor space, and has dedicated staff in each home to provide round-the-clock care. Residents retain as much independence as they want, including choosing the time they wake up and helping to plan the weekly menu for their house.

“These homes have been designed around our residents needs and for people to age in place. If we create spaces and experiences that are more akin to those we are familiar with before we move into residential aged care, we hope we might be able to reduce some of the behavioural and social issues that can result from people living with diseases such as Alzheimer’s.”

Mercy – a showcase for innovation in aged careMoving from home into aged care can be both difficult and daunting but Mercy Health is striving to make the transition a little bit easier with the introduction of a community-centred approach to aged care living.

YOUNG PEOPLE BRING JOY

Across all of Mercy Health’s residential aged care homes, activities are scheduled and programs are employed with the aim of assisting residents to live engaged and fulfilled lives. One of the most successful is Mercy Health’s Intergenerational Program, which helps to bridge the divide between generations. Groups of children from local early learning centres, playgroups and schools visit their nearby Mercy Place, where they engage in activities with the home’s residents.

The benefits for both residents and children are clear, Mercy Place Parkville Service Manager Maryann McCusker says.

“Our intergenerational activities are such a highlight for our residents each week,” she says. “The children bring so much joy to our home, and it’s wonderful to see residents who are sometimes reserved, thoroughly enjoying themselves, dancing, reading and doing craft with the children.

“Intergenerational programs benefit everyone involved — enhancing language skills and supporting emotional, social and cognitive abilities in children, while also promoting positivity and general health in residents.”

Mercy Health’s intergenerational programs aim to promote respect, social inclusion and, importantly, can help with cognition and memory triggers.

Mercy Place Parkville resident Hank Span looks forward to his regular visits from the local early learning centre’s children.

“I really love when the children visit my home, it’s so special,” he says. “The kids who come remind me of my children when they were young, and it even makes me think of my own childhood,” Mr Span says.

“No matter what stage in life they are at, [people] need to be connected to the community to flourish.”– Adj Prof Cornelissen

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AGED CARE

They became experts in change-management, leading their families through times of struggle and hardship; their skills honed over a lifetime of survival and lived experience. They were masters of the practice of strategic budgeting, ever aware of their meagre household incomes, yet maximising every cent to ensure there was food at the table and warm blankets on beds for their own children and other kids needing a safe place to sleep. Their resourcefulness and adherence to environmentally friendly recycling initiatives would cause today’s bloggers to sit up and take notice, for these women were creating candle holders and drinking glasses out of recycled vegemite jars long before these projects warranted a mention in glossy magazines. In time, these women truly flourished within their families, communities, and the landscape of a nation still grappling with its own identity.

Yet now my siblings and extended family find ourselves either living as part of or considering what it means to be part of the “Sandwich Generation”… holding discussions with our elders and finding out their care preferences for their later years when their needs grow and independence lessens. How fortunate we are to have the means to accommodate most of their desires, thanks to their foresight and tenacity in prioritising the value of education for each of us. Yet not all families caring for Aboriginal and/or Torres Strait Islander elders are so fortunate.

Research in this area attests to the fact that our elders are underrepresented in residential aged care settings. Formal and informal feedback consistently speaks of the importance of family and the desire to remain in the family home and within community is a high priority for our elders. Juxtapositional to this understanding however are the many reports by Indigenous and non-Indigenous agencies listing sub-optimal living conditions within some Indigenous homes and communities, due to overcrowding, unsanitary conditions and infrastructure damage. Regardless of these factors, as the ones following in the footsteps of our elders, our overriding desire must be for their ongoing care in their wisdom years – care that is authentic, and compassionate. While this care still predominantly takes place within the family

As a ‘40-something’ professional Indigenous woman, I am blessed by the fact that I am able to call on the wisdom and insights of my mother and mum-in-law for cultural advice and guidance. My mother with her familial ties to Hammond Island in the Torres Strait and my Gamilaraay and Euahlayi mother-in-law continue to redefine what it means to be strong, resilient and resourceful.

Caring for First Nations Elders

Darlene Dreise / Chair, St Vincent’s Health Australia Reconciliation Action Planby

Darlene Dreise

“There is much to be gained from caring for elders who have lived through some of the most important stages of this nation’s story.”– Darlene Dreise

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HEALTH MATTERS


SPIRITUALITY

Much has been documented of the critical interconnectedness of healthy aging and the recognition and nurturing of the spiritual life of individuals. Research has placed a particular emphasis on the place of spirituality and wellness for Indigenous people globally and Australia’s people specifically, with the impact of colonialism often identified as the stimulus for recorded deficits in wellness and inter-generational trauma. The understanding of and appreciation for spiritual beliefs and socially inclusive practices is therefore of particular importance in the care and healing practices of Aboriginal and/or Torres Strait Islander elders within residential Aged Care facilities. This understanding has particular ramifications for those involved in the Pastoral and Spiritual Care ministry of these residents as issues of enforced removal of children, protectionist policies as well as entrenched social and domestic dysfunction continue to affect these individuals and their families.

EMPLOYEE WORKFORCE

Research has identified the importance of Aboriginal and Torres Strait Islander carers and staff in facilities in order for our elders to feel comfortable within their aged care home. Relationships between Indigenous and non-Indigenous have not always been grounded in respectful contexts, and it is important to note that the relational uneasiness between these groups over time may ‘spill over’ and indeed become more prominent as one ages. A discomfort at being cared for by non-Indigenous people may become evident and even remind residents of historical removals or extreme disciplinary measures experienced when younger.

GEOGRAPHICAL LOCATION OF FACILITIES

The geographical location of residential aged care facilities is as important (if not more so) as the delivery of culturally safe care for many elders today, particularly for those who have lived on traditional homelands and maintained links with sea and country. This reality presents challenges relating to care models and appropriate staffing and resourcing for such facilities to ensure their ongoing viability. Some on-country models do exist, particularly in Western Australia and the Northern Territory. The availability of quality aged care services in remote areas is vital for strong Spirit and Wellness.

home, utilisation of community and home-based services are on the rise and it is anticipated that the option of residential aged care will also be considered more favourably as the life expectancy of Indigenous people slowly grows.

UNDERSTANDING THE CONTEXT

In 2017, SVHA’s Inclusive Health Program commenced work on a research study into the perceptions held by Aboriginal and Torres Strait Islander elders within residential Aged Care. In Australia, Aboriginal and Torres Strait islander elders are identified as those aged 50 or older, in comparison to the non-Indigenous population, which commences at 65 years. These elders are esteemed as role models and people of wisdom in their communities, yet research specifically focusing on this stage of life for these groups is inordinately meagre in comparison to their privileged cultural status. Given historical trauma and ongoing complex societal challenges, it is important to understand factors influencing the current low representation of these groups in residential Aged Care facilities nationally. Of particular importance to this work will be the discernment process leading up to the decision to become a resident of an aged care facility.

While this work is not complete, contextual factors such as the 50th anniversary of the 1967 referendum and recent constitutional reform work have had positive effects on our Indigenous populations, but the inter-generational trauma resulting from colonisation and the Stolen Generations continue to mould the psyche of both individuals and families today.

Existing research about these influences has identified the following recurrent key themes for consideration when planning for increased Aboriginal and/or Torres Strait Islander representation in residential aged care facilities.

CULTURE

The importance of culturally safe facilities, and culturally competent and empathetic staff is critical for the care of these elder groups. Strategies to address this meaningfully include cultural awareness training for staff however caution should also be exercised to ensure that residents are not pigeon-holed as there is no ‘on-size fits all ‘approach - people identifying as Aboriginal and/or Torres Strait Islander in the same facility may have vastly different ideas of what this means for them personally. This will also influence how they relate to non-Indigenous people. The lived experience of individual residents must be taken into account when holistic care approaches are developed so that authentic relationships of trust and mutual respect may form and be nourished. This is particularly important in aged care facilities as these settings may connect with a resident’s former experiences of institutionalisation.

“To remain in the family home and within community is a high priority for our elders.”– Darlene Dreise

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MODELS OF CARE

Research points to the often multiple chronic health conditions affecting elders, as well as the growing ‘wave’ of elderly residents – Indigenous and non-Indigenous – being diagnosed with dementia. A particularly cruel aspect of dementia for Aboriginal and/or Torres Strait Islander elders may present when minds are transported to earlier times and memories. A friend recently spoke of their distress at hearing her mother, now suffering from dementia, re-living the hellish day the authorities came to her door to take her and her siblings, wrenching her out of her parents arms. Another of her traumatic recollections focussed on the cleaning duties that had to be undertaken on a daily basis, to prove she was a parent worthy of raising her children.

Research has confirmed that each of the suggested approaches for pastoral and clinical care for these specified groups may be optimised under the umbrella approach of Person-Centred Care which promotes an individualised program of support. This is the most appropriate strategy to ensure optimal care episodes for all residents, but particularly for Aboriginal and/or Torres Strait islander elders who are underrepresented in the residential care space, and whose cultural considerations may not be known for a variety of reasons or appreciated by staff generally.

OUR ONGOING CALL TO CARE FOR OUR ELDERS

A mentor once explained to me that in Australia’s Indigenous cultures, it is our youth and our elders who hold the richness of our enduring cultures. Our little ones learn what is right through observation and example; our elders are vessels formed from lived experience – holders of story through time. The actions of those in-between should work towards the nourishment of these two groups and they should consider this a sacred privilege.

With this understanding, may we work together with our Indigenous communities, to listen, consult and educate about the support that may be offered to our elders and their families through the provision of residential aged care places. This two-way learning may then serve to shape this ministry which has, at its heart, the compassionate care of the aged. There is much to be gained from caring for elders who have lived through some of the most important stages of this nation’s story. Honouring these men and women will enhance our understanding of our country’s history and its first peoples and strengthen the ‘right relationships’ required to move forward in reconciliation.

FORMATION FOR LEADERS IN CATHOLIC HEALTH AND AGED CARE

cha.org.au/mlp


“This program fulfils the dream I, and many others, have had for decades.”– Fr Gerald Arbuckle Christian anthropologist and author

IS THIS FOR YOU?

HOW SHOULD I APPLY?

WHAT IS THE COMMITMENT?

MINISTRY LEADERSHIP PROGRAM IS TAKING EXPRESSIONS OF INTEREST FOR 2019

As Fr Gerry Arbuckle says, the MLP is the fulfilment of a dream for mission integration formation for leaders in Catholic ministries.Participants report significant changes to their leadership approach in Catholic health and aged care services and notice the impact that their learning from MLP is having on their organisations.If you require further information about MLP please contact Susan Sullivan, Director Mission Strategy [email protected], or Dr Anthony Gooley, Manager Mission Services [email protected]

If you are in a senior leadership or executive position within your organisation, this course is for you.

Express your interest to your Group Director of Mission.

There are nine (2-day) sessions over 18 months.MLP Cohort 3 commences 25-26 July 2019.

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HEALTH MATTERS


KEY DATES2019


FEBRUARY

11 Feb VAD Public Seminar and Showcase Melbourne

12-15 Feb MLP Cohort One-Session Nine/Cohort Two Session Four

14 Feb CHA Board meeting

TBA Aged Care Forum

MAY

7-8 May MLP Cohort Two – Session Five

9 May CHA Board meeting

JUNE

TBA Research Symposium

JULY

23-24 July MLP Cohort Two – Session Six

AUGUST

26 Aug CHA Board meeting

26-27 Aug Governance Symposium / AGM / Awards

SEPTEMBER

17-18 Sept MLP Cohort Two – Session Seven

NOVEMBER

7 Nov CHA Board meeting

19-20 Nov MLP Cohort Two – Session Eight

TBA Pastoral Care Forum

1 Nov Nursing & Midwifery Symposium

www.cha.org.au

“The Innovations in Nursing session is very worthwhile as it provides an opportunity for Catholic health nurses to share their work.”

Thank you to all Catholic health practitioners who shared their innovations and experiences with the Symposium.

Nursing & Midwifery Symposium highlights

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HEALTH MATTERS


The inspirational Susan Alberti AC shared her remarkable life story, punctuated by tragedy, and why she will never give up on medical research and finding a cure for Diabetes.

Emeritus Professor Jill White encouraged nurses to maximise their influence through the Nursing Now campaign.

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HEALTH MATTERS


At the CHA Nursing and Midwifery Symposium in Melbourne Matiu challenged us to be creative and innovative in how we respond to the difficulties facing our health system, particularly in the areas of aged and community care. In conversation with CHA’s Emma Hoban he said there is a tremendous opportunity for change and to allow people to live and die in their own homes. To enable the experience of a beautiful death is a legacy worth leaving.

Hm: What led you to be immersed in the health profession?

MB: I began my career at the age of 18 studying Fashion Design, it was during the Somalian famine and I become very interested and concerned with the plight of those affected. It was incomprehensible to me that these people were unable to fulfil their most basic needs, to access food, water, and healthcare and I became motivated to help in some way. So I sent a letter to Mother Theresa, who wrote back inviting me to come and work with her. So I did. I spent three months working in Calcutta, India and then four and a half years working with her in Tijuana, Mexico.

I returned to Australia to study nursing, attracted to the practicality of the profession and the human centred approach to care. I pursued the specialist pathway for a while in areas of intensive care and sexual health before deciding that it was better to become a generalist. I went from being a clinical specialist to a more operational generalist which has allowed me to move through a number of different health areas such as surgery, outpatients, management, oncology, aged care. Being a generalist has given me portability and an insight into the overarching nature of the health system that I would not have had otherwise.

Emma Hoban / CHA Policy by

When you first encounter health systems designer Matiu Bush you are struck by his energy and positivity. Where most see difficulties, Matiu sees opportunity, and he’s not the type to take no for an answer. A master’s degree in Public Health, experience working with Nobel Prize Laureate Mother Teresa in international border aid, and broad clinical and managerial nursing experience, including in emergency, oncology, intensive care, and sexual health, have shaped his unique perspective.

Q&Awith Matiu Bush

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Hm: What is the most interesting thing you learnt in your time working with Mother Teresa?

MB: I learnt that rigidity to a mindset ultimately limits you. That it’s best to be adaptable in your approach to health and be willing to adapt and evolve your model of care. Mother Therese had the opportunity to build a world class teaching hospital, and provide medications for reversible diseases to those she cared for. This could have enabled many individuals to lift themselves out of poverty and create sustainable long-lasting change. However, she was wedded to a model of care that focused on housing and feeding the poor and did not take opportunities to evolve. So she failed in that regard and saints should not be above audit or scrutiny. I also learnt the importance of not losing sight of the dignity and value of the individual and the importance of returning autonomy and agency to people. The poor are not the raw materials for our expression of a charitable philosophy.

Hm: You are currently a Design Lead for Bolton Clark, sounds fancy what does that mean?

MB: My work at Bolton Clark involves using human centred design methodology to run a range of innovation and improvement projects with frontline staff. This methodology allows us to bring new ideas to life and trial them very quickly. Normally you would have to write a business case, get executive sign off then run a trial. We move much quicker and can have something up and running within a couple of weeks or less. We test our projects with what we call a small blast radius (very small group) and get fast feedback. This enables us to run lots of prototypes of process improvement and innovation across our aged care business. A lot of our work is currently focused on aged and community care where we have developed a variety of projects in areas such as better communications with staff, virtual reality training, telehealth and new models of care.

Hm: What can the design thinking process achieve in the sphere of health?

MB: A design thinking approach looks at a problem through an empathy lens to answer questions from the patient/resident/clients point of view, such as what is it like to be on the phone to our health care services? Or what is it like to receive a visit from one of our nurses? So that we can develop solutions that are driven by their perspective, solutions that matter to our clients and their families.

We use a phenomenology approach to answer questions such as what is the phenomena of having breast cancer and being 83 years of age? Phenomenology looks at how something occurs at many levels, taking into account the entire ecosystem of an experience instead of focusing on how something affects just one part of it. Phenomenology considers the entire system, your social determinants of health, your personal history and incorporates political, workforce, environmental, ethical and social factors. It gives us a much deeper understanding of what it is like to be 83 years old and have breast cancer and provides much richer results for developing scalable solutions.

Hm: What big health problem have you solved using design thinking and human centred methodologies?

MB: I think my previous work redesigning waiting rooms is a good example. I did this at a comprehensive cancer centre in Melbourne. Through utilising an empathetic lens and considering the experience of the patient we transformed what is was like to wait for your appointment in outpatients. We implemented changes such as a pop up café, virtual reality, pet therapy, communal tables, power boards to plug in electronics, visual management of wait times, and puzzles just to name a few. We actively created moments of joy to run interference with the feelings of anxiety a person experiences when waiting for results. To better understand the patient experience, I followed every patient on social media which meant I had a direct line to how they were experiencing their cancer, so I was often aware of how a patient was feeling before they even entered the building.

Hm: What do you think are the biggest issues facing the health system right now? Where are the gaps you’d like to tackle?

MB: A lack of creativity and creativity thinking. We may not need more money to solve the problems but what could work is a reorganisation of the resources that we’re currently undertaking. Across primary health, tertiary health, the community and volunteer sector we have not aggregated all of the net benefits of all the different parts of the health system. We have ridged models of care that are resistant to change. The rigidity of current models of care limits the possibility of more creative opportunities to deliver health care. We have a crisis in philosophy. We haven’t had new models of nursing care be published that incorporate the technological revolution that we’re in, including machine learning and artificial intelligence. We need a nursing vision that is able to hold the duality of solving the problems we are facing now as well as those into the future. We need to harness the capacity of friends, family and volunteers who can provide support and lessen the burden on our stretched systems and see them as valid parts of the health team. The post person, the supermarket staff, the bank teller can all be part of the community care team.

Matiu Bush is the founder of OneGoodStreet and is determined to overcome loneliness in aging

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“Through utilising an empathetic lens and considering the experience of the patient we transformed what it was like to wait for your appointment in outpatients.” – Matiu Bush

Hm: You developed One Good Street? How did you get that off the ground and what does it seek to achieve?

MB: One Good Street was born after looking at examples in the United Kingdom where suburbs had been activated to care for older people and this impacted emergency department admissions of older people. So I knew that social capital and intentional neighbouring had a flow on effect to the health care system. I also looked at evidence from disaster zones where those who were lonely were found more likely to die than those who were socially connected.

One Good Street aims to reduce social isolation and loneliness in older people. It does this through creating a participation culture within suburbs which allows people to easily volunteer to help out their older neighbours. We are currently active in four suburbs across Melbourne with 370 volunteers. We were successful in winning the Queensland University of Technology (QUT) seniors innovation challenge which gave us the initial $20,000 to kick off the program.

Hm: What has been the impact of One Good Street so far?

MB: We have embarked on a number of initiatives. We have been able to establish Australia’s largest library of aged care equipment which enables free aged care equipment to be lent out to older people who are disadvantaged and cannot afford it. Through this we have given away over $20,000 of free equipment.

We have also established a range of smaller projects such as aircon clubs where volunteers are encouraged to invite elderly people into their home so they can enjoy the comfort of air-conditioning and escape the heat. This helps reduce isolation, loneliness, keeps people hydrated and stops people going to the ED during heatwaves. We have also purchased a cycling without age bicycle to enable volunteers to take elderly people out for bike rides who are otherwise stuck in their houses due to mobility issues and can no longer enjoy their own communities.

Hm: You spoke at the CHA Symposium, what did you hope for nurses and midwives to take away from your session?

MB: I hope they come away with a belief in their ability to shift the centre of gravity. That they will try new ideas with greater confidence and will not be deterred by what I refer to as organisational scar tissue, that is a continued dismissal of new ideas and being told ‘no’ by those higher up the organisational ladder. Nurses have so much power within themselves to create cultural change within their organisations. I hope they move beyond governance and risks and do things that delight patients… that they recognise the importance of their own abilities to change processes and ensure that we create a system that is flooded with humanity and is affirming to the individual at every touch point.

Hm: What is the next thing you are working on?

MB: Bolton Clarke has a focus on reducing social isolation and loneliness in older Australians. We have partnered with RMIT and are designing Australia’s first ‘wearable’, to detect loneliness. This will take the form of a lapel pin that counts the number of words an individual speaks in a day. The word count is a surrogate marker for social isolation as we believe loneliness can manifests itself in a poverty of conversation.

You and I speak 20,000 to 30,000 words per day but a lonely person may only speak 50. This wearable collects just the word count and the data is then linked with activated thresholds that will trigger a volunteer phone call during the days where individuals are the loneliest. The device is currently in the prototyping phase and we are finalists in the Telstra Seniors Challenge with RMIT University in the hope of receiving a $10,000 funding grant to progress to the next stage.

Hm: Has it been hard to persuade health professionals and managers to adopt new ideas?

MB: It’s a mixed response. People are invested in being a particular type of professional and delivering a particular type of services and I’m asking them to shift how they’ve been as professionals for a long time which is difficult. But I understand that so I take it slow and build relationships to help them through that. Not everyone embraces it but I’ve learnt to find nourishment in the resistance. There is that quote that says ‘Culture eats strategy for breakfast” but I have reinterpreted it. There are three meals in a day and you’ve got to eat resistance for lunch and find nourishment in it, especially if you want to change culture.

Hm: Aged care is currently not seen as an attractive career proposition? How do we entice dynamic and innovative people into the aged care space?

MB: The current crisis in aged care provides a platform through which those with an interest can excel. We will be in a good position to think creatively about how we improve what we do because the sector is under such spotlight with the Royal Commission. Telling stories of the successful dynamic individuals that already work in aged care is really important. Aged and community car is the fastest growing health sector, and provides a tremendous opportunity to be involved in impactful change for good. To contribute to older Australians being able to live in their own homes and have end of life care a defined by them is a legacy worth leaving as a health professional. Aged care is meaningful and impactful work.

Join the OneGoodStreet facebook group to get involved upload unused equipment to the OneGoodStreet website to share it.

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Shark Tank

Every day on the job health and aged care practitioners face many challenges they feel compelled to fix. Because they are a creative bunch they generate great ideas and solutions to prototype and trial. Many of these fledging projects are successful and become a part of a team’s common practice.

This process of innovation is happening everyday in the work of nurses and midwives who constantly strive to improve efficiencies, quality of care, and the patient experience.

The annual Shark Tank Competition at the Nursing and Midwifery Symposium showcases these successful and emerging innovations and is proudly sponsored by HESTA and the Australian Catholic University.

Shark Tank Judges: ACU’s Michelle Campbell, CHA’s Annette Panzera, and Vanessa Frian from HESTA

The annual Shark Tank Competition at the Nursing and Midwifery Symposium showcases cutting-edgeideas for innovation in health service provision.

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HEALTH MATTERS


The winners

Patient Safety & Quality

Best Communications Strategies

Innovation, Education & Training

MARIA NOONAN / SJOG BALLARAT

STOP BEFORE YOU ACT

The STOP before You Act initiative has been designed to slow nurses down to give them time to do their work safely, with a focus on reviewing patient’s needs rather than a set of tasks. The project is improving both patient and nurse satisfaction and wellbeing.

KATE MCKENZIE & NIKKI DE BANDI / MATER HEALTH NTH QUEENSLAND

KIDS TALK

The Kids Talk project developed a feedback tool for paediatric patients three years and older that involves them drawing and writing their thoughts about their experience and journey at Mater Health Nth Queensland.

MICHELLE RICHARDSON / SVHA PRIVATE MELBOURNE

MATERNAL SEPSIS IDENTIFICATION AND MANAGEMENT: THINKING OUTSIDE THE BOX

The Maternal Sepsis Kit provides an innovative evidence based approach to integrate clinical practise with readily accessible tools and support, in an easy to use and engaging manner for the interdisciplinary team.


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Nursing for 12 years / Theatres / St Vincent’s Private Hospital, East Melbourne

Hm: What was the greatest value or learning from the Symposium in Melbourne?

KR: The resilience of Susan Alberti, her continuous strive for a better world, especially for women in sport.

Hm: A proud moment at the Symposium?

KR: Nursing Now, the program to empower nursing and nurses to be the forefront of health care.

Hm: What is the best part of your job?

KR: Working with such a wonderful team in the operating theatre. We are diverse and have different strengths but we come together as a team to provide excellent care for our patients.

Hm: What would you like to achieve in your work, do you have a goal, or aspiration?

KR: In the last two years I have worked with my team to minimise injuries, whether it is sharps, splash or manual handling, we have seen a dramatic decrease, but there is always room for improvement and I look forward to the day I can report zero injuries in a 12 month period.

Hm: What makes working for Catholic health rewarding?

KR: Our values – each day I am driven by our values to ensure that we are providing excellence in care with compassions, justice and integrity in every action that I do.

Hm: What has been your greatest life lesson on the job?

KR: The power of communication, in all of its forms.

Hm: What is your hope for the future of health and maternity/or nurses and midwives?

KR: That we continue to expand, that we empower and educate the next generation of nurses.

Nursing for 16 years / Day Oncology Unit / St John of God, Berwick


MW: We are at times quick to label issues as too big to fix whether due to financial or time restraints. I think that many of the speakers highlighted that a good plan and a supportive team can go a long way to bridging gaps in the care we deliver as an organization or as a wider community.


MW: I love how my fellow caregivers and I am able to create an environment which enables a patient to feel safe and supported throughout their treatment. Knowing that you have made a positive impact on a patient’s journey is very rewarding.


MW: We should never underestimate the power of just taking the time to be there to listen to a person. We may not be able to solve all of their problems but we can acknowledge them and let them know that they are supported.

Katherine Rance

Monika Whitehead

Nurses – the heartbeat of hospitals

“We should never underestimate the power of just taking the time to be there to listen to a person.”– Monika Whitehead

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HEALTH MATTERS


EN for 25 years and then graduated in 2004 as an RNDiv1 / Nurse Unit Manager of 2West Medical / Cardiology Unit St John of God Hospital, Ballarat


AL: To look after yourself. In order to manage a team to success, you need to have a good work life balance and lead by example. Take time for your own self and wellbeing. I was very inspired listening to Susan Alberti and her message of respect, responsibility and making a difference.

Hm: A proud moment at the Symposium?

AL: I am proud of my vocation because we do make a difference to people and their lives, sometimes small and sometimes life changing.


AL: Achieving positive patient outcomes, even the smallest of things like getting a patient home with full support services despite being in their 90’s and living alone. Also staff satisfaction. It is often not easy to achieve but when the team gels and feedback is positive and encouraging it is very rewarding. Maybe I do get it right sometimes!


AL: My greatest life lesson on the job is lead by example, never ask your team to do anything you wouldn’t do yourself. Don’t raise the bar so high that it’s unachievable, small steps can become big steps in change of practice/culture and improved patient outcomes. The patient is the centre of the reason we are here.

Nursing for 9 Years / Medical/Renal Ward / Mater Health Services, Brisbane


CP: I was inspired listening to Susan Alberti’s story, making me feel positive that one can come from adversity to a position of status, of such respect, and with a following.

It was a reminder that all things are possible, you just need to work hard, have self-belief and a passion for what you are trying to achieve.

Hm: Was there anything that prompted bride in your vocation?

CP: Leadership, team building and camaraderie are values that I strongly believe in. They are equally essential when treating patients or developing staff.

I am proud of my chosen vocation and the opportunities it gives me to really make a difference to people’s lives, whether it be mentoring and developing staff or caring holistically for patients.

Hm: What would you like to achieve in your work, do you have a goal or aspiration?

CP: I would like to develop a functional holistic space to enhance the lives of those suffering from dementia. Such patients deserve respect and dignity. Taking into account their emotional needs, as well as their physical symptoms, can vastly improve their wellbeing. With the help of some external stakeholders I would be able to develop the way we look after patients and help fill gaps in the aged care sector.

Angela Langdon

Charlotte Perkins“The patient is the centre of the reason we are here.”– Angela Langdon

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The importance of a dedicated innovation hub was recognised and in 2016 the Cabrini Centre for Innovation was established. This included a physical location to meet, plan, prototype and test ideas that focus on the intersection of technology and contemporary health delivery to create and demonstrate new models of care.

Josh Farrington / Innovation Manager, Cabrini Technology Group

Two Years into our Innovation Journeyby

Soteria can also capture the resting heart rate and respiration rate of patients without the need for any physical leads or electrodes.

Cabrini Centre For Innovation

Born out of the Cabrini Centre for Innovation was ‘Health Kite,’ a fresh new emerging brand and range of medical grade products and services. Health Kite has been developed in close collaboration with clinicians and potential users and through the application of design thinking and human centred design tools and methodologies. Since the success of its first product in 2017, a pregnancy application named ‘Eve’ (featured in the previous edition of Health Matters), Health Kite has continued to collaborate with hospital partners to derive innovative solutions designed to improve health outcomes, educate and engage patients, and reduce healthcare expenditure.

In November 2017, the Health Kite team completed the installation of an exciting new falls detection system called ‘Soteria’ at Cabrini’s Residential Aged Care Facility in Ashwood, making them the first facility in Australia to pilot the technology. Soteria is an easy to install, maintenance free sensor designed to monitor wellness and improve the safety, care and experience of vulnerable patients or residents in their home, including those with physical and mental disabilities, those with deteriorating health and the frail. The system monitors key vital signs, detects falls, unusual activity and inactivity and is the only contactless fall detection and alert system with the ability to accurately detect falls 99% of the time. This contactless technology operates autonomously in the background 24 hours a day, 7 days per week with total privacy. Soteria can also capture the resting heart rate and respiration rate of patients without the need for any physical leads or electrodes to be attached to the patient. With an additional software module, Soteria can also be configured to accurately assess the user’s Apnoea-Hypopnea Index for patients at risk of Sleep Apnoea.

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HEALTH MATTERS

SECTOR SPEAKS

Cabrini Technology Group, a division of Cabrini Health, provides solutions

across three core technology streams: Health Technology, Information and

Communication Technology and Assistive Technology. Clients are

based throughout Australia and New Zealand and are supported by over 500 staff across 20 offices, with a

presence in every capital city and a number of regional centres.

Cabrini Technology Group has the proven capacity to develop hardware

and software solutions and then support these on an ongoing basis.

On the other hand, it is widely recognised that Cabrini Health

has a wealth of clinical knowledge emanating from research conducted

by its Institute and academic partners which in turn has been the catalyst for ideas for new clinical service models.

About Cabrini Technology Group

eHEALTH INNOVATION

In the eHealth space, Heath Kite has partnered with a US hardware provider to develop a telehealth solution called the ‘Health Kite Hub and Console’, which connects remote chronic disease sufferers with their caregivers and enables the seamless collection and transmission of healthcare data from Bluetooth-enabled medical devices through to the clinical care team who actively monitor the physiological and survey based data in real time. The Health Kite hub has been designed to integrate with a wide range of medical devices, and clinical IT systems while also incorporating features such as Amazon Alexa voice control. Final testing of the system is scheduled for December 2018, after which the Health Kite team will be seeking hospital partners to pilot the telehealth solution in the community.

THE NEW YEAR

Next year will see continued growth of the Health Kite team with the planned launch of a suite of healthcare applications and software solutions across a number of areas including Palliative Care, Dietetics, Wound Care Management, Remote Oxygen Therapy Management and Patient Experience. During this time the Cabrini Centre for Innovation and Health Kite will continue to build on the success of the first two years and explore opportunities to partner with hospitals and healthcare providers looking to design, develop or deploy innovative solutions to improve the experience and outcomes of their patients.

For more information visit: www.health-kite.com

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SECTOR SPEAKS

A priestly vision to serve the underprivilegedAs a leader at America’s largest Catholic healthcare and educational institutions, Reverend Dennis Holtschneider has had a constant focus on serving those in need.

Menios Constantinouby

Dennis Holtschneider sees himself as blessed. As executive vice president and chief operations officer of Ascension Health, the 56-year-old represents an organisation that gives away some $2billion worth of healthcare every year to the poor and vulnerable. Every day when he packs his briefcase and heads to work, the Vincentian priest knows his ethical radar is clear.

“It’s definitely nice to wake up in the morning and have work that you believe in,” Fr Holtschneider said.

“I joined a religious order founded by St Vincent De Paul specifically because this order cares deeply about the poor, and I’ve been blessed to have been involved in projects that are in line with those beliefs and values all my working life.”

For 13 years, Fr Holtschneider was president of Chicago’s DePaul University, the largest Catholic college in the United States. His switch in mid-2017 to the St Louis-based Ascension, America’s largest Catholic health provider and not-for-profit health system, was made smooth by the similarities between the two organisations.

“DePaul is known throughout the country for providing a high-end service — an excellent, first-rate education to a population who couldn’t afford that level of education — and so it’s very similar to Ascension in that regard,” he said.

HEALTHCARE FOR THE POOR

As far as non-profit healthcare systems go, Ascension’s reach is vast, with more 2000 hospitals and clinics across 22 states and a focus on providing patient-centred care to those who need it most. Its size is its strength, allowing it to overcome the financial hurdles of providing care to people living below the poverty line.

“We provide a very high-end product for those who don’t have health coverage or can’t afford high-end healthcare, and we do that in a few different ways,” Fr Holtschneider said. “We have 2700 care sites across America, and that helps us because we treat many, many people who can pay, giving us the capacity to take care of those who can’t pay.”

Ascension has also set up more than a dozen health-related subsidiaries, including one that pools resources to bulk-purchase supplies, and another that repairs health machines. These investments provide the organisation with a margin that allows it to waive fees for the uninsured, which accounts for around 28 million people nationwide.

Reverend Dennis Holtschneider

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Even with those cost-saving strategies in place, Fr Holtschneider conceded it was “still a stretch for us to care for the number of people in America who don’t have coverage”.

THE PUSH FOR HEALTH REFORM

Ascension is faced with a challenge that is common to all healthcare providers in the United States: the need for health system reform.

While the majority of Australia’s healthcare is provided publicly through Medicare, which subsidises out-of-hospital medical costs and funds free universal access to hospital treatment, America’s health system is largely market-driven and much more expensive.

“In Australia you have the blessing of a bit more simplicity than we do when it comes to funding, and I’m not here to recommend the United States’ approach,” Fr Holtschneider said, adding that Ascension had been “a very strong advocate for healthcare reform”.

“We work on behalf of health reform constantly in Washington, thinking about ways we can rationalise the use of public money to serve more people, more efficiently and, frankly, better,” he said.

“If you’re going to continue the healing ministry of Jesus Christ and extend that, you need to make sure you’re taking care of those in society who don’t have easy solutions to their challenges, and our [government’s] current approach to healthcare doesn’t do that very well.”

PERSONALISED, COMPASSIONATE CARE

At the heart of Ascension’s successful operating model is a commitment to putting the patient first. But despite its best efforts, it hasn’t always done this as well as it could have.

“As much as we have good hearts and we always care for the people who present themselves to us, we had organised our systems around the convenience of our doctors and nurses... and often that is not ideal for the patient,” Fr Holtschneider said.

“Once the patients started talking to us, we realised, ‘oh, we really need to rethink this’.”

At the recent Australian Catholic University (ACU) health symposium in Rome, he spoke on Ascension’s “person and family engagement model”, borne of a realisation that in some cases the patient and family members are the experts.

“If you take for an example the occasion of sepsis [hospital-acquired infection], it’s dangerous and can quickly become rather dire,” he said.

“In these cases we needed to learn to listen to the patient who says they’re feeling unwell, or the family member who says, ‘hey, grandma’s colour is off and she’s speaking a little slower than usual’. That would not necessarily be picked up by medical professionals, and so we need to be open-minded about who the expert is and then engage the person and family in the process of care.”

FUTURE READY

In his 13 years as president of DePaul University, Fr Holtschneider built a reputation for fostering innovation.

“Father Dennis cultivated an environment in which faculty dared to try out new ideas in order to stay on the cutting edge,” Associate Professor Michaela Winchatz told DePaul Magazine.

His pioneering spirit was widely praised in the higher education sector, and DePaul was ranked among the country’s most innovative universities in 2015 and 2016. But despite these achievements, Fr Holtschneider acknowledged that universities and colleges were much slower to adopt new methodologies than the corporate sector.

“Higher education has a certain speed, and it’s not fast… so it’s a major challenge for educational institutions and church organisations to deal with a world that moves at a much faster speed,” he said.

He’s had a long association with ACU and its President Greg Craven, and said he’s been impressed with the university’s commitment to innovation.

“I admire how they’ve moved the organisation forward in a way that’s both Catholic and relevant,” Fr Holtschneider said.

“They’ve done that more aggressively than many others in higher education, and frankly, I think others should look to ACU of an example of what’s possible.”

His current employer Ascension also appears to be embracing the future, recently partnering with an “innovation accelerator” to identify new healthcare technologies quickly.

“Healthcare happily does move a bit more quickly with the times, at least in my experience,” he said.

“That’s another pleasant part of my working life these days.”

Fr Dennis Holtschneider was a speaker at ACU’s 2018 Catholic Healthcare and Education Executives Symposia at the University’s Rome Campus.

“We provide a very high-end product for those who don’t have health coverage or can’t afford high-end healthcare, and we do that in a few different ways.”– Fr Holtschneider

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SECTOR SPEAKS

Best practice community health and wellness for older AustraliansAs we age, increasing sedentary behaviour and physical inactivity are the greatest drivers of later life disability. On the upside, you are never too old to benefit from exercise, as proven by the demand for Southern Cross Care’s personal health and wellness programs for older Australians, which are going from strength to strength.

Dr Tim Henwoodby

Breaking up sitting reduces the risk of declining muscle mass

“You are never too old, too sick or too disabled to benefit from exercise.”– Dr Tim Henwood

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While it is reported older Australians are more active than their predecessor, they still report the lowest sports and recreational activity engagement of all Australian age brackets. This gap increases further with age, as does the gap between those reporting being active and those actually at or above the national recommended levels for physical activity. For older Australians, physical inactivity has significant health and financial burdens. In recent work by Peeters G et al (2018) it was identified that the annual Medicare cost among inactive 73-78 year old Australians was three times greater than their active counterparts, as was their risk of hospitalisation. For older adults, the greatest driver of disability is physical inactivity which leads to muscle mass deconditioning, lost strength and reduced capacity to undertake activities of daily living independently. Current research reports that one in three older adults sit for greater than 10 hours per day, but reducing and/or breaking-up this sitting reduces the risk of declining muscle mass, a precursor to sarcopenia and frailty, by greater than 45%.

Exercise and physical activity are effective and recognised counter-measures to the deleterious impacts of sedentary behaviour, with progressive resistance combined with balance training currently accepted as the most powerful stimulus in the battle against later life’s disability. So strong is evidence that a plethora of research now shows you are never too old, too sick or too disabled to benefit from exercise. However, engaging older adults in exercise is only half the job. In addition, participants need to understand the value of exercising, have purpose in participation and be encouraged to adhere. Programs need to be individualised, perceived as value for money and easily accessed, and staff need to be experienced, passionate and engaging. When programs do not consider all these aspects, participants drop away and the service suffers.

Southern Cross Care SA & NT (SCC) have embraced this body of evidence to firmly embed Health Ageing into its

mission. In 2014, Jo Boylan joined SCC and guided the organisation towards its current Health for All policy. As part of this mission SCC installed gyms in all residential aged care facilities (N=16) and implemented a robust early intervention rehabilitation program for residents at risk of declines and/or adverse events (e.g. falls). To compliment their work in the residential setting, SCC has modernised and now offers a unique Community Health and Wellness (CH&W) model to support its growing membership of community dwelling older South Australians. A 50 years-and-older service, the model offers customers the opportunity to better their physical, mental and social wellbeing. This includes CH&W centre that offers a range of exercise opportunities and state of the art equipment. Customers have programs written for them based in their individual needs with health outcomes targeted towards prevention, maintenance, rehabilitation and/or reablement. Centres accept people to group exercise and one-to-one (1:1) therapy through the usual referral and front door entry processes, and leverage all customer funding support pathways available. This ensures a reduced out-of-pocket cost and the offer of affordable activity opportunity for all.

For those still not ready to undertake exercise, there is the offer of social engagement and educational seminars. These programs provide a “back door” opportunity for new customers to familiarise themselves with the service and the staff, while supplying a purposeful activity where they meet others already participating in exercise. Equally important, for existing customers the program values an individual’s desire more than exercise. It reinforces the benefit of adherence by linking their ability to go on the social outings to the benefits of participation.

An overview of the SCC CH&W customer’s health journey may include a CHSP referral for allied health and therapy due to declining health and increasing disability. A preliminary health assessment with the new customer feeds into a multi-disciplinary case-conferencing exercise

“Evidence is strong that resistance training drives independence.” – Dr Tim Henwood

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SECTOR SPEAKS

Dr Tim Henwood is the Group Manager, Connected Living,

Community Wellness and Lifestyle SCC.

Prior to taking on this role, Dr Henwood was a strong advocate for the aged care sector, assisting

providers to translate evidence into practice and to grow their exercise

program memberships, and had spent 20 years studying the value of

resistance training and other exercise in promoting independence for

healthy and unhealthy community-dwelling older adults and those living in residential aged care.

His research has included the ground breaking Muscling Up Against

Disability (MUAD) and Active@Home (A@H) programs, both of which have

been acknowledged by Minister Wyatt as important community aged

care exercise programs.

About the author to identify the most suitable reablement pathway. As part of this process, the allied health and therapist team make internal referrals through a multi-disciplinary pathway breaking down the disciplinary silos of treatment and maximising the customer’s health journey.

During case-conferencing, discussions also include information about alternative engagement opportunities, followed by the clinician discussing the importance of finding purpose, engaging socially and/or being informed via educational seminars. The primary goal, independent of where the customer starts their journey, is to achieve and maintain optimal social and physical health and wellbeing. In the presence of increasing disease (e.g. COPD), new incidents (e.g. Stroke) and/or changing situations (e.g. emergence of dementia), experienced and highly trained staff revisit the customer’s management plan and refocus it to ensure that it continues to suit the customer’s capacity (e.g. compromised mobility) and needs (e.g. improving lower body strength and balance).

With a growing acceptance of exercise being essential to the health pathway, community aged care service models need to change to support more than just a low-intensity, rudimentary offering. Evidence is strong that resistance training drives independence, that social engagement drives adherence, and that adherence drives prolonged health. Aligned to its Health for All policy, SCC has developed what is believed to be a complete health and wellness model of care for its customers. A growth in membership and referrals, complemented by customer benefits, indicate the model is working.

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Lisa McDonald and Christine Carolan

Practical action against Modern Slavery and Human Traffickingby

“Human trafficking is an open wound on the body of contemporary society, a scourge upon the body of Christ. It is a crime against humanity.”– Pope Francis

Modern slavery and human trafficking are devastating global issues which present some of the most pressing humanitarian and moral challenges of our time. For that reason, and driven by our mission to assist the most vulnerable members of society, St Vincent’s Health Australia (SVHA) recently joined with the Australian Catholic Religious Against Trafficking in Humans (ACRATH), to build an evidence-based, integrated and impactful healthcare response to the issue.

Staff from both SVHA and ACRATH (Lisa McDonald far left) at the signing of our partnership agreement

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SECTOR SPEAKS

Our partnership has two main aims: educating our staff and introducing processes to help them best care for people who present at our hospital Emergency Departments who might have been trafficked; and commencing the long work to guarantee slavery-free procurement across St Vincent’s.

It’s still early days, but we have made the following steps since we launched our partnership in May 2017:

1. Our working party has made connections with peer organisations in the US that are well-advanced in similar work, in particular Dignity Health. Dignity Health’s program is run by Holly Austin Gibbs, a human trafficking survivor. We seek to emulate the strengths we’ve identified in the US including building strong links to community outreach and tight processes for identification and support of victims.

2. We’ve undertaken research into how best to support and train our health workforce to identify any ‘red flags’ related to slavery. Our research tells us that healthcare workers are among the most likely in the community to encounter trafficked persons, thus giving us a unique opportunity to offer care and support.

3. We’re addressing slavery in our supply chain by including our commitment to eradicate modern slavery in Group wide procurement policies. We ask our suppliers to assess their own supply networks. In addition to this SVHA has also engaged legal firm Mills Oakley to audit our top 50 product and service suppliers. Each supplier will have their responses individually analysed, and a tailored report provided back, outlining any key risk categories as well as providing recommendations on how to manage and mitigate those risks. If the risks of slavery and trafficking are identified in the course of either audit, SVHA is committed to working

with our suppliers to support them address any issues. We are encouraging our suppliers to view the impacts of the proposed legislative changes (Modern Slavery legislation will soon take effect in Australia) as a positive driver to not only identify and address slavery within their own supply chains, but also review and update existing policies and processes.

4. Finally, SVHA and ACRATH gave written submissions to the Commonwealth Department of Home Affairs’ consultation on the Modern Slavery in Supply Chains Reporting Requirement and have given evidence at the Senate’s Legal and Constitutional Affairs Committee Inquiry into the Modern Slavery Bill. We are committed to continued advocacy on this issue.

We are leading this from a values base, mindful that it is our mission that drives us.

We know that most people who find themselves trapped in modern day slavery attend a hospital at some point. We have a unique window of opportunity, to not only address their health care needs, but invite an organisational response in a way that might bring wider hope and transformation.

For both SVHA and ACRATH, success will be when victims are identified and offered the help they need, leading to their restoration of dignity so they can live freely and flourish.

We look forward to a time when all health care supply chains are free of modern trafficking. We commit to working with others to achieve this sector-wide.

Lisa McDonald is Group Mission Leader at St Vincent’s Health Australia and Christine Carolan is an Executive Officer at Australian Catholic Religious Against Trafficking in Humans.

Lisa McDonald and Christine Carolan presented their work at the CHA National Conference

We’re addressing slavery in our supply chain by including our commitment to eradicate modern slavery in Group wide procurement policies.

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HEALTH MATTERS

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Courtesy of St John of God Healthcare

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Organisations ubiquitously seek feedback from their customers, for a vast range of reasons. The data may assist in improving services, responding to concerns, celebrating excellent service, or determining that desired standards are being achieved. Australian hospitals utilise a range of techniques to collect patient feedback, and to use that patient feedback as part of continuous improvement. Whilst every hospital in Australia is expected to provide excellent medical care and treatment, private hospitals regularly purport to offer some form of ‘distinctive care’, and options for patients that do not usually exist in public hospitals. Most often, private hospital patients are contributors to private health insurance, which is expensive, and additional ‘out of pocket’ expenses are the norm. Patients, therefore, often have particular expectations of a private hospital, which may include their choice of doctor, surgeon or anaesthetist; a private room and ensuite bathroom; a high standard of food choices; being kept well-informed with regard to their treatment; flexible hours and arrangements for visitors; a longer stay; and personalised care.

In the 2017 annual report of St John of God Healthcare (SJGHC), the organisation notes that it is Australia’s largest Catholic not-for-profit private health group, with over 13,000 employees across twenty-three facilities, and annual revenue over $1.6 billion. SJGHC’s vision statement focusses on ‘the healing touch of God’s love’ and refers to both hope and dignity. The mission statement refers to ‘the healing mission of Jesus Christ’ and a focus on holistic patient care. SJGHC has five values that underpin the organisation’s Code of Conduct: hospitality, compassion, respect, justice and excellence. SJGHC describes the organisation’s focus on ‘service ethos’ as acknowledging the founding story (primarily, the legacy of the Sisters of St John of God), a disposition toward building relationships, and seeing every encounter as an opportunity to provide a unique experience. The enactment of SJGHC’s vision, mission, values and service ethos statements should represent the ‘personalised care’ that patients are likely to seek and expect in a private hospital experience.

The project reported in this article had ethics approval from SJGHC and from the University of Notre Dame (UNDA reference 016177F).

Understanding the Patient’s Experience

Keith McNaught and Geoffrey Shawby

An extract – the full research paper can be found at www.cha.org/news

The Catholic Hospital:

In reading through hundreds of handwritten cards prior to formally commencing the research, it was demonstrably clear that a major complexity was finding a way to cluster and link the feedback.

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cat) needed to be translated into broader concepts to appreciate the intrinsic meaning of actions.

Five research questions emerged:

1. Using the feedback provided by patients on SECs, what do patients identify as praiseworthy?

2. How could the text provided by patients on SECs be themed to distil trends and summarise the feedback?

3. SJGHC posits a focus on holistic care, rather than a simply biomedical model. Is this focus evident in the feedback provided by patients on SECs?

4. SJGHC posits a values-based, Christian focus on care. Is this focus evident in the feedback provided by patients on SECs?

5. With the advent of technological tools to collect patient feedback, could the themed and collated feedback, from the cards, assist in creating filters for digital data?

METHODOLOGY AND DATA ANALYSIS

The 2893 service ethos cards (SECs) received at St John of God Subiaco within the 2017 financial year were analysed, using thematic analysis. The cards related to a variety of wards and facilities: Admissions, Day Surgery, Endoscopy, Surgery Recovery, Short Stay, Peri-Operative, Patient Records, Delivery, Maternity, Surgical, Colorectal, Oncology, General Medical and Vascular. No notable differences were evident in the spread of responses from different wards. The cards are open-ended, allowing, and indeed encouraging, writers to note anything about their experience, without being constrained by any wording used on the cards’ pro-forma. The words used by writers are therefore of infinite variety.

Consequently, the project involved identifying major themes into which the responses could be grouped so that patterns could be identified. The method used was based on a grounded theory approach to developing code structure and on thematic synthesis. Three phases were followed: (1) initial review of the data was carried out without coding and to gain an overall feel for the material; (2) codes were developed inductively from close reading; (3) ongoing comparisons were made between separate assignments of each code. It is consistent with this study’s broad approach that the inductive development of codes ‘limits researchers from erroneously “forcing” a preconceived result’.

The analysis of the language the patients used involved collating common text, but also looking for broad synonyms as well as phrasing with different but comparable concepts. Three primary categories emerged; these were attitude, efficiency and manner. An iterative process then expanded the number of codes to six. The primary task of coding was carried out by one researcher and then the chief investigator responded to the coding and further adjustment was made.

The themes that were identified through this iteration were the caregiver’s (1) nature or personality, (2) attitude, (3) helping ethos, (4) work-ethic, (5) responsiveness to need,

SECTOR SPEAKS

SERVICE ETHOS CARDS

St John of God Subiaco, in Western Australia, is the oldest and largest of the hospitals within the SJGHC group. The Subiaco hospital uses a range of tools and approaches to collect patient feedback, and has used, for many years, a ‘service ethos’ card (SEC), which is specifically designed for patients (and others) to provide staff affirmations with regard to their care. These affirmations were originally developed and used as part of a specific employee recognition scheme. SJGHC refers to all employees, regardless of role, as ‘caregivers’. When a patient or visitor is leaving the hospital, he or she is provided with the opportunity to complete a card acknowledging the work of one or more of the caregivers, knowing that comments will be conveyed to the specific carer as affirmation. Cards are collected and the comments are collated and passed to the caregivers. A tally is also maintained and the carer with the most affirmations is publicly named ‘Caregiver of the Month’. The cards are archived.

On average, in the 2017 financial year, 241 SECs were received each month. The hospital’s then Director of Mission expressed initial surprise that the cards rarely referred to medical excellence. Even cards from the Intensive Care Unit mentioned care and kindness, not life-saving treatments that had occurred. The cards seldom referred to the institutional services of the hospital, but rather focussed on the attributes where staff went ‘the extra mile’ to provide distinctive care. Comments such as ‘thank you for arranging someone to feed my cat’, and ‘thank you for walking my wife to the carpark late at night’ demonstrate what patients considered noteworthy. Research demonstrates that a focus on positive feedback is an underutilised resource in improving the customer (patient) experience.

This research sought to analyse the feedback to determine themes within the personal expressions of gratitude. Whilst the primary purpose of the cards was for employee recognition for distinctive care, it was realised that that these were a rich source of data that could provide insights into patient care expectations and experiences. In reading through hundreds of handwritten cards prior to formally commencing the research, it was demonstrably clear that a major complexity was finding a way to cluster and link the feedback, with comments that were inherently idiosyncratic. This is, of course, a difficulty common to the use of open-ended questions as a source of data in any research. The specific examples (e.g., feeding the

Courtesy of St John of God Healthcare, Ballarat

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and (6) professional and clinical knowledge and skills. It is worth looking more closely at the actual words used within each theme to see how the categorisation operated.

‘Nature or personality’ related to the type of person the carer gave the impression of naturally being. ‘Very friendly’, ‘a pleasure to be with’, ‘patient’, and ‘calm’ were typical of the expressions used for this theme.

‘Attitude’ covered the general behaviour of the carer. ‘Exceptional care’, ‘made me feel comfortable’, ‘particularly attentive’, ‘respectful’, ‘kindness and concern’, ‘relaxed’, ‘engaged’, ‘courteous’, ‘respectful’, and ‘assisted with a smile’ featured amongst these responses. These were generally distinct from the first theme in that they implied a deliberately chosen form of behaviour, rather than a natural default state.

‘Helping ethos’ particularly related to the carer’s specific endeavour to assist: ‘made me comfortable and at ease’, ‘I believed N genuinely did care about me’, ‘soothed me’, ‘made my stay relaxed’, and ‘constant concern for pain’.

‘Work-ethic’ included ‘quick but not hurried’, ‘engaged’, ‘dedicated’.

‘Responsiveness to need’ included ‘informative’, ‘re-assuring’, ‘explained well’, ‘took the time to answer questions’, and ‘provided a good summary of the procedure and, later, the results’.

Finally, ‘professional and clinical knowledge and skills’ included ‘no bruises after injections’, ‘I was confident N knew what (he/she) was doing’, ‘professional’, ‘competent’, and ‘[re-]acted promptly to my drop in blood pressure’.

It must be noted that there is a certain blurring at the borders of some of these themes. It was not always unequivocally obvious to which theme a comment would be allocated. However, these six allowed for a practical

level of definition. In six per cent of cases, the SEC respondent did not identify a specific area to commend, noting for example in relation to a unit that ‘everything was excellent’ or, in relation to an individual, ‘I could not fault N’s care’. (At the extreme end of such affirmations was the comment, ‘My wife and I will certainly return’! This seemed a little morbid when considered closely but presumably indicated that the respondent [and wife] regarded the hospital as comparable to a good hotel.)

The two major themes that were acknowledged were ‘nature or personality’, and ‘attitude’, these being highlighted in 21 per cent and 20 per cent of SECs, respectively. Then ‘helping ethos’, ‘work-ethic’ and ‘responsiveness to need’ received, respectively, 17, 18 and 16 per cent of acknowledgements. ‘Professional and clinical knowledge and skills’ was specified in just under three per cent of the cards. The patients in this study of the use of SECs were overwhelmingly more impressed by attitudinal and interpersonal factors. In terms of using the comments to optimise the quality of customer care, this provides valuable insight.

DISCUSSION

That the three per cent of SECs acknowledging professional and clinical knowledge and skills is significantly below the other categories might initially seem strange, as noted earlier. Yet, one could hypothesise that such knowledge or skill is assumed as a starting point for all hospitals, public or private, in a developed country. One does not commend their presence; on the contrary, if they are absent, one considers lodging a formal complaint or criticism. High quality medical care and high levels of clinical excellence are a fundamental expectation. Then, one judges the

SECTOR SPEAKS

Courtesy of St John of God Healthcare, Ballarat

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HEALTH MATTERS

Anecdotally, working in a hospital, even when visiting patients who have had life-saving surgery (and at times multiple surgeries in succession to keep them alive), they will acknowledge the clinical skills, but focus on the personal dimensions of the care.

There is a noted disparity in the literature between how clinicians consider patients will rate and experience their standard of care and how the patients actually do rate it. Noting that 97 per cent of the commendations related to interpersonal skills and attitudinal factors, it is apparent that caregivers’ emotional intelligence is a vitally important skill. Being clinically excellent is not only ‘not enough’ for patients, it is not what they value as part of the patient experience. For example, a clinically excellent caregiver whom the patient perceives as lacking good manners or empathy, is likely to be negatively evaluated. Hospitals are busy places, and caregivers are often continuously engaged in pressing tasks, and there can appear a misconception that ‘I am too busy to be friendly’. Indeed, some caregivers articulate that being friendly can slow down your work rate and that they intentionally avoid interactions that may delay them. There is ample evidence that the patient experience is closely linked to better clinical outcomes, and that the application of emotional intelligence can reduce the time spent with patients overall.

SECTOR SPEAKS

quality of treatment in terms of other, more personal dimensions. In the same way, we expect a bus driver to be able to drive safely and competently; if the driver does not do so, we complain. We then look to the driver’s inter-personal skills to determine the exceptional level of service provided. Nevertheless, this is contrary to von Essen and Sjödén’s comment that patients often identified clinical competence in areas such as taking blood pressure, administering injections or intravenous insertions as one of the higher- ranked behaviours. In writing this paper, the authors were simultaneously involved in the early stages of a ‘net promoter score’ (NPS) patient feedback tool, delivered via SMS to mobile telephones. Although the data collection is in the early stages, it is evident again that clinical skills are complaint points when there has been a problem, but rarely occur within commendations.

Being clinically excellent is not only ‘not enough’ for patients, it is not what they value as part of the patient experience.

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This research supports the need for caregiver training and increased understandings of patient expectations.

As noted, SJGHC is currently undertaking an NPS project, where all patients receive an SMS asking for a ranking (1-10) and a comment that explains their ranking. Unlike the SECs, this evokes both positive and negative feedback. Whilst the quantitative element of NPS is easily scored, the qualitative data needs to be filtered, and currently depends on a ‘text matching’ application within the software. It has been identified that the use of the six categories from the current project within this NPS project may be of value as a way of validating the selection of those six categories for the NPS project, and may also provide a ‘first cut’ in clustering the comment-based data. Whilst no systematic analysis has occurred at this time, a cursory view of the NPS project data appears to strongly support the view that virtually all commendations are linked to interpersonal skills and attitudinal factors. Clinical skills, even when patients have experienced acute care, appear to remain a standard expectation and are seldom commented on. This research could be enhanced and useful in future research on the use of the NPS tool to understand the patient experience of care within an SJGHC hospital.

The SECs were developed in an era prior to the widespread use of social media and electronic tools. Social media are a commonly used platform for both commendations and criticisms of most organisations, and particularly healthcare providers. The internet has become a source, often problematic, of medical information and there is evidence that online forums are widely used as part of selecting a specialist and hospital. Facebook reviews began to appear for Subiaco from May 2013, yet SJGHC began to track and analyse Facebook responses from July 2017 only. During the period this research reviewed, Facebook posts were less frequent, and not analysed. In the period from July 2017 to November 2017, there were 549 Facebook reviews of Subiaco, with an overall rating of 4.5 out of a maximum of 5. Whilst outside the scope of this research, reading every review for Subiaco demonstrated an alignment with the underpinning principles drawn from this research. The only significant difference noted through that superficial review was that hospital meals appeared more frequently in Facebook reviews, with apparently more positive than negative views of catering services. Comparing negative feedback (e.g., Facebook 1-star ratings) might help to identify useful information about what most aggravates patients, noting this is potentially feedback likely to be more idiosyncratic as it is outside the usual range. Facebook comments appear to be written in immediate response to specific events, rather than as summative views, which are captured through the SECs and within the newer NPS data project. The analysis of Facebook feedback warrants research in its own right, given the platform is so widely used and could be a source of potentially valuable feedback. It is also worth remembering that the default language-style in social media platforms is commonly strong and unqualified.

A core methodological approach used in this research, that of thematic synthesis, has potential for use with other

similar data. The adoption of the three stages (the coding of text ‘line-by-line’, the development of ‘descriptive themes’, and the generation of ‘analytical themes’) is a useful way of having a consistent approach to data provided via open-ended commentary sources. This approach makes it less likely to have the result of data reinforcing existing views. Reading and interpreting comments is innately subjective and can be difficult. Very often it is necessary to interpret the meaning through the nuances of language use, including the use of hand-drawn emoticons (such as a smiley face) or other means to determine if the comment was intended to be read as humorous.

CONCLUSION

Understandably, most staff working in healthcare would expect that the most appropriate measure of their skills would be their professional and technical competence. However, when reviewing patient commendations, interpersonal and attitudinal factors are the elements of ‘distinctive care’. Patients would appear to view professional and technical competence as base-level expectations. The evidence from this research suggests that additional training is needed for caregivers to appreciate patients’ experiences of distinctive care.

As healthcare providers move to digital tools that collate vast amounts of data, thematic analysis, rather than text matching, could provide valuable information and insights. Private healthcare is expensive, and many Australians have questioned the value of membership when ‘out of pocket’ expenses are common, even on an expensive private health insurance plan. Fairly, private health users will expect ‘distinctive care’ and additional benefits (e.g., shorter waiting times, being able to select their specialist) as part of the rationale for remaining with private health insurance.

For St John of God Healthcare, a values-based and faith-based provider, the total patient experience is considered core. One measure of the integration of the mission, vision and values espoused will be patients’ reporting on their experience, and their perception of the care. As this research concluded, it appears that service ethos cards have been deemed fundamentally flawed as a staff recognition program (in part, a by-product of this work), and that newer tools such as the net promoter score will better capture the patient experience. The team developing NPS at SJGHC have taken an active interest in this research, and see it as valuable to their ongoing work, and to future research on how the organisation understands the patient experience.

When reviewing patient commendations, interpersonal and attitudinal factors are the elements of ‘distinctive care’.

The concept is simple but the impacts have been profound. Her project creates 5-10 minute digital life stories of residents’ lives – their family, work, hobbies, travels, dreams. Passionate about the quality of life in old age Elizabeth explains that life history exploration is an important and therapeutic process for older adults.

In 2013, at Catholic Homes Inc (WA) where Elizabeth is a Senior Occupational Therapist (OT), she linked with OT students from Curtin University to create life story film clips for a selection of residents. Due to the success of the project, it has been on repeat annually for seven years and is going strong.

Life histories come alive with digital biographiesOccupational Therapist Elizabeth Oliver says knowing the person, not just the health issues, is crucial in delivering personalised care. She developed a program that is changing the lives of patients and the next generation of therapists.

Thumb drive in box

“The great thing about getting older is that you don’t lose all the other ages you’ve been.” – Madeleine L’Engle

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HEALTH MATTERS

AROUND THE NETWORK

This is my story:

“Keith has taught me the importance of respecting older adults and their experiences that have shaped them to who they are today.” – Ellie-Caitlin

This project deliberately responds to research to improve care delivery.

Current studies show that life story work can be important in maintaining a person’s identity and in promoting and maintaining a sense of self, and providing an improved sense of belonging and satisfaction for family carers and people with dementia, as well as reducing feelings of anxiety and depression (Kellett et al.,

2010; Sebern & Whitlach, 2007).

Elizabeth says in many care settings, a residents’ life history information is often collected and collated, but remains unaccessed and underutilised. “The focus of this project was to provide a modern and innovative way of sharing our residents’ life histories with staff to improve care delivery, as well as providing a unique opportunity for residents and their families.”

Elizabeth says the project helps staff to see each person, to tune into who they really are, not just a body who needs to be washed or fed. “Creating the connection between OT students and patients is where the innovation and greatest impressions occur.”

“The students can be shy, fearful and unconfident when they commence and throughout the process they learn how to develop rapport, how to interview, how to communicate with families and staff, and that old people aren’t smelly or scary!”

OT Student Ellie-Caitlin Clemitshaw created a life story for Keith Glance, diagnosed seven years ago at the aged 52 with early onset dementia. Keith and his wife, Wendy, have been tireless advocates for dementia awareness and established a Memory Café, a Memory Walk and other safe and inclusive spaces that reduce social isolation.

While Keith’s wife Wendy was enormously grateful to have his life documented visually, for Ellie-Caitlin the experience was transformative.

“Keith has taught me the importance of respecting older adults and their experiences that have shaped them to who they are today. Older adults whether they are in an aged care setting, or different environments should always be entitled to, and have access to engaging in meaningful activities to provide fulfilment to their lives, which uphold their current interests and provide a renewed sense of purpose,” Ellie-Caitlin reflects.

“Throughout this project getting to know Keith as a person, what he has achieved, his interests, and relationships has reinforced the importance of seeing the individual who has an extensive history, and not for their diagnosis. Keith also taught myself not to let an illness define who you are, or prevent you from engaging in what life has to offer.”

Ellie-Caitlin is considering an future specialising in aged care, which is music to Elizabeth Oliver’s ears. To know that the project is opening aged care as a possible career for emerging OT students means we will all be in good hands.

Keith Glance Students and Wendy Glance

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AROUND THE NETWORK

L-R: Dr Natalie Hannan, Gavin Hazel-wood and Dr Tu’uhevaha Kaitu’u-Lino in the lab

L-R: Co-founder of Mercy Perinatal Professor Sue Walker AO with Gavin Hazelwood

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HEALTH MATTERS

AROUND THE NETWORK

Gavin Hazelwood, helped by his mum and dad, set up a website to sell his handmade pasta creations after Her Royal Highness’ unique necklace received worldwide attention.

“We’ve received a lot of orders from across Australia but also Canada, England, France, Switzerland and Iceland,” Gavin’s mum Rowan says.

“Gavin has been working on the necklaces every day after school and I have been staying up until 1am most days organising the labels and packaging.

“The support has been amazing but more importantly is the awareness that the necklaces are creating around stillbirth.”

The six-year-old was inspired to help bring babies safely home following the loss of his baby sister Clara who was stillborn in 2014.

Gavin presented a cheque to Mercy Perinatal Co-Founder Professor Sue Walker AO during a visit to the research laboratory on Wednesday 7 November 2018.

“This shows us how stillbirth affects families in such a devastating way,” Prof Walker says. “Stillbirth affects one in 130 Australian pregnancies and it resonates across families, friends and the community.

“The conversations that I’ve had as a result of Gavin’s work have been so moving. We’ve had so much feedback about the program and it reminds people that young children also feel the brunt of stillbirth.”

Mercy Perinatal is a three pillar centre of excellence in clinical care, education and research based at Mercy Hospital for Women in Heidelberg. Mercy Perinatal and researchers from Melbourne University are trying to develop a blood test to help women avoid stillbirth. The blood test aims to measure ‘danger signals’ that can let doctors know when a mother’s placenta is stressed. These at-risk babies could then be safely delivered before stillbirth occurs.

To help prevent stillbirth and purchase your own gold-painted pasta necklace fit for royalty, visit www.imadeyouanecklace.com

Pasta necklaces fit for royaltyA Melbourne schoolboy who gifted a gold-painted pasta necklace to the Duchess of Sussex on her recent Australian tour has donated $8,000 to Mercy Perinatal for research to help prevent stillbirth.

“The support has been amazing but more importantly is the awareness that the necklaces are creating around stillbirth.”– Rowan

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AROUND THE NETWORK

raise $8,000 for stillbirth research

Across the six organisations, seven hundred and twenty-eight hospital patients and aged care residents participated in the study.

Patient with Pastoral Practitioner in SJOG Rehab

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HEALTH MATTERS

MISSION

50

Prof Sandra Jones and Dr Chloe Gordon

What are the benefits of Pastoral Care to hospital patients and aged care residents?by

While we know intuitively and from personal feedback that pastoral care practitioners provide hospital patients and aged care residents with support that enhances their wellbeing, there is surprisingly little research into this important area of care. This evidence is important for several reasons. First, in an era of increasingly limited budgets, healthcare providers need to be able to demonstrate the benefits of care in order to retain and expand funding for the provision of services. Second, this dedicated group of professionals need to be recognised and acknowledged for the contribution they make to the wellbeing of the community. Third, increasing our understanding of who benefits, and how they benefit, will enable us to continue to improve the provision of pastoral care.

Australian Catholic University partnered with six healthcare organisations (hospitals and residential aged care facilities), to collect data to better understand and demonstrate the benefits of pastoral care for Australian hospital patients and aged care residents. The six organisations – BaptCare, Cabrini, Mercy Health, Southern Cross Care Vic, St John of God, and Villa Maria Catholic Homes – were located in Victoria, New South Wales, Queensland and Western Australia. The project, which commenced in 2017, was a truly collaborative effort. Pastoral care managers and practitioners and ACU academics co-designed the research protocol and the questionnaire used in the project; staff and volunteers from each of the organisations were involved in the distribution and collection of the questionnaires; and project champions at each organisation ensured the smooth running of the project.

Across the six organisations, seven hundred and twenty-eight hospital patients and aged care residents participated in the study. The 575 aged care residents who participated were from 41 residential aged care sites, and the 153 patients who participated had received care from 11 different hospital sites. The majority of participants were female (74%), secondary school educated (65%), and aged 80 and above (58%). Forty-four percent identified as Catholic and 17% as Anglican.

Dr Vivian Romero, Ms Julie Binstead, Ms Trudy Keur, Ms Mary Klasen, Ms Mary McInerney, Ms Karen Rolfe, Ms Karen Smith, Mr Michael Taylor, and Ms Jennifer Wegener

Project co-authors:

Professor Sandra Jones

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MISSION

What did we find?Participants were asked five questions about the quality of care they received from the pastoral care practitioner. The overwhelming majority (more than 85%) reported that during their meetings with the pastoral practitioner they were listened to, were able to talk about what was on their mind, had their situation understood, and had their faith/beliefs valued. Ninety-nine percent reported that they were treated with dignity and respect.

Participants were asked five questions about the benefits of the pastoral care they received, using the items from the Scottish Patient Reported Outcome Measure (PROM). Overall, more than three-quarters of the participants reported that they benefited from their meeting with the pastoral care practitioner ‘often’ or ‘all of the ‘time’. Examining the individual questions, similar proportions reported that ‘often’ or ‘all of the time’ after meeting with the pastoral care practitioner they were able to be honest with themselves about how they were really feeling, had a positive outlook on their situation, felt in control of their life, felt peaceful and did not feel anxious.

Through open-ended questions, participants shared their thoughts about the most helpful aspect of their experience with the pastoral care practitioner. Three overarching and closely connected themes were identified: personal qualities of the pastoral care practitioner; pastoral care practitioner met specific needs; and positive impacts on their emotional wellbeing.

PERSONAL QUALITIES OF THE PASTORAL CARE PRACTITIONER

The caring, supportive and empathetic presence of the pastoral care practitioners was a common theme amongst the participants:

“...The pastoral care person was warm and engaging and sensitive to my capacity to engage…”

“The compassion and understanding and empathy is what stood out for me. It created a safe and secure place to share what I was experiencing honestly.”

PASTORAL CARE PRACTITIONER MET SPECIFIC NEEDS

The participants valued having a range of specific needs met by the pastoral care practioner, including their spiritual needs, friendship/social support needs, and practical needs:

“I enjoy prayer group – it keeps me in touch with the Lord. She enables me to have a link with church.”

“As a parent in SCN it can be very isolating. Having that friendly face really helped on some really hard days.”

“[She] is always helpful and approachable and brings me communion if I am unable to attend daily mass. Never a trouble to her.”

POSITIVE IMPACT ON THE PARTICIPANT

Participants frequently commented on the value of feeling listened to and being able to freely express their emotions; and feeling encouraged and uplifted by their time with the pastoral care practitioner:

“I am not religious, I do not go to church but it is good that [she] will come and listen to me. One day when my daughter was very ill I asked [her] to pray with me and it made me feel at peace and positive.”

“Pastoral carer was very calm, cheerful and lovely to talk to. Her relaxed attitude made it easy to talk about a range of issues. Her insights and suggestions were very valuable.”

“She uplifts me. I am always happy when we talk. She gives me a sense of worth – that somebody cares.”

In terms of opportunities for improvement, the majority of participants noted that there was no aspect that they found unhelpful when meeting with the pastoral care practitioner. A number of participants instead took the opporunity to express that their experiences with the pastoral care practitioner were completely positive. A very small number of participants (six) noted specific religious aspects of the service that they found unhelpful, for example: “I am Anglican but sometimes taken as Catholic.”

A number of participants instead took the opportunity to express that their experiences with the pastoral care practitioner were completely positive.

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MISSION

Do people have to be religious to benefit from pastoral care?In relation to the perceived quality of care, there were no significant differences between those that did and those that did not identify as religious and/or spiritual in feeling that they were listened to, that they were able to talk about what was on their mind, that they had their situation understood, or that they were treated with dignity and respect. Those participants who identified as both religious and spiritual were significantly more likely to feel that their faiths/beliefs were valued than participants who identified as neither religious nor spiritual. This difference may be because of the shared religion/spirituality of the practitioners and participants. The majority of pastoral care practitioners in this study’s sample had a Catholic affiliation, and close to half of the participants identified as Catholic.

In relation to the perceived benefits of care, there were no significant differences between those that did and those that did not identify as religious and/or spiritual in being able to be honest with themselves about how they were really feeling and in (not) feeling anxious. Participants who identified as religious and/or spiritual were more likely to report having a positive outlook on their situation, feeling in control of their life, and feeling a sense of peace. These results are not surprising given that several studies have reported a positive correlation between religious practices and indicators of psychological well-being, including life satisfaction, happiness, positive affect, and higher morale.

What does it mean, and where to now?The results demonstrate that participants perceive considerable benefits from engaging with a pastoral care practitioner. Participants also perceive the quality of care that they receive to be high and characterised by empathy, care, dignity and respect. As aptly stated by Dr Brené Brown:

“We are hardwired to connect with others, it’s what gives purpose and meaning to our lives, and without it there is suffering.” Brené Brown.

Equally importantly, the study itself demonstrates the significant advances to knowledge that can be gained when multiple organisations collaborate to answer the big questions that face us in the provision of healthcare. The quality of the study was underpinned by deep and meaningful engagement of the university research team with the individuals and organisations who provide this important, but often undervalued, aspect of health and aged care. The value of the findings is enhanced by the multi-organisation dataset, enabling us to state with confidence that these very real benefits of pastoral care are not limited to a single organisation or a single context.

Courtesy of St John of God Healthcare

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MISSION

An Ethical Dilemma?

Gabrielle McMullen AM by

The 2016 Catholic Health Australia (CHA) Annual Conference in Sydney saw the commencement of a significant ‘conversation’ focused on planning for the future provision of ethics services across the Australian Catholic healthcare sector. Over the last two years this conversation has been continued by a group of over 30 representatives from Catholic health and aged care providers, CHA, the three ethics centres, the two Catholic universities and four theological institutes. Towards the end of 2017, they agreed that it would be timely to survey stakeholders to get a ‘measure’ of current ethics resources and future projections.

Professor Gabrielle McMullen AM, former Deputy Vice-Chancellor (Academic) at Australian Catholic University (2000-2011) and Trustee of Mary Aikenhead Ministries (2011-2017)

About the author

From the wider group of stakeholder representatives, a working party1 was established and commissioned to develop and conduct the survey of stakeholders to inform future planning. Stakeholders to be surveyed were divided into two categories, namely CHA members and nine other entities encompassing the ethics centres, Catholic universities and theological institutes. Survey results have recently been analysed and a major report2 prepared summarising survey responses and synthesising the findings as the basis for making recommendations on the provision of future healthcare ethics services.

SURVEY OF CHA MEMBERS

CHA members were surveyed across a range of areas, namely the ethics component of induction and formation in their facilities, internal and external ethics resources currently accessed, 5- and 10-year projections of their ethics requirements, and related succession planning. Across each of these categories the feedback indicated major variations between the large healthcare systems and the smaller providers. The former generally have access to substantial internal and external ethics resources supporting induction, formation particularly of the executive and senior management, the entity’s ethics committees, research and advocacy.

1 Details of the working party are as follows: Dr Dan Fleming, Group Manager, Ethics and Formation, St Vincent’s Health Australia; Professor Sandra Lynch, Founding Director, Centre for Faith, Ethics and Society, University of Notre Dame Australia (UNDA); Rev Darryl Mackie, Campus Chaplain and Mission Integration Manager, St Vincent’s Private Hospital Sydney; Professor Gabrielle McMullen AM, Emeritus Professor, Australian Catholic University (ACU); Rev Dr Joe Parkinson, Director, L J Goody Bioethics Centre; and Mr Xavier Symons, Research Associate, Institute for Ethics and Society, UNDA and doctoral student, Centre for Moral Philosophy and Applied Ethics, ACU.

2 The working party’s report

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MISSION

The smaller ministries have very limited access to internal ethics resources and depend on the services of other agencies, particularly the ethics centres – L J Goody Bioethics Centre (Perth), Plunkett Centre for Ethics (Sydney) and Queensland Bioethics Centre (Brisbane); for some, their source of expertise had been the recently closed Melbourne-based Caroline Chisholm Centre for Health Ethics. Some of these smaller providers also seek occasional assistance from ethicists at the larger healthcare services. Others rely on the expertise of one of the ministry’s experienced senior executives who is not necessarily a qualified ethicist. The frequency of usage of ethics resources ranged from “rarely – not within the last 10 years” for a small agency to “on a day-to-day basis” for one of the large healthcare systems.

The most frequently utilised and widely distributed ethics resource, as reported in the survey responses, is CHA’s Code of Ethical Standards for Catholic Health and Aged Care Services in Australia (2001) with the related Supplementary Papers (2016). Decoding the Code, the online Catholic healthcare ethics program offered through a partnership between BBI – The Australian Institute of Theological Education (BBI) and CHA, is valued by the Catholic healthcare sector; hundreds of staff have undertaken the course, the majority from the larger providers.

Interest in extension studies was indicated, again particularly by the major healthcare systems, and some content differentiation in such programs for the health and aged care sectors, respectively, was requested.

Most respondents anticipated an increased need for ethics services in the future, particularly in the aged care sector.3 Contributing factors are social and political change, the ageing population, technological developments, secularisation and allocating limited health and aged care resources. Together with healthcare ethics, requirements for business and organisational ethics were identified.4

SURVEY OF OTHER STAKEHOLDERS

The survey of the above-listed ethics centres, the Catholic universities (Australian Catholic University and University of Notre Dame Australia), and theological institutes (BBI, Catholic Institute of Sydney, Catholic Theological College and Yarra Theological Union) sought details of current and projected future provision of services to the Catholic healthcare sector in relation to ethics training, consultancies, course provision, advocacy support and research.

3 A number of responses also noted the recent or forthcoming retirement of leading Australian healthcare ethicists. Findings of a 2018 American survey of healthcare ethicists were similar to those of the current survey; see J Speckart (Fall 2018) ‘Ethics Recruitment and Role Awareness: What We’re Hearing’, Health Care Ethics USA, Vol. 26(4), accessed at www.chausa.org/publications/health-care-ethics-usa.

4 The breadth of issues requiring ethics expertise and likely increased resources encompassed: end-of-life care/choices, voluntary assisted dying legislation, advanced care plans, aged care-related support including dealing with dementia/cognitive impairments, elder isolation and abuse, abortion, sexual health, reproductive and genetic technologies including conducting specialised Catholic fertility clinics, working with LGBTIQ, ATSI and CALD people, disability care and abuse, complex addiction issues, working in prison and detention settings, new technologies and artificial intelligence, just allocation of resources, research ethics including Human Research Ethics Committee [HREC] membership, clinical trials and research governance, translational research, religious freedom and conscientious objection, appropriate pastoral care in the complex environment, and the ecological crisis.

We need to be more strategic and... will best achieve this if the entire Catholic health and aged care sector could work together.

Mercy

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MISSION

The ethics centres are widely utilised by both larger and smaller healthcare ministries, offering advice, undertaking consultancies and research, providing ethics training, and supporting advocacy initiatives as well as contributing to university courses. Each of the centres has a director, whose services are in high demand, supported by a small number of staff. Further, the ethics centres are also asked to provide some services to other bodies such as local dioceses and Catholic Education Offices.

Responses from the higher education providers indicated a range of activities already in place and a willingness to work with the Catholic healthcare sector to address future needs. Current involvement includes teaching ethics units within more generic degrees, limited offerings of formal courses in ethics, and contributions through supervision of doctoral candidates, consultancies, advocacy and research.

Some healthcare providers described their relationships with the higher education providers as currently ad hoc. Another perspective was that the higher education providers are not yet “seen as resources for applied health care ethics expertise”. The higher education sector’s willingness to work more closely with the Catholic healthcare sector augers well for developing its applied ethics expertise and contributing to increasing ethics capacity to meet the projected increased needs of Catholic health and aged care.

MOVING FORWARD

“We regard the need as being for access to local expertise and advice, together with a sustained national conversation around ethical issues in health care that encompasses clinical and non-clinical issues”

The working party recently distributed its report of the survey findings to stakeholders and anticipates that the report will be informative for the Catholic healthcare and higher education sectors and, importantly, catalyse much fruitful cooperation and collaboration into the future. Four key areas for moving forward were identified through the survey:

1. Catholic Health and Aged Care Sector-wide Partnership Cooperation and collaboration across the Catholic health and aged care sector is proposed to enable ethics capacity to be optimised and to minimise unnecessary duplication of services. This would be preceded by an initiative to explore effective options to meet the needs of both major national systems and small healthcare providers with less resources, and to ensure accessible expertise for staff professional learning, consultancy services, support of ethics committees, policy development and advocacy in all Australian jurisdictions.

2. Provision of Future Ethicists The Catholic higher education and healthcare sectors should work together to develop and implement a strategy to prepare the next generation of ethicists. Stakeholders named critical requirements as establishing scholarships and other support to underpin education and training, relevant academic programs preferably with a practical mentorship component undertaken in the Catholic healthcare sector, and instituting career paths and resourcing ongoing professional learning for those trained as ethicists.

3. Exploration of Models of Cross-Sectoral Ethics Services Developing a model/s for effective and sustainable delivery of ethics services was seen as critical. Elements identified for a future strategy were coordinating a multi-disciplinary, multi-site service for health care, aged care and social service providers, ensuring all Australian jurisdictions have appropriate access to the services, and developing funding resources to support such collaborative activities. This strategy would be underpinned by a concerted approach involving the current ethics centres and the Catholic health and aged care and higher education sectors.

4. Fostering Ethics Research across the Catholic Higher Education and Healthcare Sectors This partnership is seen as critical to strengthen the evidence-base for good professional practice in Catholic health and aged care, to inform new initiatives in ethics education, to raise the profile of this field of study, to maximise research expertise, and to inform advocacy and policy development.

It is envisaged that Catholic Health Australia will have a key and strategic role in fostering the cooperation and coordination proposed above. Further, advancing this agenda should be underpinned by a commitment to dialogue and potential partnerships with the Australian Catholic Bishops Conference and local dioceses and other relevant Church authorities (e.g. Catholic Social Services Australia).

The working party’s next task is to prepare formal recommendations for moving this agenda forward. They will be presented to CHA and its members and to the Catholic higher education providers as the key stakeholders in addressing the provision of future ethics expertise and resources for the Catholic healthcare sector.

“We have been unable to identify a model that we believe will meet our needs, and don’t believe that this can be done in isolation. This is a challenge that needs to be addressed by the sector as a whole”.

Partnerships amongst the members of the Catholic healthcare and higher education sectors, like those suggested above, will become critically important in Australia continuing the healing ministry of Jesus.

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MISSION

Largest study of its kind in AustraliaIn 2014, The Little Company of Mary Health Care Ltd, through its Calvary Hospitals, began a major research project into the efficacy of pastoral/spiritual care using a Patient Reported Outcome Measure (PROM).

“Are pastoral care interventions effective in improving the overall wellbeing of patients as reported by the patient or family member/carer?”

RESEARCH AIM

The aim was to ascertain whether the pastoral/ spiritual care provided by pastoral care practitioners (PCP) was deemed by the patient to be an effective component of their overall health experience regardless of their stated religious/ spiritual outlook.

The validated tool to be used was Snowden, A., Telfer, I., Kelly, E., Mowat, H., Bunniss, S., Howard, N. & Snowden, M (2012).

The research objectives were:

• To establish the effectiveness of the spiritual care provided to patients as reported by patients as reported by the patients and/ or their family member/ carer

• To correlate the patient reported outcomes to the patient’s stated religious/ spiritual outlook

• To use the feedback to inform the delivery of spiritual and pastoral care at the service site

It was hypothesised that patients would find a pastoral care intervention from a trained PCP helpful and meaningful to their healthcare, regardless of their stated spiritual or religious profile.

As with many research projects, everything took longer than expected and the project was around four years from initial email to journal publication.

Seven Calvary Hospitals across the Southern and Eastern coasts of Australian took part and almost 500 surveys were returned with a response rate of 21%, considered acceptable for a mail-in survey going to an older demographic with this type of questioning.

Susanne Schmidt / Pastoral Care Manager Calvaryby

Reference: Healthcare Chaplaincy: The Lothian Patient Reported Outcome Measure (PROM). The construction of a measure of the impact of specialist spiritual care provision. Retrieved from www.snowdenresearch.co.uk/download/healthcare-chaplaincy-the-lothian-prom-2012-revised-col-online-only.pdf

Elizabeth A. Lobb, Susanne Schmidt, Natalia Jerzmanowska, Ashley M. Swing and Safrina Thristiawati

Project co-authors:

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MISSION

FAITH OR NO FAITH PASTORAL CARE IS VALUED

Across the board, results indicated that patients felt that, regardless of religious/ spiritual preference, they benefited from a visit by a PCP. The patient reported outcomes included: being able to be honest with oneself, a sense of peace, a better perspective on illness, less anxiety and felt more in control. The five factors of the Pastoral Care visit that related to significantly higher patient’s overall outcomes were:

The patient reported outcomes included: being able to be honest with oneself, a sense of peace, a better perspective on illness, less anxiety and felt more in control.

THE METHOD

Using the Lothian PROM, patients were asked to score their feelings using a 5-item scale for during a pastoral care visit, after a visit and statements that described themselves now. The Lothian PROM was identified as having good face content and validity. With the permission of the authors, it was adapted to the Australian context by replacing the word “chaplain” with “pastoral care practitioner”. Demographic questions were added as was a free text response relating to how the PCP’s input affected the writer.

Scores were combined. Internal reliability and consistency tests were conducted and statistical models used to determine the factors that contributed statistically significantly to overall outcomes of pastoral care visits. Variables were also assessed against patient’s stated spiritual/ religious outlook. Ordinal Logistic Regression was conducted as well as odds rations, 95% confidence intervals and p-values. Content analysis was undertaken on the open-ended questions.

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MISSION

1. having more Pastoral Care visits (p<0.5 0R 0.778, CI 0.17-1.38);

2. the patient was able to talk about what was on their mind (p<0.01, OR1.48, CI 0.58-2.37);

3. they had something to be hopeful about (p<0.01 OR1.18, CI 0.51-1.85);

4. the visit focused on decisions about the patient’s healthcare (p<0.05, OR0.70, CI 0.05-1.35); and

5. a belief in God/Higher Being (p<0.01, OR 1.01, CI 0.43-1.71).

Point 2 has been further validated by the data from this study contributing to a larger data set by one of the PROM’s original authors, Austyn Snowden, on the value of specialised spiritual care listening in contributing to improved health outcomes for patients. Snowden, A., Lobb, E., Schmidt, S., Swing, A. Logan, P. and Macfarlane, C.; ‘What’s On Your Mind? The Only Necessary Question in Spiritual Care, 2018, Journal for the Study of Spirituality.

The PROM had a twofold aim – to contribute to the wider research about the value of pastoral care and to improve service delivery at each site and to date, all sites have worked on projects based on particularly the free text information from their own site, which were a rich source of data for pastoral care delivery at each specific hospital.

Reference: (2018) Patient Reported Outcomes of Pastoral Care in a Hospital Setting, Journal of Health Care Chaplaincy, DOI: 10.1080/08854726.2018.1490059. www.tandfonline.com/doi/full/10.1080/08854726.2018.1490059

“I want a super fund that acts in my best interests.”

Sarah Tooke, HESTA member

HESTA is an industry super fund. That means we’re run only to profit members, not shareholders. So you can trust that your future is in good hands.

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant product disclosure statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider any relevant risks (hesta.com.au/understandingrisk).

LARGEST OF ITS KIND

This project is, as far as the researchers know, the largest of its kind in this field in Australia to date, and possible in the world and we are extremely pleased to be able to both add to the body of research, to provide some specifically Australian research and to work to both validate local practice and to work to improve practice as needed. A quote from one of the survey forms sums up why pastoral and spiritual care continue to be a vital part of healthcare:

“At the end of one’s life, medical care with chemical preparation is not enough – spiritual care becomes even more important. In fact, it is essential to be able to survive without being permanently damaged.“ A Patient in the ACT.

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Formation more critical than ever

Susan Sullivanby

Catholic services are facing significant business and moral issues which have the potential to challenge our life affirming Catholic ethos.

MINISTRY LEADERSHIP PROGRAM COHORT THREE COMMENCES JULY 2019

CHA members consistently tell us that formation of senior executive staff within the health and aged care sector is of the highest priority to ensure the Catholic identity and mission of our services. Catholic services are facing significant business and moral issues which have the potential to challenge our life affirming Catholic ethos. Now more than ever, leaders need dedicated time and space for formation, to foster deeper understanding and connection of their leadership practices, within a community of leaders, to enable them to reflect and extend our mission.

To respond to this call, in July 2017, CHA launched the Ministry Leadership Program, in collaboration with its original developers, the US-based Ministry Leadership Centre. Catholic Social Services Australia (CSSA) also came on board to support program implementation.

The Ministry Leadership Program (MLP) is a unique formation program designed for Australian Catholic health, aged care and social services leaders to ensure our healing ministry is delivered in the spirit of the Gospel which inspired our founders. This spirit strives for a very special and distinctive approach to the care and compassion provided within all our Catholic services.

The MLP program gives executive leaders the knowledge, skills and resources to better understand, integrate and live out this distinctive mission, identity and ethos. It is highly practical rather than academic in orientation. In-session learnings are immediately applied on return to the workplace so program impact is immediate and observable. This immediate practical integration is central to ongoing leader growth and development, while simultaneously contributing to organisational growth in Catholic ethos and mission.

It is essential for the most senior leaders of a facility, to enable those with the greatest impact-capacity, to collaborate together to cultivate a mission-driven culture.

The first two cohorts achieved a full complement, with the commitment of ten CHA organisations and four CSSA organisations. Four new organisations came on board in Cohort Two, testament to the recommendations of Cohort One participants.

“The program fosters self-reflection and is delivered in such a way that application of the concepts to everyday practice is overt. It challenges your thinking and tackles the hard issues currently faced within Catholic healthcare with honesty and integrity.”

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CHA IS NOW SEEKING MEMBERS’ COMMITMENT TO PLACES IN COHORT THREE, COMMENCING JULY 2019

Continuing support from CHA members is critical to ensure the original, courageous investment in establishing the MLP in Australia continues to build on success so far, and ensure this innovative formation program continues to be available to CHA members small and large.

Feedback from participants, from participating systems and organisations, and from other observers, confirms that this new formation model is increasingly recognised and valued for its capacity to support confident, mission-driven leadership. The program continues to be refined and developed in response to evaluation and other feedback.

A COMMUNITY OF LEADERS

Many participants have expressed a high degree of satisfaction and excitement around the value and power of growing capacity for trusted cross-sector collaboration enabled through each offsite session. This fulfils an original goal of the MLP, to facilitate development of a community of leaders supporting and encouraging one another and embodying community as the core element of Catholic identity. This sense of community is not easily developed through other CHA networking opportunities which are necessarily more transient in nature.

“…the program fosters self-reflection and is delivered in such a way that application of the concepts to everyday practice is overt. It challenges your thinking and tackles the hard issues currently faced within Catholic healthcare with honesty and integrity.”

“Each session I have walked away with the desire, knowledge and ability to practically apply what I have learned within my organisation.”

“I have never been exposed to such a high calibre of subject matter expertise and thought leadership, with deep and considered responses to my questions.”

“…this program offers exceptional networking opportunities. You get the chance to exchange ideas with colleagues and to form bonds over a period of time that will hopefully facilitate collaborative healthcare leadership amongst CHA members”.

The Australian Catholic University (ACU) has recognised the potential of the MLP and is currently working with us about Recognition of Prior Learning (RPL) for their graduate programs, and possible future alignment with its suite of executive programs.

Learn more by viewing the MLP video linked at the CHA Home page.

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REFLECTION

Loneliness and Aging‘Ageism’ is the term that describes the negative stereotyping of and/or discrimination against people by reason of their age. The victims may be young or old. Robert Butler, when considering the status of older people in the Western world, concludes that ageism “allows the young generations to see older people as different from themselves, thus they subtly cease to identify with their elders as human beings.”1 Older people may lose adult titles like ‘Miss’, ‘Mrs’, or ‘Mr’ and be treated like children, being summoned by their Christian names “or given diminutive titles like ‘dear’ or ‘love’.”2 Little wonder that the self-esteem of aging people is undermined by this nasty stereotyping, thus increasing their feeling of loneliness. The fact is that most older people remain active, relishing their independence, often providing significant assistance within families, such as childcare, or continuing paid employment, if possible (many countries insist on compulsory retirement at 65 and/or employers discriminate against older people).3 Unfortunately, since the emphasis in Western societies, including Australia, is focused on young people, sociologists have for the most part given insufficient time to studying aging and old age however it is defined.4

The Royal Commission into Aged Care Quality and Safety is most timely. It provides us with the opportunity to examine key issues relating to aging and loneliness in our society. What “nasty stereotypes” about older people does our culture accept and encourage? What can we – individually and collectively – do to stop these negative stereotypes in the media and in our conversations?

Gerald A. Arbuckle, S.M., author of the recently published book: Loneliness: Insights for Healing in a Fragmented World (Maryknoll, NY: Orbis Books, 2018)

1 Robert Butler, Why Survive? Being Old in America (New York: Harper & Row, 1975), 35.2 Mike Featerstone and Mike Hepworth, “Images of Ageing: Cultural Representations of Later Life,” ed. Malcolm L.

Johnson, The Cambridge Handbook of Age and Ageing (Cambridge: Cambridge University Press, 2005), 358.3 See Christina Victor, The Social Context of Ageing (Abingdon: Routledge, 2005), 400.4 See Gerald A. Arbuckle, The Francis Factor and the People of God: New Life for the Church (Maryknoll, NY: Orbis

Books), 37-38.

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At this time of year the sights and sounds of Christmas are everywhere! The rush to Christmas – and for the lucky ones, some personal downtime – envelopes many of us in a busy cycle of planning, preparation, parties, shopping. While often exhausting, there’s also a special kind of atmosphere about this time of year, and the opportunity to be reminded of who and what matters most to us. Wrapped within this awareness is the connection with the deeper, spiritual dimension of the season.

Too often Christmas is distilled into a message about celebrating the birthday of Jesus. Perhaps this results from the child-centred focus that often prevails. In reality, rather than a limited celebration of a past event Christmas offers the possibility of a meaningful focus on the future.

Much can be said about the mystery of God entering into the limitations of the human condition in the person of Jesus. For those from all faiths and none, who share our ministry of service to those who are sick, suffering and dying, the significance of Jesus’ birth lies in the promise of a new way of being and relating. We encounter this tangibly through all that Jesus was, all he said and all he did. Christians have a ‘shortcut’ for expressing the richness of this new way of being and relating... the ‘Kingdom of God’.

At the heart of the Catholic faith is the embrace of this mystery of the Kingdom which Jesus’ birth signals. So much of Jesus’s healing and teaching was about making this ‘new way of being and relating’ real and visible in the here and now. For Christians the coming of Jesus celebrates the coming of a ‘better way’ promised by and through Jesus; the way which leads to fulfilment and wholeness, to connectedness and human flourishing.

And herein lies the paradox. Jesus was born and lived among us… the Kingdom is here! Yet the world is not yet as it could or should be. This ‘new way’ of being, the way modelled by Jesus, is not yet fully realised, it is here but it’s not yet complete. So we find ourselves still waiting,

Christmas Reflection

HEALTH MATTERS

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still longing… for that reality we believe and know in our hearts is possible. A reality we experience in moments that can often fade all too quickly… We glimpse something meaningful and sustaining in a moment of connection with a colleague, in the satisfaction of providing caring support for a patient, in the hopefulness of a quiet exchange with an elderly resident. Then we are caught again in the busyness and demands of our roles.

So as we (busily!) approach the celebration of Christmas, it’s worth reflecting on how we might live today so that the ‘future’ possibility of wholeness ‘breaks through’ into the present. What are the ways open to us each day to make ‘the way of Jesus’ more visible, more real, for those we live with and work with and serve? In modelling the way of Jesus, we not only make this way present in the here and now, we actually keep the promise of a better way alive, we build hope that it is possible even when the evidence seems slim.

For what do you dream for your family? For your workplace? For your patients, residents, clients? As Christmas approaches, now is the time to enable the longing for wholeness, connection, meaning and fulfilment to grow in our hearts and motivate our actions in the here and now.

We may not be able to realise our dream fully but we CAN bring it a little closer to reality – through noticing and then responding to the opportunities small and large for a personal, relational, compassionate connection with others and through working to bring this same ‘way’ alive in the vision and plans of our organisations.

Together we can inspire others to share the challenge of living a new reality. And we can keep hope alive that we are moving closer towards fully realising the wholeness God dreams for each of us.

– by Susan Sullivan

This ‘new way’ of being, the way modelled by Jesus, is not yet fully realise.

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THE CHRISTMAS GIFT OF PRESENCE


A message from Catholic Health Australia

For Christians, Christmas celebrates the mystery of Jesus’ coming among us. It is a celebration of presence, God’s presence.In a guise that changes all our understanding of the divine. Jesus’ presence emanated compassion, inclusion, no judgement. His presence overturned conventional ways of seeing and doing things. He was drawn to the humble, the scorned, the misunderstood, the invisible. Uninterested in power, status, wealth and merit. Presence is the gift of Catholic health and aged care to those who are sick, suffering and dying.

May this Christmas season deepen our commitment to be an unconditional presence, so our ministries reflect Jesus among us.

catholic health australia health matters matters/2018... · pictured below is his eminence cardinal...

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