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ILC GLOBAL ALLIANCE 2019 Meeting SYDNEY
Members of the ILC Global Alliance gathered in Sydney in November for the Biennial meeting and symposia.The board meeting was held on Monday 3rd November, preceded by a workshop of the LTC working group,and followed by a symposium on Long Term Care and Caregiving.
6As for Long Term Care
While the need for LTC in later life is acknowledged, there is little consensus on what such care entails. Partly this lack of consensus reflects the diverse and changing needs across later life as well as cross-country differences in social norms, care systems, policy, and financing. The WHO defines LTC as “activities undertaken by others to ensure that people with, or at risk of, a significant ongoing loss of capacity can maintain a level of functional ability consistent with their basic rights, fundamental freedoms and human dignity” (WHO, 2015). The focus is on maintaining the functional ability of older persons in spite of significant ongoing loss of intrinsic capacity, and explicitly notes a link between effective LTC systems and the preservation of human rights and dignity throughout later life.
The Global Alliance Working Party on Long Term Care has been working together to develop a framework that can be used to make person-centred international comparisons of LTC systems. Using this framework, LTC can be described in terms of:
- AVAILABILITY – supply, services, sector, workforce, and support for caregivers.
- ACCESSIBILITY – access to information, eligibility and referral.
- AFFORDABILITY – costs and financing.
- ADEQUACY – needs, social and mental wellbeing, hygiene, and health and medical needs.
- ACCEPTABILITY – culture, safety and satisfaction.
- ACCOUNTABILITY – accreditation, regulation, quality indicators, compliance, human rights and
The working party is partway through a Delphi consensus process to identify and define the items within each of the 6As.
The ILC meeting coincided with the release of the interim report Australian Royal Commission into Safety and Quality in Aged Care. This report cites numerous problems with LTC and shows how it can be very difficult to ensure care that meets the needs of frail older people in a safe and adequate manner. The need for our 6A framework, and for sharing better ways to provide care that meets the needs of older people, could not be more evident!
The report is available here.
International Research on the Positive Aspects of Caring for Older Adults (PACOA)
Briony Dow and Brian Beach updated ILC GA members on the activities of the caregiving working group. The group held a workshop in July 2019 in Ottawa to scope the available data on positive aspects of caregiving, and to prepare a protocol for qualitative and quantitative analyses. They are also working on a review of policies for supports for caregivers.
Prevention in an ageing world - SYDNEY
ILC-UK is leading a series of events which highlight various approaches to prevention in an ageing world. The Sydney event was held as part of the Australian Association of Gerontology pre-conference workshop programme. The panel was chaired by the Baroness Sally Greengross and included presentations by Prof Andrew Wilson, Director, Prevention Partnership Centre; Vincy Li, Manager, Evaluation and Strategic Programmes, New South Wales Office of Preventive Health; Arunima Himawan, Research Fellow, ILC-UK; with a summary and overview by Prof Julie Byles. Key messages from the panel include the need for life course and systems approaches to prevention.
From a life course perspective, healthy ageing starts even before conception, continues in utero and throughout life: from the first cell, to the last breath. Wellbeing in older age also depends on the dynamic interaction between the intrinsic capacity of the individual, the influence of physical and social environments, and the availability of supports for those with greater needs. Viewed in this way, long term care can be seen as the “long tail” of prevention with a focus on long term ability to engage meaningfully in life, long term dignity, and long term autonomy.
From a health systems perspective, there is a great incentive to prevent disease through improving health behaviours at a population level, and through screening and early intervention. However, while many disease risks may be viewed as the responsibilities of individuals to change their behaviours, governments also have a responsibility to create healthy promoting policy and environments, and to promote equity in peoples’ ability to receive support in their older age in accordance with their needs. There is also a need for better integration of preventive activities, clinical services and long term care, and for streamlined pathways between different stages and services.
Robert N Butler Memorial Lecture
This year’s Robert Butler Memorial Lecture featured the work of Professor Tony Broe and his team from the Aboriginal Health and Ageing Program at Neuroscience Research Australia. The Lecture was opened by the Honorable Brad Hazzard, NSW Minister for Health and Medical Research. A series of presentations provided information, evidence, insight, empathy, understanding, hope and ways forward for a better future for Australia’s first peoples. The audience listened with absolute stillness, silence and profound feeling. It is an event that will be remembered by all.
We thank Prof Tony Broe, Prof William Brooks, MS Ellen Finlay, Uncle Terry Donovan, and Ms Sharon Wall for sharing their work, experience, and their mission for healing through love and understanding. I am proud that ILC were able to create this opportunity to share the information, and to gain understanding. We all learnt a lot. it was affective knowledge, as well as cognitive knowledge.
Human rights and Wicked Problems in Ageing
Many ILC GA members joined the AAG conference which continued on from the ILC events. Strong themes for the conference included human rights and how these can be protected for older people, ageism (and other isms) and other wicked problems that get in the way of people ageing with health and dignity. Margaret Gillis gave a very enlightening talk on how ageism is evident everywhere including the workplan of the UN General Assembly, and the WHO, and how we have to fight for the rights of older people - even at the UN. This pervasive ageism was further debated on the Big Ideas panel which included ILC Ambassador Sally Greengross. Sally reminded us all, that age is not the problem, it is illness, loneliness, circumstances, and discrimination. Ageism is a health risk. Sally was also the special guest of the AAG as the Gary Andrews Visiting Fellow, giving a keynote address to the conference, meeting with government, and engaging in other activities around Australia.
Big Ideas programs air on ABC radio national
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