Institutes & Centres
As the leader of aged care research by the Caring Futures Institute team at Flinders University, Professor Julie Ratcliffe knew that ignorance and indifference had long shaped young people’s opinions on aged care.
However, the team’s most recent report, triggered by the ongoing Royal Commission into Aged Care Quality and Safety, signalled that a majority of Australians of all ages are prepared to do the unthinkable and pay more tax to ensure universal access to high-quality aged care services.
“When my 18 and 20-year-old children answered our survey, their answers reinforced a change in views and preferences about the quality of aged care and future funding,” says Professor Ratcliffe. “Previously, I’d seen a real lack of attention given to older people and aged care by younger people. Now a whole new conversation is happening.”
The closer Professor Ratcliffe looked at the survey data, the more apparent this became. Nearly 90% of people who participated in the research agreed that the government should provide higher funding for aged care services, with a majority believing it should be doubled. Almost 60% agreed there should be a reallocation of public expenditure to aged care.
More than half of current income taxpayers say they would be willing to pay an additional 1.4% income tax per year to ensure satisfactory quality aged care is delivered, and a further 1.7% per year to achieve high quality aged care.
It’s breakthrough research that can help steer the future of aged care in Australia – a task that the Royal Commission is determined to address – and reveals a decisive change in thinking from younger Australians. “Young people tend to only think about aged care as involving older people residing in nursing homes, yet a growing proportion of older people receive services in their own homes,” says Professor Ratcliffe. “However, there’s a shortage of provision, with quite a long waiting list of older people wanting to access home care packages. People are dying who are eligible to receive home care services that they never end up receiving. Most young Australians are not generally aware of this, or the need for more investment and greater transparency about how aged care funds are allocated. The survey helped to inform younger people about what is actually happening in aged care.”
As a consequence, more than 70% of survey respondents indicated that they would be willing to pay a larger co-contribution to receive the support they would need to remain living at home rather than entering a residential aged care facility.
Professor Julie Ratcliffe
Striving to improve care for aged people has been the focus of Professor Ratcliffe’s work since she emigrated from the United Kingdom in 2007, to commence research at Flinders University evaluating the transition care program for older people. Now, the aims of the current Royal Commission has provided Professor Ratcliffe with an opportunity to pull together the many threads of her aged care research. Much of it has involved talking with older people about their own needs and preferences rather than just taking the advice of clinicians.
However, it struck Professor Ratcliffe that the recent survey represented the first time many older Australians have been asked about how they want to be cared for. They expressed great relief at finally being included in the conversation. During interviews, some people burst into tears. “They were quite emotional when they told me that no-one had ever asked them before about their opinions – and it has a great effect on what we found.”
It took patience and considerable time to extract these answers, but Professor Ratcliffe has long valued the wisdom of older people. As a young girl growing up in Stoke-on-Trent, she loved spending time with her grandparents. While her grandmother baked, Professor Ratcliffe listened. When grandfather was tending his garden, she hung on his every word.
“I've always found older people to be very, very interesting to talk to. Over time, I became aware of how much we were really neglecting older people, not taking the time to talk to them and not prioritising health economics research which focused specifically on older people, or on the aged care services that they receive.”
Professor Ratcliffe is confident the current research will make a difference, but like pulling a loose thread that just keeps unravelling, she has found more areas that need attention with every question she asks. “There is not just one aspect, but a big series of issues that are not being addressed properly.”
The Caring Futures Institute at Flinders University illustrates the strength of a multidisciplinary approach to provide solutions for such complex public health issues. Drawing on the research expertise of health science, medical, nursing and social welfare experts, Professor Ratcliffe and her Health and Social Care Economics team is engaging with each limb of Australia’s aged care industry to drive necessary reform – informing government policy, advising industry best practice and workforce improvements, and delivering stronger models for the care of all older people.
This includes new tools to measure quality of care and quality of life indicators. Application of this research is already having a positive effect. The Caring Futures Institute is working closely with five aged care industry partners, operating across five Australian states, to test the reliability, practicality and validity of these new tools. Aged care industry partners and clients involved in the tests say they are happy with the results, and the quality of life assessment tool will be ready for a sector-wide rollout towards the end of 2021.
Professor Ratcliffe is confident the Royal Commission’s final recommendations will include routine assessment of quality of life and quality of care across Australia's aged care system, and she’s thrilled the outcomes of long-term research look set to have wide-reaching ramifications.
“Yes, I’m wanting to give something back, which hopefully will have a lasting impact. If there is going to be significant reform in the aged care sector, everyone in society – older people, their families and the wider population – really needs to be involved in that process, and to own the transformation of this sector.”
Article published on 13 November 2020
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