Episode 18 - Opportunities and Challenges in Aged Care

In this episode, Scott Lynch (Managing Director of Community Therapy) speaks with Viv Allanson (CEO of Maroba Caring Communities).

They discuss the challenges and opportunities in residential aged care, the importance of physical activity and wellness programs for older adults, and the complexities of government regulation and its impact on the sector.

We hope you find this conversation inspiring and illuminating! See a list of the resources mentioned in the podcast below.

Resources
Sunbeam Trial Info Article
Sunbeam Trial Study
Hunter Ageing Alliance
Active Stronger Better

Maroba Website
Viv's LinkedIn

Community Therapy Website
Community Therapy YouTube
Community Therapy Facebook
Community Therapy LinkedIn
Scott's LinkedIn

Takeaways

• The funding and staffing requirements in aged care need to be addressed to ensure the delivery of quality care.
• Physical activity and wellness programs are essential in aged care to improve residents'  well-being and quality of life.
• Government regulations and reporting can be burdensome and are not always perfectly aligned with the best outcomes for residents.

Timestamps
0:00 - Introduction and Background
2:45 - Challenges and Opportunities in Residential Aged Care
8:18 - The Role of Allied Health in Aged Care
11:09 - How Physical Activity Programs Improve Quality of Life
18:19 - Communicating Benefits of Physical Activity to Older Adults
26:20 - Quality Indicators and Regulatory Burden
31:15 - Structural Reform and Government Involvement
38:49 - The Need for In-Field Experience in Government Cabinets
42:38 - Leadership and Maintaining Optimism

Transcript

Scott Lynch (00:02.218)
Welcome to the Community Therapy Podcast where we talk all things community health care. I'm your host, Scott Lynch. Today we're chatting with Viv Allenson about recent changes in aged care funding and how models of care are changing. Viv is a CEO who never accepts the status quo. In fact, for three years running, she was announced as the Australian Game Changer of the Year.

and visionary CEO of the year in her role as CEO of Maroba, an aged care organization in the Hunter region of Australia. Very well known in our region being in the Hunter, but for those of you listening in other areas. In 2023, Viv was awarded the Order of Australia medal in the King's Birthday Honours List for her services to aged care.

The registered nurse in VIV never lays down, and I really liked that line, being a physioin clinician myself, and is always advocating for the profession and its advancement as an integral part of the healthcare team. VIV has created a positive teaching aged care facility over 29 years, which continues to provide exciting career opportunities for the young and more mature students and employees.

Viv is best known for her thought, leadership, and candid, unscripted, yet powerful, commentary across many media platforms on a range of topics. Welcome, Viv. Thanks for joining me for a chat about Aged Care today.

VIV ALLANSON (01:37.685)
So thank you for having me Scott.

Scott Lynch (01:39.598)
Ah lovely. I thought a nice, there's a lot of things we could talk about aged care and it feels like there always is. It's been about not as long as your career yet but I hope to get to that, those lovely milestones in the future but it's been around 13 years in aged care for myself now and I just missed the RCS to ACVI transition. However most of my career has been in ACVI but

Since October, 2022, we waved goodbye to ACVI and hello to ENAC in residential aged care. I thought a nice place to start is, how's the first 12 months and a little bit after that been for you key challenges, opportunities in residential aged care.

VIV ALLANSON (02:26.137)
Well, it was good change to go to ANAC because it did promise that there would be more reasonable funding, which proved to be the case. However, with that came different expectations about what staffing requirements and as you know now the compulsory care minutes and registered nurse minutes just sort of wiped out any benefits from

the funding instrument, but also our commitment to allied health in that mix. So I don't think that it addresses that as well. And something we argued for that we felt that was an important plank in the structure of aged care funding and we still do, but it doesn't properly get recognised. And I think

that's going to remain problematic until there's a real focus on wellness. It's more, it's still an old health care model funding and it's a fairly blunt instrument. But it's interesting because we just saw a report yesterday that was commissioned by the new government pricing commission.

Scott Lynch (03:52.488)
I hack that.

VIV ALLANSON (03:53.329)
Yes, and they did a small sample of 118 facilities, which I think is quite a robust sample, and did, you know, time and motion and all of those sorts of things. And the glaringly obvious news to all of us providers is that they were $100 underfunded on the ANAC. And we're all cheering

Scott Lynch (04:01.215)
Mm.

VIV ALLANSON (04:22.1)
commission that report and hopefully they will take notice of their own report and extend the study or accept that, yeah, that's likely to be the case, let's not waste any more money on studies, let's accept that and fund aged care as it ought to be because we know the real costs. I mean, they always say we should be doing a cost of care study. Well, I signed the cheques, I know how much it costs to give the care.

Scott Lynch (04:51.615)
Yes.

VIV ALLANSON (04:53.353)
and the funding doesn't match it. We're funded for the cheapest beer possible, but what's expected of us is a service of a five-star cruise ship in an acute hospital setting, but the funding doesn't match. So there's huge gaps there, but yet our governments, successive governments, continue to put the beer where it's best.

put the weight right on the aged care provider as if it's all our fault. But we're trying to deliver with what we have and it doesn't add up. So it's no wonder that even after those funding changes and ANNAC and the benefits of ANNAC that we still find that 50% of the sector is in the red. And keeping in mind that doesn't take into account the number that have closed.

even just in the last 12 months, I think it's 39, have closed down. We also know that these many facilities that aren't operating at their full number of beds because we mentioned the staffing and the compliance around that, they can't meet the staffing requirement, can't attract people to regional areas or just can't attract them because of the nature of aged care.

Scott Lynch (05:51.79)
Hmm

VIV ALLANSON (06:18.149)
So we're seeing the failures come to an outcome now of, well, people will just have to close their service or minimise their service.

Scott Lynch (06:32.066)
And we see a continued consolidation of the sector through mergers and acquisitions. So I think, and straight closures. Yep. I think that's an amazing summary of where the sector is at. And you've touched on many of the points that are on my mind, really. I think there's, I feel optimistic around iHackers' view on things so far.

VIV ALLANSON (06:35.853)
Mm. And just close, and find closures. Closures, yeah.

Scott Lynch (07:00.05)
and had held that stance, I guess, from earlier last year from some things that I'd seen as well. And I hope that optimism is correctly held. And it was nice to see that study come out. And I think that's the right point of view that you've conveyed to everyone there. Let's see that continue or let's stop doing studies and accept the facts that can continue to be presented in front of everybody.

VIV ALLANSON (07:26.069)
and

Scott Lynch (07:27.686)
And it's difficult for providers when you have the weight of regulatory requirements and quality indicators continuing to march on and expand of, like you were saying, expecting a five-star experience and then funding not matching that ability to do so. And I'm definitely biased around allied health, running an allied health organization myself and being a physiotherapist by trade. But

It's nice to hear you speak so nicely about allied health and the part that we play as a workforce in the evidence base around well-being. And it was the double-edged sword of ACVI. It was an incorrect administration of the evidence base and putting allied health professionals, in particular physiotherapists with pain management programs, in a very difficult situation.

VIV ALLANSON (08:00.405)
I'm going to go to bed.

VIV ALLANSON (08:05.993)
Good.

Scott Lynch (08:24.578)
from the evidence base, but it also allowed older adults across Australia to have skilled healthcare professionals and an expansion of that within residential aged care. And it was quite difficult for aged care facilities to navigate that change management from fundamentally decommissioning pain management programs and that sort of commercial setup that occurred through to, okay, how do we meet care needs and under this new instrument and not...

VIV ALLANSON (08:51.552)
Mm.

Scott Lynch (08:54.29)
everyone approaches things in the beautiful way that you do of being able to manage the commercial side of a structure, but also combine that with delivering the evidence base as well.

VIV ALLANSON (09:10.001)
Well, we have chosen our preferred future and we haven't waited to be told how we're to do it because as you know in aged care there's announcements and then everyone's scrambling and waiting for the detail of how they're to deliver and perform. So we tend not to wait for the detail. We

select our future that we prefer and we go for it and hope that we can make it work. So we haven't taken our foot off the pedal with allied health. Very difficult to get a physiotherapist so we still advertise for that. We have great allied health team here at Maroba and they're doing mighty things with residents. We invested in gymnasium with excellent

Scott Lynch (09:43.575)
Mm-hmm.

VIV ALLANSON (10:07.605)
age-specific designed equipment from Finland and that the gym, I love coming to work and I nearly get run over by residents flying out of the lift on their walking frames and I say, where have you been at this hour of the morning? Oh, I've been at the gym and you know, they've done their workout, then they're going to breakfast and you know, then they're going to a bus outing or you know, seated exercise classes or whatever it is.

Scott Lynch (10:25.454)
So nice.

VIV ALLANSON (10:37.341)
But it is a priority here for us. And we know that if we can maintain the strength, the physical strength of our residents, even for those that are in the water wheelchairs, even their upper body strength, then we're giving them extra value to their life. And we may not extend their years, but we'll extend the enjoyment of their years by giving them that physical strength.

So we know that is very popular. So we're not prepared to say, well, there isn't enough funding for that, so let's stop those programs. We've continued those because we know that it's a benefit to our people, to our residents. And, you know, I love going down and seeing who's the gym member of the month this month and there they are in their Ostefrock and Crosby slippers. We have one rule in the gym and that's no Lycra.

Scott Lynch (11:26.007)
So nice.

Hehehehe

Scott Lynch (11:34.122)
That's fair.

VIV ALLANSON (11:35.217)
Yeah, and that works for me because if I was going to a gym I wouldn't be wearing a lifeguard. So we've made that the rule here too and the residents fit right in with that. They love it.

Scott Lynch (11:41.038)
Hehehe

Scott Lynch (11:46.686)
That's nice. I think I might put in the show notes a link to the sunbeam trial. If residential aged care facilities, leaders, people in a position to influence change within the sector are thinking about what is the evidence base for strength and balance and exercise programs in residential aged care. There is lots of research out there, but a more contemporary study done by a physiotherapist is...

by Jenny Hewitt, the Sunbeam trial, and it used that type of HUR equipment as well in combination with group exercises, challenging balance, challenging strength, predominantly accumulated. We know from the evidence in terms of balance and falls prevention, both in the community, but also in a residential aged care setting, you need to accumulate 50 hours.

of training to then see the decrease in falls across a cohort. They achieve that through twice weekly sessions at an hour. And then typically for those that have then gained that functional improvement, you can then with the evidence base move to more of a maintenance program. That could be two half an hour sessions or one hour session. But typically

you do want a little bit of a two to three times frequency a week ongoing. Noting that research is for falls prevention. There's lots of other research around exercise that you need to weave into that program around quality of life. And we know that that's well measured and often has its benefits from group programs and socialization that comes through that as well as cardiovascular.

VIV ALLANSON (13:13.61)
Yeah.

Scott Lynch (13:35.322)
exercise is well researched into that and being able to do that in a seated position, just because you have lost that ability to transfer or walk doesn't mean that you have lost the ability to exercise and gain benefits in other ways.

VIV ALLANSON (13:36.618)
Hmm.

VIV ALLANSON (13:41.237)
Please.

VIV ALLANSON (13:52.897)
Correct. And the, I don't know if you've heard of our program called Active Stronger Better, but that's, I'm involved with Hunter Aging Alliance and we're trying to change the trajectory of older people coming into aged care prematurely. So we've managed to get some funding. This program is being rolled out across the region.

VIV ALLANSON (14:21.973)
programs that have been conducted already. And we're now looking at getting it into aged care services where they don't have a gym or they're not doing the exercises or they don't have allied health teams. So we think this could be an exciting opportunity. We're going to raise it at the Maroba hosted community of practice that we've initiated, which involves the commission.

Scott Lynch (14:47.949)
Oh, lovely.

VIV ALLANSON (14:52.021)
the Quality and Safety Commission, our local health district, our primary health network, and New South Wales Health, as well as aged care leaders and particularly directors of nursing and people that are on site that can make a difference. So we're going to raise it there and try and seek.

engagement from the services that would be prepared to have this introduced into their facilities to enhance the wellbeing of older people. And we think it would be great. So that's going to be launched at that in February to announce that. But it's been well run in the community. You know, over 250 sessions have been run already. And we've got funding to

take it further up the valley. And because we believe that, you know, people end up in aged care prematurely or unnecessarily because the time of their life where exercise will really help them, no one's telling them to get off the couch, walk down to the corner, get involved in a group. Nobody's telling them that. So they're not doing it. They're just staying at home.

So we think we can help people stave off the need for aged care. So here I am, the CEO of an aged care. And what do I need? Yes, I need new customers. But I'm trying to put people off, trying to delay that need or stop that need altogether by supporting these initiatives.

Scott Lynch (16:39.458)
Well, I think it's a nice example of, you know, like what you said before, of, you know, planning for the preferred future and really pushing into the evidence base and knowing what works actually, you know, leads the success of an organization. So it keeps it in front of, you know, where the trends are moving. And we know that most older adults that preferred way to age is to age at home.

age in the community, age around your informal supports. And one of the biggest barriers there for staying at home that can be, whether it's the right, it probably is the right word, avoidable, bar a medical change or emergency is just functional decline from frailty and psychopenia. And the tough thing is being a physio myself, I struggle with my own exercise compliance, even at my age of...

VIV ALLANSON (17:27.234)
Oh, wow.

Scott Lynch (17:37.386)
mid thirties, but the tough thing of exercises is you have to keep doing them. So you have to just like medication to maintain our effect. You have to keep doing them. And with, we have a cohort of older adults that haven't experienced a lot of the positive, maybe branding around exercises that now a lot of younger cohorts may carry into their later years. So.

VIV ALLANSON (17:42.965)
Mm.

Scott Lynch (18:04.414)
the program that you're talking about, like a lot of the success there over time is from a positive branding of that, of re-changing and reframing older adults' perspective of what exercise is and the benefits of it.

VIV ALLANSON (18:12.405)
Hmm.

VIV ALLANSON (18:19.441)
Well, you don't look old enough to remember the old norm on the couch and the life beginning program.

Scott Lynch (18:25.158)
I think I've seen, not at my time, but I think I've seen the videos. Yeah. Yep. Branding. Yep.

VIV ALLANSON (18:28.701)
Yeah, and that actually worked. That got people off the couch. It was a great program. And we don't get so much health prevention education these days than what we used to. We used to see the heart ads all the time and melanoma and all of that. So there isn't the investment in that. There's more investment in a spin.

Scott Lynch (18:35.925)
Mm-hmm.

Scott Lynch (18:53.794)
Hmm

VIV ALLANSON (18:57.125)
spinning a health story so that the government doesn't look so bad, rather than investing in genuine health prevention education programs and information. So it's up to us, Scott, it's up to health professionals to get that message out and to promote it and to live it. I mean, I was just saying to someone the other day, you know, I've turned 66 and I'm still mowing

Scott Lynch (18:57.198)
Mmm.

Scott Lynch (19:11.118)
That's a really good point.

VIV ALLANSON (19:26.461)
female peers still don't know how to use a lawn mower. But I give thanks that I can still do it. Now, I'm not going to a gym, I haven't got time, but I do try to walk the dogs and, you know, I still do my own lifting and carrying, and I've got nurses back and, you know, yelp all the time, but the thing is, I can still do that, the lawn. And I just think...

Scott Lynch (19:29.974)
Mmm.

Scott Lynch (19:34.06)
Mmm.

Scott Lynch (19:44.366)
Mm-hmm.

VIV ALLANSON (19:53.961)
I've got to keep doing what I can do not to say, oh, well, I'm at a time of my life where I should be able to put my feet up and not worry about that stuff. No, I should keep doing exactly, exactly. And so I share that message with friends, you know, and I'm saying to younger women in my sphere of influence, if you don't yet know how to use a lawnmower, you come over to my place on Saturday and I will give you lessons.

Scott Lynch (20:03.946)
Unfortunately, it gets more important the older that we get.

Scott Lynch (20:10.912)
Mmm.

VIV ALLANSON (20:22.609)
so that you can be an older woman like me and not be dependent on someone else and you'll still be able to mow your own lawn.

Scott Lynch (20:29.354)
I know the occupational therapists in our team and around the country listening to this would love this conversation around engagement in ADLs because, and so would other health professionals, physios, EPs, et cetera, because we know that it's quite interesting. Like my, before going into aged care, if you talk to an undergraduate, Scott, I would have thought.

private practice, young musculoskeletal sports. So that's where a lot of my knowledge was and a lot of my background. There's a principle in high level athletics and high level Olympic training around general physical preparedness. Then there's another principle around like more specialized physical preparedness. So a lot of these principles apply just because they apply to human bodies. And

And that applies to older adults as well. And when we're talking around activities of daily living and mowing the lawn, you may not have the time for that component of that structured exercise that you're talking about, but engaging with all of those things maintains that level of general physical preparedness. It's helping you meet that.

the World Health Organization's level of moderate physical activity minutes per week or per day accumulating. You are getting resistance there. You are getting challenging balance exercises as well.

VIV ALLANSON (21:56.905)
I'm doing weights, I'm lifting the catcher and emptying that and then pushing the bin around. Even mopping my floors, you know, I'm getting that movement, upper body range of movement, I'm lifting the bucket and you know, it's like, yeah, who likes mopping their floors? No, I have to think of it as dancing, you know, dancing with that mop handle and enjoy it, put some music on and get in the swing and it's my workout.

Scott Lynch (22:09.643)
really important.

Scott Lynch (22:21.398)
Yep.

Yep. Good podcast on. Beautiful. No, I think that's lovely.

VIV ALLANSON (22:26.833)
Yeah, yeah. But I think people think that, oh, look, I couldn't go to a gym. I find gyms intimidating. It's, I think it's all the Lycra and all the gym drinks and, you know, all you've got to get your protein. It's so intimidating. And I think there's many people that just wouldn't even enter the door. And yet,

Scott Lynch (22:36.27)
Hmm.

Yep, that'll do it.

Scott Lynch (22:43.97)
Hmm. And the different music and yeah.

VIV ALLANSON (22:54.501)
we find here, you look at the generation that's in aged care at the moment, they weren't gym junkies. They didn't even know, the only gym they might have been in the town was the boxing arena and that's where you know their husband might have had a drink and a bet and watched the boxing but people didn't go to gyms. So to see them streaming to that gym, can't wait for their turn is so exciting but I

Scott Lynch (22:58.179)
Hmm.

Mm.

Scott Lynch (23:05.634)
Hehehe

VIV ALLANSON (23:21.961)
But I also think for myself then is if we can just make movement and exercise, physical challenge, normal as an activity of daily living, then it takes a bit of the stress out of, oh gosh, I'm less of a successful person that's aging because I don't go to a gym and all my friends do. Well, but they're not mowing their own lawns. They can't do that. But it's like...

Scott Lynch (23:32.711)
Mm.

VIV ALLANSON (23:49.937)
We have to get that message that, you know, to keep up your physical activity, even if you're not in a formal program, because it is still helping you.

Scott Lynch (24:00.774)
Yeah, I think so much of modern society has tied physical activity to a gym. And, you know, they have become extremely successful commercial structures and large, you know, global franchise systems. And but there's been plenty of other fitness structures that have, you know, permeated hundreds of years and even thousands of years of human existence. And

VIV ALLANSON (24:16.177)
at COVID spreaders and yeah, they're great.

Scott Lynch (24:30.162)
And those are things like yoga and Tai Chi and just moving. So, and we know there's great evidence based around falls prevention with Tai Chi specifically. So, yeah, I think it's a reframing of what helps meet meaningful goals for people. And most people's meaningful goals as we age them all around just being able to participate in the ADLs, get out into the community, have a coffee with friends, walk on the beach, have a swim, garden.

VIV ALLANSON (24:32.914)
I'm out.

VIV ALLANSON (24:39.914)
Yes.

Scott Lynch (24:59.842)
do general things and enjoy life. And a lot of the level of exercise that you need to do there and the environment is quite flexible and doesn't need to be confronting. So yeah, it's lovely to see initiatives like you're talking about that are looking to rebrand and reshape that for older adults in quotations.

VIV ALLANSON (25:01.65)
and

VIV ALLANSON (25:20.773)
Well, those programs are often done in parks. Again, so people are getting their vitamin D, their fresh air, they're not at risk of respiratory infection and contamination, and they're meeting people. So they're getting a lot of important personal wellbeing goals that people aren't even aware of that they need to have are being met in that outdoor exercise moment.

Scott Lynch (25:24.96)
Mm-hmm.

Scott Lynch (25:33.255)
decrease infection. Yep.

Scott Lynch (25:50.322)
Oh, I could just talk about this conversation all day, but I'm gonna move the conversation to around quality indicators. And this is all tied together, but how have you felt with the continued expansion of the quality indicator program and that regulatory burden and reporting through, and how has that affected processes and the workforce across the team?

VIV ALLANSON (25:56.026)
Sure.

VIV ALLANSON (26:17.617)
I think the tragedy is that governments and commissions seem to think that measurements are going to actually improve care at the bedside. So people are doing a lot of measurements, but they're doing them because there's a stick whipping behind them saying you'll be non-compliant if you don't do these measurements.

Scott Lynch (26:33.239)
Hmm

Scott Lynch (26:43.851)
Mm.

VIV ALLANSON (26:47.221)
that actually deliver something different to the bedside. Now, in this whole reform agenda, remember the title of the report. Do you remember it?

Scott Lynch (26:59.038)
not off the top of my head.

VIV ALLANSON (27:00.749)
One word, neglect. Right, now where was that neglect alleged to have occurred?

Scott Lynch (27:08.234)
At the bedside, in the bed. Not in the spreadsheets.

VIV ALLANSON (27:09.361)
Yes, isn't that interesting? Not in the Quality Office, not in the Corporation Office, not in the spreadsheets. It occurred at the bedside. So what are we doing? We're doing all these reforms that insisting on minimum minutes, but so much of the resources are being taken away to do report after report and measurement after measurement.

And yes, some of those quality indicators, they're very important. I'm not suggesting we do not measure quality indicators, but it's what difference is it making at the bedside? Is anyone actually analysing that? Because I used to say I was never admired by my fellow CEOs because...

Scott Lynch (27:45.162)
Mm.

VIV ALLANSON (28:04.289)
You know, I went to a meeting once and I was asked, so what are your KPIs, Viv?

And I said, well, are my people happy?

Scott Lynch (28:16.239)
Heh heh.

VIV ALLANSON (28:17.981)
And well, no, don't be silly. You know, what are your KPIs? You know, what are your financial benchmarks? And what have you, you know, what are you being measured on as CEO? I said, I'm being measured on other people happy.

Scott Lynch (28:32.622)
There'll be some team members at community therapy listening to this laughing because that's very similar to what I say.

VIV ALLANSON (28:38.597)
Yeah, and it's, I, you know, I can take a good pulse. And just walking through our building and touching people, you get a pretty good feel of where people are at and whether these adjustments need to be made. Sure, you know, I love it when people throw a whole lot of data at me and

Scott Lynch (28:52.61)
Mm-hmm.

Scott Lynch (29:05.524)
Mm-hmm.

VIV ALLANSON (29:05.949)
whatever and then they come up with a conclusion and I say I'll rest my case. Because I did that without doing the measurements, the formal measurements. Now I'm not suggesting we don't do formal measurements, we must. And we report those to our quality committee, clinical governance committee and all of those things. So there's a lot of reporting going on. But you think of every hour of face to face meetings to discuss these things. Is it?

Scott Lynch (29:14.392)
Mmm.

Scott Lynch (29:29.381)
Mm.

VIV ALLANSON (29:35.517)
changing anything at the bedside. We might say, oh, there's a few urinary tract infections. Well, we better see if we can get more water to the people. Okay, well, that'll be a good outcome. Is it something different? You know, and we can identify possible training needs and things like that. So there's benefit in that. But it's people are driven by numbers, KPIs.

Scott Lynch (29:39.364)
Hmm.

Scott Lynch (29:50.968)
Hmm.

VIV ALLANSON (30:04.509)
benchmarks. You know, I hate the benchmarks because it's like, but what are we comparing to? Have we been in those facilities? Do we want to be like them? Because, you know, we might walk into that facility and they've got great benchmark numbers, but they stink. The facility smells. The people are looking sad. I mean, how does that tell us?

Scott Lynch (30:13.591)
Hmm

Scott Lynch (30:20.65)
Yeah.

Scott Lynch (30:27.054)
So at a national level, knowing that like it feels like, at least in my career of like 13 years, also in aged care out of my times, it's the same conversations year after year, report after report. What is the structural reform that results in change there? Is it simply a better auditing system that has a harder stick at the audit time when people get in and go,

Okay, what is this facility actually like? Thank you for your data, but we're going to review the bedside and talk to people and review the environment and actually have firmer outcomes from those audits. Or what are your thoughts?

VIV ALLANSON (31:14.073)
Now let's think about the outcomes. Now aged care is but a part of a healthcare system, right? You agree? So why is it that aged care is singled out and now would you like a side of prison time with that service that you're doing? Now really, let's think this through. Are you, who, as a young man, you'll probably make a great board member.

Scott Lynch (31:24.232)
I agree.

Scott Lynch (31:32.132)
Yes, recent update.

VIV ALLANSON (31:43.881)
some time, right? Clinical skills, you've got good interest in aged care. But are you gonna sign up to a board? Now, you could, you know, end up in jail because of something that's been done in the dark by someone that you don't even know and haven't met, but you're responsible for them. That, you know, cause when people do something wicked, they're not doing it on show for everyone to know.

Scott Lynch (31:53.91)
I'll now be the responsible person.

Scott Lynch (31:59.416)
Mm-hmm.

Scott Lynch (32:13.049)
Mm.

VIV ALLANSON (32:13.477)
in the dark, behind the scenes, but yet if something catastrophic happens, then it's the onus of proof on the individual to prove that they didn't do it, not the onus of proof on the person. Someone's only got to say something and then the person's got to disprove it, which is completely contrary to law. So, who do you think is going to be rushing to sign up? So we've got all these...

Scott Lynch (32:30.83)
Hmm.

VIV ALLANSON (32:42.833)
measures, all these new layers, all these new expectations, now very severe punishments, who in their right mind is going to run up to an aged care service and say I just can't wait to lead this service. Let me at it.

Scott Lynch (33:02.159)
And extending that privilege in the legislation to registered nurses as well.

VIV ALLANSON (33:06.781)
Yes, exactly. Now, but again, we're part of a system. So why doesn't that apply across the system? Because we know what goes on in acute hospitals. It's shocking what goes on in the deaths, the calamities, the disasters, the mismanagement. Yes, there's some great stuff happens in our public hospitals, but it's shocking. What about NDIS? Gosh, isn't there some cowboys there?

Scott Lynch (33:08.836)
Mm.

VIV ALLANSON (33:36.349)
But no, they don't get included in this. And the new legislation, the way people are speaking, we have to get this new legislation started to finally give older people rights. Now, I find that the greatest defense to every aged care worker in this country who has been working across decades.

honouring people's rights. But now this is framed as if we've never acknowledged or given people their rights, which is just a lie. And it's a lie to put fear into older people to think they can't trust anyone going into aged care unless there's a jail sentence attached to the leaders. I mean, it's careful what you wish for because

Scott Lynch (34:23.534)
Hmm

VIV ALLANSON (34:34.813)
This is going to drive away good people and it's going to prevent people from staying. And we will be, you think there's a crisis in aged care now? I tell you what, you haven't seen anything yet until, because more, treating people with a stick, right? We're in human services. How do you want to get the best out of those that are doing human services?

Scott Lynch (34:55.459)
Mmm.

VIV ALLANSON (35:02.941)
We want to embrace them. We want to love them. We want to appreciate them. We want to value them. No, no, not this legislation. No, no, we've got to show we're tough. There's more punishment. There's more severe punishment. We'll make them do the right thing. Now, if they think that is going to be the answer, more things will get hidden. The people that are doing the wrong thing will find a way around it. You'll be sure of that. And the people that are doing the right thing

Scott Lynch (35:13.419)
Mmm.

VIV ALLANSON (35:32.817)
get caught by some unscrupulous person that's doing the wrong thing that nobody knows about until the disaster happens and then they'll be called to jail. So I find to say that this is a human rights based act, this new act, I just can't see it because if you've seen anything of the act or even a couple of years ago, the

Older person used to have rights sitting alongside responsibilities. Right? That's citizenship. Because as a citizen, we both have rights and responsibilities. But wait a minute, you're going to come into aged care now, we're going to take the responsibilities off you. So we're not going to treat you as a full citizen. We're going to treat you as less because you, you know, sorry pet but you can't handle having responsibilities. You're there, poor thing.

Scott Lynch (36:08.131)
Mm-hmm.

Scott Lynch (36:21.282)
Hmm

VIV ALLANSON (36:32.269)
we can't put that pressure on you. But older people are up to responsibilities. They really are. And they want to know that they are full citizens in coming into care. So if you want to really focus on people's rights, give them full citizenship. Even at the United Nations, when you read or talk about or discuss rights, there will be corresponding responsibilities.

every human being on the planet. But no, Australian aged care residents and people receiving home care will not be treated as full citizens. No matter how many, how much they say it's a rights based act, I think it's a, it's a smoke and mirrors.

Scott Lynch (37:23.266)
It's a really good point. I think you framed that really well around the responsibilities part. And we know from the evidence base of healthcare that that's how you provide great healthcare. That's that people having rights and responsibilities is what leads to proper consumer directed care and shared decision-making. People have that responsibility to take that information on board and make an informed decision.

VIV ALLANSON (37:44.207)
Mm-hmm.

Scott Lynch (37:51.486)
around the risks associated with those things. So that just, I think as healthcare professionals, a lot of these concepts that we learned in healthcare then apply to frameworks of, whether it's funding instruments like this or running an organisation, which I've found very interesting through my career, those concepts of clinical reasoning then applied through to that organisation and governance level as well. If you had a magic wand, what would you do?

What's one thing that you would totally change?

VIV ALLANSON (38:27.297)
I would change the structure of how we're structured, because we have bureaucrats that are setting up our systems of healthcare and aged care. And many of those people have never set foot in an aged care service. They are not clinicians. They may never have been a patient in a healthcare system. But those people...

who have no operational idea of how a service runs and how to get the best service to people are making up the rules and it is absolutely appalling. Look how well we've done so far with these notions of well add more layers, add more compliance, that'll fix it, they don't consider the humans. If we start treating our aged care workers

as special people, as human beings, and start treating them in a way, and look, I treat our people well here, but if the government, the language of the government, if the expectations of the government was more around, well, let's get the best out of humanity, because when we get the best out of humanity of the workforce and the volunteers, that's when the residents will get their best. And that's how I see when our residents are so happy is because I treat my...

Scott Lynch (39:32.919)
Mm-hmm.

VIV ALLANSON (39:51.909)
employees the same way as I want the residents to be treated and I see it played out day in day out where they are loving the residents, they're respecting them, they're giving them dignity, they're enjoying them as fellow human beings, they're enjoying them and taking their wisdom and it's amazing but as a sector we are not treated.

humans. We're treated as machines and you can do better. Look how you've messed this up. We're gonna punish you. Uh the bigger the stick the faster you'll make this happen and it is so demoralizing. To finish my career and I'm not far away from retirement but to finish my career on this note of my heart is no longer required. So I might as well hang up my commitment.

Scott Lynch (40:21.794)
Hmm

Scott Lynch (40:45.614)
Hmm

VIV ALLANSON (40:48.937)
That's how I'm feeling at the end of my career because of this new wave of, we'll fix it, we'll legislate it, and we'll make them pay. Yet we'll continue to underfund them, we'll continue to diminish them, and we'll continue to over demand, and we'll continue to expect them.

to look after people who have no responsibility for their own wellbeing or the community wellbeing. Isn't that a formula for crisis and failure? But no, all these bureaucrats and commissioners and government leaders think it's a formula for success. How deluded they are.

Scott Lynch (41:22.53)
But I think I can.

Scott Lynch (41:40.094)
It sounds like you're making the common sense suggestion that people in different government cabinets, and this applies to all sectors, should have either lived experience or worked experience in that sector that they're responsible for commissioning or looking after. And then, which I think is, if I had a magic wand, I would be happy to wave that with you to make that change. And then the other part I would say is, I think, you know,

VIV ALLANSON (42:04.981)
Hmm. Yes.

Scott Lynch (42:10.05)
being a leader can often feel lonely, especially when you've advocated for so long. However, I can say you may feel that way at times, but those of us that have listened to you and hopefully those that have listened today have felt that inspiration and that light has been lit in so many other people and will continue to be because of you. So.

Keep that in mind when you have those moments of thinking that all have lost, because there's plenty of people that are, you know, having their flames lit by your passion as well.

VIV ALLANSON (42:47.837)
Wow, Scott, thank you. That's very kind of you to say, and I feel greatly encouraged. I certainly wasn't expecting that comment, but I do want to encourage people to let their dreams loose, because we all have a dream, and my dream was to make a difference. As a young girl, I wanted to make a difference.

And people say, well, how do you plan for that? How do you set goals for that? Well, you don't. You live it. Every day. And I say, well, I make a difference every day, one person at a time. And I know I make a difference. I want to encourage everyone out there, have that naive dream that you can make a difference. And I guarantee you will. And if everyone, can you imagine if everyone in...

Scott Lynch (43:21.21)
Mm.

VIV ALLANSON (43:44.233)
Healthcare, every healthcare professional determined to let that dream loose and made a difference to one person, one day at a time. Imagine how aged care would be turned around, how our healthcare system would be turned around. We wouldn't be under the weight of bureaucracy and filthy lies from, you know.

government rhetoric and all the rest of it, we would be running the show with hope, with anticipation and with joy. Because that is where we will make our patients' hearts sing.

Scott Lynch (44:27.606)
What a lovely way to wrap up the podcast. I really enjoyed chatting to you today. Do you have anything that you think people should go and look at? I'll put it in notes. The Sunbeam trial, I might put a link to age care reform processes if anyone's interested of having a look there.

VIV ALLANSON (44:44.953)
Well, they can have a look at ageing lines and act stronger, better. But, yeah, keep hope alive because it's up to us. If we're relying on governments, it's not going to happen. We have to make this happen. So I'm excited about you younger generation and what you're going to do. And I'll be in your care one day, Scott. And I thank you for that.

Scott Lynch (44:47.83)
Perfect. I'll put a link to that in the notes.

Scott Lynch (45:11.006)
No, well, you'll be well looked after if I'm looking after you. But you will be you will be doing your exercises, though. I can tell you that much. That's so good. Everyone listening, you'll find the notes and links in this episode on our website, comm slash podcast. Thanks for listening to the Community Therapy podcast. I look forward to chatting to you in the next episode. Goodbye for now.

VIV ALLANSON (45:17.25)
That's right. I'll be, song me up, song me up.