Keep Able Reablement Podcasts
Keep Able is your go to authority on Wellness and Reablement. Our various podcasts cover discussions on real world issues and examples from people in the at home aged care support sector, specifically for CHSP providers.
Keep Able Reablement Podcasts
Reablement Through Connection & Transport (P1)
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With Jasmin Higlett & Lisa Bird - St John Ambulance discussing the importance of transport services to connect clients to their community and how this is reablement. Key messages they convey to clients for a positive pathway.
Discover more reablement resources at keepable.com.au
Hello and welcome to this episode of the Reablement Podcast, where Keep Able are talking to a range of people who have experience with using reablement and will explore how it all comes together and why it works. I'm Alison Bella from Keep Able. I'd like to welcome my two guests today. I have Jasmine Higlett and Lisa Byrd from St. John, Queensland. Welcome to both of you. Thanks, Alison. Thank you. We first met at a conference last year, straight away sharing stories about our love for reablement, and here we are today. So tell me about your experience and your roles.
SPEAKER_00So we'll start with you, Jasmine. Yeah, so I'm Jasmine from St. John, Queensland. I am the client and community engagement manager. So basically, I get to talk to members of the community about the good work that we do at St. John, particularly within our community services. I also look at things that affect our clients and reablement and wellness is one of them as well. So I have a background in health science, in public health. So wellness and reablement is very close to my heart and making sure that people stay independent, healthy, and active and living their best lives.
SPEAKER_01Fantastic. And Lisa. And I'm Lisa Byrd. I'm also from St. John, Queensland. I'm the partnerships manager. So I work a lot with the service providers and other businesses that we work with, reaching out to community organizations to really share the information about what St. John does and how we can work better together to support the people that work with us.
SPEAKER_02Fantastic. I love that. Work better together. That's what we're here to talk about. So tell me about St. John Queensland and the services you deliver.
SPEAKER_01So St. John as an organization has been around for a very long time, started in Jerusalem, made our way over to Australia around 140 years ago, and made our way to Queensland about 120 years ago. So we have a very long history in the Australian space. We love really supporting people, and that looks different in all states and territories. But here in Queensland, we have a few arms of our organization. The one we're here to talk about today is our community services team. And really we support people in the community across Queensland to help make their lives better. That's the nutshell version, isn't it? How we do that is we do community transport, we do social support, we visit people in their homes and aged care facilities, we talk to people over the phone, and we just really try to make sure that they're living the best life that they can.
SPEAKER_02Fantastic. How many clients do you work with? And that's probably a bit of a loaded question.
SPEAKER_01Very loaded question. So at the moment we have over 2,600 clients. We are taking on anywhere between 20 and 40 new clients a week. And we currently have around 400 clients who have contacted us in the last two weeks to take on their services as well. And to support them, we have 61 paid staff in Queensland and 260 volunteers.
SPEAKER_02And that's what I love about sort of community transport in the communities. When I used to do referrals for transport myself a few years back, I'd always let people know, you know, sort of a lot of the time you will get a volunteer driver who is there to give back to their community. So it's just fabulous.
SPEAKER_01We love our volunteers. They're really the spine of the organization, and they're the spine of every community organization. It's just people who want to do good things for other people. Yeah, absolutely.
SPEAKER_02How do you support your clients using a reablement model? Sort of what can it look like?
SPEAKER_00Yeah, so the main aim of our program is to promote independence, and we know that people value their independence, and a loss of independence has a devastating effect on people, particularly for our older cohort. We've also recognised so the World Health Organization Commission on Social Connection, they've actually said that social connection is essential for health, strength, and resilience of individuals and societies. This makes it clear that engaging with your community is really good for health, for your own health. So, in terms of clients, so we're identifying their goals. So this could be as simple as I want to get to my medical appointment, I want to keep doing my shopping, I just want to get out into my community. So then we're looking at actionable goals. Okay, so that could be all right, or to get out and do see my community and increase my social activities. It might be I want to meet a friend for coffee once a month, once a fortnight. And then as a service, how can we help facilitate that goal? So, from our point of view, to help the client, that would be providing transport to get them to the coffee shop to meet their friend. And speaking of coffee shops, I know that you guys have a fact sheet about the benefits of going to meet a friend for coffee as well. So you can clearly see that all of these little activities all come together to promote this reablement and wellness. So we're also encouraging client participation. We're continually providing opportunities for our clients to get out and about and experience what they've got. So, for example, we're always looking to see other expos on that clients might want to go to local libraries. We've got the ECA coming up, so we'll take people there. And then for our accompanied activities, it's finding out what they want to do. So while people might mostly think, oh, it's to go shopping or go to a medical appointment, we've got a client who just wants to go walk along the foreshore. And without the support of the support worker, they wouldn't have the confidence to do that. We're also looking at strength. So, what can the client do? Can they enter the vehicle by themselves? Can they put on the seatbelt by themselves in terms of our accompanied activities? Can they carry their own bags? Can they push their own trolley? Do they need assistance to lift up heavier items? So I remember a story from a few years ago that there was a client who, due to their health conditions, his needs could change daily. So it might be one week he was quite capable of pushing the trolley through the shopping center, picking up his own groceries. So very minimal assistance. But then the following week, he might have declined a little bit. He'd need assistance to get up from the chair, assistance to push the trolley, and assistance to select his grocery items. So it's just really working with that person on that day. So I say to people, don't assume that because a client is receiving services that they can't do anything, they can. And removing their choice to be involved and do things actually strips them of their independence.
SPEAKER_02Absolutely. Some really great points there. So on a similar vein, then, when you receive the referrals, what would be really great for you to see in the goals when you receive those referrals that sort of indicate that they've had a really deep conversation with the person?
SPEAKER_00So a lot of the referrals that come through at the moment, either they don't have a goal or they'll have something really simplistic like to get out and about. It would be great if the assessors could dig a little bit deeper. What's their motivation? And I find that that really helps when you're having conversations with people too. Find out why they want to keep getting out and about or why they want to keep doing their grocery shopping and what does a good day look like for them.
SPEAKER_01And what's their roadblocks too, right? Like saying that people want to get out in the community is fantastic, but we all want to get out in the community. They want to get out into the community because they want to do their own shopping because they don't like the home delivery food service and they really like to cook for themselves. They really enjoy it. So being able to get out and buy their own ingredients and get them home to their kitchen bench empowers them to follow their passions, their hobbies, gives them dignity and choice and lets them live their best life their way.
SPEAKER_02And that enables you then to sort of go, right, this is a fabulous reablement opportunity here. And you can see through to the success of the person achieving that for themselves.
SPEAKER_01Correct. And it gives you a metric by which to measure your progress as both as an organization, but also for the client, not only for them meeting their goals, but also as their goals change over time. It lets us understand that when they started their journey, their real goal was to cook in their own kitchen. But maybe as they've gotten older or as their wellness has declined, which it does for us all, knowing that actually their goal has changed now and they want to make informed choices on the food options that are available to them, but being able to do that in such a way that still gives them the choice to make and do what they can and want to.
SPEAKER_02Fabulous. What are the biggest barriers you come across regarding using reablement with the clients?
SPEAKER_00I'd say the biggest barrier is so lack of knowledge and what reablement actually is. So it doesn't have to be this big, huge, scary thing. It can be as simple as wanting to go to your letterbox and get your mail out of the letterbox yourself. So it's lots of little things combined to form a picture of total improved wellness. Um, we also come across the notion of once someone is receiving services that, okay, well, the support worker is there to do absolutely everything. And that's not true. We want people to stay independent. It can also be lack of motivation from the client, especially when you've got things like mental health or depression setting in, it can be quite hard to motivate the client to go on this reablement journey with you. And an interesting one that I've come across, particularly last week at the National Agare Provider Conference, was benevolent ageism, where just the fact of being a support worker or working within the aged care industry that you just automatically assume that the person will need help. And it's really great that people want to help. It's fantastic, but we need to let people reclaim their ability to stay independent.
SPEAKER_01It's the older person's equivalent of you see someone in a wheelchair and you're automatically inclined to check if they need help or if they want you to push their chair. But actually, they're quite capable of moving around by themselves. It's no different with older persons and people looking to live in that older space that they can still do the things for themselves and it's empowering to do so.
SPEAKER_02Exactly. And giving them that choice as well. Talking to them, asking them the questions.
SPEAKER_01They're not they're not children, they're not infants. They've they are human beings who've lived a fantastic, wonderful life, who bring so much experience and personality, they shouldn't be stripped of that just because they got old.
SPEAKER_00So, what sort of methods do you use then when you come across those barriers? Yep. Um, so mainly education about what reablement is and what it means at all levels, um, particularly so for staff, for clients, uh, for their family members and carers, explain the benefits of reablement. And I think you need to actually translate it into practical examples. So could be entering a vehicle by yourself, putting on your own seatbelt compared to needing assistance to get in the vehicle, needing assistance to put on the seatbelt, needing assistance to get out of the vehicle, so that kind of thing in terms of our accompanied activities. Uh, so being able to pick up the groceries of your choosing, or if something is too bulky, well, maybe you pick the item that doesn't weigh as much. So things like that. So small modifications just to make your life easier and to stay independent.
SPEAKER_02Fantastic. Can you give me an example of a client story where reablement was used? And in our past conversations, I know you've got a thousand of them.
SPEAKER_00There's many. Oh, there's lots of stories. Um, so one of the ones that stands out for me the most, this was many, many, many, many years ago, around when I first started working for St. John, there was a lady who registered with us, and she had to go to an eye specialist every so I think it was every six months and get these eye injections. And she was terrified. And transport was a barrier, and she just didn't like it, didn't want to go. But if she didn't go, her health would decline. And then she would potentially go blind, which would affect all sorts of things. And I remember there they had this interview with her, and she was she was talking about the simple act of transport just to get to these appointments and what that achieved. And she developed this really quiet good relationship with the driver at the time, who really calmed her fears. And she said it it became instead of being nervous about these appointments to get these eye injections, she actually started to look forward to them because she wanted the chance to chat to the driver. So, anyway, so she would ended up getting these, going to these appointments, getting these injections, helping with her eye health, but also then getting that social connection with the driver. And it turned for her what was a scary situation or full of unknowns into this quite positive situation where she knew she was looking after her health, um, and she was getting the chance to socially connect with someone at the same time. So I always like it gives me the warm and fuzzies, those type of stories.
SPEAKER_01We do love the warm fuzzies. I've got two that really stick out to me. I've been with St. John now for a little over five years, and there's there's two situations that always jump to mind. One is one of our clients who does accompanied activities. So that's where a driver will come and stay with her for a period of time to support her to access the community side by side. And I think the one that really jumps out at me for her is that she was living at home in her daughter's converted basement. She had her own entrance exit, and she never went anywhere. And she'd moved so that she could be with her daughter, so she could be with her grandkids and things, and she just stayed in the house. And she got to a point where she was afraid to go out because what if she had a fall? What if she lost something and couldn't get home? She didn't know how to use her mobile phone. So she wasn't really accessing all of the things that were available to her in her community. So she started working with one particular driver in the accompanied activity space. And now she goes out twice a week, right? And it's her thriving time. She's gone from just having to go to the doctors because she had an appointment and her daughter couldn't take her, to going for walks on the beach, to going to different shopping centers to explore what other options there are available for in her community. She's now decided that she's going to join our social trips and meet other people. It's a far cry from sitting in the daughter's basement for six days a week a few weeks ago, a few months ago, right? And that to me is the difference of being empowered and having the reablement in place to allow you to live your best life, right?
SPEAKER_02Absolutely.
SPEAKER_01You're giving them, yeah, sort of the options and it builds their confidence. It builds confidence, it builds dignity, it builds health, right? We know, as Jasmine said, World Health Organization says that that social connection is the third pillar of health. So if you sit alone, you don't have that pillar, and all of a sudden your foundations are not very strong. So being able to get out, meet people, join and participate changes your entire outlook on life.
SPEAKER_00Right? And I think it also instills a sense of trust in yourself that you can do it.
SPEAKER_01Confidence is key, right? And and who knows, she still goes out with our support worker twice a week now. But I bet you what, she knows that if she has to go out on her own, she's much closer to doing that than she was 12 months ago sitting on her bed not knowing what to do with her day. Right. Such valuable points in in those examples. Do you have one more if I can take up more of it? Totally. The other one that I absolutely love, super warm and fuzzies, is we have our uh social trips where we get a collection of clients together and they go for lunch or to a show and activities. And we actually had three ladies meet on those social trips they'd never met before. They sat down at a table for lunch together, and they realized that they were actually really good friends. They had a lot in common. They had a lot of the same available time, they liked doing the same things, and they started going out together outside of our planned social trips. And it really became apparent how close of a bond they had formed when one of the ladies had a fall. And so she's ended up in a rehabilitation facility while she's learnt to walk again and while she has to redevelop her physical health. And the other two ladies booked one of our transport vehicles and drove into the rehab center and went and took her morning tea twice a week. And all of a sudden, she's gone from a situation that we know statistically, having a significant life-altering fall changes the everything about the progression of your social well-being to not feeling isolated and alone at all. She had these lovely ladies using the St. John Transport Service able to come in and spend the time with her and maintain that connection and get her home. And when she got home, she wasn't alone. And how important is that? We know that people sitting at home alone impacts their physical well-being as well. Social isolation has been found to be worse for your physical health than smoking 15 cigarettes a day. Now, I don't know about you, but I wouldn't be smoking 15 cigarettes a day knowing what we know now. But we definitely sit at home alone. And she made friends, and those friends stuck with her to empower her to come out of that for a better person.
SPEAKER_02What would you like to tell other people working with clients like support workers or even allied health workers about using the approach of reablement?
SPEAKER_00I would say to be curious and ask questions, find out the motivation behind people, find out their stories, and then use reablement to relate it back to where they are in their life. Aged care workers can empower the process of reablement. It's so much more than just providing a service. It really can change the person's life.
SPEAKER_01And when you say be curious, stop, breathe, and listen to the answers. I think that in this day and age, we've all got so much paperwork to do and so many tick boxes and so many pieces that we know we just have to finish this paperwork to keep moving. But actually stop, look at them as a person, listen to them as a person and understand if you were sitting in their chair, or your mother, or your friend, or your next door neighbor, right? If you were sitting in that chair, how would you want that person to be listened to and supported? What do you want that person to be able to achieve? How do you want to make sure that they have everything at their fingertips to live the best life that's available to them?
SPEAKER_02Yeah, the basis of that conversation is, you know, it can open things up, can't it, and the opportunities because everybody's got their own individual story and how lucky are we in the age care sector to hear about these life stories.
SPEAKER_01And you don't hear about the life stories if you ask the tick and flick question and you move on the second you think they've stopped talking. You just don't hear it. You need to ask the and then question, or how does that make you feel? Or how can I support you in that? Or what do you enjoy? You need to ask the questions, give space for the answer, and then ask the follow-up question because that's the only way you'll find out who they are and what they need and want.
SPEAKER_00I think you've hit the nail right there on the head, Lisa, about the the tick and flick. Yeah. Forms that they don't necessarily like they'll they collect information to provide the service, but to get the person to get to know the person really well and their individual motivations, yeah, you really didn't do need to ask those open-ended questions and give the time to listen.
SPEAKER_01Person is not a form. I can fill out a form about me and you will not know anything about me. But if we have an open, honest, friendly conversation with space and time for the answers, all of a sudden that person adds vibrancy and colour and depth. And they're not just a number on a page. They become a human being with life experiences, with hopes, with desires, with needs, all the things that make up the spectrum of who we are as a person. You can't get that off a piece of paper. You have to get that from a conversation.
SPEAKER_02It can be done both ways, can't it? Sort of whether it's a phone conversation in that listening, you know, ask those open questions, give the prompts and see what comes back to you and listen to that. Or if it's face-to-face, what gives them a glint in the eye? What changes the body language? Absolutely. Thank you both so much for these insights. And I feel we need to continue this discussion in our next episode. In the meantime, we encourage our listeners to head to the keepable.com.au website for all of our information and resources on reablement.
