Linda Justin

RESEARCH THESIS

Who do  you say I am? Language, Culture and their intersection with Quality and Safety in Aged Care.

The most pervasive and ubiquitous question ever asked across all time is “what is the meaning of life?”(Erickson, 1959; Frankl, 1985). This question gains more import for the elders within our society and care who contributed to the fabric of society and the Australia we now know (Erickson, 1959). 

As frailty and the ageing process progress, care needs can increase and at times there appears to be an irreconcilable tension between quality of life and quality of care; further compounded by an ever-increasing compliance burden against a desire to provide a meaningful supportive quality of life. 

But how is it that we actually acknowledge the dignity of the elder, oftentimes the most vulnerable within our society? 

To answer this providers of aged care homes often espouse person-centred care models and although these terms are universally acknowledged, they can be poorly understood and implemented (McCormack, 2010; McCormack et al., 2010). 

Their implementation can be truncated due to organizational factors, changing structure, priorities or lack of cultural appreciation to assist with the implementation (McCance, 2015; McCormack et al., 2010). 

Language and a multiplicity of terms which undergird various models can conflate the lack of agreed coherent organisational enablers. They are also at times are disconnected from the business of operations and the financial and human resource requirements to deliver care (Baldwin, Chenoweth, Dela Rama, & Liu, 2015; Wells, Brooke, & Solly, 2019). 

This can be further, confounded, by the culture within the Residential care home or facility where at a local level language and terms such as ‘feeder’, ‘faller’, ‘wanderer’ and ‘demented’ can be used innocently but in fact stigmatise and categorise older people. 

The Royal Commission into Aged Care Safety and Quality (RCACSQ) has highlighted some of the failings, loss of dignity and abuse within our aged care services. 

In the foreword to their Interim Report entitled A shocking Tale of Neglect the Aged Care Royal Commission has stated that “As a nation, Australia has drifted into an ageist mindset that undervalues older people and limits their possibilities, Sadly, this failure to properly value and engage with older people as equal partners in our future has extended to our apparent indifference to aged care services. Left out of sight and out of mind, these important services are floundering. They are fragmented, unsupported and underfunded. With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring.” P.1  (Quality & Safety, 2018). 

This study utilises a mixed methods approach to review organisational, management and health contexts and interviewing international leaders to determine the factors that support the development of the ‘what and the how’ for culture change and practice delivery within health and social care, specifically reviewing the language in use throughout the aged care system and how that pertains to quality service delivery.