When you see a problem being solved, well, you want to talk about it. And so I feel about what we saw in Singapore, in particular Dementia Day Care as part of their 4 part model of care. Singapore don’t call it that, I think they call it integrated care, or similar, but the point is they are running 4 parts and in Australia, we are running 2 parts, and one of them is just so obviously right. Let me explain.
Part 1, Community Centre Care
St Lukes Elder Care were kind enough to host us in their Bashin Active Ageing Centre (“AAC”) as part of the Austrade delegation to World Ageing Forum. Bashin AAC is one of 32 AACs operated by St Lukes across Singapore. Operators like St Lukes are allocated blocks and funding (sound familiar) to offer a drop-in community centre for 60yo+ to get fit, use the specialised gym, play pool, socialise and generally look after their mental and physical health. At Bashin, St Lukes are allocated 80 apartment blocks with around 4,200 60yo+ seniors who live in them. And they have good data on their cohort as the Singaporean government funds a different party to conduct regular door knocking of these residents to assess the levels of activity and socialization. What they call “reach out”. This drives use of the AAC. A bit like Denmark, but instead of Councils applying mandatory assessments of all 75yo+, Singapore applies block-based funding for private operators to “reach out” and “care” for 60yo+. The same AAC also has a regular rehab service, providing paid physio and OT services and programs.
Part 2, Day Care
St Lukes also operate Maintenance Day Care and Dementia Day Care centres. We saw 3 “bays” of day care, larger ones with 30 or more participants for low care, to smaller ones with 10 or fewer high care dementia participants. Family drops off the participants, or St Lukes transports them, and operates a 9-5 day program of activities, care and food. These centres are operated under government funding and government owned premises, and a mix of paid and volunteer staff. For example, the day we were there, a local church volunteer group was running a program for the low care centre. In addition, home care workers can bring their care recipients for day. They also observe what they call ABCD – Asset Based Care Delivery – leveraging existing communites and networks to bring in elders – in the case of Bashin the local Baptist Church had strong community networks and is leveraged to reach out and provide volunteers.
Parts 3 and 4, Home Care and Residential Care
These are the 2 parts we have in Australia. Note, we have just re-designed aged care in Australia and have arguably missed 2 important parts of 4. Evidently Singapore and Denmark think funding enablement and prevention makes social and financial sense (witness Denmark has 30% fewer residents in aged care beds per 100 head of pop than Australia). Of course, Singapore has a family-first model where the government relies on families with means to look after elders and offers home care and residential care on a means tested basis. Australia has opted for a rights based model of aged care for all with limited co-pay. For the Australian context that may make sense. But what is our justification for a failure to fund enablement and prevention in a meaningful way.
Dementia Day Care
We have a dementia tsunami coming. There are remarkably few dementia dedicated facilites, residential or day care. Folk like Group Homes Australia are doing an awesome job, as is Hammond Care and Anglicare Sth Qld with the Specialist Dementia Care Programs for severe dementia patients, but these are mostly residential facilities. Non-residential dementia day care is an obvious need in the community. The lived experience of many partners managing loved ones with dementia is a common one. If they had somewhere to take their loved ones, where their needs are me, and the carer can get respite, it could be a game changer, potentially avoiding residential care. A combination of high lever SAHP funding and user pays might get close to making the model work in Austalia.
Shout out to Austrade and Ageing Australia, and the Award Winners Lenexa and SilVR
Thank you so much to the Austrade folk here and in Singapore for prompting us to go to the World Ageing Forum in Singapore. An excellent example of industry and government working hand to make the most of the Event. A special thanks to Lisa, Juliet, Carmel, Diana and Helen, you know who you are. And huge congratulations to Lenexa Medical and SilVR, two great Australian innovations that swept the awards pool at the World Ageing Forum.
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