Today is World Elder Abuse Awareness Day (WEAAD). The purpose of WEAAD is to provide an opportunity for communities around the world to promote a better understanding of abuse and neglect of older persons by raising awareness of the cultural, family and many other forms of abuse of the older persons.
Over the years, the family has been the hub for care of all members and in particular of the older persons.
Family members are integral to services that cater for the health andwellbeing of older people in all settings across the aged care continuum including government, non-government organisations, hospitals, health settings, and private practice.
However, the families now appear be the main focus of abuse not only the older persons but all forms of violence. This culture of violence must stop. The theme for WEAAD 2023 is “Seniors Deserve our Respect and our Attention”.
This is quite explicit, as respect and attention have a very wide range of issues to address.
Older people need to have access to skilled and knowledgeable professionals who can provide support in relation to their psychosocial needs, including relationship, family, grief and loss and mental health issues.
A more comprehensive approach is needed in order to identify and care for those older people with complex needs that include psychosocial issues.
Enhanced psychosocial assessments and the resultant appropriate supports will not only improve the quality of life of older people, but also that of their families and reduce work pressures on care staff.
Currently there is a lack of services able to intervene in complex situations where abuse is occurring.
The loss and grief associated with the transition into aged care and dementia is not adequately assessed or supported by the existing aged care workforce, and the aged care sector requires better integration of professional social work services to ensure psychosocial needs are addressed.
Institutional Care Forum
This forum has been set up by the Department of Social welfare of the Ministry of Women, Children and Poverty Alleviation, and is chaired by the director. The second meeting for the financial year 2022/2023 was held on May 18, 2023.
The meeting was chaired by the acting director of social welfare, Diliti Baleinabuli and attended by the principal social welfare officer, National Council for Older Persons, St Vincent de Paul Society president, HART director and the HART nursing home manager, the chair of the board of trustees of Pearce Home, the manager of Golden Age Home – Suva, Lautoka and Labasa; and a representative of Chanel Home of Compassion.
This meeting agreed that:
• The current composition of the aged care workforce at all levels does not adequately provide services that consider the full range of psychosocial needs of older people of Fiji. There is not much research and literature demonstrating the importance of addressing the mental health needs of aged care residents as they have a direct impact on all other aspects of their physical and emotional wellbeing, including care needs.
• The meeting was unanimous in its view that the aged care facilities did not have qualified officers to supervise and certify the practical attachment trainees of APTC. The supervisors of CSO aged care facilities did not have any qualification to provide practicals and they were further disappointed that tertiary institutions that provided courses in care giving, despite the generous level funding by overseas donors did not pay for the attachments. All aged care facilities are short staffed and there was serious concern about the “care givers”going abroad for employment for they are not adequately trained. Is this not tantamount to abuse of the older persons.
• Comprehensive enhanced assessments and supports will not only improve the quality of life of residents, but also that of their families and reduce work pressures on care staff.
• Improving the skills of the aged care workforce is essential to address issues related to the increased longevity of Fiji’s ageing population. Infact, there is need for qualification in geriatrics for medical personnel, and in social gerontology for social and aged care workers.
• Furthermore, the loss and grief of older persons and their families associated with the transition into aged care services and dementia is not adequately assessed or supported by the existing aged care workforce.
• This is a highly complex area were individuals and their families are grieving the loss of independence, family and identity that significantly impacts adjusting, coping and wellbeing.
• The aged care workforce needs access to training to adequately identify and address the range of issues experienced by older people and their families, for example the significant mental health and grief and loss issues.
• Greater emphasis on a comprehensive approach to service delivery and education and training of direct service staff is an important factor in meeting the future challenges of the sector.
• The current workforce is hampered and undermined by a lack of service integration leading to poorer outcomes for consumers.
• Older people with complex needs greatly benefit from coordinated interventions from appropriate agencies and workers. Ultimately, it must be realized that greater inclusion is needed of appropriately trained professionals who are able to provide support in relation to the complex needs of older people. June 15 has been dedicated to World Elderly Abuse Awareness Day. In fact it really about drawing our attention to the urgent need to promote care for the elderly or aged care or care of the aged. Aged Care Awareness is a more positive way to go, for the National Council for Older Persons (NCOP) and Fiji with a plan to find out the situation. Some pointers for immediate action are:
• Do the Fiji Higher Education Commission (FHEC) and the National Council for Older Persons (NCOP), have the trained officers to monitor and evaluate the various training programs given. What about the role and regulation of registered training organisations, including work, work placements, and the quality and consistency of qualifications awarded;
• Is it satisfactory and legally correct for unqualified personnel in Senior Citizens facilities to supervise and certify practical training? In one instance, there manager of seniors facility, who supervises the practical side of APTC trainees, the supervisor was a chef. • Is the half to one day training in Aged Care of the Ministry Of Health approved and certified by FHEC.
• What training is provided by the NCOP to the current composition of the aged care being done by families in the cultural settings?
• What is being done for future aged care workforce requirements, including the impacts of sector growth, changes in how care is delivered, and increasing competition for workers;
• The challenges in attracting and retaining aged care workers in families and aged care homes in Fiji;
• The urgent need to address the factors impacting aged care workers, including remuneration, working environment, staffing ratios, education and training, skills development and career paths;
• Review and revamp the National Policy Framework on Older Persons in order to provide a coordinated strategic approach for the sector;
• Urgent need to address the challenges of creating a culturally competent and inclusive aged care workforce to cater for the different care needs, culturally and linguistically diverse groups. In the particular aged care workforce challenges in rural Fiji and remote island communities.
• MOHAMMED HASSAN KHAN is the chairman of Suva Relief Trust and the Pearce Home Board. The views expressed in this article are the author’s and do not necessarily reflect the views of this newspaper.
