HammondCare AnnualReport2011

A passion for care

ANNUAL REPORT 2011

“The past year has seen new initiatives and

innovations, including the refurbished Neringah

Hospital and our first Chair of Positive Ageing:

HammondCare continues to pursue its mission of improving quality of life

for people in need.”

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It almost looks like Rev Bob Hammond is wondering what he’s done.

Surrounded by people in dire straights in the midst of the Depression in 1932, he has just exchanged his superannuation to buy land west of Sydney to give them a hand.

Soon there were settlers, a school, a new suburb... Hammondville. More importantly, new hope for people who had nowhere else to turn and were unable to help themselves without a critical hand at the right time.

This is our DNA, this is where HammondCare has grown from, and this is the spirit in which we do our best to continue each day.

Independent

Throughout its history,

HammondCare has been

highly independent.

This means we can be flexible and

are able to move to areas of changing

need. We are also innovative in our

approach to health and aged care

and in the services we provide – we

seek to lead rather than follow.

Christian

HammondCare remains

strongly and intrinsically Christian.

HammondCare stands for

compassion as clearly seen and

heard in the Gospel records of the life

of Jesus and in his challenging words

in Matthew 25:

“I was hungry and you gave me food,

I was thirsty and you gave me drink,

I was a stranger and you made me

welcome, naked and you clothed

me, sick and you visited me, in prison

and you came to see me...whenever

you did this to one of the least of my

brothers and sisters, you did it to me.”

Charity

HammondCare has always

been a charity.

While needs have changed over the

years, HammondCare has and will

continue to focus on those who need

our help. Like the good Samaritan we

cannot “walk on the other side”. We

cannot ignore or decline to do things

because they are too hard, or they

involve risk, or they are unprofitable.

We continue to be risk takers for

those whose lives are at risk.

Our DNA

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HammondCare is determined that what it does is informed by research, mindful of the task of developing the workforce of the future. And so a key highlight this year was the appointment, with the University of NSW, of the inaugural Hammond Chair of Positive Ageing, Associate Professor Chris Poulos, and the opening of the multi-million dollar Clinical Training Centre at Hammondville.

The $1.6 million refurbishment of Neringah Hospital was begun and approached completion during the past year.

This is a vital expansion to palliative care across Sydney’s north of which HammondCare is the principal provider, as it is in Sydney’s south-west, where our research program received significant awards. When we acquired Hope Healthcare’s health and hospital network we made a commitment to renew and grow these services and that is exactly what we have done.

Other highlights include the move to fresh food cooking at Greenwich Hospital kitchen - part of a larger HammondCare-led revival of better food choices for patients and residents - and the launch of HammondPress which publishes resources representing research, knowledge and practice from across HammondCare.

Major construction projects began and continued such as the expansion of the HammondGrove retirement living development and the first stage of a major new health and aged care development in Miranda.

These and other examples of growth and improvement are the result of many years of work by hundreds of dedicated people including my fellow board members who I thank for freely giving of their expertise and insight.

An example of this is board member Ian Miller who retired in November 2010 after 17 years outstanding service and to whom I extend heartfelt thanks on behalf of the HammondCare Board and Executive.

Ian became one of four Directors in October 1993 at a time when our name had just changed to HammondCare and annual income was $8 million, with all services located in Hammondville.

He has worked tirelessly, particularly providing his legal expertise for major projects and can be well satisfied with our current position - a board with eight directors, total group revenue of $140m and hospital, community and residential services being provided in an area ranging from Newcastle in the north, to the Shoalhaven in the south and out to the Central West.

And with the enthusiastic support of the board I also express our appreciation to our Chief Executive Dr Stephen Judd and the entire HammondCare staff for again passionately pursuing our mission of improving quality of life for people in need across 30 different services and 18 locations.

The year ahead promises many significant developments in furthering this mission as we extend our innovation and influence through working together.

Rod Mewing BEng (Mech) Chairman

The Chairman with Dr Stephen Judd at the 2011 HammondCare Conference

A great milestone: opening the refurbished Neringah Hospital with the NSW Premier and Member for Ku-ring-gai, the Hon Barry O’Farrell.

“The past year has seen new initiatives

and innovations, including the

refurbished Neringah Hospital and our first Chair

of Positive Ageing. HammondCare

continues to pursue its mission

of improving quality of life for people

in need.”

As you read the 2011 HammondCare Annual Report - the second I have had the pleasure of presenting as Chairman - you will gain insight into a busy and productive organisation that is steadily, and sometimes rapidly, moving forward across a range of services while retaining its core values and identity.

As governments seek to address issues of reform and the community becomes increasingly discerning about the services they engage, it is crucial that we remain focused on our future and informed by our past.

HammondCare connects with a history in health and hospitals that extends back more than 100 years and continues a journey of caring for the most vulnerable in society that began with the establishment of Hammondville as a land settlement scheme by Anglican Archdeacon R B S Hammond 80 years ago next year.

The coming together of these streams during the past three years has given HammondCare a unique opportunity to be at the very forefront of residential and at-home aged care, specialist dementia care including younger onset, hospital and community based palliative care, rehabilitation and older persons’ mental health.

This combination allows us to offer comprehensive service and vital connections, focused on the best possible outcomes for the people we serve.

All of this takes place in the context of providing equity of access, and care that is wrapped around the nearly 2800 patients, residents and clients, as well as a welcoming and enabling work environment for more than 2100 staff.

In terms of growth, HammondCare has experienced significant growth of 20 per cent compound during the past 15 years. This year was more modest at 14 per cent, with the greatest growth being in our services in people’s own homes.

Chairman’s Report 2011

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I am optimistic this will result in a framework for important changes in aged care. We all know that there are more and more older Australians - something we should consider a triumph of public health, and not a problem.

Nevertheless, it does provide challenges that as a nation we must meet. I am confident that we will see legislative improvements to how aged care is delivered in this country.

What should we expect to see?

A freeing up of the market, moving away from the highly regulated market that we now have - without reducing the quality of outcomes or standards.

Organisations such as ours would be able to begin delivering a particular service in a particular area if we feel there is a need. It means if people are able to pay for services, they can - but there’s a safety net for those people who can’t.

There is the potential to unleash innovation in aged care that we haven’t seen for a decade.

One example could be new forms of financing, such as with philanthropists through social bonds or funding partnerships, that would help us deliver smaller, more individualised services. This is something we love to do but are often constrained by current funding models.

I think Australia has one of the strongest aged care systems in the developed world and the Productivity Commission’s proposal would go a long way to making sure it continues in a sustainable way.

What other external factors have been significant for HammondCare?

The new state government, elected in March 2011, has shown a very clear intent within its health portfolio, and indeed in other areas, to work with organisations such as HammondCare.

For example, in terms of community and hospital palliative care, there has been encouragement to open more services in that space. It’s early days yet but we believe this is very promising.

The sum of all of this - charity reform, the Productivity Commission’s reengineering of aged care delivery and the NSW government’s willingness to work with organisations such as ours - means that HammondCare, as a provider of services in hospitals and clinics, residential aged care, and in people’s own homes, is extraordinarily well placed to make the most of these opportunities.

In light of this level of change, how do we ensure that at the simplest level, the care of people remains central?

So often organisations focus on what they are doing and how they are doing it. Our primary focus must always be on who we are and why we do what we do. And that is summed up by saying we are an independent Christian charity.

We are independent - we hope that’s not just an historical phenomenon but a present reality as we show independence in how we do things. We hope that means we are constantly seeking to think outside the square and do things that other people aren’t doing. For example, setting up younger onset dementia services or continuing palliative care when it’s not being subsidised, because we know it’s important.

Also, we are without apology, Christian. That doesn’t mean we are exclusive - we are inclusive both in the people we serve and the people who work for us. But it does mean we’ll focus on those people who have tenuous lives, the marginalised, those in great need for whatever the reason. We’ll focus on the hard cases even when they are difficult to do.

And we never want to forget that we are a charitable organisation. We are not a government contractor, we are a “for purpose” organisation. Being charitable means we will always look at the person and their needs first, and the dollars and subsidy become secondary.

This highlights the importance, within a diverse organisation, of being able to focus on core areas. How has that focus developed in the past year?

“We have the capacity, if we have the will, to have the best aged care system in the world.” Keynote address, 2011 Conference.

Addressing the quality of food in aged care with special guest Maggie Beer, at the HammondCare 2011 Conference.

A key element of HammondCare’s identity is that we are a charity and there has been a renewed focus on the role of charities in Australian society. What does this mean for HammondCare?

Charities fulfil an important purpose and I think people are becoming far more aware of their role, on two fronts.

Firstly, charities play an increasingly important role in providing services that governments simply can’t provide. This is seen most sharply in emergencies such as bushfires in Victoria or floods in Queensland.

But it’s also the case more generally in the context of governments looking to moderate their involvement in the delivery of social services. This means charities have an opportunity to be innovative in filling gaps in services that, frankly, governments are not providing.

At the same time, the Australian Government has been heavily engaged in reforming the governance of charities in Australia. With others, HammondCare is participating actively in this reform process.

One outcome is the introduction in the coming year of the Australian Charities and Not-for-profit Commission. That’s an important development, as is the development of a statutory definition of a charity.

Overall this means there’s greater visibility of charities and HammondCare is well placed because we do so much that is philanthropic and charitable. In every service we are taking risks for people whose lives are at risk, such as people in rehabilitation, in palliative care and those with younger onset dementia.

Another big issue in our operating environment is the work of the Productivity Commission in reporting on aged care reform.

Yes, the Productivity Commission’s Report on Caring for Older Australians has been an important development during the past year and in the coming months we should see the Australian government’s response.

Chief Executive’s Report 2011

“I think Australia has one of the strongest

aged care systems in the developed world and the Productivity

Commission’s proposal would go a long way to making

sure it continues in a sustainable way.”

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be perfectly frank, our role is to get this right for HammondCare and, thereby, assist the sector as a whole.

Having said that, we are doing something in the larger space as well.

The reason we are passionate about clinical training centres - illustrated by the appointment of our inaugural Hammond Chair of Positive Ageing, Associate Professor Chris Poulos - is that these centres will train student doctors, nurses and allied health professionals in residential or community aged care or sub-acute environments.

Much of the education for the health workforce to date has been in acute hospitals. We all need acute hospitals but most people aren’t in them. Which is why, in association with the University of NSW, we have begun in the past year to train medical students within our services, which will help them become familiar with best practice in sub-acute health, residential and community aged care.

The same applies for nurses and allied health professionals. In that way we grow our own, and of course we won’t be only growing our own, we’ll be growing for others, but that’s fine. Alongside the appointment of A/Prof Chris Poulos, another key appointment in the past year has been in leadership of the Dementia Centre.

Colm Cunningham’s appointment as head of the Dementia Centre [see page 28] has in a short time transformed the way the Dementia Centre not only supports our work internally but also the work of other service providers.

There’s a great deal of consultancy that actually helps the industry as a whole. Now, is that peripheral to what we do? No it’s not. We actually think that is integral. If we are going to have expertise in dementia, yes we want it available for our services, but if we are able to support other providers as well, that’s a good thing.

Continuing the theme of workforce, what other measures are underway to strengthen opportunity?

Across our workforce, there exists amazing examples of compassion and passion.

Remarkable things are being done in the direct care of people in need. We want to develop better career paths for our direct care workers, and are increasingly doing so.

Some care workers may want to move on to care coordinator or manager roles, but there are others, some who are our star providers of direct, hands-on care, who don’t. They want to continue in direct care and we want them there, but we do need to recognise them.

While still in the early stages, we are developing more tiers, more career prospects for our direct care workers, empowering them in team leadership but also team selection.

At the end of the day, without strong direct care workers in our aged care services and in our hospitals, we are nothing…

In terms of growth and finances, you emphasis that HammondCare is not just a government contractor. How important is the financial support of our donors?

Our finance figures this year show a reasonable surplus and this is partly because we’ve had significant bequests. Bequests and other fundraising account for nearly $4 million and it’s important to understand that this support is our engine room for delivering more services to more people.

Without the support of bequests and donations, our only option for strategic projects such as refurbishing Neringah Hospital, is to borrow.

Likewise, the only option for funding a development like the one underway in Miranda would be bank finance. Of course, there still is bank finance involved, but what people are doing by supporting us financially is providing the equity that helps us gain the necessary finance.

Donors want to see us achieving and being effective and they can be sure their gifts or bequests will continue to make a difference in the lives of people of need for many years

to come through the projects and services they support.

Also, in the past year we established The HammondCare Foundation which will be another key engine room for supporting things like our research. In its early stages, we’ll hear much more about the Foundation in the year ahead.

You have some writing projects underway, why is that an important part of the communication process for you?

It is a challenge to write while in the role of Chief Executive but too often people who are writing are separated from what is actually going on so I believe this is an important part of communication for me.

With two other authors, I have a book on dementia design being published by Wiley’s in February that covers more than 20 case studies across about 10 countries. I also have two other books underway, one that looks at purpose driven organisations, which will be published next year.

And to finish, could you name a few areas that you are particularly excited about in the years ahead?

I’m excited about finding ways to empower our highly respected direct care workers to build their own teams. I’m excited about our new project at Miranda where we aim to put into practice great design principals including four eight-bed residential care services.

I think the rebirth of Neringah Hospital is a very interesting and strategic step. And I think the creation and building of the new HammondCare Foundation is very exciting.

And while we continue to grow on many fronts, I don’t want us to forget, whether our size is $50 million or $500 million, that it is people, real people, that we are here for.

“At the end of the day, without strong direct care workers in our

aged care services and in our hospitals, we are nothing”.

Internally we announced a restructure around our three key service portfolios -health and hospitals, residential aged care and at home care - which are served by nine “enabling” portfolios.

The reason for this is that the key to quality is focus. We recognise that we can’t be all things to all people in every space and that is one reason, from a structural point of view, we’ve increasingly got our people focusing on services in the home, or services in hospital, or services in residential aged care.

That is not to say we are building silos. There is always a propensity for that to occur, but I’m absolutely determined that it will not. We are one team with one mission, one plan, one brand – but to effect those plans we need people to focus. And we’ve got enabling portfolios, such as finance, communication, risk and quality and the like that work across all services.

That makes me wonder about the integration of HammondCare’s aged care services and the health and hospital services. What are the key issues there?

Some people ask, “Why did you acquire the health and hospitals?” Well, the reality is that a very significant proportion of the patients in our hospitals and health services are of the same demographic as the residents and clients of our aged care services. Also, in many cases we have health services in the same geographic area as aged care services, giving us an important capability for integration and coherence.

An example, and one of our objectives, is that if you are a palliative care patient, perhaps in one of our palliative care units, and you can’t go back to your own home, for whatever reason, and the best place is in a nursing home, I can see no reason why that nursing home shouldn’t be closely related, if not right next door or upstairs. The same applies in rehabilitation and in older persons mental health. In terms of rehabilitation, for most people residential aged care is permanent care, and we want to change that.

We want to make sure there are far more short-term options - that’s consistent with what the Productivity Commission is saying as well.

For example, if you are happily living at home, there’s an incident and you’re admitted to an acute hospital, you could well end up going into long-term residential aged care.

But it could be different - that’s why we are planning short term restorative care programs for older people. This means putting far more allied health and rehabilitative services into residential aged care services.

This is a big change in the way health services are delivered. How is this being received?

Some people have muttered that we are dumbing down our health and hospitals services. We are not dumbing them down! To the contrary, we are actually making sure that health services are spread far more widely and we are increasing the expertise available in our aged care services.

I’m passionate about making sure that sub-acute services - older persons mental health and especially palliative care and rehabilitation - are available for older people wherever they are at. And that’s what it’s about.

Will there still be dedicated rehabilitation and palliative care services? Of course! And they will be pivotal. But we’ve got to make sure there are no Berlin Walls between services. We’ve got to have greater specialist medical and allied health services available to older people, wherever they live.

It sounds like a plan to organise services around people and not the other way around?

Organisations can easily slip into talking about how many programs they’ve got, how many staff there are and the numbers of residents, clients and patients. But really, our services come to life when we talk about real people, the stories of care, such as those featured throughout this annual report.

We can talk here about our younger onset dementia service, but it’s really about the people involved. We can talk about palliative care services but it’s really about the individuals cared for.…

At the same time, I acknowledge that in growing organisations such as ours, there are important business processes that need to be in place. But I don’t want them to mitigate against the people we support receiving care that is focused on them. Nor do I want these organisational processes to impede the capacity for staff to enjoy what they do.

Keeping that in mind, what are some of the current challenges to ensuring we deliver high quality services to the people we care for?

If I was to nominate the biggest task we have to do well, it is having the right people in the right jobs.

It is making sure that HammondCare is somewhere people love to work and that our staff are highly engaged, believing in what we are doing. That they know - because it’s true - that they belong with HammondCare and are making a contribution in whatever role they have and that the organisation itself is achieving as much as they are individually. Those concepts of believing, belonging and achieving are vital.

This means recognising the achievements of staff, not just in a formal way, but in informal ways. Not just me as Chief Executive, but everyone on a team, be it the manager or fellow team member.

Aren’t workforce pressures a major issue in health and aged care with predictions that it will be difficult to staff these sectors?

There’s a lot of talk going on about workforce pressures but you’ve got to break down the issues and in the long run it’s about the individual.

And yes, there are challenges in finding the workforce we’ll need into the future, but to

“I’m passionate about making sure that sub-acute services - older persons mental health and especially palliative care and rehabilitation - are available for older people wherever they are at.”

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Older Person’s Mental HealthComprehensive programs for older patients with mental health problems, including dementia, with severe behavioural disturbances, or other mental health issues. The aim of the service is to provide comprehensive multidisciplinary assessment, treatment and management of each patient and resident with a view to appropriate placement back into the community. Support for carers and community follow-up is an important aspect of the service.

Braeside Hospital

Greenwich Hospital

Linden Cottage, Southwood

Residential careHammondCare is the largest provider of dementia specific residential services in Australia. Residential care provides a range of services for people who cannot live independently at home and require care in a residential setting because of dementia and or complex health care needs.

Hammondville

Erina

Woy Woy

North Turramurra

Horsley

Miranda

Sub-acute Hospital careSub-acute Hospital care provides Palliative care, Rehabilitation and Specialist Mental Health Services for older people.

Braeside Hospital

Greenwich Hospital

Neringah Hospital

At Home care

A range of services to assist people, many with complex health or aged care needs, to remain living in their home. Services for older people; people with dementia including younger onset dementia; people diagnosed with an incurable illness and needing palliative care; people rebuilding lives through rehabilitation following accident, illness or trauma: and people with complex disabilities.

Central West

Hunter

Central coast

Hornsby Ku-ring-gai

Lower North Shore

South East Sydney

South West Sydney

Northern Beaches

Illawarra

Shoalhaven

Aged and Dementia careComprehensive care services to assist older people and people with dementia and their carers to remain at home. A range of services is also provided for older people who cannot live independently at home and require varying degrees of care, including all levels of dementia care, in a residential setting. A Special Care Program is provided for residents with severe and persistent behaviour associated with their dementia, as well as a residential care cottage for people with young onset dementia. Important support is also provided for carers through residential respite services.

From Newcastle in the north, to Ulladulla in the south, and out to the Central west.

Palliative and Supportive careSpecialised care services for those diagnosed with a life threatening illness when relief from symptoms or pain management may be required. Includes both Residential and At-home care, as well as Palliative Care Day Hospitals, and ongoing bereavement care. Our aim is to provide physical, spiritual and emotional comfort, skilled symptom control, good communication as well as support for the family both during the final stages of illness and in the bereavement period.

Braeside Hospital

Greenwich Hospital

Neringah Hospital

Northern Beaches Palliative Care Centre

Hammondville

Rehabilitation

Comprehensive programs for patients experiencing a wide range of disabilities following serious trauma, accidents or illness, including stroke, joint replacement, lower limb amputation or fractures. Services at Braeside and Greenwich Hospitals include inpatient units, outpatient clinics and day hospitals. Greenwich is a specialised rehabilitation service for the aged and also offers a home-based rehabilitation service.

Braeside Hospital

Greenwich Hospital

See inset

Sydney

North Turramarra

Horsley

Wollongong

Bathurst

Woy Woy

Mona Vale

Erina

NararaNorth Gosford

Toronto

MirandaSylvania

Hammondville

Lithgow

Oberon

Shoalhaven

Fairfield

PrairiewoodGreenwich

Liverpool

Blayney

Carbonne

Orange

Nowra

Wahroonga

Care services and locations

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As cricket stories go, Greg’s is pretty good.

As a bowler, he had made his way into the top grades of cricket in Sydney, playing for Mosman. Then came the day he was dropped from a side to make way for an up and coming cricketer - none other than future Australian captain, Allan Border.

Cricket is just one of his passions and another is the Essendon AFL team, although he recalls his father was a Hawthorn fan who used to take him to games at the old Glenferrie Oval.

Although he had studied political science, Greg’s real desire was to be an artist and so he worked as a driver so that he could focus on his art, submitting works for exhibition. Along with wife Joanna and daughters Davida and Ruth, they enjoyed an active life together in Sydney’s northern suburbs.

As Greg entered his mid-50s, worrying changes began to occur. He seemed to have less empathy for others, was struggling to concentrate - even on his art - and began to have difficulties managing at work. The family began to feel the strains but it was a crisis at work that marked a sudden decline in Greg’s health and capacity.

In August 2008 behaviour and performance issues led to him being sent home from work to have a break and being told to see his doctor. Joanna came home to find that Greg was suddenly ‘on holidays’.

Then began a difficult period for Greg and his family as his capacity rapidly declined, his behaviour became more challenging and his personal safety was at risk. Medical tests showed that Greg had developed younger onset Alzheimer’s disease. With no prospect of going back to work, family life began to revolve around medical appointments, carers visits and support groups.

The rapid change was a shock to Greg’s loving family and deeply frustrating for him. With his day-to-day safety and wellbeing at stake, options for care became vital. In need of high-level care, the only services available were nursing homes that were not suitable for a younger, active man.

Then the local Aged Care Assessment Team mentioned HammondCare’s Streeton Cottage, a younger onset dementia facility, part of a larger dementia facility in Horsley, near Wollongong.

In June 2010, Greg spent a month’s respite at Streeton before moving in permanently six months later. His family was relieved to find a facility catering for the special needs of younger people living with dementia. Although his ability to concentrate is reduced, he has retained his ability with numbers and so his love for sport remains important - he still places the occasional bet on the cricket or footy!

Perhaps the words of Greg’s daughter, Davida, best sum up the family’s pain of loss mixed with the emerging hopefulness of Greg’s new life: “Sometimes life can be a bit crap. A couple of years ago my father was diagnosed with younger onset Alzheimer’s. Watching him every day has had a profound effect on both me and my family.

Greg

“He has lost so much for someone

still so young.”

Case notes

For Greg, Streeton offers the safety, care and socialisation needed to regain a positive quality of life. As Greg has settled into his environment, his social interactions have grown - he is talking and joining in more.

Specific areas where we assist include encouraging Greg to keep mobile, maintaining the afternoon walk that he used to take with his dog Theo. He is also involved in regular activities such as a weekly BBQ and outings with other residents.

Greg is not always aware of maintaining his appearance so our care workers assist with this, and encourage him to enjoy some of his favourite foods and continue his love of contemporary art.

Overall, the care at Streeton Cottage is aimed at providing an environment that encourages younger people living with dementia to stay engaged in normal day-to-day activities and connected with the wider community. The model of care encourages and enables residents to actively contribute to the Streeton Cottage and Horsley communities.

Michele Prior Danielle McIntosh Manager Senior Consultant HammondCare Horsley Dementia Centre

Whilst the past few years have been incredibly tough, it has been HammondCare, who now look after him full time, that has made all the difference. There are many ´aged care’ facilities out there that offer excellent services, but it was only HammondCare that could offer the level of care required in this unique situation. “

Greg’s daughter Davida raising funds for dementia care at Hammond Care at the City to Surf.

Younger Onset Dementia Streeton Cottage Horsley

Some images and details in this Report have been changed to protect the privacy of people involved.

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Chris Poulos and researcher Juliet Kelly work with Hammondville resident Inge Jahn, to develop exercise programs on the specialise equipment provided in the gym at Hammondville.

Researcher Juliet Kelly is working on a 12 month program to identify the key to seating and support systems for people in the later stages of dementia.

“I came to Australia in 1949 and I have loved my life here. At the moment I try to use the treadmill for about 45 minutes each day with the incline on 13 degrees! Exercise is an essential part of life and health for me.”

Inge Jahn is a resident at Hammondville

For this reason, the Clinical Training Centre is located in Hammondville adjacent to HammondCare’s largest aged care campus, with undergraduate medical training placements already underway and nursing and allied health placements being planned.

In addition, A/Prof Poulos is developing postgraduate courses with UNSW in aged care, community rehabilitation and care in residential aged care, to be offered in 2012 and conducted at the Clinical Training Centre.

Researching the aged care “missing link”.

An increasing number of older people are affected by a ‘missing link’ in rehabilitative and restorative care. They have not had an acute incident requiring a hospital admission, aren’t ready for an aged care admission and find there are very few services catering for them.

The aim of A/Prof Poulos’s research program, which is already in its early stages, is to build an evidential base to support new models of rehabilitation and restorative care in the community to address this missing link.

Research into models of community rehabilitation will focus on sustainability in terms of producing a positive benefit to the patient, having the workforce to deliver the service and being economically viable.

Provision of clinical services linked to training and research

A key benefit of the appointment of a Chair of Positive Ageing and Care is the way it links training and research directly to the provision of clinical care for patients.

The Clinics began in April 2011 for residents of HammondCare’s aged care campus in Hammondville and also for older people and people with disabling conditions in the broader community.

The clinics are staffed by Dr Poulos and Dr Andrew Cole in the purpose-built clinic area of the Clinical Training Centre, as well as in residents’ homes if they are immobile.

In the future, the range of medical services available will increase to include allied health services and other specialist medical and general practice services.

“Positive ageing is more than just the absence of disease. You can have

absence of disease and not feel well at all due to your social circumstances,

outlook on life, reduced mobility…”

The appointment of Associate Professor Chris Poulos as first Hammond Chair of Positive Ageing and Care, in partnership with the University of NSW, is the birth of a pioneering clinical training scheme for medical, nursing and allied health students in NSW.

The position is located at the new Clinical Training Centre at Hammondville, built with the support of an Australian Government grant, where clinical training placements will be provided for more than 100 medical, nursing and allied health students in the coming year.

A/Professor Poulos is a rehabilitation physician who has held several senior roles in the NSW health system including area director of rehabilitation and aged care for the Illawarra Area Health Service. He was a member of one of the first Aged Care Assessment Teams in Sydney and has taught at postgraduate level on Australia’s health system and services for older people.

A/Prof Poulos began his appointment in March 2011 with a focus on three distinct aspects - clinical training, research and clinical service provision.

An innovative approach: training where the people are

To ensure a positive ageing experience, doctors, nurses and allied health professionals must be trained where the

people are – in the community, in people’s own homes, in residential aged care, in sub-acute hospitals – as well as acute hospitals.

“We need to focus on wellness, and

on helping people maintain their

independence, abilities and quality

of life as they get older.”

Associate Professor Chris Poulos

Hammond Chair of Positive Ageing and Care

Clinical Training Centre and Chair of Positive Ageing and Carein partnership with the University of NSW

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Ian Darley, in his early 60s, enjoyed life on Sydney’s iconic northern beaches with family and friends and also loved his work as chief mechanical engineer - design and development at a major Australian technology firm.

A man known for his sense of humour, Ian enjoyed hosting barbecues and was an avid Rugby Sevens fan, always making the trip to Hong Kong for the annual tournament.

Then in January 2010 came the shock discovery of advanced bowel cancer. Ian spent Australia Day in his first round of chemotherapy. It was a difficult time as Ian tried to come to terms with his diagnosis and having to finish work. Meanwhile his wife Virginia was thrust into the role of carer, seven days a week, 24 hours a day.

A referral was made to Hammond Care’s Northern Beaches Palliative and Supportive Care Service (NBPSCS) and Ian was encouraged to become involved in a support group for people with terminal illness that met at the Palliative Care Day Hospital in the grounds of Mona Vale Hospital.

Struggling at times to accept his situation, Ian was initially reluctant about attending and also unsure about being matched with a volunteer for one-on-one visits.

But from the moment he first attended the day hospital, Ian loved it and the four hours on Tuesday became a highlight of his week. He could forget his health situation while being surrounded by the friendship and support he needed. For Virginia, it was encouraging to see him get out of the house, and at the same time be in a safe environment, given the seriousness of his condition.

Ian also began to enjoy regular visits from a volunteer, Sam, and this became especially important as by November 2010, Ian had become too unwell to attend the support group. Ian and Sam would often just watch television together for two hours on a Monday. On one occasion, the chaplain visited Ian, and they spent some time talking. It was a chance for Ian to share some of his feelings “man to man”, as he was concerned about overloading his wife.

As Ian became weaker, he found it hard to get around. With help from the physiotherapist and occupational therapist at NBPSCS he learned strategies to cope with this.

Another important service was the loan of equipment from NBPSCS at no cost. It was comforting to Virginia that the experienced staff knew what equipment might be helpful - and that she didn’t need to worry how much it cost or how long they had it. Toilet seats, handles, walking frames, wheel chairs, shower chairs - all helped Ian live at home as normally as possible.

This support enabled Virginia to care for Ian at home until the very end of his illness when he was admitted to hospital. Once again the link with NBPSCS made a difference with volunteer Sam spending many hours besides Ian’s hospital bed. It was more care than Virginia could have imagined.

Ian and Virginia

“Vital support from the circle of care when it was needed most.”

Case notes

Ian was referred to the Northern Beaches Palliative and Supportive Community Service in February 2010. He had earlier been diagnosed with metastatic adenocarcinoma of the bowel, widespread skeletal metastases.

During the 12 month period that Ian was known to the palliative care team, he received palliative chemotherapy for the systemic disease and radiotherapy to painful bone metastases. Ian regularly attended the Palliative Care Day Hospital at Northern Beaches for therapies, advice and support from the multidisciplinary team.

Towards the end of Ian’s life, as he became weaker, home visits by the team occurred. They worked closely with the Northern Sydney Home Nursing Service and the GP.

When Ian’s condition became unstable he required hospital admission close to home. Our palliative care Staff Specialist provided consultative advice and support. Ian died in February 2011.

Dawn Hooper CNS Northern Beaches Palliative Care

Then several months after Ian’s death, there was one last support for which Virginia was thankful. She was invited to be part of a grief and loss session for a time of remembrance, at the palliative care day hospital. It completed the circle of care and filled her with thankfulness for the role of the Northern Beaches Palliative and Supportive Care Service.

Palliative Care Day Hospital Northern Beaches

Virginia with CNS Dawn Hooper

16 17

“Everything we do is aimed at improving the outcome for residents, patients and clients,

and for the people who care for them.”

Preventing falls - a critical risk for older people

Across the community, falls are the leading cause of deaths from injury for people aged 65 and over. This means any organisation involved in caring for older people, such as HammondCare, will need to be proactive about minimising the risk of falls while maintaining the dignity and personal choice of clients, residents and patients.

Our Risk and Quality team has been focusing on two aspects of the issue - reducing the risk of falls occurring and finding ways to reduce injury if a fall does occur. Risk and Quality head Naomi Rynne says, “We’ve been considering the issue of falls reduction in aged care and looking at our services and falls rate.

While we have a good record in this area, our residents are becoming more frail and we have many residents who have dementia and are mobile. This could lead, potentially, to a higher rate of falls.

“Our approach is not to restrain residents - we try to encourage their independence and activity - but we also want to minimise both the number of and harm from falls. Reducing the harm resulting from falls is important because a resident’s increasing frailty might lead to greater harm and result in decreased mobility.

“So for us, it’s about figuring out where to target resources and find what’s important for each service. We will work to get all staff involved including the direct care staff and the service managers, improving things step by step. Whatever we do is aimed at improving the outcome for residents, patients and clients, and the people who care for them.”

“The Risk and Quality Team have been a continuous support to me from the beginning of my role and have assisted me in building confidence in myself with the daily challenges of a managerial role.

They have taught me how to manage issues and view the positive outcomes of challenging situations resulting in an improvement of service for our residents.

They have encouraged me to challenge myself and step out of my comfort zone to attain goals which I would have otherwise not attempted.

They have been my guidance and given me the ability to recognise that there is not only one person involved in the functioning and maintaining of The Meadows but a support network who will regularly come together to deliver the HammondCare Mission and Mission in Action to our residents.”

Meriem Mota Manager The Meadows Hammondville

Risk and Quality Team

HammondCare’s Risk and Quality team, is a network of Risk and Quality Officers operating across every service, facility and region.

Their focus is to fulfill our policy of continuous improvement at every level. An important part of driving improvement is to identify gaps and problems and work with teams to find pathways for improvement, and to identify and manage risk intelligently.

Quality improvement comes down to the questions, “What does the service want to achieve to better serve their clients?”

The Risk and Quality team works closely with our managers and carers across our key service areas to assist with this process.

It includes regular cycles of assessment and review, as well as assisting teams to pull back from the busyness of their work and consider the best way forward.

Managing risk for better care

Risk management covers the full spectrum from helping a manager assess the risk for one resident in a dementia facility through to enabling a whole department to measure their practice against independent standards.

In each case risk factors will be identified, processes considered, adjustments suggested and a system developed that will ensure an appropriate level of risk can be

“We work at constantly

improving things step by step. We

work to get all staff involved including

the direct care staff and the service

managers.”Frances Jones and Veronica Meera from the Risk and Quality team work with Manager Meriem Mota

balanced with the freedom and dignity of the individual or the flexibility and innovation of a whole service.

The team manages a register of major risks across the entire organisation, ensuring appropriate controls are in place. It is part of an integrated database that also includes an incident management system and a feedback module.

A quality improvement module is soon to be added which will allow risk to be considered in light of incidents, feedback and improving systems.

Transparency and balance

The Risk and Quality team reports to the HammondCare Board’s Risk and Compliance Committee ensuring a transparent view of risk across the organisation.

Being independent of but working alongside teams that run services, means Risk and Quality can provide a balanced and impartial view - vital to intelligent management of risk .

Whether assisting aged care or health services to achieve mandatory accreditation, conducting audits or seeking feedback from residents, patients, clients and their families, Risk and Quality balances careful management of risk with a focus on continual improvement resulting in better outcomes for those being served.

18 19

It has been a long journey of caring for others that has eventually led Mavis to receiving the special care she needs in her latter days.

Born and growing up in Dubbo, Mavis was immersed in the love of her mother and father, and describes her mother as “perfect in every way” and remembers fondly rising at 4am to help walk her father’s seven greyhounds. When he took up bookmaking on the side, Mavis was often asked to grab her pencil and get around and check the prices, much to the delight of the other bookies.

Mavis worked at the Bonds factory in Dubbo until she married husband, Peter, who worked on his family’s farm. She loved children and was keen to start her own family but during a time when she had a series of miscarriages, Mavis found much hapiness in caring for other children.

Her younger sister had a daughter, Betty, and Mavis became a wonderful aunty for Betty, walking her to school, working in the school canteen and taking Betty and her friends to play tennis after school. Finally, she was blessed with her own daughter, Vicki.

Along the way, Mavis cared for her ageing mum for several years when she was unwell and recalls being called to her mother’s side, a week before she died, so that her mother could pass on her concerns and burden of care for the extended family - something that Mavis, of course, took to heart.

Later in life, she moved to Sydney to live with her daughter who was battling breast cancer. Mavis relished the opportunity to care for her three grandchildren, delighting in cooking for them and being there when they got home from school.

Then in her eighties, the resilient, caring Mavis, with the bouncy sense of humour, began to be affected by dementia and over time, her increasing needs for daily care brought the family to HammondCare’s North Turramurra aged care home.

After a lifetime of caring for so many different people, it was time for Mavis to be looked after. But this was not easy for someone who’s life had been one of giving care to others.

Eventually, Mavis found the place where she really felt at home at North Turramurra - at the centre of the home, in the kitchen.

Today, though age and dementia are gradually reducing her capacity, Mavis can usually be found pottering around the kitchen, washing up, making cups of tea, encouraging and serving other residents. It’s wonderful to see her happy, secure and still getting satisfaction from being busy and looking after others.

Mavis

“After a lifetime of looking afters others,

now it’s Mavis’ turn to be looked after.”

Case notes

Mavis is a very popular resident who loves nothing better than to tidy up in the kitchen, washing up after morning tea or whispering a kind word in another resident’s ear.

It has been important to encourage these activities, even at times carrying cups of tea to residents, as her fondest memories are of cooking for her mother when she was unwell or waiting for her grandchildren to come home from school, with a cold drink on the bench.

At times Mavis has struggled with being in care, wanting nothing more than to be at home looking after her family. But she realises that her family does not feel confident in being able to care for her at home and she is quite frank about ‘loving this place’

Robyn Hoye Assistant Manager Leighton Lodge

Residential Care North Turramurra


20 21

Award winning research at Braeside Hospital: just one example of research at HammondCareAssociate Professor, Dr Meera Agar, Director of Palliative Care at Braeside Hospital, received Palliative Care NSW’s 2011 Significance in Research Award and the NSW Premier’s 2011 $20,000 Innovation in Cancer Clinical Trials research award. The research program conducted by Dr Agar and palliative care staff across HammondCare has attracted $4.5 million in grants to date covering 25 studies. Research papers have been published on 27 occasions including in refereed journals such as Palliative Medicine and Journal of Pain and Symptom Management.

Our direct care experience fuels a growing passion to discover, learn and develop expertise through a diverse range of research activities so as to better

care for residents, clients and patients.

Psychologist Catriona Lorang’s innovative doll research program has had startling results, with many residents with advanced dementia finding high positive emotional responses.

Our Assistive Technology project developed strategies to increase the acceptance and use of technology to decrease carer burden and support carers in helping people to remain safely in their own homes for as long as possible.

In the past year, HammondCare staff and facilities have been involved in more than 40 research projects covering palliative care, rehabilitation, dementia care, and residential and at home aged care.

Significant investment in research

Independently, and in collaboration with others, HammondCare has been awarded significant research grants. At the same time, HammondCare has itself invested in research projects and infrastructure.

The goal of this investment is to identify and support the breadth of research occurring across HammondCare as well as continuing to cultivate a spirit of discovery and investigation. HammondCare’s research committee facilitates internal research by reviewing the suitability of projects.

Robust collaboration and leadership

Research at HammondCare is strengthened by robust linkages and partnerships with universities, collaborative research centres, peak bodies and other service providers. HammondCare is an industry partner in the Primary Dementia Collaborative Research Centre based at UNSW and the Dementia Collaborative Research Centre based at QUT.

The Clinical Training Centres at Hammondville, opened early 2011, and at Greenwich, to open by December 2011, will foster even stronger relationships with universities and be central to HammondCare’s ongoing academic and research capability. The appointment in March 2011 of the inaugural Chair of Positive Ageing and Care, Associate Professor Chris Poulos was an important step in this process.

HammondCare’s Dementia Centre has a strong reputation in Australia and overseas as a thought-leader in dementia and continues to inform research and promote

innovation and best practice in the delivery of services to people with dementia and their carers.

The Dementia Centre oversees HammondPress which provides publications and resources reflecting the wide range of research, knowledge and practice from across HammondCare.

Sharing knowledge and professional service

Along with direct and collaborative involvement in research, HammondCare staff have had a busy year in publishing and presenting the results of their research.

Staff have been part of the authorial team for peer reviewed journal articles and book chapters; have presented workshops and oral presentations at state, national and international conferences; and have been strongly represented in poster presentations at conferences and seminars.

As well, staff members have been influential across the health and hospital and aged care sectors through their professional service on boards, committees, journals, peak bodies and university positions.

HammondCare’s research team

A/Prof Chris Poulos is head of research within HammondCare, as well as the founding UNSW/Hammond Chair of Positive Ageing and Care.

Chris has held academic appointments at the Medical School and the Centre for Health Service Development at the University of Wollongong. He has published on a range of issues in the areas of rehabilitation and aged care and is the incoming President of the Australasian Faculty of Rehabilitation Medicine, where he chairs the Faculty Policy and Advocacy Committee. He is also Co-Chair of the EnableNSW Advisory Council.-

The Research Team coordinates and supports research projects in at home and residential care and across our hospitals.

Research

“As a service provider

HammondCare is uniquely

positioned to translate research into practice. We

focus on research that is sustainable

and capable of implementation

both in the community and in

residential care”.

Researcher Meredith Gresham demonstrates The Better for Everyone Toolkit, focused on residential aged care, and developed from the two-year Federal Government-funded project ‘Improving social interaction by working with staff, families and the environment’.

22 23

Elizabeth Coupe, a mother of eight and with 25 grandchildren, had everything to live for when she was diagnosed with terminal liver cancer and told she had about five more years.

As she battled the disease there came a point when she had almost given up on life due to overwhelming symptoms, especially constant and severe nausea. Liz would cook dinner for partner Brian and then just cry as she couldn’t eat and was struggling to cope.

In desperation she eventually told her oncologist that if this was what her remaining years were to be like, she couldn’t go on. The doctor said she could do no more for Liz and recommended she visit Braeside Hospital’s palliative care unit.

Liz was initially admitted to stabilise her symptoms and it was clear that she was also depressed and very fearful of dying.

The specialist palliative care given to Liz was able to treat her nausea and also acknowledge and treat her depression. She also learned that the care and symptom management available through Braeside meant dying did not have to be such a fearful prospect. Before long, Liz’s zest for life had returned.

Since then the Bonnyrigg resident has visited the palliative care day hospital twice a week and, nine years after being given five years to live, Liz says she is almost back to her normal self, defying her condition.

She loves the care shown by the nurses who sit with her while she knits or paints, make her cups of hot chocolate and check up on her if she is feeling a bit unwell. And over the years, Liz has been helped by most of the palliative care team at Braeside including dietician, social worker, physiotherapist, occupational therapist, diversional therapist, massage therapist, medical staff and chaplain.

Perhaps the greatest comfort for Liz, however, is the chance to sit with other patients who visit the day hospital and to talk about how they are feeling, knowing that they are going through similar things. It’s a chance to share feelings that she even keeps from family because she doesn’t want to burden or worry them.

For Liz, palliative care is not for dying, it’s for living - for making what life you have left more enjoyable. And yes, she has lost a few friends along the way but has been comforted by the love and expert care they’ve received from Braeside, an assurance for when her time comes, whenever that might be.

As for Brian, he blesses the day that Liz went to Braeside as it is giving them a precious season of life that had nearly slipped away.

Liz and Brian

“Discovering a precious season in a life that had

nearly slipped away.”

Case notes

Liz has lived with metastatic Carcinoid tumour for years. She was referred to the Braeside Hospital Palliative Care Service when some of her symptoms were overwhelming her.

An admission to the Palliative Care Unit helped through changing her medications and giving her access to the support of a multidisciplinary team to review her functioning and overall wellbeing. Liz has benefitted from the ongoing support of the Palliative Care Day Hospital team including regular review and ongoing multidisciplinary therapy.

Along the way Liz has had a number of medical problems, but has managed to stay at home with very few days in hospital over the past three years due to her own determination and family support, as well as ongoing management by her oncologist at Liverpool Hospital, and her involvement with the Day Hospital.

Specialist palliative care may be involved for months or even years in managing difficult symptoms when someone is diagnosed with a life limiting illness, and the treatment is no longer aimed at cure. It’s not just there for the last few days or weeks, but is often a substantial support for months and sometimes years for those with difficult symptoms and complex needs related to their diagnosis. Our involvement with Liz is such an example.

Dr Elspeth Correy Staff Specialist, Palliative Care Braeside

Palliative Care Day Hospital Braeside


24 25

It offers the latest research and practice knowledge on design of the build environment. The school brings together architects, project managers and practitioners to consider the critical issues in design.

Research

The Dementia Centre is involved with more research than ever before, conducting both independent research and many collaborative projects with our partners, including the Dementia Collaborative Research Centres, Flinders University for Palliative Care, Dementia Services Development Centre, the University of Stirling and NSW Health.

Our research is strategic and practical, drawing together issues facing those involved in aged care, ensuring findings inform service development and training.

The secret of our success is quite simple: The Dementia Centre’s research team are able to work closely with HammondCare’s residents, staff and families, ensuring practical and translatable research outcomes at the front line of care.

Care Planning Assessment Tool (CPAT). CPAT is used to measure a resident’s or client’s dependency across several key care areas before they enter a service to ensure it is able to meet their individual care needs, and to monitor their progress while in care. CPAT will be rolled out in the next year, and the tool will also be launched in Japan, known as J-CPAT.

International Aged Care Conference

HammondCare’s 2011 Annual Conference was called Rehabilitating Aged Care. The conference was held on June 23-24, with a series of fascinating and challenging addresses from a wide range of international and local speakers.

The Minister for Mental Health and Aged Care, Mark Butler, unable to attend the conference in person, addressed the conference via a written message, stating that “HammondCare’s innovative approach to aged and health care is an example of what was needed in facing Australia’s challenges in these sectors.”

Another highlight was a vibrant and meaningful session delivered by Maggie Beer, Senior Australian of the Year, television chef and award winning author, who focused her inimitable spotlight on the critical role of food in the lives of older people in aged care.

Consultancy: help for families dealing with dementia

Dementia Centre Consultants invited families of the residents at HammondCare dementia facilities to specially designed support sessions aimed at helping families and carers understand and cope with the distress of seeing a loved one suffer the loss of cognition and capacity through dementia.

The sessions address key issues such as: ‘What is dementia?’ ‘Why nutrition and hydration are so important’ and ‘What happens at the end of life and how can we best care for a person who is dying?’ The groups have had a positive impact. At one support group, a participant said “the sessions were fabulous and the relatives loved the discussion with the consultant”.

Maggie Beer was a featured presenter and very popular guest at our 2011 conference!

Dementia Centre Consultant Rejane LeGrange meets with family members during the support sessions.

We carry a vision of a world where all people with dementia are treated with respect and dignity and

the past year has seen major advances in the pursuit and sharing of this vision.

Founded in 1996, HammondCare’s Dementia Centre is focused on six core functions: consultancy, education, conferences, research, publications and products, and information services.

The Centre’s Director is Colm Cunningham, formerly deputy director of the United Kingdom Dementia Services Development Centre at the University of Stirling. Colm brings strategic expertise in his core research areas of dementia-related design, pain management, delirium, learning disabilities, telehealth and night care.

ConsultancyConsultancy is a major focus of the Dementia Centre’s work and ranges from assisting a local HammondCare service with their care for a person with dementia through to travelling internationally to consult on the development of new dementia facilities.

In all cases, the vision of people with dementia being treated with respect and dignity is the motivation for the Dementia Centre’s experienced, passionate and practical consultants.

A focus in the past year has been increasing awareness of dementia consultancy within HammondCare’s own services while the next 12 months will see an increasing national and international uptake.

Training

Another major aspect of the Dementia Centre’s work is the Dementia Care Essentials Course offered across NSW and the ACT to train care workers in a deeper understanding of dementia and ageing.

During the year a Certificate IV version of the course was developed, piloted and rolled out alongside the Certificate III course. About 2,500 care workers in aged care and hospitals were trained in the past 12 months.

Annual ConferenceThe Dementia Centre holds an annual conference offering an outstanding cohort of international and Australian speakers, delivering cutting-edge insights into Dementia, Aged Care and Palliative Care. Recent conferences have highlighted:

2011 Rehabilitating Aged Care

2010 Dementia, do we need a different point of view?

2009 Depression in the Elderly

2008 Finding the Gaps and Maintaining the Passion

The 2012 conference Risky Business will be held on 27-29 June at Darling Harbour. It will showcase the latest in research and best practice in dementia care, particularly addressing the critical issues involved in meeting the needs of both younger and older people with dementia.

The Australian Dementia Design SchoolThe Dementia Centre presents The Australia Dementia Design School every Spring and Autumn – a specialist event for those involved in the architectural design and delivery of environments for people with dementia.

HammondPress

The launch of HammondPress was another key achievement for the Dementia Centre and an expanding suite of publications including books, workbooks and training manuals has been published across a wide range of areas. These publications provide wide access to best practice and focus on practical outcomes. Work has continued on the full electronic version of HammondCare’s

Hearing, sound and the acoustic environment for people with dementiaD

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s

back cover

This book is one of a series published by Hammond Press to assist providers, architects, commissioners and managers to improve the

design of buildings which are used by people with dementia.

The quality of the acoustic environment is a vital component of good dementia-friendly design. People need to be able to hear well in order to make sense of it and in order to function at the highest level possible. It is essential that adaptations which simplify and

clarify the acoustic environment, and which reduce discomfort and auditory ‘clutter’, are put in place.

Good acoustics can actively contribute to ensuring that a person with dementia can communicate and remain included within the

community within which they live, be that a care home, supported housing scheme or hospital care.

Greenwich Pallister House, Greenwich Hospital 97-115 River Road, Greenwich NSW 2065 • PO Box 5084, Greenwich NSW 2065

Hammondville Judd Avenue, Hammondville, NSW 2170 P +61 2 8788 3081 • F +61 2 9825 1044 • E [email protected]

Contact uswww.hammond.com.au/dementiacentre

www.facebook.com/thedementiacentre www.twitter.com/dementia_centre

Level 2, 447 Kent Street, Sydney NSW 2000 • P 02 8280 8444 • F 02 9267 3103

www.hammond.com.au

As an independent Christian charity, HammondCare relies on community support. To make a donation visit www.hammond.com.au or give us a call on 02 8280 8488. Please partner with us as we care for those in serious need.

Designing balconies, roof terraces and roof gardens for people with dementiaD

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This book is one of a series published by Hammond Press to assist providers, architects, commissioners and managers to improve the

design of buildings which are used by people with dementia. As land values increase and people wish to remain in familiar inner city areas, we are more likely to see higher multi-storey aged care facilities.

This book describes the practical ways in which new and existing buildings can maximise opportunities for people with dementia to

access outside space in balconies, roof terraces and roof gardens.






www.hammond.com.au


An introduction to dementia skills for family, friends and professionals

What is dementia? What causes it? How do you understand someone living with dementia? How do you care for them and

communicate with them?

This Introduction to Dementia Skills is book is another in the Dementia Skills series published by Hammond Press.

It explores the causes and definitions of dementia and provides key insights into things that are important to people living with dementia. It also provides practical advice on effective ways to provide effective and sensitive care, and promotes dignity and

independence and understanding






www.hammond.com.au


Dem

entia

Ski

lls S

erie

s 1010 helpful hints for carers Practical solutions for carers living with people with dementia


Hammondville Judd Avenue, Hammondville, NSW 2170

P +61 2 8788 3081 • F +61 2 9825 1044 • E [email protected]



As an independent Christian charity, HammondCare relies on community support. To make a donation visit www.hammond.com.au or give us a call on 02 8280 8488.

Please partner with us as we care for those in serious need.


www.hammond.com.au

Hel

pful

Hin

ts a

nd Q

uest

ions

Ser

ies

10 Helfpul Hints for Carers is an easy-to-read guide for carers living with people with dementia. It provides simple, practical

solutions to the everyday problems family carers can face when looking after a person with dementia. Covering areas like how to cope with aggression, creating relaxing environments, ‘wandering’, sleeplessness and how to cope with dementia and depression, it is mine of information and good advice.

back cover

Pain in Older People and People with DementiaA practice guide






www.hammond.com.au


Using telecare effectively in the support of people with dementiaD

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This book is one of a series published by Hammond Press to assist assessors, care and support staff and their managers, telecare service managers and development staff explore how

telecare can contribute to the support, protection, and quality of life of people with dementia.

Senior managers should also find this book useful in informing service planning, and it should help raise awareness, expectations and generally advance understanding

among service users and carers.

This book also considers the importance of telecare in providing support and reassurance to carers.






www.hammond.com.au


The Dementia Centre

“The Dementia Centre is committed to

promoting excellence in dementia care.

Older and younger Australians living with

dementia need services to be designed and

delivered based on evidence and practice -based

knowledge on what works. We make this

possible”Colm Cunningham

DirectorThe Dementia Centre

26 27

Learning to walk again is not something Lillian expected to do in her eighties but that’s exactly what has happened after a spinal condition suddenly robbed her of mobility.

The independent and sprightly North Shore resident went to bed as normal one night in early May, but when she woke up was shocked to find that she couldn’t feel anything below the waist or move her right leg.

She was urgently admitted to hospital, her mind in a blur, trying to comprehend the turn of events. Extensive tests suggested that Lillian had suffered a relatively rare ‘spinal cord infarction’ or spinal stroke. When she was admitted to Greenwich Hospital about two weeks later, Lillian was completely unable to walk. She required a sling and hoist just to get in and out of bed.

Still reeling from the suddenness of her loss of mobility, Lillian faced the prospect of permanent incapacity and a subsequent long-term admission into a nursing home. But armed with a positive attitude and surrounded by the expert staff of Greenwich Hospital’s rehabilitation unit, Lillian made the choice to put her best foot forward.

Our multi-disciplinary team of medical and health professionals assessed Lillian’s situation and set-about working with her to reach the goal of not only standing again, but eventually to walk unaided. A big part of this was getting Lillian’s mind to teach her legs to walk again, despite the lack of feeling.

Lillian rose to every challenge and determinedly carried out her exercises in the rehabilitation gym. She is full of praise for the Greenwich staff who, as she describes it, went well and truly beyond the call of duty. “I’d often look at the clock and realise they had stayed into their lunch break to assist me. The staff here are so caring!”

Lillian was particularly thankful to the physiotherapists who helped her work around her health problem and re-learn how to walk. And she also acknowledged volunteers who complement the work of staff, encouraging people as they undergo therapy.

Eventually, Lillian was able to overcome the challenges she was facing and in time, step by step, she was able to regain some mobility. As the time approached for Lillian to leave Greenwich, she was walking unaided for several metres and could get around independently with a walking frame.

“I can’t believe it was me that came in, unable to put any weight on my legs and needing a hoist to get in and out of bed,” Lillian says.

Thanks to the diligent efforts of Greenwich staff, Lillian can return to her home, with appropriate modifications, and with the support of At Home Care. She looks forward to regaining much of the lifestyle she enjoyed and rejoices in every step she takes.

Lillian

“I can’t believe it was me that came

in, unable to put any weight on my legs and needing a hoist to get

in and out of bed,”

Case notes

Lillian was admitted to Greenwich Hospital’s rehabilitation unit about two weeks after suffering a spinal cord infarction.

She was experiencing leg weakness with no feeling below the waist. Assessment was made by the multidisciplinary team to determine what function could be regained and suitability of medications.

Physiotherapists began a program of assisting Lillian to re-learn how to walk. Much of this was a retraining of her mind in how to use her legs with limited sensation.

Lillian approached her rehabilitation with a positive attitude and responded well to the challenges set by physiotherapists. She pushed herself on every occasion in order to achieve extra. One of the key pieces of equipment for Lillian was the parallel bars, used to help regain her strength, balance, range of motion, and independence.

Brad Carpenter Clinical Nurse Educator Greenwich Hospital

Rehabilitation Braeside

Lillian and Physiotherapist Zheng Cao

28 29

Paul Pickering has served as Pastoral Care Coordinator at HammondCare’s 84 bed, low-care dementia facility at Woy Woy for more than six years. A former nurse with theological and counselling qualifications, Paul is a key part of the care team.

Pastoral care coordinators bring the gift of time and listening to the facilities and services in which they work. In the dementia setting where Paul Pickering works, this gift is especially important in connecting with older people with dementia.

“The challenge is to keep building bridges with new people all the time. The more we can ascertain where they’ve come from and who they are as a person, the more we are able to connect with them,” Paul said.

Giving the gift of time and listening

“The brain might be diminishing in function, but the heart and the soul

are still very much alive”

Meaningful connection

Ron was a person for whom Paul’s role was instrumental in opening meaningful connection and relationship despite the advancing path of dementia.

Paul noticed that Ron, a new resident, had a picture of himself shaking hands with John Gorton with an inscription saying ‘Royal Australian Airforce’. Realising that planes and war service might be a point of connection, Paul searched for a book on aircraft and brought it with him to see Ron.

Ron’s family was unsure that it would help but Paul persevered. At first he turned the pages slowly allowing Ron to take in the pictures and before long, Ron was turning the pages himself. Then to everyone’s amazement, Ron began to point at the planes, naming them.

“He started saying, ‘That’s a Lancaster, oh, and that’s a...’ and he started mentioning all the names,” Paul said. “And he was not normally verbal, but the images had touched something deep inside him.”

As they continued looking at the aircraft, Paul noticed a tear roll from the corner of Ron’s eye and fearing that he’d stirred up some hurtful wartime memories, he asked Ron what was happening for him.

Slowly Ron began to express what he was feeling. “Exploits… many exploits… mates… friends…” Ron was describing the surge of rich memories that were still very much a part of who he was, and which dementia could not deny.

Understanding people’s passion

“The brain is where the diseases are, the heart isn’t,” Paul said. “The brain might be diminishing in function but the heart and the soul are still very much alive. You can reach people by understanding what they are passionate about.”

This includes taking the keen gardener to look at the flowers...or assembling a book featuring pictures of ballroom dancing and art for the woman who excelled at both, pictured here.

For some people their passion might be their past career, a favourite pastime or a powerful experience they have had. For others it might be the chance to reconnect with their faith and Paul is often found reading the Scriptures and praying with residents and family alike.

A distinctive feature of HammondCare is the network of highly skilled and trained Pastoral Care Coordinators, led by Pastoral Care Manager, Carol Allen.

The integrated role of Pastoral Care Coordinator is motivated by HammondCare’s Christian principles and the belief that the best way to provide excellent and responsive clinical care flows from knowing and understanding the person.

Pastoral Care Coordinators seek to meet new patients, residents or clients as soon as possible - to get to know them, listen to their needs and develop a plan for spiritual care, where appropriate. People’s wishes are respected - and this may be for no involvement or it may be for assistance with connecting to support from another faith community.

Innovative and creative

The pastoral care team of 17 across HammondCare is encouraged and empowered to be innovative, flexible and creative in the way they connect and support people. Common forums for this include one to one encounters, small groups and ‘worship’ settings.

A ministry of prayer, Bible readings and other readings may be offered and, in the simplest of terms, Pastoral Care Coordinators endeavour to help people make sense of what is happening in their world.

Creativity and innovation are closely linked with the provision of individualised care in the hospital, residential and community setting. Pastoral Care Coordinators are encouraged to try new ways of connecting with people by tapping into the remaining ability to see, hear, touch and feel.

Images, poems, aromas

And this creative approach is especially important in seeking to care for people living with dementia. Pastoral Care Coordinators use a variety of resources in seeking to reach into the world of a person with dementia. These include hymns, songs, music, images, pictures, objects, textures, childhood poems, aromas.

A typical day for a Pastoral Care Coordinator may include participating in a case conference or family meeting, sitting quietly listening to a patient or resident or researching their interests, coordinating with volunteers, chatting with a family member over coffee, encouraging a fellow staff member or leading a service in a chapel. These activities, wrapped in prayer, are inclusive of people of all Christian backgrounds but also to people of other faiths or of none.

The pastoral care team is at the front line of expressing HammondCare’s Christian identity and it does that in an inclusive and respectful way.

Carol Allen

Director of Pastoral Care

“Pastoral care offers the gift of time and listening: of being

fully present to the person, for the

person in need to be heard without

judgment, criticism, advice, censure,

reproof or patronising or condescending

attitudes.”Carole Allen

Head of Pastoral Care

Pastoral Care

30 31

Rex Bower remembers to the very minute when wife Margaret had a stroke that paralysed her left side and changed their lives forever.

It was 5.45pm on September 6, 1989 and Margaret, who was an outstanding cook, was in the kitchen when she suffered the stroke. Rex, who had retired with Margaret to Brisbane after working for more than 30 years with the NRMA, was instantly thrust into the role of carer.

Margaret only partially recovered and faced the frustration of being unable to use her left arm and needing a walking stick to get around. Rex was very keen for them to remain independent as he cared for Margaret.

Some years after moving to Wallerawang in 2003 to be closer to family, their much prized independence again came under threat. In 2008, Rex had a pace-maker inserted to manage a serious heart problem, which was a serious set back for both of them. Then in November, Margaret fell in their bedroom, breaking both bones in her lower left leg, leading to five months recovery in hospital.

When she returned home, the task of caring was much more difficult for Rex due to the extra lifting, and he developed a serious back problem. Still they fought hard to maintain their independence at home and eventually they sought help from HammondCare’s Central West At Home Care service.

HammondCare carers began an intensive program of support in the home seven days a week. In time, as Rex’s back became more painful, additional care was provided, including practical support cleaning the house, now beyond Rex, and taking them shopping.

Rex says these may seem like small things, but they are what makes their lives at home work so well. Going shopping with Margaret had been extremely difficult because of the work in helping her in and out of the car and loading and unloading her wheel-chair. Now, going shopping together has become they can enjoy together again.

Assistive technology is another way we have been able to support Rex as carer for Margaret. A special bed which can be raised and lowered, plus a lifting machine which enables Rex to lift Margaret into bed at night, have further extended their sense of independence.

Sometimes Rex wakes in the night, worrying about the needs of his wife and his own challenges. But so far, we have been able to successfully work with him to meet every challenge that has arisen, and it’s wonderful to see them together, and still in their own home.

The very first day that Rex and Margaret considered help from HammondCare they read a brochure that said, ‘If you’re happy, we’re happy; if you’re not happy, we’re not happy.” The couple agree that HammondCare has been true to this in every way...except they can’t think of a time they’ve been unhappy. We’re hoping to help keep things this way for Rex and Margaret.

Margaret

“Rex says these may seem like small things,

but they are what makes their lives at

home work so well.”

Case notes

After returning home after a five month stay in hospital due to a broken leg, Margaret was completely reliant on Rex for her daily wellbeing. While Rex had been a very competent and loving carer for Margaret since she’d had a stroke some years before, the task was now growing too large for him.

The first step was to offer her an EACH package which provided daily personal care for Margaret including tasks such as getting her up, showered and dressed. Rex was able to cope with care for the rest of the day, but in time his own capacity was reduced mainly due to severe back pain.

Recently he accepted a CAPC which provides assistant with household tasks and also makes it possible for the couple to enjoy a shopping outing together. In addition, HammondCare has supplied two pieces of assistive technology – hospital bed and lifter – that further reduce the physical burden for Rex.

Erin Kuilart EACH Manager HammondCare Bathurst

At Home Care Central west


32 33

“I simply come to give.”Sarah Balzer lives locally to Greenwich Hospital, which she regards as part of her community, and has enjoyed volunteering there for more than two years. She believes in the importance of fostering care and service for those going through difficult times and volunteers in both palliative care and older people’s mental health (Riverglen).

“I love volunteering and have seen that simple acts of kindness can make such a big difference to someone’s day. By extending kindness and acceptance to people, I also foster this inside myself, and learn so much about living this way. Every visit has highlights, even just seeing someone smile,” Sarah said.

She recalled the experience of relating to a woman with a severe psychiatric illness in Riverglen. Due to her condition, the woman was extremely withdrawn and unable to look at Sarah or speak to her.

“I massage people’s hands and feet,” Sarah said. “I kept visiting and briefly sitting with her and offering my massage. One day I offered my services to massage her hands, and she looked up and said ‘Yes’. The Occupational Therapist saw what happened and told me she had just made a big breakthrough.”

Like many volunteers, Sarah has to carefully organise her time to account for other commitments, such as family. She has found that it works to commit to two hours a week although she is conscious there are endless opportunities to do more.

“It is important to come, and have no expectations. I simply come to give, I focus on being present, not on results,” Sarah said. “We need more volunteers here at Riverglen. People think of mental illness as scary. Being here has demystified mental illness for me. I now see it is treatable. The staff are fabulous at supporting the volunteers, they let me know what is happening.

“I would encourage others to volunteer. It fosters a humble and grateful attitude to life. By extending kindness to others, we are lifted up ourselves.”

“I would encourage others to volunteer. It fosters a humble and grateful attitude

to life. By extending kindness to others, we are lifted up ourselves.”

Snapshots of volunteering

A young woman plays the piano beautifully in a HammondCare aged care facility, and brings tears of joy to some of the older people listening.

A businessman links with one of HammondCare’s hospitals and takes some time off each week to visit a man facing his last days. He becomes a trusted friend and a great strength for the family in their time of need.

A man urges his mate to join him as a volunteer and after a few years he finally signs up and loves it so much he can’t work out why he didn’t do it sooner.

We acknowledge and celebrate the vital contribution of volunteers at HammondCare.

More than 250 dedicated volunteers enhance the lives of residents, clients and patients across HammondCare.

Thousands of hours of volunteer care and support are provided in roles as diverse as hospital visitation, massaging hands and feet, driving people to appointments and assisting with group activities such as music and art therapy.

A growing and vibrant team

This vibrant community of volunteers is served by a growing number of Volunteer Coordinators who help train, supervise and support volunteers as well as coordinate regular activities and special events.

The main centres of volunteering in the past year were HammondCare’s Braeside Hospital, Greenwich Hospital, Hammond Village, Horsley, Neringah and Northern Beaches, covering aged care, dementia, palliative care and rehabilitation.

Integration across HammondCare

Five dedicated volunteer coordinators worked with volunteers in these sites and in the past year a significant strength has been the sharing of expertise and experience from site to site. This integration was enhanced with the appointment of HammondCare’s first group-wide head of volunteers, Barry Costello, who is passionate about HammondCare growing in its reputation as a premier organisation for volunteers.

Barry aims to have volunteer coordinators based in each of HammondCare’s 18 service locations, with overall volunteer numbers growing in the next five years to as many as 1000.

Mutually beneficial relationships

A key purpose of involving volunteers is to develop mutually beneficial relationships with people from the communities within which HammondCare serves, and to supplement HammondCare’s services in a way that is rewarding for the volunteers and residents, patients and clients.

Those who have benefited from the care of HammondCare services, whether themselves or a friend or family member, are commonly seeking to become volunteers to give back and extend this care to others.

Thank you!

And while volunteering is its own reward, the past year saw the inaugural HammondCare volunteer acknowledgement events coordinated across several sites as part of Volunteers Week. As well as expressing appreciation to all those who serve, certificates were presented to several people who have volunteered with HammondCare for up to 20 years.

“You are listening ears, you provide the transport, you help with administration, you push the drinks trolley, you get alongside our patients and residents. We want to thank you not only for what you do, but how you do it,” was one expression of thanks.

Barry Costello, Head of Volunteers, with Alison Grimm, Volunteer Coordinator at HammondCare Horsley.

Volunteers

Many of HammondCare’s 250 volunteers gathered together in regional centres to be honoured as a part of National Volunteers Week in May. David Martin, Manager, People, Learning and Culture, hosted the events that honoured volunteers with celebratory morning teas.

My vision is for a growing army

of passionate volunteers,

assisting HammondCare

to achieve its mission

34 35

Sisters Lillian and Val, aged 91 and 81, have always been close and loved nothing more than to meet each week at Miranda Fair for a cuppa and catch-up. That is until progressing dementia and reduced mobility became an almost impenetrable barrier between them, reducing their contact to just once a year.

Despite the best efforts of family and carers, it seemed as if Lillian and Val would lose their special relationship. They were increasingly restricted by disorientation, they were both becoming confused, and Val’s dementia was depriving her of the ability to speak.

One day, Val and Lillian’s daughters got together and discovered an amazing coincidence - both the sisters received care from the same organisation - HammondCare.

When our south-east Sydney manager Jennifer Gavin learned of the loss of the very close relationship between the sisters because of their challenging conditions, she realised the importance of finding a way to renew regular contact.

So despite their various complex needs, she organised that the two sisters would both be brought to HammondCare’s South-east Sydney Social Club on Fridays.

“Immediately they recognised each other and were able to connect,” Jennifer said. “Now they get to see each other every week. Lillian puts her arm around Val and tells everyone proudly, ‘This is my little sister!’ Even though Val can no longer speak, the tears of joy can be seen running down her cheeks.”

While bringing the two sisters together this way may seem the obvious thing to do, the challenges can’t be underestimated - a previous care service provider had already found Lillian’s mobility issues too difficult to overcome and would no longer accept her as a client.

The HammondCare team were determined to find a way and for Jennifer, seeing the joy of the two women as they are reunited each week is motivation enough.

Val’s former husband Ken still visits, and he is grateful for the suport provided. “It makes a hell of a difference having HammondCare come in to help with Val’s care. What those girls do is wonderful.” At the same time, Lillian’s daughter Jan receives the support she needs in caring for her parents, and gets some time out to attend to her own needs.

Val and Lill-sisters

“Immediately they recognised each other

and were able to connect.”

Case notes

Val was diagnosed with dementia in 2007 and became a client of HammondCare in June 2008.

She has Alzheimer’s disease, a history of falls, disorientation, incontinence, arthritis and hypertension. HammondCare visits Val each morning for personal care such as showering, dressing, grooming, meal preparation and other household tasks. Val attends the social club in Caringbah each Friday.

Lillian’s dementia was diagnosed in 2005 after falling and fracturing her hip and she and husband Rex became HammondCare clients in November 2009.

Lillian has dementia, an unsteady gait, and can be affected by depression. HammondCare visits Lillian and Rex at least twice a day, sometimes three, to assist with personal care such as bathing and dressing as well as meal preparation, medications, appointment and other household tasks.

Lillian also attends the social club on Fridays while Rex enjoys his social club outing on Thursdays.

Jennifer Gavin EACH Manager At Home Care South East Sydney HammondCare

Aged and Dementia At Home care South east Sydney

36 37

Heather Burgess was amazed to find a note in her late mother’s diary that she had donated a “mangle and a pram” to HammondCare on Thursday, August 20, 1936.

Heather grew up hearing about HammondCare from her mother, a long-time supporter of Archdeacon RBS Hammond’s depression-era housing scheme at Hammondville.

A mangle was a common piece of laundry equipment in those days and Heather remembers it well, as she does the wicker pram that she and her older siblings used as children.

This was probably not the first support Heather’s mother had provided for HammondCare, and it continued on for several decades.

As her mother entered her latter years in the 1970s, Heather’s sister Barbara took over the role of supporting HammondCare, until her death last year. It was then that Heather found the note from her mother’s diary that her sister had kept. She decided to honour

the memory of her mother and sister by continuing their tradition of regular support.

“I can remember mother receiving news and information from HammondCare and sitting and reading it. Later, I would attend supporter events with Barbara and was impressed with how staff at HammondCare kept a close friendship with all the supporters,” Heather said.

Heather was touched by the support given to her at the time of her sister’s death. Mindful of her sister’s long support, Heather invited people to donate to HammondCare in lieu of flowers at her funeral and was moved when senior staff attended.

Now she continues to enjoy supporter events and says that being a HammondCare supporter is very much a two-way relationship. When she was going through tough times, she appreciated contact with HammondCare that she found encouraging and reassuring.

“She decided to honour the memory of her mother and sister by continuing

their tradition of regular support.”

One family’s quiet support - since 1936.

A growing family at Hammondville in the early 1930’s when Heather’s mother starting donating.

It’s not hard to see why her gift of a “mangle and a pram” would have been very valuable contribution for young families like this at Hammondville...

Supporting HammondCare is so much more than giving money. It’s about meaningful engagement and building bridges into the community so that supporters can be a part of the journey of providing life-changing care for people in need.

The generosity and hard work of supporters was a fitting match for the extensive delivery of charitable services by HammondCare in the 2010/11 financial year.

A record total for donations and gifts in wills over the past 12 months is a testimony to the growing partnership shared with dedicated supporters in improving the quality of life for those in need.

Donations ranged from large bequests to the donation of a few dollars in memory of a loved one and we are thankful for every cent! Complementing this were community fundraising events with a focus on particular services and projects.

Supporters take to the streets

HammondCare fielded a team in the City to Surf for the first time in August 2010 and the team of more than 50, consisting of staff and supporters, raised $8335 towards palliative care services. Wearing team t-shirts and hats, it was also an opportunity to raise awareness about HammondCare and the important role of palliative care.

Fundraising continued in the inaugural Jacaranda Walk held near Greenwich Hospital in November 2010. With Greenwich’s magnificent Jacarandas in bloom, participants joined either a two or five kilometre walk through the streets of Greenwich. They finished back in the leafy grounds of the hospital for a special garden party celebration with barbecue lunch, live music, face painting and pony rides.

The event raised nearly $16,000 for Greenwich Hospital’s palliative care services and the purchase of vital equipment. Alongside the festivities, there was a special moment when people were invited to plant a flower in the memorial garden in memory of a loved one.

In appreciation of the many donations and bequests and for the supporters who have participated in fundraising events, a Thank You Lunch was held in HammondCare’s city office and addressed by Deputy Chief Executive Sally Yule.

Growing level of connection and engagement

The appointment of a new head of Fundraising, Julian Martin, has ensured the relationship between supporters and HammondCare will only grow stronger in the coming year.

Julian and his team are keen to develop an even greater level of relevant connection with HammondCare supporters as well as providing new opportunities for engagement. This can include volunteering, touring of facilities and services, or being involved in a fundraising activity.

Another focus will be continuing to build engagement in the communities around key facilities, working with and growing these faithful bands of supporters. Capital fundraising projects will be the focus in Hammondville, Greenwich and Neringah and supporters will be invited to do more than give money, with opportunities to contribute to the work such as in the development of gardens.

A highlight for the coming year is the new Hammond Christmas Catalogue, which will allow donors and supporters to connect closely to the heart of HammondCare’s mission. The catalogue will feature genuinely needed items across our services that donors can choose as a Christmas gift which will improve the quality of life of people in our care.

Interaction with donors and supporters of all kinds is a much-valued point of connection with our communities and remains essential if HammondCare is to continue to expand its charitable endeavours.

While sources of funding such as grants and government subsidies are important, there are many areas they do not touch, including vital areas of research, special equipment and ground-breaking services that make a significant difference to quality of life to people in need.

Thanks to the generosity of our supporters, our campaign to provide a new van for our very special Young Onset Dementia residents at Streeton Cottage, Horsley, was a great success. And the new van that resulted is providing some much needed freedom for younger people with dementia who have lost so much, and are now in need of daily care.

Premier Barry O’Farrell opened our newly refurbished Neringah Hospital in 2011 - another project made possible by the generous donations of our supporters, and making a great difference in the lives of people who need it most.

Our supporters

38 39

A few years after Maree moved house to be close to her family in Sydney’s west, they began to feel uneasy about the sudden appearance of some unusual behaviours.

She had become reclusive, and had started arguing with her neighbours with whom she had previously got along well.

The family was close, and it was clear there was a problem, but they were uncomfortable to talk to Maree about their concerns regarding her mental health, and unsure how to access assistance.

Within the next 12 months, Maree’s behaviour became increasingly erratic. She began ringing the police regularly to accuse her neighbours of spying on her, and started blocking the drains around her home, worried that her neighbours were a threat.

She had stopped visiting her doctor, taking her blood pressure medication and was losing weight. When Maree moved into just one room because of the ‘electrical forces’ in the house, her family insisted that she come with them to see her doctor.

The doctor made a referral to Braeside Hospital’s Specialist Mental Health Services for Older People. A community team consisting of a psychiatrist, nurse and health interpreter visited Maree at home, along with Maree’s daughter.

Maree, confused and fearful, was initially reluctant to allow them in the home, but they took the time to win her trust and were eventually able to spend some time with Maree. Along with careful investigations and medical history from her doctor, an initial assessment of major depression was made, with accompanying mental health issues, along with malnourishment.

The Braeside team’s first goal was to manage Maree’s condition at home and to work with her doctor to prescribe necessary medications and other supports.

When Maree’s difficulties persisted, with support from her family Maree agreed to a voluntary admission to Braeside Hospital. Once in care, her condition was stabilised, medications confirmed and other support was provided by the multi-disciplinary team of medical staff, nurses and allied health professionals.

Supports were put in place for her to return home, including visits from the community arm of Braeside’s older people’s mental health team and links to a community group from Maree’s cultural background.

Maree was also introduced to the friendship group which meets at Braeside twice a week and came to enjoy this new social outlet, while maintaining contact with Braeside’s caring staff. It’s a delight for Maree’s family that she is now comfortable, back in her home, and once again enjoying their visits. And she continues to benefit from the vital support and increased network that will continue to care for her.

Maree

“It was clear there was a problem, but the family

was uncomfortable to talk to Maree about their concerns regarding her

mental health.”

Case notes

Braeside Hospital’s Specialist Mental Health Services for Older People was contacted by Maree’s family doctor who asked for a mental health assessment after she presented as disturbed, anxious and malnourished.

Maree had become isolated from her neighbours and wider community due to increasingly reclusive and paranoid behaviours. With the assistance of Maree’s daughter, a team psychiatrist, nurse and health interpreter visited Maree at home and conducted a 90 minute assessment of her mental health condition. After a two month period of seeking to manage Maree’s condition in the community, we negotiated a short, voluntary admission to Braeside’s low care older people’s mental health unit.

Here, we were able to conduct more detailed and comprehensive assessments and a thorough treatment program was commenced. The medications used to treat her illness were adjusted and regularly reviewed. Gradually Maree responded and her condition began to improve. After stabilising her condition, case management was provided to ensure further supports for her return home including regular socialisation with an appropriate cultural day centre.

It is pleasing to see Maree living at home and enjoying interactions with her family, community and services.

Dr Megan Alle Psychogeriatrician Community Aged Care Psychiatry, Braeside Hospital

Specialist Mental Health Care for Older People Braeside Hospital


40 41

“I have to say, I’m very impressed.”“I was reluctant to take on any course or study that was fluff that I couldn’t use in my work day to day but I have to say I’m very impressed with the Frontline Management course.”

Amanda Weaver, the manager of HammondCare’s Woonona Cottage, an overnight respite service located near Neringah Hospital, participated in the course in the past year and highly recommended it to other managers and team leaders.

“The course is delivered in an adult learning environment which is interactive and you use real life examples from your day to day practice with staff and clients. Each component, whether time management, recruitment and selection or situational leadership, informs the work we do. And there is also great value in spending a day with your peers and sharing ideas and insights into common issues. When we looked at time management, I was able to take the principles learned and evaluate what I was doing, and look for improvements.”

Amanda said that she had been managing Woonona for four years and when HammondCare took ownership, two great innovations were the introduction of Learning and Development and Risk and Quality.

“I was unsure at first but now I’m a big advocate for both and love the fact that there is an education focus each month with training I can offer my staff which is relevant to the care we offer clients.”

New RTO will bring expansion of courses despite funding reduction

In the past year the Certificate 3 in Aged Care and Home and Community Care have been delivered by the Learning and Development team with full government funding and in partnership with an external RTO.

In a radical shift in funding, training for organisations with more than 199 staff will now only be subsidised up to a third of the cost, meaning many aged care providers are considering opting out of training in the coming year.

HammondCare has demonstrated its commitment to training by maintaining its training program and will become more efficient by offering the accredited training through its own internal RTO from 2012 onwards.

This will also allow an expansion of accredited courses to include a new Certificate 4 in Aged Care and Home and Community Care for team leaders and coordinators. Another Certificate 4 will be offered in Training and Assessment for all staff involved in a coaching or mentoring role, complementing a strategy for a buddy/mentoring program throughout HammondCare.

And an existing frontline management program, offered in the past year but not aligned with a vocational qualification, will be developed into a Diploma of Frontline Management.

Graduate nurse program successful

A new Graduate Registered Nurse program began in the past 12 months and provides an intensive education program leading to consideration for full time permanent positions that may become available within HammondCare.

Some of the graduate RNs are based exclusively at Greenwich Hospital while others rotate through Health and Hospitals, At Home Care and Residential Aged Care. They are mentored by a member of the Learning and Development team.

“The course has benefitted the people I care for by increasing my

confidence and my skills,”

The heart of the work of the Learning and Development team is building employees’ knowledge and skills to do their jobs well and develop satisfying careers. So to is the outcome of this process - better care for people in need.

The past year has featured a constant schedule of education and training covering Health and Hospitals, At Home Care and Residential Aged Care ranging from orientation days and safety training through to certificate three courses and new graduate mentoring.

This will expand into new areas in the coming year including the development of a range of new courses and the commencement of HammondCare as a Registered Training Organisation (RTO).

At the same time, the Learning and Development team is an integral part of the quality improvement framework for HammondCare, responding to emerging learning needs as they are identified through the ongoing quality improvement process. Head of Learning and Development is Cas Condie with a team of eight workplace trainers and eight L&D Consultants.

Imparting our model of care

In the past year nearly 80 staff have participated in Certificate 3 courses delivered in both Aged Care and Home and Community Care. These nationally accredited courses are, in part, a response to the Federal Government’s push for an increased skill level in the aged care workforce.

But the motivation to provide this training goes far beyond meeting government requirements. The courses have been adapted to reflect HammondCare’s unique model of care that is at the heart of service delivery across the organisation.

Staff completing the Certificate 3 courses learn a model of care that focuses on: relationships, quality of life, individual choice, at home, the right people.

They are challenged to apply what they learn to the scenarios of care in which they are engaged. It is then that the model comes alive.

At the same time, the training offers an increased clinical awareness for staff which, joined with knowing clients well, ensures the best possible response to their needs. As the level of acute need rises among people seeking care, this increased knowledge base is essential.

More than just courses - a framework of learning

The training courses aim to build a qualifications framework that provides career pathways and transferrable employability skills such as problem solving and communication. It also ensures, from the government’s perspective, an up-skilled workforce.

Alongside the certificate courses, Learning and Development facilitates a range of baseline training sessions across Health and Hospitals and also numerous less formal training opportunities.

During 2010, an education focus was developed for each month covering relevant topics such as palliative care, stroke awareness, dementia, flu season, hydration and fire safety. The theme is carried to staff in facilities and services across HammondCare through posters, fact sheets, a monthly newsletter and staff meetings.

Alongside this, practical clinical and personal care workshops were introduced in the past 12 months utilising anatomical dummies. These workshops provide direct care workers with hands-on training in, for example catheter care and stoma care.

Cas Condie Head of Learning & Development

My passion is to empower staff

with the skills and knowledge they

need to do their job. I love hearing them say “I didn’t know that - I’m going to

use that!”

Learning and Development

42 43

Nearly three weeks after suffering a severe stroke requiring surgery, hope of recovery seemed to be running out for 71 year old Frida Zammit.

Frida had lost capacity in her left side and her family thought she would never walk again. With little sign of improvement, the hospital was planning to send Frida to a nursing home, as she would require high level care, beyond what her family could offer at home.

As decision time approached, there was an unexpected glimmer of hope. A slight movement in Frida’s lifeless left hand was detected. This was enough to hope that Frida could possibly benefit from specialised rehabilitation. She was referred to the rehabilitation team at Braeside Hospital.

Three weeks after the stroke, Frida arrived at Braeside. She was still so incapacitated that a hoist was required to move her in and out of bed. She also required full assistance with all the activities of daily life.

The multi-disciplinary team of doctors, nurses, physiotherapists and occupational therapists at Braeside developed a daily routine of rehabilitation therapy for Frida.

She commenced exercise in the rehabilitation gym every day. Slowly the program begun to make a difference. Eventually Frida was regaining movement, in time she was learning to walk again, using parallel bars. She moved on to using an A-frame to walk independently.

Over time, Frida came to love being at Braeside. So remarkable was her recovery, that her daughter Liz said that Frida was walking even better than before her stroke! Liz also noticed that in some ways, Frida didn’t want to go home.

One day Frida was resting when she had a dream that all the nurses and staff involved in her rehabilitation we going to be coming home with her. Her first concern was what she would feed them and she rang her son to discuss it.

“Go back to sleep mum, you’ve been dreaming,” he told her. But he was thankful that she was so peaceful and secure at Braeside that should would dream of bringing the staff home.

After three months as an inpatient at Braeside, Frida went home supported by family and the Transitional Aged Care Program, which supported her move from Braeside back into life at home. Frida receives ongoing support from Braeside, including regular visits to the day hospital.

A tiny squeeze of her hand, and the dedicated team approach of Braeside rehabilitation team, means Frida is able to live at home independently with the support of family.

Frida

“So remarkable had been her recovery, that her daughter

said that Frida was walking even better

than before her stroke.”

Case notes

Frida Zammit was an inpatient for three months after three weeks in an acute hospital where she had been treated for a right parietal intracranial hemorrhage.

When she arrived, Frida was functionally quite debilitated and was a ‘Hoist x 3 assist’ and required full assistance with all her activities of daily life.

During her rehabilitation admission, she lost some of her weight, progressed to using an A-frame independently and managed her ADL’s independently, within a modified environment.

Frida received a Transitional Aged Care Package upon discharge and once the program had finished, returned to our Day Hospital.

Aroha Sakaria Clinical Nurse Educator Rehabilitation Unit Braeside Hospital

Rehabilitation Greenwich Hospital

44 45

that an ordinary aged care residential facility can’t because it doesn’t have those people in another arm of its organisation in the way that we do. And that is just one very practical way in which we can converge the health part of the business with the aged care part of the business.

What have been some of the other highlights and achievements for this year?I think the first key achievement, at a time when the health and aged care sectors face funding and staff retention challenges, is that all our existing clinical services, and particularly the healthcare services in the hospitals, have continued to run extremely well.

To have clinical services running well means you have to maintain a good corpus of clinical staff - they need to be well educated, well motivated and well supported and none of these things can be taken for granted.

In terms of new things achieved, we have built and commissioned the first of our Clinical Training Centres at Hammondville. And together with us, the University of NSW appointed the foundation Hammond Chair of Positive Ageing and Care, Associate Professor Christopher Poulos, who began in March. Having the centre commissioned and the Chair appointed, along with support staff, gives us a platform to continue to develop our clinical training model.

What does future development of clinical training look like?At Hammondville, we are looking to appoint a nursing and an allied health academic, hopefully by the start of the 2012 academic year, so that we can fulfill the dream of multi-disciplinary academic training covering medical students, nursing students and allied health students. These staff will not necessarily be just from UNSW, but other universities as well.

The second of our Clinical Training Centres will be based within Pallister House at Greenwich and will focus on palliative care. We’ve received the funding, the plans have been approved by council and construction is to be completed by Christmas 2011.

And then we are looking forward to the appointment of senior academic staff at this centre.

Let’s talk about clinical research and how it ties in with the Clinical Training Centres.We have advanced the scope of clinical research very considerably in the past year. We’ve had some significant publications and advances within research that has occurred particularly in rehabilitation and palliative care streams both at Braeside and Greenwich.

Members of our staff have read papers at international conferences during the year, and national conferences, and have had some significant publications.

And that is a part of the continuing process that we will bring to further significant fruit with the academic centres over the next two years. If you really want to be at the cutting edge you have got to run good services, and you have got to think critically about how they can work better and you have got to have people actively researching what you’re doing now to make it even better.

You mentioned earlier the importance of clinical services across HammondCare. How do they look today, what are the challenges and where are these services heading?Our medical and clinical services across HammondCare have developed, not just in the hospitals, but also in the aged care and community space. For example, in developing and extending the range of ambulatory care and outpatient clinics that we provide. At the moment the bulk of our clinics are attached to the hospitals, and we are a looking to expand the range and complexity of those clinics as well as developing a range of new clinical services, particularly in association with our age care facilities.

The difficulty, particularly with aged care facilities, is that as the age of residents increases and as their needs become more complex, it is getting harder to find family practitioners who have the time, interest or

capacity to be seriously involved in the care of older people in the aged care setting. There aren’t enough geriatric consultants to be released from hospitals to do the job, and it’s getting harder to find general practitioners with a special interest in aged care.

How is HammondCare addressing the challenge of sourcing doctors to work within aged care?We realise that we have to grow our own doctors in these areas as well.

And that involves providing clinics for doctors who are interested in working with our older people, both in the aged care setting and in the community.

It also involves training for those people - our clinical training is not just about training students at undergraduate level, although it is critical to give them this experience at the beginning of their careers - but it’s also about offering post graduate qualifications in aged care to practicing doctors, nurses or allied health specialists in their disciplines.

A/Prof Chris Poulos is building into his program of work new courses that will integrate with existing university courses and lead to post graduate qualifications in those disciplines for nurses, doctors, allied health aged care specialists.

And everything we’ve been talking about naturally shows the importance of integrating clinical services that are within hospital settings, clinical services that are in community settings and clinical services that are in aged care settings, which are the three arms of HammondCare.

HammondCare has steadily worked towards a strong integration of aged care with health and hospitals during the past three years. Where has that placed us in 2011?There has been strong discussion in the community on the need for better integration of aged care with sub-acute health services and this is the very innovation we have been working on within HammondCare.

I think we have the best opportunities of any organisation in the country to get it right. What we are careful of is that we grow at the right speed to retain viability, and that we grow in clever ways that allow us to remain cutting edge.

This might include running pilots of different ways of combining services at different points, to work out what really works, and establish those as more general models.

What do you mean by cutting edge?I want the clinical services which I oversee within HammondCare to be the best possible.

It’s really about thinking of new ways of doing things, different ways, more efficient, thinking laterally and not just doing more of the same, even if what you are doing is very good.

If you just do more of the same then you grow bigger but you don’t become cutting edge and world-leading in how you do things.

Our structure, and the opportunity it brings for innovation, gives us influence not only in Australia, but also beyond Australia. I and other senior practitioners have invitations to teach overseas in places that are not always immediately obvious as being in need of the kinds of services we do well.

God has given us many blessings both in this organisation and in this country and it is not for us to hold onto them and not share them.

How might the strategic integration of services and commitment to thought leadership be outworked?There are interesting and exciting possibilities coming up. For example, in the aged care space these include taking palliative care into residential aged care facilities, taking restorative care into aged care facilities and linking these much more strongly with hospital-based services. At Bond House, a palliative care suite project is under way and other forms of integration are part of the future planning challenge.

Let’s make this more personal. How might these integrations actually benefit the people we care for?Look, you have an older person and they fall over and they break something, or they don’t break something, but they’re bruised and sore. They go to hospital but the acute hospitals can’t keep them for more than the minimum number of days, especially if they don’t have broken bones. If they return home and are not coping, they may compensate by not leaving the home, by narrowing their social connections and in six months you’ve got someone who is depressed, becoming confused; they fall over and break something; they are on the downward spiral.

Our view is that it ought to be possible to pick these people up. Sure, they don’t need rehabilitation in the hospital unit, but they’re not quite well enough to go home. Is there something else we can do in a transition aged care space, to enable that person to get back to where they were, in a way that is not as high pressure or as costly as in hospital, but in an environment that allows the person to have as much therapy as they need under medical specialist guidance? We think we can do this and do it well.

What is the basis for your confidence?The difference is that we as an organisation can put specialists and allied health people into residential aged care facilities in a way

Chief Medical Officer’s Report

“If you really want to be at the

cutting edge of what’s going on you have to run good services, and you have

to think critically about how

they can work better and you

have to have people actively

researching what you’re doing now

to make it even better”.

Dr Andrew ColeChief Medical Officer

46 47

What we earned $’000

Investment Income 4,174

Other Income 3,210

Donations & Bequests 3,980

Consultant Fees 2,645

Fee for Service Income 25,382

Govt Subsidies (Aged Care) 64,941

Govt Subsidies (H&H) 35,875

Total Income 140,207

What we spent $’000

Food & Catering 3,429

Finance, Admin and Int. 6,542

Medical & Client Supplies 5,029

Property (inc depreciation) 10,111

Staff Costs 101,898

Total Costs 127,009

Surplus for year 13,198

What we own $’000

Debtors 14,173

Investments 25,099

Cash & Deposits 21,836

Plant & Equipment 11,813

Bed Licences 25,185

Land & Buildings 203,887

Total Assets 301,993

What we owe $’000

Creditors 19,539

Provisions 14,581

Resident Entry Contrib. 21,958

External Borrowings 40,800

Resident Accom. Bonds 74,692

Total 171,570

Total Net Assets 130,423

Govt. Subsidies (H&H) 26%

Fee for Service Income 18%Govt. Subsidies (Aged Care) 46%

Consultant Fees 2%Donations & Bequests 3%Other Income 2%Investment Income 3%

Staff Costs 80%Property (inc depreciation) 8%Medical & Client Supplies 4%Finance, Admin and Int. 5%Food & Catering 3%

Land & Buildings 68%Bed Licences 8%Plant & Equipment 4%Cash & Deposits 7%Investments 8%Debtors 5%

Resident Accom. Bonds 44%External Borrowings 24%Resident Entry Contrib. 13%Provisions 8%Creditors 11%

What we earned What we spent What we own What we owe

Govt. Subsidies (H&H) 26%

Fee for Service Income 18%Govt. Subsidies (Aged Care) 46%

Consultant Fees 2%Donations & Bequests 3%Other Income 2%Investment Income 3%

Staff Costs 80%Property (inc depreciation) 8%Medical & Client Supplies 4%Finance, Admin and Int. 5%Food & Catering 3%

Land & Buildings 68%Bed Licences 8%Plant & Equipment 4%Cash & Deposits 7%Investments 8%Debtors 5%

Resident Accom. Bonds 44%External Borrowings 24%Resident Entry Contrib. 13%Provisions 8%Creditors 11%

What we earned What we spent What we own What we owe

Donations and bequests

Our donations and bequests grew this year to $3.9 million and these funds provide for continued growth, especially into areas of innovation and great need not subsidised by government. As a charity we remain exceedingly thankful for the generosity of our supporters and determined to be faithful stewards in return for the confidence shown in us.

It can sometimes be interpreted that when a charity reports sound financial performance, as HammondCare does, that the support of donors is less valued and less needed. In fact the opposite is true. It is the support of donors, bequests and other giving that allows us to lead the way in services such as younger onset dementia and to continue services when governments withdraw, as with community palliative care.

It enables us to champion areas of research, such as for continued improvement in positive ageing and restorative care, palliative or dementia care.

And it is our donors who provide the support for capital projects such as the Neringah Hospital re-opening, reducing our dependence on bank debt. We will continue to capitalise bequests so the benefit endures long into the future.

Future outlook

HammondCare will continue to grow across all it service areas and anticipates this will be undergirded by continued strong financial performance. At the same time, a conservative approach will reflect the broader economic uncertainties.

The 2011-2012 financial year will see a continuation of our strategic re-engineering of health and hospitals from a financial perspective while maintaining the strong performance of our aged care services.

Highlights include:

• Completion of 45 new Independent Living Units at Hammondville

• Leading the sector through investment in teaching and training facilities

• Completion and opening of our newest residential facility in Miranda by the first quarter of FY13.

• The enhancement of existing residential aged and dementia care facilities such as the integration of palliative care beds

• Continued strength in delivering At Home Care and further development of younger onset dementia services.

Within this financial context, HammondCare’s board remains deeply committed to a focus on mission and this is emphasised by the continued financial underwriting of the academic, research and teaching unit.

Each and every amount, transaction and detail will attract our continued diligent attention so that the past year’s key number - 2778 care places - is fulfilled and exceeded in the future.

The most important number in our 2010-2011 financial report is 2,778.

It represents our passion to improve the quality of life for people in need and is the number of care places HammondCare provided across Health and Hospitals, At Home Care, Residential Aged Care and Independent Living.

Each of those places is someone’s home, their hard-fought recovery, a family’s bedside vigil, a person’s last days, a new season of life, security at last, much needed respite, an environment that’s safe and a community to belong to.

As you read the financial figures below, remember that numbers are not our core business. Instead they represent the hard work, diligent leadership, careful management, creative solutions and generous giving needed to provide 2,778 care places - translating into many thousands of residents, clients and patients over the course of the past year. And many more in the future.

Financial snapshot

Strong financial results in 2010-2011 were undergirded by prudent management, complemented by increases in service delivery, and featured record capital expenditure to ensure continued growth in services:

• Revenue increased by 14% on the previous year to $140 million, while through careful management, expenditure grew by just 9%.

• A surplus of $13.2 million benefitted from record bequests and donations of nearly $4 million and Federal Government capital grants for current and future projects.

• Spending on capital works reached $27.5 million as foreshadowed in the annual report for FY10.

• Net assets increased by $11.2 million for the year and total assets grew $17 million to $302 million.

Across our services

At Home Care: The provision of services increased by almost 10% in FY11 to more than 1,380 At Home Care places across

aged care, dementia specific and community health. This service growth outstripped an increase in revenue of 8% to $34.6 million.

Residential services for aged and dementia care delivered 681 places in a year of consolidation and planning. This included refurbishments at existing sites and planning for and commencement of construction of a new $20 million, 90-bed facility in Miranda and the planning of an additional 90 beds for the Hunter region.

Health and Hospitals incurred a deficit of $1 million while significantly increasing the number of hospital services. In the last quarter of FY11, Neringah Hospital underwent major refurbishment at a cost of $1.6 million, expanding beds from 15 to 19. The addition of these beds and those at Greenwich Hospital in FY10 means we have increased access to in-patient palliative care places in Northern Sydney by 47% in two years.

Independent Living Units (ILUs) continue to be much sought after and a further 45 ILUs are under construction at Hammondville and will be completed in the coming year.

Revenue, expenditure and growth

HammondCare’s 14% revenue increase to $140 million represents the continued success of our diversified revenue strategy:

• Fees-for-service income from the clients, residents and patients grew $3.3m or 15% to $25.3m.

• Aged care subsidies grew by $7.1m or 12% to $64.9m, while

• Health and hospitals subsidies grew by $1.9m or 6% to $35.8m.

• Donations and Bequests grew to almost $4m with strong donor support, particularly for research supported by The HammondCare Foundation.

• Investment income increased $1.3m or 45% to $4.1m.

Coupled with revenue growth, expenditures were well contained:

• Staff costs increased by 10% to $102 million but remained constant at 80% of expenditure. The growth in staff costs reflects growth in all service portfolios

• Property costs, including depreciation, fell from $12.1 million to $10.1 million

• Other cost areas, such as food and catering and medical and client services, grew in line with the expansion of services.

Balance sheet and prudential reserves

HammondCare continued to strengthen its balance sheet during FY11 with the level of bank debt reduced and maintaining our prudential reserves.

Accommodation bonds and entry contributions (resident debt) grew by $12.1 million to $96.7 million and these funds were applied to:

• Reducing our external and bank debt by $4.5m to $40.8m.

• Funding the construction of Stage 3 ILUs at Hammondville.

• Commencing the construction of our much-anticipated Miranda aged care facility.

• Upgrades to existing services

Informed by independent actuarial advice, the reserves policy is reviewed regularly, ensuring that HammondCare is financially sound and able to withstand extraordinary events. At the same time, the reserves policy has an upper limit reflecting our commitment to charitable purpose.

Surplus and capital expenditure

HammondCare continues to apply its surplus into services for those we support. Alongside reducing interest bearing liabilities, new capital expenditure occurred at many sites. A substantial refurbishment of Neringah Hospital was completed, construction continued at Miranda and planning for other sites began. Construction of Independent Living Units at HammondGrove continued including the completion of the Village Centre, a community centre designed for this campus.

The Clinical Training Centre at Hammondville was constructed with Federal Government grants that form part of our revenue. This is a direct investment in educating, in conjunction with our university partners, the workforce of the future which is an important building block for better care for residents, clients and patients. Refurbishment work for a second Clinical Training Centre will occur in Greenwich in the coming year.

Finance report

48 49

The Board

John KightleyDirector

BCom, MPhil in Economics, CA (SA), CFA Institute USA

John Kightley has extensive investment management experience and is currently a non-executive director and member of the Investment Strategy, Due Diligence and Remuneration Committees of Maple–Brown Abbott Ltd. Mr Kightley was until 2009, Managing Director and CEO of Maple-Brown Abbott and has previously held senior positions with Norwich Investment Management Ltd and Allan Gray Investments (Cape Town, South Africa). He is also a Member of the School Council of Barker College. In February 2010, Mr Kightley was appointed to the Board of Together for Humanity Foundation, a multi-faith charity that teaches children in public schools to be accepting of people from different religious and cultural backgrounds. Mr Kightley is a member of the HammondCare Board’s Development Committee and Chairman of the HammondCare Foundation. He was elected as a Director in 2009.

Neil LewisDirector

Neil Lewis has had extensive experience in commerce, merchant banking, aviation and financial markets in Australia and overseas for more than 30 years. Mr Lewis currently has business interests in the developing renewable energy sector and infrastructure. He is a founding shareholder of Lloyd Energy Systems Pty Limited and a consultant/adviser to the board of directors of ASX listed CBD Energy Limited. He is also a member of the large wholesale AMP Infrastructure Equity Fund investment committee. Over the past several years Neil has focused on working with emerging businesses, renewable energy, board representation and assisting not-for-profit Christian organisations. Mr Lewis is a member of HammondCare’s Finance Committee and was elected a HammondCare Director in 2005.

Richard MayesDirector

BArch (Hons) MBA FRAIA

Richard has over 30 years experience in the property industry and is currently the Head of Facilities Management at the Reserve Bank of Australia, responsible for the management of the Bank’s property portfolio, security and other services. Previously he was the Director of Operations and Construction with the WA Building Management Authority. Richard has occupied leadership roles in industry and a variety of other Christian organisations. He is married with three adult children. Mr Mayes became a HammondCare Director in 2008.

Rodney John MewingChairman

BEng (Mech)

Rod Mewing has over 35 years experience in senior management and marketing roles. Currently with the Telstra Corporation Limited as Business Consultant within Enterprise and Government Sales, he has previously been Managing Director of David Jones Australia Limited and Managing Director of Tempo Services Limited. Mr Mewing is a member of HammondCare’s Risk and Compliance Committee, a member of HammondCare’s Board Development Committee, a member of the Property Committee and became a Director of HammondCare in 2003. Mr Mewing became Board Chairman in 2009.

Susan Elizabeth KurrleDeputy Chairman

MBBS PhD (Med) Dip Ger Med

Sue Kurrle is a geriatrician and Director of the Division of Rehabilitation and Aged Care at Hornsby Ku-ring-gai Health Services, and has held the Curran Chair in Health Care of Older People in the Faculty of Medicine at the University of Sydney since 2005. In December 2010 she was appointed to the Board of the Northern Sydney Local Health District. Associate Professor Kurrle has an international reputation for her gerontological work. She is Chair of HammondCare’s Research Committee and has been a Hammond Care Director since 1998, and Deputy Chairman since 2004.

Rosemary BondDirector

Grad Dip Admin (Social), Assoc. Dip. Nursing Admin., Dip. Theology

Rosemary Bond has over 40 years experience in nursing and administration, including 15 years at the Royal North Shore Hospital. This was followed by 10 years experience with HammondCare as Director of Care Services and eight years in Service Development and Pastoral Care. Miss Bond is a Fellow of the NSW College of Nursing, Chair of HammondCare’s Risk and Compliance Committee and became a Director of HammondCare in 2006.

Michael J MonaghanDirector

BA FIA FIAA FAICD

Michael Monaghan has over 30 years experience in superannuation, banking, funds management and investment consulting. Michael is currently the Managing Director of State Super Financial Services Australia Limited and has previously been a partner of Deloitte Touche Tohmatsu, CEO of Intech Investment Consultants and held senior executive positions with Deutsche Bank, IBM and Lend Lease Corporation. Michael is Chair of the Finance Committee, a member of the Property Committee and became a Director of HammondCare in 2008.

Dr Louise ParkesDirector

BSc (Psychology) PhD (Psychology)

Louise Parkes has extensive experience in researching and assessing organisational culture and the impacts of person-culture fit. Dr Parkes is currently Senior Consultant, Voice Project in which she designs and manages survey projects in leadership, culture and engagement and facilitates action planning and organisational change. The not-for-profit sector is Dr Parkes’ specialty. She has previously lectured in organisational psychology and assessed and developed executive talent with DDI Asia Pacific. Dr Parkes is a registered psychologist and a member of the Australian Psychological Society and College of Organisational Psychologists. Dr Parkes was elected to the HammondCare Board in November 2010.

Dr Stephen Edwin JuddChief Executive

BA PhD

Dr Stephen Judd has more than 25 years experience in the health care and information technology industries. Dr Judd has been Chief Executive of HammondCare since 1995. In that time he has seen the development of HammondCare’s services to its communities from 250 clients and an annual revenue of $9 million, to almost 2,800 clients and residents and an annual FY 2011 of $140 million. Dr Judd is a director of Community Council for Australia and Aged Care Services Association NSW, and a member of the Minister’s Dementia Advisory Group. Dr Judd’s special interests include designing environments for people with dementia, the appropriate use of technology in both aged and health care and the future role of charities in the provision of social services and health services.

www.hammond.com.au

HammondCare AnnualReport2011

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