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HIV & Ageing
The document discusses the challenges and strategies related to supporting individuals living with HIV as they age, emphasizing the importance of community partnerships and comprehensive care services. Successful collaborations among various organizations, such as the AIDS Action Council and UnitingCare Ageing, aim to provide tailored support for complex care needs and promote independence for those affected by HIV. The document highlights the need for ongoing networking, awareness-raising, and collaboration to enhance the quality of life for the HIV-affected community.
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HIV & Ageing
- 1. Positive Services Forum2009 HIV & Ageing Nada Ratcliffe Manager Community Support Services A COMMUNITY PARTNERSHIP
- 2. This is about………Community development Mainstreaming HIV and Ageing Partnerships Legislative reforms Supporting our communities
- 3. WORKING TOGETHER Thesuccessful Australian response to HIV has been based on partnerships across various levels…….
- 4. Partnerships with mainstreamservices Particular relevance for small areas – may be unable to have specialist services e.g. Pozhets Bobby Goldsmith Foundation Positive Women Paediatric HIV services
- 5. The Australian CapitalRegion Relatively small The AAC ACT and PLWHA ACT are the only community sector agencies in the region specialising in minimising the impact of HIV on our communities
- 6. Current partnership successesACT SPECIAL NEEDS DENTAL HEALTH PROGRAM In partnership with ACT Health….. (community/government)
- 7.
- 8.
- 9. Current partnership successesIn partnership with………….. Havelock Housing Association Inc. (other community agency)
- 10. WILLIAMS HOUSING PROGRAMDedicated Community Housing Long term accommodation Income based rental Currently accommodating Currently…… 1 large family +1 couple = 7 affected
- 11.
- 12. AAC Legal AdviceService Free legal advice sessions With ACT private practice Experienced legal practitioner Registered migration agency HIV + and GLBT community (a community/corporate partnership)
- 13.
- 14. Partnerships in anageing environment More people than ever are living with HIV Large numbers of people ageing with HIV
- 15. REALITY Ageing Bio/psycho/social issues of ageing Frail aged Unable to fully self manage Wanting to maintain independence Need for day to day support Special needs relating to HIV Every situation = unique
- 16. REALITY We needto ensure that: high quality, flexible, specialist aged care services are available for people living HIV and affected communities
- 17. Community Aged CarePackages (CACPs) Provide a planned and managed package of community care Complex care needs Would like to remain living in your own home
- 18. Types of Servicesmeal preparation laundry assistance with continence management transport personal care social support home help gardening, and temporary in-home respite care ……
- 19.
- 20. WHAT NEXT THEN….Initial meeting Exchange of information Follow up meeting & approval Community Aged Care Rounds Joint submission – with Uniting Care Ageing being the primary applicant (as a long term provider)
- 21. AND THEN…..MOST IMPORTANTLY Agencies have shared….. VALUES
- 22. AIDS ACTION COUNCILOF THE ACT -OUR VALUES- Strive for excellence Empower individual & communities Commit to shared responsibility Promote equity of access, dignity & respect
- 23. UnitingCare Ageing -Values Courage Compassion Growth Respect Integrity Community
- 24. ROLES -UNITINGCARE AGEING-STAFF RECRUITMENT STAFF MANAGEMENT ADMINISTRATIVE OUTPUT REPORTING ONGOING COLLABORATION
- 25. ROLES -AIDS ACTIONCOUNCIL- CIRCULATE INFORMATION THROUGH NETWORKS
- 26. Provide information to…..Men & women with HIV Partners & family members Affected communities Medical practitioners Other medical services Allied health professionals Community based organisations Aged care agencies including ACAT
- 27. ROLES REFERRAL TO UNITINGCARE AGEING
- 28.
- 29. ROLES MONITORING & ONGOING SUPPORT
- 30.
- 31. “ yes…..” ..…potentiallya high quality flexible service to assist people living with HIV and affected communities to remain living independently in their own homes
- 32. “ no………” Goodnetworking Relationship building Awareness raising Put the issue on the table Reinforces sense of community Reinforces the issue internally…. Opportunities for reflection & review
- 33.
- 34. …the political isthe personal …the personal is the political
- 35. thankyou ………… .anyquestions?
Editor's Notes
- #2 This presentation has been named as a community partnership – there were 2 community based non profit human service agencies that came together through like minded people and a community event – I must add that the outcome of an application has not been received – HOWEVER, irrespective of the eventual outcome there will definitely be positives from the work and motivation of those involved in the PROCESS.
- #3 When I thought about the context of the relationship – IT WAS CLEAR TO ME THAT ALTHOUGH THERE WERE VARIOUS ELEMENTS TO THE RELATIONSHIP AND THE PROCESS, IT WAS ABOUT - first & foremost : COMMUNITY/IT’S ALSO ABOUT MAINSTREAMING BUT IN A MORE EMPOEWERED WAY – NOT JUST BY REFERRING AND ADVOCACTING FOR OUR CLIENTS BUT BECOMING A PART OF A PARTNERSHIP – A PARTNERSHIP WITH THE ENSUENT LEVEL OF CONTROL. IT’S ABOUT FLEXIBLE SERVICES FOR AN AGEING POPULATION – A SPECIAL GROUP OF PEOPLE WITH MANY COMMON NEEDS BUT ALSO WITH THE UNIQUE NEEDS OF INDIVIDUALS, PARTNERS, FAMILIES AND COMMUNITIES. IT’S ALSO ABOUT THE FEDERAL GOVERNEMENT’S COMMITMENT TO CHANGE LEGISLATION TO ERADICATE DISCRIMIATORY FRAMEWORKS AND PRACTICES – AND IDENTIFYING OPPORTUNITIES FOR THE FEDERAL GOVERNMENT TO PUT THEIR MONEY WHERE THEIR MOUTH IS! LITERALLY. IT’S ABOUT RECOGNISING A GENUINE NEED AND EMERGING TREND WITHIN COMMUNITIES AND FOR US TO “WALK THE TALK” IT’S ABOUT THE POLITICAL IS THE PERSONAL! It's
- #4 CLEARLY PARTNERSHIPS ARE ABOUT WORKING TOGETHER - Of course this partnership has and continues to involve the federal government, state & territory governments, researchers both clinical and social, clinicians and health care workers, community agencies working with gay men and MSM, sex workers and IV drug users and importantly PLWHA groups and agencies. Australia’s response to HIV is probably one of the word’s greatest examples of “working together” to achieve positive outcomes for communities. IT IS ON A MUCH BIGGER SPECTRUM BUT IT IS THE PARTNERSHIP THAT DEMONSTRATES THE BENEFITS TO THOSE INVOLVED…..
- #5 …..and now we have what may be badly termed as ‘mainstreaming’ What is mainstreaming in the context of HIV. Well, ultimately it’s about better lives for positive men, women and children, their families and all of those affected by HIV. There are improved efficiencies, ability to provide more specialised services, the availability of more resources AND a wider range of resources for people./ turn page/ In smaller regional areas, partnerships work particularly well – as we are unable to have specialist services in the area of HIV – such as in the metropolitan areas of Sydney or Melbourne which have POZHETS, agencies for positive women - and so on. in the act along with councils in areas like Tasmania and NT THERE IS ONLY THAT AAC AND PLWHA GROUPS TO PROVIDE LOCAL SERVICES & ADVOCACY FOR SUCH DIVERSE GROUPS – IT IS CERTAINLY A CHALLENGE
- #6 Therefore, partnering with other ‘mainstream’ services enhances our ability to provide broader range of, and more specialised services to our communities. In the ACT we have a population of roughly 320,000 with the number of positive men, women and children with HIV estimated at roughly 350 – although numbers range from 300-400. The AAC has male clients (gay and heterosexual), adult female clients (ranging from 18 – 68) and indirect contact with children of all ages. We also have contact with adults with haemophilia when specialised HIV related services are required…………………….. ( By the way………….Not all bad as there are a lot of good things that come with a small community and a small agency)
- #7 I WILL JUST FOCUS ON A COUPLE OF EXAMPLES THAT HAVE BEEN SUCCESSFUL - While the AAC worked intermittently in partnership with other agencies – as we still do – for instance with the ACT Cancer Society in the delivery of anti-smoking education – it became clear that partnerships on an ongoing program basis would provide benefits to positive people particularly in KEY areas of demand DENTAL / HOUSING / LEGAL – THESE WERE AREAS WHERE DEMAND and need is high AS I AM SURE YOU EXPERIENCE ALSO – DENTAL HEALTH ISSUES FOR PEOPLE WITH HIV CAN BE FREQUENT AND THIS SITUATION ONLY EXACERBATES AS A PERSON GETS OLDER. SO WE FORMED A PARTNERS THROUGH THE SPECIAL NEEDS DENTAL PROGRAM - Briefly this program commenced in 2005 - Clients requiring dental work are referred directly to ACT Dental Health Services with 2 way consent forms. This program is working extremely well – with virtually unanimous positive feedback. (One complaint was received about the size of dentures which was rectified.)
- #8 Turn page on screen
- #9 SHOWS HOW GOVERNMENT & COMMUNITY SECTOR CAN WORK WELL TOGETHER. We have a particular liaison person that ensures consistency on both sides. While, in the past, we advocated for clients wanting to access dental treatment, there was little consistency and it really depended upon the frame of mind of the person answering the phone at any given time – now there is consistency through A MEMORANDUM OF UNDERSTANDING – WITH CLIENTS INITIALLY SEEN AND EXAMINED WITHIN A COUPLE OF WEEKS AND AN ONGOING DENTAL PROGRAM IS DEVELOPED WITH THAT PERSON. THERE IS A MINIMAL COST INVOLVED – IF SOMEONE IS GENUINELY UNABLE TO MANAGE THAT COST, THEY CAN BE ASSESSED UNDER THE TREVOR DALY FUND FOR ASSISTANCE.
- #10 ANOTHER EXAMPLE OF A SUCCESSFUL PARTNERSHIP IS IN THE AREA OF HOUSING WHERE WE HAVE PARTNERED WITH ANOTHER COMMUNITY SECTOR AGENCY – HHA – THE LARGEST PROVIDER OF AFFORADABLE (COMMUNITY ) HOUSING IN THE REGION. Turn page………….
- #11 This is: DEDICATED COMMUNITY HOUSING/LONG TERM HOUSING/SUBSIDISED RENTAL/CURRENTLY 2 PROPERTIES HOUSING 7 PEOPLE – AWIAITNG THE ALLOCATION OF ANOTHER RESIDENCE.
- #13 This is a more recent COMMUNITY/CORPORATE) partnership commenced this year and is presently a pilot – doing very well. People with HIV have sought information and advice on immigration issues and workplace discrimination. The lawyer will also be delivering group information sessions on wills and power of attorney – AN AREA OF IMPORTANCE FOR US ALL BUT PARTICUALRLY AS WE GET OLDER (the service is also open to those affected by HIV and members of the Westlund House/AAC community).
- #14 SHOW BROCHURE…………..then turn page………….
- #15 Like the general population a large proportion of positive people are ageing. AIDS Councils and PLWHA agencies are specialists in the field of HIV, and may (or may already have) specific services for older people with HIV– AND maybe in LARGER AREAS possibly residential care & independent living. However, as I have said in a small population this is not feasible, so partnership arrangements with mainstream services could be very effective way to address this trend in a small area.
- #16 IN another life I worked in the area of mainstream aged care both community based and residential based care - I feel that we’re on the cusp of something HUGE here……. all of these areas of concern must be coupled with the special needs of positive people.
- #17 Some may say that why not just leave it totally to the mainstream – getting old and frail is getting old and frail – what’s the difference. As we well know there is a huge difference – down to the basics about how someone is treated in a nursing home by staff and residents to how someone with HIV is treated by others coming into their own homes. That sense of loss of control over ones body, home and social life is painful to deal with for anyone at any time - let alone if services are delivered by people that are completely ignorant about HIV and worse still, may have preconceived and incorrect views about living with HIV
- #18 SO THAT LEADS US ON TO COMMUNITY AGED CARE PACKAGES These community aged care packages FUNDED BY THE FEDERAL DEPT OF HEALTH AND AGEING CAN work very well in that they are individualised to suit the home environment and condition AND CIRCUMSTANCES of the individual and their significant others.
- #19 As I mentioned the CACPs are individualised packages and may include such services AS:…………… read out …………….However, I clearly recall as a community aged care worker – I had an office in a large public housing complex where the residential population was largely over the age of 65 years. There was an older gay man who had HIV and was confined to bed and had services visit him to maintain as semblance of independence. WHILE the services themselves were provided and were good quality in terms of his physical health, they were lacking in terms of his psycho-social and emotional health. There was a lot of comments from carers – bordering on gossip. What was needed was specific training for these people and ideally the involvement of an HIV specific agency.
- #20 FAIRDAY – the Canberra Community – A LOCAL GLBT COMMUNITY EVENT ? WHAT happened is what happens in small communities like Canberra. Someone who WAS AN employee of UnitingCare Ageing - NOW AN ACTIVE VOLUNTEER and active in the LGBT community talked to AN AAC STAFF MEMBER REGARDING AGED CARE SERVICES FOR POSITIVE PEOPLE AND THE BROADER GLBT COMMUNITY– THE AAC STAFF MEMBER GAVE ME HER NAME / I PHONED HER/SHE INFORMED ME THAT THIS YEARS COMMUNITY AGED CARE ROUNDS WERE UNDERWAY AND COULD WE DISCUSS THE POSSIBILITY OF WORKING WITH UNITINGCARE AGEING. As there was a current Federal Community Aged care Approval Round open our discussion led to that possibility.
- #21 I had an initial meeting with her after we had both discussed it with management of our respective General Managers – who both expressed mutual interest and approval was given on both sides to move along with the submission process.
- #22 For me, and I think for any community agency/ies interested in specific service partnerships, that it is essential that each member of the partnership have shared values. Sure, all agencies have their own vision and missions, even like minded agencies in the HIV sector because of different target groups and geographical locations but what is essential is that are values are congruent.
- #23 The AAC ACT has 4 strong values that underwrite all of our work with individuals, families, groups and communities
- #24 CLEARLY THE VALUES OF UnitingCare Ageing and the AIDS Action Council of the ACT are indeed congruent – they don’t have to be the SAME but there must be a consistency or congruence between the two service providers. WITHOUT THIS – WE COULD NOT EXPECT TO WORK TOGETHER FROM NOW AND INTO THE FUTURE …WHICH OF COURSE, IS THE HOPE IN PURSUING THIS PARTNERSHIP
- #26 It will be important that positive people, their families and affected communities are aware that this individually packaged services actually exist. Therefore, it is essential that as an agency and through our multidisciplinary team communicate with a range of people and agencies/ services INCLUDING (OVER) Men and women living with HIV………..
- #27 It is essential that the word gets out so that people can approach us to provide assistance
- #28 ROLES AAC - After determining through our own case management system that a person may be suitable for a CACP then the AAC will contact UNITINGCARE AGEING to ensure that processes take place – essentially that they satisfy the criteria for a CACP – essentially that will be through an ACAT ASSESSMENT (AGED CARE ASSESSMENT TEAM), the person, couple or family can be referred to Uniting CareAgeing ( all parties will meet to determine exact services required, frequency, days, commencement dates, any fees payable (generally only token fees, if at all)
- #29 This is possibly one of the most important roles of the AIDS ACTION COUNCI: OF THE ACT. This will be important in differentiating these Community Aged care Packages from the “normal run of the mill” COMMUNITY AGED CARE PACKAGES. TRAINING WILL BE FOR THE ON THE GROUND STAFF – THE PERSON THAT GOES INTO ANOTHER PERSON’S HOME ENVIRONMENT, INTO WHAT HAS BEEN THEIR LOCUS OF CONTROL. – BESIDES TRAINING RELATING TO HIV TRANSMISSION AND PUTTING ANY FEARS OR MISINFORMATION TO BED, IMPORTANT PSYCHO-SOCIAL ASPECTS OF HIV – ESPECIALLY SURROUNDING STIGMA, LABELLING AND DISCRIMINATION WILL BE INCLUDED. Training will also include cultural competency and training in diversity.
- #30 The provision of ongoing monitoring of services to ensure best possible bio/psycho/social outcomes for the client and their sufficient others will be essential to the success of the partnership. It will be important that as a person ages, changing needs be addressed, that the client and others are happy with the type and quality of services delivered and have every opportunity to maintain control and self-determination as far as possible within the framework of CACPs. The clients involved MUST have an ability to contact the agency and a complaints or feedback mechanism at all times. Of course, all people will be informed of and have an easy avenue to make complaint.
- #31 Before going ahead with the submission, we had to ask the question – does the AAC have the resources to maintain such a relationship. While the AAC has not received any additional funding for the 3 partnerships we have outlined, they are clearly within our mission to: LESSEN THE IMPACT OF HIV – through ensuring high quality services for people with HIV and people affected by HIV. Our current human resources have absorbed any additional time in maintaining effective partnerships. In the first instance the submission is for only a small number of packages – we are fortunate to have a potential partner that administers a large number of (generic) CACPs in the ACT. IT is also interesting that for the same aged care approval round, UCAgeing also applied for a similar number of CACPs tailored towards the Chinese community in Canberra in partnership with the Chinese-Australian Friendly Society.
- #32 IF WE ARE SUCCESSFUL THEN A MEMORANDUM OF UNDERSTANDING WILL BE DEVELOPED FORMALLY TO OUTLINE THE TERMS OF EACH AGENCY’S ROLES AND RESPONSIBILITIES. I MIGHT ADD THAT BOTH THE DENTAL AND HOUSING PARTNERSHIPS, THERE EXISTS A MEMORANDUM OF UNDERSTANDING – POSSIBILY THE MOST IMPORTANT ASPECT OF ANY SUCH RELATIONSHIP. THERE WILL ALSO BE MUCH MORE PLANNING AND PROGRAM DEVELOPMENT TO PUT IN PLACE.
- #33 If the submission is unsuccessful then …..we still have achieved a great deal 1.GOOD NETWORKING WITH OTHER AGENCY 2.BUILD RELATIONSHIP WITH OTHER COMMUNITY SERVICES 3. AWARENESS RAISING OF THE ISSUES RELATING TO AGEING IN PARTIICULAT – INTERNALLY/WITH UNITINGCARE AGEING/IN THE SECTOR/ WITH THE BUREAUCRATS (POWER)/
- #34 ……….AND, IF ASSESSED TO BE APPROPRIATE – AFTER REFLECTION & REVIEW THEN WE TRY AGAIN
- #35 Remember that the political becomes the personal and the personal is political
- #36 THANKYOU VERY MUCH FOR YOUR TIME AND ATTENTION – LIKE I SAID IN THE BEGINNING – THIS IS DOWN TO EARTH STUFF – IMPORTNATLY - IT IS A PART OF OUR CORE BUSINESS