Researchers from James Cook University, Queensland Health and the Torres Strait are working together to support a community-led and owned model of ageing well.
This follows their recently completed project looking at dementia and other diseases of ageing within the Torres Strait, during which they visited all 18 inhabited islands and mainland communities, which demonstrated a pressing call for action.
This new work is part of a five-year research project to develop a framework for improving health services for older people in the Torres Straits enabling them to age well in their own homes on Country. The project is funded by a $1.1 million grant from the National Health and Medical Research Council.
JCU Adjunct Professor Edward Strivens, chief investigator, says they will take a whole of community and whole of life journey approach. ‘Once we have identified champion sites, it’s about looking at what people’s understanding of healthy ageing is and trying to identify those environmental, cultural, spiritual and other priorities which we can then look at working with to improve community-driven outcomes.’
Research partners include the University of Western Australia, the University of Melbourne and the Torres and Cape Hospital Health Service. Professor Strivens says initial workshops with communities will be held in the next six to nine months. ‘We are going to work with the communities and health teams up there to see what their first priorities are and ways forward.’
A geriatrician and Clinical Director of Older Persons Health Services in the Cairns and Hinterland Hospital and Health Service, Professor Strivens notes: ‘We’re going to be utilising the technique of yarning circles to see what the gaps and needs are and then work on them in turn through a continuous quality improvement framework.
‘These methods mean that we can see what the community really values in ageing well and how any change can be implemented, not just putting in we outsiders think is needed.’ The team has the capacity to work with multiple communities and hopes to introduce interventions that will have a snowballing effect and provide lasting benefit to the community and older Torres Strait Islanders.
The professor, who started geriatric outreach services in the Torres Straits in 1996, says in previous research they found that ‘the rates of dementia in Torres Straits were three times what we would expect to see compared to the overall Australian prevalence’. The islanders also had higher rates of other conditions in middle age associated with ageing, including diabetes, cardiovascular and respiratory diseases.
Professor Strivens said: ‘Specialist care can be difficult for older Torres Strait Islanders to access, with a trip to Cairns sometimes meaning a combination of small planes, boats and buses is needed, which mobility, functional or cognitive limitations can make even more difficult. Telehealth and physical outreach visits can help to bridge that divide but sometimes new ways of looking at ageing well are needed.’
The new research will look into implementing programs and changes based on the priorities of each community and seeing if they are effective at bringing about improvements in ageing well.’ The interventions needed could differ from island to island or between communities, says Professor Strivens.
Interventions might range from changing diet, as even in the Torres Strait weekly fish intake has reduced over the last 50 years, to island dancing. Professor Strivens said island dancing was the archetype of an intervention to promote ageing well, with its combination of physical, social, cultural and cognitive engagement. ‘So I feel optimistic that there’s a lot we can do to flip that paradigm away from thinking about risk factors and towards prevention and ageing well. It’s all about instituting changes that will be effective over the longer term and have the ability to self-sustain.’
