A Lively conversation with Anna Donaldson

The Governing for Reform in Aged Care Program recently held their Co-Designing for the Future of Aged Care webinar, featuring panellists David Panter, Evonne Miller, and Anna Donaldson. Anna Donaldson is the founder and CEO of Lively, an organisation that trains and employs young jobseekers to provide support and connection for older people in their local community.

We interviewed Anna to get her insights on why aged care providers should co-design with their consumers, how Lively has implemented co-design, and the positive impact of models of reciprocal care.

What motivated you to start Lively and why do you believe it was required in the sector?

Growing up, I was fortunate to have a number of very significant and treasured relationships with older people, which instilled an appreciation of elders in me from a young age. Then, in my early 20s, I started volunteering as a life story writer and was connected with an older lady who was extremely isolated and lonely in the last years of her life. It was a shocking eye opener for me, and woke me up to the many challenges facing older people in our community today – and to the ageism in our culture that drives them. Meanwhile, I was frustrated by the lack of opportunities for young people to find meaningful employment without previous experience or qualifications, and wanted to grow the pool of employment opportunities available to young people who wanted to contribute to the community from their very first job.

When the idea struck me to put these two issues together, it felt like such a no-brainer that I was convinced someone must already be doing it. But as I looked around, I found that no one was! So from there, I simply couldn’t not do it. The opportunity to employ young people to offer support and connection for older people, and to build relationships that would enable older people to share experience and skills back with the young, was just too enticing – and here we are today, doing it!

At Lively, you developed a unique approach to home care by engaging a group of young and older people in a co-design trial. Can you talk us through this process and why other executives and board members in the aged care sector should co-design with consumers?

We did! I’m really happy to share a write up of the process and outcomes, which you can read here. We ran this process back in 2019, at which point our only program was a technology help program (helping older people learn how to use smartphones, computers, etc. to connect, communicate and maintain independence). At that time, we had a sense that more was possible for Lively – that young and older people would be interested in connecting with and supporting each other in different ways – and we were thinking of setting up our own home care service and becoming a provider. We had a whole set of hunches and ideas about what might make for a better care experience than we were seeing around us in the community, but we knew that for anything to work, we needed the buy-in of young and older people to help us shape the emerging service to their actual wants and needs.

The process was really thoughtfully put together and executed, and engaged 13 older people and three young ‘Helpers’. In short, it involved a few key steps:

  1. Identifying the key questions that we were holding, and that we needed young and older people’s assistance to explore through the project (e.g. ‘how do we provide transparency so older people have control/visibility over their care and how their money is being spent’?).
  2. Introducing young and older people to Lively’s vision, the purpose of this design work, and the type of participation that we were seeking from them.
  3. Running a series of workshops to explore a range of our key questions as a group.
  4. Simulating the service in practice by connecting each older person to a young ‘Helper’, allocating them a real budget to work with over a period of a few months, and getting them to reflect, log and feed back on what was working, and what could be improved.
  5. Checking in and conducting 1:1 interviews with participants when needed to tease out emerging insights in more depth.
  6. Collating our learning and sharing it back with the group, and identifying the next set of design questions for us to continue investigating after the initial trial.

The trial enabled us to design a unique service model that was greatly appreciated by both young and older participants, and that went on to have extremely high satisfaction levels amongst ‘real life’ clients when we launched as an approved provider later in 2019. The process also gave us confidence to go ahead with approaches that we might not otherwise have felt confident to pursue if we weren’t 100% sure that they would work for the participants – one good example is trusting young and older people to manage their schedules and time together, within the bounds of the agreed care plan, rather than centrally rostering their sessions. Indeed, this is one of the aspects of our service that has been most consistently noted and appreciated by participants in program evaluations ever since!

Lively implements a reciprocal care model where young people and older people support each other. What are the positive changes you've seen as a result of this and how can aged care organisations get involved?

I’m always blown away by how such a simple concept can have such a profound impact on both the young and older participants. Our impact measurement shows that young people come out of this experience with increased confidence and self-esteem, improved employability skills, greater awareness, understanding and respect for older community members, and increased interest in supporting older people throughout their personal and/or professional lives. On the other hand, older people report feeling enlivened and reenergised by the connection with a young person, and feel that their knowledge and life experience is more seen and valued. They feel increased stimulation and enjoyment in everyday life, rediscover their capacity and interest to pursue valued pastimes, and feel that their daily life is more comfortable and under control. Most importantly, we hear both young and older people raving about the special connections and relationships that they have formed with each other – as one Member recently said to me, ‘it’s like having a grandkid, who’s not a grandkid’, and ‘it’s given me my self-esteem back’.

In terms of how aged care organisations can get involved, we partner with home care providers who broker in our Helpers to provide support to CHSP (Social Support) or HCP clients who could benefit from this sort of engagement and interaction. With a huge and growing pipeline of young people eagerly seeking out employment at Lively, we hope to provide an attractive, complementary solution that helps providers meet their workforce and service delivery needs – enabling them to tap into an enthusiastic, well-trained and highly competent group of young people who are able to meet some of the needs of their clients. I’m always more than happy to chat with providers who would like to understand more or pilot our model in their service!

To hear more from Anna, watch our Co-Designing for the Future of Aged Care webinar recording on the online learning platform.