Strengthening Partnerships to Improve Health and Aged Care Outcomes

At the recent statewide care finder network meeting, Adelaide PHN and Country SA PHN had the privilege of welcoming the Integrated Team Care (ITC) program from Sonder, which delivered a presentation highlighting its vital work in supporting individuals and families to better manage chronic conditions and improve health and wellbeing outcomes.

Through a deep dive into the program, care finders gained clarity on free support for Aboriginal and Torres Strait Isalnder people to improve the management of chronic health conditions (cancer, diabetes, kidney disease, lung disease and others), including building self-management capability and engagement with primary care services.

The care finder service is specifically for vulnerable older people who need intensive support to access aged care and other local services.

Care finders support older people eligible for an aged care needs assessment and take a multi-dimensional approach when considering needs and other relevant supports in the community that may assist the clients to:

• Maintain and/or improve their psychological, emotional and physical wellbeing
• Break down barriers that may impede their access to aged care

The ITC program comprises teams of clinical Care Coordinators and Aboriginal Outreach Workers collaborating closely with a range of service providers (including medical specialists, doctors and allied health practitioners) to improve access to culturally responsive multidisciplinary care.

The members shared case studies involving an older person experiencing aged care navigation barriers, homelessness, chronic health issues and social isolation.

The session was a turning point in strengthening collaboration between Care Finder and the Integrated Team Care clinical team.

About ITC - previously known as Closing the Gap program
The Integrated Team Care program provides free support for Aboriginal and Torres Strait Islander people to improve the management of chronic health conditions (including cancer, diabetes, kidney disease, lung disease and others). The program is delivered from three sites across the Adelaide region, working at the local level by engaging with community, healthcare providers and Aboriginal organisations.

About Care Finder program
Care finders can help vulnerable older people navigate the aged care system and find support services to improve their quality of life. Care finders can help with both accessing services for the first time and changing or finding new services and supports.