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Add your voice to the conversation

SARA MILLS, General Manager of Fish Hoek Elder Care

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SARA MILLS, General Manager of Fish Hoek Elder Care, 63 years of age, has led this organisation for 8 years. A professional nurse, she believes in the inherent good of people.

Fish Hoek Elder Care started with their first care home Carlisle Lodge in 1962. Ivy Carlisle was the Mayoress at the time in Fish Hoek, and supported the development of the first home for older people in this community. Nerina Gardens followed in 1976. They offer accommodation to 260 older people.

Thinking of what can be attributed to FHEC’s success over the years, Sara focuses on relationships – relationships between staff and residents and among residents themselves. The focus on person-centred care has been key to the organisation moving forward. There is a positive energy in the homes, and an easy friendliness. People comment on this all the time. Sara is proud of this. Another attribute contributing to success is good financial stewardship. The organisation is comfortable. As General Manager, Sara is supported by her board, not hamstrung by the board.

A key strength for FHEC has been their open-door policy, and their desire for family input. If it’s not working for you, let’s talk about it. The notion of “shared caring” is paramount here. Families are always included and encouraged to be a part. There is an ease of communication.

FHEC’s current biggest excitement has been the opening of Chapman’s House. The first resident has moved in. Sara maintains that 80 is the new 60, and this concept of communal living in a house is the way to go. The concept still needs to “take on”. It offers a balance between individual privacy and independence and companionship of others who share the house. The rooms, all en suite, have their own little patios, and can be very private.

For Sara, the biggest challenge ahead for FHEC, is moving towards community care, and ageing in place. They are struggling with everyone to adapt to this concept, but as an organisation they are sure that it is the way to go. She accepts it’s discouraging at times, but they want to keep moving forward. They are seizing the opportunity to change their homes into resident-led homes. There is a lot of involvement of residents on committees, both formal and informal, in both their homes. They turn their residents’ meetings into celebrations, such as a party for all those celebrating their 90th birthday, and combine it with long service awards for the staff.

Sara believes that the staff feel FHEC is not a place where they are going to work; it’s where we choose to be. She believes there are always pockets of moments, the “good stuff”, pockets of happiness that mean so much.

Talking about her leadership role, Sara thinks her role is to keep pushing forward with community care. FHEC have entered into a partnership with the Care Company and sponsor 20 people in the community to receive care in their own homes from the Care Company.

She also believes organisations need to reach out, and they reach out to the communities in Masiphumilela and Ocean View, with donations of electricity payments, food hampers at Christmas time, knitted items for crèches and homes for abused children. Together residents and staff experience lessons in humility and focus on gratitude for their own many blessings. Feeling needed she believes, feeds the domains of well-being, in giving to others. At FHEC, they embrace this giving in all that they do.

In-house, they are focusing on residents living with mild to moderate dementia, trying to preserve their independence, dignity and personhood in their original rooms, in order to delay and even prevent a move to traditional frail care. She believes it is the right thing to do.

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She believes that as a leader she needs to lead by example in terms of attitude and acknowledging everyone’s, both staff and residents’, individuality and personhood. She feels that the way she is with the staff and residents must be infectious, so that the atmosphere at FHEC is always positive. Sara has not experienced a good year healthwise, and she has indeed shown this positive spirit to all whose paths she’s crossed, as she has dealt with the curved balls thrown her way. An inspiring example indeed!

In terms of the organisation, Sara believes leadership keeps standards high, and gives confidence to clients and the community, always striving to improve, listening to others, being open to change and flexible. This encourages others to question and think and debate.

In terms of the care sector as a whole, Sara believes leadership sets standards for the industry. She underscored the value of networking, belonging to organisations like the South African Care Forum, that are raising the bar and creating opportunities for new conversations to be had. She believes all organisations should support this initiative. Walk the talk – join as members, make a contribution.

One of the new conversations Sara would like to see accelerated is getting things to be resident-led, a stronger move away from the medical model, and getting this concept across to all the local general practitioners, families and other practitioners. She feels there’s need to remain quietly determined and not be afraid of making the change, and sharing with doctors the evidence of care. She would like to see regular group discussions when doctors visit, with family, staff and resident, to give a better picture of wellness, rather than the old focus on an illness model. But she acknowledges that time is a problem. However, this would inspire staff.

Reflecting on her organisation “shedding its skin” and moving from provider to facilitator, the “letting go” is what is difficult. She reminds me that we are but stewards – we work in the residents’ home, they don’t live in our workplaces. The struggle is sometimes with traditional nursing staff for whom medical liability is foremost in their mind. A change in mind set is also needed in not thinking about “difficult” residents, but rather what unmet needs are being expressed, and how can these be met.

One of the greatest “dark” areas in the aged care sector, is for Sara, that ageing is not every agenda, and for our government it is not a priority. Dignity for older people needs to be restored, particularly in the public health sector. The brightest light in the sector, for Sara, is that person-centred care is spreading and making huge inroads in the majority of homes around the country. She is not despondent, but feels there is a long journey ahead.

Beyond aged care, Sara lives with Duncan and they love to go camping. She has 4 grandchildren and 2 step grandchildren. For her, starting the day with a cup of coffee outside on the patio is what feeds her soul. She loves gardening and enjoys the birdlife that comes to the stream running through her garden. She is inspired by people who stand up for what they believe in. You do just that Sara! You are an inspiration to many. The South African Care Forum salutes you for your leadership in aged care!