Unspoken, Unheard, Unmet: Improving Access to Preventative Health Care through Better Conversations about Care.

Most older Australians will experience hearing, vision, speech, language, or cognitive changes that impact their ability to communicate. Over time, they will need support to express their care needs, choices, and concerns.

Currently, many aged care workers do not have the skills or resources to provide this support, resulting in a cycle where needs, choices, and concerns go unspoken, unheard, and unmet - critical preventative care is not received – and poor health outcomes are perpetuated. We will address these issues through co-design, implementation, and evaluation of "Better Conversations": a fit-for-purpose, interdisciplinary, multi-component intervention to support better conversations about care.

We will use Experience-Based Co-Design to explore enablers and barriers to effective, culturally responsive, and age-appropriate communication about care. We will work in partnership with older people, families, care workers and managers, and subject-matter experts to co-design an intervention that meets the needs of a diverse range of end users.

Following experience testing (usability and acceptability), we will evaluate our intervention in an implementation-effectiveness Cluster Randomised Control Trial. We will evaluate its feasibility, acceptability, and effectiveness in improving care worker knowledge; care worker-recipient communication; and care recipient experience of care and loneliness (compared to usual care).

Our research is supported by strong Government, industry, and community partnerships. Through broad and meaningful engagement, we will produce an intervention that can be feasibly and sustainably implemented, at scale, across aged care settings, giving older Australians a voice.