Knowledge Flows Both Ways: Why Frontline Voices Must Shape Aged Care Reform

There is a particular kind of knowledge that is not always found in a policy document. It lives in the hands of a care worker helping someone shower for the first time after a fall, in the honest and deep conversations about what care someone truly needs, or in the day-to-day skill of understanding a person holistically. The kind of knowledge that can too easily remain absent from the formal processes that shape aged care policy.

This is why events that bring together policy professionals and frontline aged care workers are essential for bridging the two worlds and driving meaningful system change.

I recently had the opportunity to witness exactly this kind of exchange when Catholic Health Australia (CHA) staff attended the Catholic Religious Australia Health and Wellbeing Committee Seminar as guest presenters. The day brought together frontline aged care workers, CHA policy professionals, and Acting First Assistant Secretary, Josh Maldon, from the Department of Health, Disability and Ageing, to work through the practical realities of the new Aged Care Act and the Support at Home program. Five months into implementation, the questions in the room were pointed and practical, reflecting implementation challenges and a need for clarity on how the new system actually works on the ground.

What struck me the most was not only the desire for information, but the quality of knowledge that flowed in both directions when the right people were in the room together. This idea of reciprocal exchange is something I find myself returning to often. As a person of Māori ancestry, the Māori concept of tauutuutu offers a guiding framework for understanding relationships and reciprocity. Tauutuutu speaks to the balance and harmony maintained through an ongoing cycle of giving and receiving, affirming that all stakeholders should be considered, decisions should be mutually beneficial, and outcomes should be equitable. When policy professionals share clear information, when frontline workers share honest experience, and when both sides are genuinely open to hearing and responding to the other’s realities, that process of reaching balance is set in motion.

What this means in practice is that the exchange cannot be one-directional. Good policy communication requires translating complex reforms into language that is genuinely useful to the people delivering care – but it equally demands deep listening to the challenges felt on the ground. The most valuable moment of the day came when we responded to the concerns raised by frontline workers, including communication gaps, access and assessment difficulties, and financial sustainability. These challenges represent the lived experience of people working within a system in transition, and they deserve to be heard by those with the power to act on them.

Frontline aged care workers occupy a unique position. Alongside family, friends, and community, they often hold the closest relationships with older people in need of care. They understand the power of listening and what it reveals about a person’s needs, wellbeing, and dignity. They know when someone is struggling because they have been there, standing alongside the person. That expertise deserves a strong and dedicated place in how we shape and refine the systems that are built.

The aged care sector is navigating significant change. The new Act represents a cultural shift, and there is honest acknowledgement across the sector of the need for continual improvement, laying the foundations for the conversations that reform requires.

Ultimately, the success of this reform will be measured by whether those delivering and receiving care are genuinely listened to and considered throughout its implementation. Events that bring these worlds together are a meaningful step. The work now is to ensure the conversations they generate travel back to where decisions are made and form part of an ongoing and reciprocal process of change.