Publish date: 16 February 2024
When the Dean of Medicine asked each first-year student ‘why medicine?,’ Maria Foundas answered honestly she wasn’t sure she was in the right place.
“I thought perhaps I should be doing Law as I loved the humanities, especially literature, and I really liked connecting with people,” she said. “But the Dean insisted I could still write as a doctor and that the connection was up to me and the specialty I chose.”
The daughter of migrant parents, Maria worked hard as a nod to the sacrifices they made for her future. That work ethic continues today as she juggles responsibilities as a geriatrician at St John of God Midland, teaching at Notre Dame University and her position as a Director on the Bethanie Board.
Each role provides balance for the other. “All of my roles are related,” she said. “I keep current in delivering geriatric care at the hospital, which effects good governance to the Board. And I’m presenting the geriatric medicine curriculum to the next generation of doctors and influencing aged care as a career.”
Geriatric medicine was part of all junior doctor’s rotation at Royal Perth Hospital, and it piqued Maria’s interest immediately.
“I could immediately connect with the person while finding out about their needs as a patient,” she said.
Complexities of aged care
“I discovered aged care was incredibly complex and truly reflected the bio-psycho-social model, which examines how the three aspects – biological, psychological, and social – occupy roles in relative health or disease.
“It stresses the interconnectedness of these factors; that yes there is a physical disease, which possibly impacts on someone’s capacity to live independently, perhaps they now find it difficult to socially connect, leading to the decline of their overall well-being.”
Geriatric medicine gave Maria a voice in advocacy, and she’s passionate about the care of older people. “Their vulnerability means they’re often not heard, and they need someone standing behind them to be their voice”, she added.
Dignity of Risk
This philosophy brought Maria to her second Masters degree, this time a Master of Bioethics where she is writing her dissertation on the ‘Dignity of Risk’.
Maria’s introduction states, “The dignity of risk principle embodies and maintains there is dignity in risk-taking, and therefore optimising safety by inhibiting risk-taking erodes dignity. This unique relationship between dignity and risk, especially in aged care, is still largely underexplored...”
“But we do know that respecting the dignity of aged care residents also includes affording them opportunities to take risks. Inhibiting residents from risk-taking to protect them from potential harm raises inevitable questions around whose risks are we seeking to limit, and at what cost to the resident’s dignity?”
The Royal Commission and the new Aged Care Standards surrounding the sector send a powerful message to the community that older Australians deserve to be treated “with dignity and respect; as individuals with their own identity, goals, values and preferences”.
Maria cites the example of George who wants to swallow his medication whole despite significant swallowing difficulties. His caregivers have helped him understand the risks, but George considers independence with his own medication management, including the right to take risks, as integral to his ‘dignity’ and quality of life in residential aged care.
It’s a complicated concept, and Maria is still grappling with the questions and the consequences. But she knows that while she’s considering the balance between the provider’s responsibility and the individual’s wishes, the dignity that comes from risk taking is
the key.
Eternally learning, when Maria was asked to join the Bethanie Board position in 2021, she Maria saw the opportunity to be a change maker from behind the scenes.
“Clinicians weren’t traditionally involved in aged care Boards, but the Royal Commission has re-set the framework, making space for clinical staff who care for older people on a day-to-day basis to have a say,” said Maria.
“It’s been great to be part of a revitalised thinking at the Board level – this is why we do what we do and we all have a role to play in the various aspects of governance – clinical, financial, and operational.
“I’ve been so humbled to be part of a group of people who care so deeply for the people we serve at Bethanie, and who take their responsibilities seriously.
It’s another opportunity for Maria to advocate for her patients, her residents, and for the people who deserve to be heard in the later part of their life.
“The Dean was right – I found the speciality where I could really connect with people.”
