• Charles Sturt Dr Belinda Cash continuing push for better services for older residents
• Researcher is Deputy Lead of Charles Sturt’s newly-formed cross-faculty Ageing Well Research Group
• Dr Cash will present her research at the Australian Association of Social Workers Rural Social Work conference this month

Australia’s older residents, particularly those living in rural areas, have a strong and committed advocate in Charles Sturt University (Charles Sturt) lecturer Dr Belinda Cash.

The social work researcher has dedicated her academic and professional life to investigating the issues around the health of older adults in rural communities, with a particular focus on the supports that are available to those who choose to stay in their rural community as they age.

Dr Cash lives at Yackandandah, in a quiet corner of north-east Victoria, having spent most her childhood in the small town of Heathcote, near Bendigo.

She was 17 years old when she undertook a Bachelor of Social Work at La Trobe University in Wodonga.

“I see myself very much as a rural person,” Dr Cash said. “It is something that is inherent to me, who I am and how I live.”

That rural upbringing, paired with some of her experiences, steered her towards the field of social work.

“I come from a fairly low socio-economic background and I’d seen a lot of people involved with social workers over their lifetimes and the different ways social workers had helped them,” explained Dr Cash who began doing some sessional teaching with Charles Sturt’s School of Humanities and Social Sciences in 2014.

“I spent a week of my school work experience in a solicitor’s office contemplating studying family law, and another week working with Greenpeace, protesting and learning about social action.

“Social work was the perfect balance between my passion for social change and the need for a profession that would pay the bills.”

After graduating, Dr Cash spent about 10 years in practice, mostly with Wodonga Community Mental Health, as well as stints in disability services and some project work in government departments.

It was at this time that her passion for rural health supports was ignited.

“For most of my clinical career mental health was my passion and I travelled a lot to Corryong, my outreach area, to provide outreach services for many years,” Dr Cash explained.

“We were working with people living on farms who were struggling to access support, and I leaned that policy and funding just didn’t allow for geographic distance; it didn’t allow for people who weren’t in a place where there were lots of services to choose from.

“There was one health service and it was the only option they had, and my frustration with that was part of what informed my shift to academia really.”

While working as a social worker Dr Cash did her Masters of Mental Health with the NSW Institute of Psychiatry, while also undertaking a research stream looking at how clinical practice could be changed to be more recovery-oriented.

“People were changing their language but not meaningfully changing what they were doing in practice,” Dr Cash said.

“My master’s gave me a taste for research and I really enjoyed it.

“So instead of being a rural practitioner who drove up to Corryong once a week, I found a way I could broaden the way I could make change beyond the individual.

“I could see a way I could start to influence communities and policy on rural health at a different level.”

In 2007 Dr Cash had twins (a boy and a girl), and 18 months later she received a phone call from La Trobe University asking her to do some casual lecturing which led her down the path of academia.

Within a couple of months she started doing the field education co-ordination for social work, placing students in the local area.

In 2011, she enrolled to do her PhD with La Trobe University, delving into a study of ‘the impact shifts toward more consumer-directed approaches to aged care was having on informal caregivers in rural areas’.

“There have been a lot of changes in aged care policy to try and encourage older adults to be more independent and more in control of their own care needs in later life,” Dr Cash said.

“My specific interest is what happens to people living in rural areas where there are limited formal services, and what that means for family, for care-givers, for partners who are providing the majority of support to older adults.”

Dr Cash’s PhD research looked specifically at couples where one partner is providing care at home for the other.

As well as talking to couples, she ran a series of focus groups with many of the health services in north-east Victoria to gain an understanding of how they were working with informal care-givers.

“In a system that focuses on consumer-directed care, what happens to the unpaid family members who are actually providing most of the care?” Dr Cash asked.

What she found was that there is not enough consideration of rurality in policy.

“One of the big things that came out of my research is that funding for aged care, such as for home care packages, doesn’t consider geographic distance,” she said.

“So a lot of people who live in rural areas receive less services because the funding they have has to be used to pay for travel.”

That financial discrepancy can have a profound impact, even at the most basic level of care.

“It can mean the difference between someone having help to shower only once or twice a week compared to four times a week for people in town centres,” Dr Cash explained.

“It really creates a huge inequality for older adults who choose to stay in rural areas, and for me that’s a social justice issue and we shouldn’t be OK with that.

“We are such a big country and a third of our older adults live in rural areas, and they deserve to have access to services that take into account geographic limitations.”

From a service perspective Dr Cash said that while policy talks about consumer choice, in reality there is quite often only one choice, or no choice at all, for older people in rural areas.

“I find it interesting that there’s been this major reform in aged care but so little of it has considered what it looks a like in practice, particularly in rural areas,” she said.

Most of her research to date has been around her PhD, which she completed in 2018, and ‘translating’ that research is starting to pay dividends in the field.

“I don’t like the idea of having research that sits on the shelf,” Dr Cash said.

“I have recently been working in a really innovative program to teach leaders of health and aged care services in north-east Victoria, which is helping to get our knowledge back into practice in local organisations.”

Developed by her Charles Sturt colleague  Ms Robin Harvey, the Leadership in Healthy Ageing program combines knowledge from Dr Cash’s PhD and Ms Harvey’s extensive knowledge in social gerontology; while also drawing on the expertise of Dr Kathleen Brasher, who leads the Building of an Age-Friendly Indigo Health System project.

“These kinds of partnerships and education innovations are a great chance to turn some of our research into reality,” Dr Cash said.

She is Deputy Lead of Charles Sturt’s new cross-faculty Ageing Well Research Group, which started in the past six months, and includes some 30 academics, including Professor Marguerite Bramble from the School of Nursing, Midwifery and Indigenous Health, and Dr Melissa Nott from the School of Community Health.

“It’s a fantastic opportunity as an early-career researcher to be able to work in this space with some of the more senior researchers in ageing here at Charles Sturt,” Dr Cash said.

She is also President of the Australian Association of Gerontology Student and Early Career Group, which she identifies as an “opportunity to support new researchers and practitioners as they build their careers in ageing”.

“Being involved on the national executive of such a great professional association has given me so many opportunities to work with leaders and emerging researchers in gerontology over the past eight years,” Dr Cash said.

Another research activity under development that she is involved in is a project with Dr Wes Ward at the Charles Sturt Institute for Land, Water and Society “on the United Nation’s sustainable development goals and how Charles Sturt and the rural nature of our University is achieving some of these”.

Dr Cash will present her research at the Australian Association of Social Workers Rural Social Work conference in Horsham (Thursday 25 to Friday 26 July).

She will also deliver a public lecture on her work at Charles Sturt University in Albury  during Social Sciences week from Monday 9 to Friday 13 September.