Member Profile: Bernadette Milsted

5 September 2023

Currently in part-time private practice, Bernadette is a member of PACFA’s Older People Interest Group, which advocates for recognition of older people and promotes good practice among counsellors when working with them.

She holds a Masters in Couples and Relationship Counselling, Grad Dip (Counselling) and BASc. Her clinical practice includes grief and loss, trauma, relationships, anxiety and depression, group work, life transitions and end-of-life preparation.

Bernadette has been practicing as a professional counsellor for over 25 years. Prior to that, she was in Pastoral ministry. She has recently retired after 10 years with Dementia Australia where she provided counselling, support and education for people living with dementia, their families and support networks.

For the Member Profile, we asked Bernadette a few questions about the growing fields of palliative care, dementia and aged care.

Bernadette Milsted presents ‘Understanding Dementia: Why is it important for clinicians to know?’ on 14 September, from 7:00pm-8:30 pm.

What led you to specialise in Aged Care, and what unique challenges and rewards does this area of counselling present?

I found myself feeling more and more comfortable with clients dealing with grief and loss (although I believe this is at the core of all issues that are presented in counselling). I went on to develop my skills and training in this area and my last role at Dementia Australia certainly knit my diverse experiences into a rewarding skill set.

I think, as I age (I’m in my mid 60’s now) I have both lived experiences and opportunities to hear the stories of friends and families and I am becoming more aware of my own future planning needs.

In your extensive career, what are some of the most common challenges or issues that individuals seek counselling for in the context of Palliative Care and Dementia?

Some of the most common challenges are the poor understanding and limited experience of, loss and grief in our society as a whole. I am always astonished by how many people have not put much thought into their own aging or mortality (I had a 96 year old client who asked me how long he would live following his recent diagnosis of dementia).

There is also the fear of the unknown and lack of general education about loss and grief, particularly as we age. There is much ignorance of what we would call ‘anticipatory grief’ and the ripple effect of apparently small losses and their accumulation.  Also, as we age, many of our regular supports are also missing, often through death itself, illness, moving into aged care, inability to drive or mobility issues—and these are losses in themselves.

What are the key qualities or skills you believe are essential for a counsellor to be successful in this field?

Key qualities would be patience and excellent listening skills, as a good counsellor in this area needs to understand the person’s context and story. Providing a safe place and sitting with sometimes a messy narrative. It is also important that you have a good understanding of both normal and complex grief and be able to provide psycho-education to clients.

What advice would you offer to aspiring counsellors looking to specialise in areas like palliative care, dementia, or aged care?

For many clients, life experience and even your age can be important. In this space, being ‘older’ can be an advantage as clients may  interpret ‘age’ with life skills and experience, so it is  important to back it up with relevant CPD and training, and knowing your own grief experiences and triggers and getting good supervision. Having an awareness of the Aged Care system (which is very complex and always changing) is important too as this can be a complicating stress for many people and families. 

Why was it necessary to establish an Interest Group specifically focused on older people? What unique challenges or needs do older individuals face that warrant such a group?

I have only recently joined the Older persons interest group, which was set up by Caroline  Romero, with a focus on advocacy in the aged care space and better access for people as we age.  For myself, I think there is also a need for more opportunities in training and education for us working in the field as well as peer support and networking opportunities. These I hope will continue to develop under PACFA’s support. 

This demographic has unique challenges as their regular support networks dwindle, their own agency may deteriorate due to health or cognitive decline and Aged Care services become more complicated and difficult to navigate, where people ‘fall through the gaps.’

Even if you are not working with an older client, often family members are, and they can be presenting with stresses relating to their own family in counselling.

My experience has been quite diverse over the years, having worked in community and NFP agencies, including a time as Director of Karinya Counselling Centre at Syndal Baptist, as well as higher education of new counsellors.

As I adjust to my semi-retirement stage in my career, I find I am becoming more engaged in my role as a supervisor, mentoring and encouraging newer counsellors in the profession. I am passionate about supporting other counsellors in professional and ethically sound practice and delight in the shared learning in our supervision spaces.

Click here to register for ‘Understanding Dementia: Why is it important for clinicians to know?’