A Productivity Commission draft report into caring for older Australians recommends a rethink on how aged care facilities are funded and how residents pay for their accommodation.
Australia’s aged care sector is already overstretched, the report found, with 3.6 million Australians expected to rely on care facilities by 2050. Only reform can avert an imminent crisis, Council on the Ageing CEO Ian Yates told ABC Radio today.
“The general directions are consistent with the submissions that we’ve made and will result in improved choice for aged care consumers, for better services, for more equitable funding and for an aged care system that’s going to be sustainable for the next 25 years,” he said.
With the final report to be released in June, after some 487 submissions, Crikey brings you some of the highlights:
The daughter of Bob and Hazel Hawke believes there is not enough knowledge about dementia, a disease that has been stigmatised and is viewed negatively due to societal attitudes. She said there is a disparity between “good dementia care practice, and most current practice”. Pieters-Hawke wants a rethink on aged care facilities and practices, calling for the Commission to ensure systems allow for best-practice in dementia care that is affordable for all Australians.
CEO Jack Barker is proposing a rebate system similar to that of the Child Care Rebate, but for elderly Australians who can no longer cook for themselves, but do not want to be moved to an aged facility. The rebate would be run through Medicare to subsidise the services which would “curb the ever growing demand on the hospital system and high care nursing facilities”. TLC argues these meals would improve the quality of life and alleviate the cost of living for elderly Australians.
This support group argues that GLBTI ageing issues have been neglected by research and action around ageing — including a lack of training for those working in aged care. In the submission there are a number of letters and documents which say even though same-s-x couples are recognised in pension arrangements, many now fear being outed due to the torment and violence endured as younger years. The submission urges to have cushioning for “vulnerable old people” who fear coming out in their aged care facility.
The National Rural Health Alliance
According to the Alliance, elderly Australians in rural areas are finding it difficult to access service providers, and believes the Gillard government’s National Health and Hospitals Network proposal for a one-stop shop for information about aged care is a step in the right direction. They note this will help older people and their families navigate a complex system, but have concerns for others who do not have family, a health professional or community worker to help them. The Alliance believes mobile services in rural areas would assist these people. The Alliance also believes in greater flexibility and quality of life options for older Australians in rural areas, in care and education.
The Royal Australian and New Zealand College of Psychiatrists
RANZCP is particularly concerned with ensuring the models for care are evidence-based and integrated into any reform. Its focus is on management of dementia through detection and recognising behavioral and psychological symptoms of dementia or BPSD, such as psycosis, depression, agitation and aggression as they are a leading factor in the stress of carers. The RANZCP also recommends personalised care, integrating the carer and patient for more effective treatment.
Sue Pieters-Hawke is spot on about ignorance concerning dementia, but it isn’t just the community which fails to understand it. I have found that the doctors don’t really understand it, either. That isn’t just the GP. It also includes the geriatrician and the neurospychologist.
Dementia is a chronic illness but any spouse/ carer can attest to the fact that there are plenty of acute flare-ups which require urgent help. Such help is unavailable. ACAT responds months later, after the crisis has passed.
The present system treats the spouse/ carer very shabbily. The doctors only see the demented patient dressed and well-presented in their clinic and they fail to realise what the spouse/ carer had to do to make it happen. They tend to disbelieve what the spouse/ carer tells them about the dementia patient.
The spouse/ carer has lived with the dementia and formed their own presumptive diagnosis several years before the medical experts find the MRI evidence. Those years are hellish and soul-destroying.
Diagnosis is supposed to rest on history, physical examination and tests. Why do modern doctors pay such little regard to history?
Why, John, do “modern” protagonists for the ever-increasing range of various worthwhile causes they support [when their goals involve obvious spiralling costs] “pay such little regard to history”?
Financial disaster may develop sooner than we want to think.
I will own up straight away that I am employed in a large Aged care Facility that specialises in the care and treatment of people with behavioural problems.
I endorse Johns comments regarding the paucity of support, and the aggressive lack of compassion and understanding, that the current State & Federal Governments actively exploit so as to avoid responsibility for the most precious asset this country has.
The same outstanding lack of care and understanding and respect for Johns input regarding the day to day, 24 hour detailed history that he can provide to his GP, specialist and, no doubt, the staff in the emergency department of the local hospital, is now, as you suspect, being taught to the next generation of health care employees.
Did they ask you for an advanced care directive before they would treat your loved one? They do at our local and Metropolitan Hospital.
It is a disgrace. The whole system is a disgrace. The only people who see any value at all in our Aged are their families and the not for profit nursing home operators who can afford to run at a loss. It is a disgrace.
I had a specialist physician lecture me for over an hour, (during my personal cardiology examination!!!), about my patients taking up his beds in his hospital. He also told me that his Son, who is in his last year of at Medical School has been taught, among other things, not to commence the “Cascade of Care” that the presentation of a nursing home patient triggers when they present to an emergency Department.
Yes they need to look at the disgraceful politically created and driven complaints mechanism farce and the uneven playing field for profit vs non profit and the ACFI funding tool. The potential for abuse that the ACAT tool presents
Yes they need to look at “Accreditation” and unannounced, peculiarly named, “support” visits. Yes they need to justify the ridiculous amount of paperwork that is never looked at, never tested and is driven by funding and not resident care to satisfy statisticians.
Why do they purposely force my highly skilled, irreplaceably experienced, compassionate old and tired Registered Nursing Staff staff to resign in frustration and disgust at the lack of
money, support, respect and wages.
This review has gone on for years and Warren Hogan will be an aged care resident himself before the most important parts of his reforms are politically able to be considered.
I salute you John. We spend 90% of our time counselling the carers; I always tell them that we have three shifts and many people to try and provide the same care that he has done by himself.
Jeez there’s and irony; John is probably the only person in this game that gets paid less that we do. He gets nothing and we get next to nothing.
Holland has, for the last 5 years, had dedicated ‘aged homes’ for junkies and other long term substance imbibers.
It would seem to be a indigenous employment growth area, not easily shipped O/S, as the boomers wilt with the vast majority of assets, real & monetary, in their clammy grasp.
We won’t be wanting Vera Lynn & Hogey Carmichael, more likely Oils, AC/DC and Beatles, porn DVDs and strapping male (or female, ’twas ever so) attendants tominister to our needs.
Seems like a win-win to me, unlimited employment for the otherwise useless Gen Wotevers, gradually asset transfer and, who knows, maybe some shift in the euthanasia regulations to let those who wish slide out on heroin, or acid (like Aldous Huxley) or Chivas Regal.