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Aged Care Facilities

By John Hargreaves - 22 September 2014 3

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How many of us have really given much thought to the quality of services delivered in aged care facilities? I mean the quality of care in the nursing homes and lower care category facilities?

As I grow older and approach the time when “it could be me”, I start to reflect on this subject and notice articles about it.

Yesterday morning I heard a great program on the ABC about the standard of care, or should I say lack of it. There was also an article in the Crimes about funding cuts to the nation’s nursing homes.

Unless the deaths are spectacular or heinous, the stories rarely rate the news. However the two instances related yesterday on the ABC really related to the lack of quality of care not to some deliberate act.

The Crimes talked about the withdrawal of the $16 a day Dementia and Severe Behaviour Supplement on July 31 and the payroll tax subsidy for the “for-profit” sector in aged care.

This is an area where the Commonwealth has responsibility and the withdrawal of these subsidies is to be deplored. But it is not the only thing failing those folks resident in the aged care facilities.

All facilities have to be accredited and there is a federal complaints scheme in place. But complaining is about the past. Having appropriate process in place is about the present and the future.

Accreditation is also about the quality of the facilities such as supportive care services, access to recreational programs, infrastructure and dietary needs, to name a few.

Commonwealth funding is often dependent on the achievement of accreditation but that funding isn’t directly to quality of care, and how the individual needs of residents can be catered for.

One of the stories related to an older person being required to wear incontinence pads because there was insufficient staff to help with toileting.

I am aware of medication dispensing mistakes, probably because insufficiently trained staff were dispensing medication to a large number of residents. Proper training regimes should be mandatory for accreditation and funding but I question whether they are examined.

The two deaths described on the ABC yesterday didn’t need to happen. They just should not happen.

People don’t go into aged care facilities because it is a great thing for the next stage of their lives. They go there so that they can be looked after and be safe.

They go there because the families can’t look after them. Families are amateurs at this and sometimes older folks need professional care 24/7.

I’m putting this out because it disturbed me and I am looking for feedback. I might just look into the role advocacy groups and what information is available about the quality of care in aged care facilities.

Watch this space.

What’s Your opinion?


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3 Responses to
Aged Care Facilities
John Hargreaves Ex M 11:25 am 23 Sep 14

Daniel said :

My mother has been in a Home in Canberra for 6 years, the last 4 in High care. She is now receiving palliative care. Last year the Home was taken over by a large aged care provider from Sydney (if not national) that works to a successful (for them) business model. Since this change I have noticed that the level of care is lower, despite their spin on training and management priorities, but their emphasis on financial matters has grown. I hope I’m wrong but this decline appears even greater since they were unable to deduct the monthly fee from the $300,000 bond after she had been there 5 years.

The staff consist of some older born and bred Aussies with recent immigrants who do a great job in the circumstances. I admire their patience with the stubbornness and contrariness of some of the residents or with those affected by dementia. Like those who often call out to be toileted when there is no result. In an ideal world staffing ratios would be increased, but when do we stop?

And finally, at the risk of being labelled a mother-hater, when should a decision be made to minimise medical intervention? My mother has been in chronic pain as a result of a botched spinal operation almost 20 years ago. Despite being on strong painkillers, depression worsens, her life very much has been a burden and her time is spent waiting for God to claim her. That is very heart-wrenching to watch for children and grandchildren.

I am not saying this applies to most aged care residents, but it is not an isolated case. Everyone would probably benefit from a brave decision earlier in the march towards death, but it is frowned on by society. So who wins?

Daniel, all too common a story. I can only empathise with you from my own personal experience. It is frustrating and angering. What is also interesting is the lack of engagement in this post. If I launch into a savage attack on the Abbott government, there will be heaps of people engage and a conversation ensue. Not so with this most serious of issues.

These people are not there from choice. Families don’t place their rellies there from choice. But when they get there, can we be sure that they are treated with dignity? with respect? with “care”? And are they safe?

I don’t think so. But where are the advocacy groups? Where is the agitation for and on behalf of these folks? MIA….

Daniel 10:32 am 23 Sep 14

My mother has been in a Home in Canberra for 6 years, the last 4 in High care. She is now receiving palliative care. Last year the Home was taken over by a large aged care provider from Sydney (if not national) that works to a successful (for them) business model. Since this change I have noticed that the level of care is lower, despite their spin on training and management priorities, but their emphasis on financial matters has grown. I hope I’m wrong but this decline appears even greater since they were unable to deduct the monthly fee from the $300,000 bond after she had been there 5 years.

The staff consist of some older born and bred Aussies with recent immigrants who do a great job in the circumstances. I admire their patience with the stubbornness and contrariness of some of the residents or with those affected by dementia. Like those who often call out to be toileted when there is no result. In an ideal world staffing ratios would be increased, but when do we stop?

And finally, at the risk of being labelled a mother-hater, when should a decision be made to minimise medical intervention? My mother has been in chronic pain as a result of a botched spinal operation almost 20 years ago. Despite being on strong painkillers, depression worsens, her life very much has been a burden and her time is spent waiting for God to claim her. That is very heart-wrenching to watch for children and grandchildren.

I am not saying this applies to most aged care residents, but it is not an isolated case. Everyone would probably benefit from a brave decision earlier in the march towards death, but it is frowned on by society. So who wins?

curmudgery 6:12 pm 22 Sep 14

John – let’s not pretend. You know that health care in this country is rationed.

It’s rationed on the basis of value-for-money; return on investment.

A younger person with a serious chronic condition will receive quite a different degree of support than an older person with the same condition.

There are individuals and committees that covertly decide if expensive drugs will be made available for this category of person or that. Others decide on the level of funding for one service or another. And a prime criterion for these decisions is what the recipient is likely to contribute to the future.

What that person has contributed to the past – they paid rates and taxes, fought wars, raised a family through the country’s social and financial ups and downs and all the rest of it – is largely set aside; consigned to history, diminished and devalued. They no longer contribute to the GDP or the Treasury: they’re on the ‘wrong side of the books’.

Consider this policy: for the last Olympics the Government OK’d $310 million dollars so that a minuscule percentage of the population could indulge themselves ‘chasing gold’: $8.85 million dollars per medal – and some of them are still dining-out on it.

I’m not against the Olympics or sport; it’s just an example of policy. But considering the state of aged care in Australia, is it a reasonable policy and use of public funds? (I am warmed by the thought that those who excuse such policies and mis-allocation of public monies will get older.)

John, the shortcomings you refer to in your post only exist because, under our system of rationed health care, the residents are no longer considered worthy of anything better.

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