The Australian Law Reform Commission on the Enquiry into Elder Abuse with regard to Aged Care found that two of the areas highlighted by stakeholders needing improvement were transparency and accountability. As an Aged Care Placement Specialist these recommendations are especially critical to my clients, who are moving into aged care facilities. The Commission is recommending that aged care providers be required to report certain types of abusive conduct, which become ‘reportable incidents’, to the Aged Care Complaints Commissioner with the Commissioner’s office taking on an oversight and monitoring role of the aged care provider’s response to the incidents of abuse. This complements existing functions of the Aged Care Commissioner and enhances safeguards, improving responses by the aged care providers.
Stakeholders also wanted enhanced employment screening for people working in aged care and looked to the working with children checks as an example. Currently aged care workers are required to have a police check, but the Commission noted that not all workplace conduct that could be of concern will be identified in a police check. The Commission proposes that any findings made against a worker from the ‘reportable incident’ scheme and other disciplinary findings, would be ‘flagged’ when a person applies to work in aged care. It also proposed that unregistered aged care workers, such as assistants in nursing and personal care workers, be subject to a code of conduct, bringing them into line with professionals such as Doctors and Nurses already subject to codes of conduct.
Another area for reform that was raised by stakeholders was in relation to restrictive practices or interventions that restrict the rights and freedoms of movement of a person. The primary purpose of using these practices is to protect the person or other people they are around from harm. Some of the practices reported were people being locked in a room or ward, physical restraint like clasping or holding a person’s hands or feet together, mechanical restraints such as being tied to beds or chairs and chemical restraints such as sedatives. Of concern was that restrictive practices are sometimes used as a means of coercion, discipline, convenience or retaliation by staff or other support people. They are most often used on people with an intellectual disability or cognitive impairment who exhibit what has been described as ‘challenging behaviours’ (eg: striking themselves or others or wandering). The Commission concluded that the use of these practices can be abusive at times.
The Commission proposes that these practices be regulated through a legislative framework that would apply to residential aged care. They should only be used to prevent physical harm, and only to the extent necessary to prevent the harm and before enacted require the approval of an independent decision maker, such as a senior clinician, and that the practice only be used as prescribed in a person’s behaviour management plan.
The Commission is now taking responses to its recommendations and final proposals will be published in August 2017. In my role I inspect many aged care facilities and most are well run with the residents’ best interests at heart, so I look forward to seeing these reforms that will help to ensure that all facilities treat their elderly residents with the utmost care and respect.