Meeting Residents’ Expectations in Aged Care Homes

As an Aged Care Placement Consultant I find  clients always ask me about two main issues. The first is staff ratios, which has become a hot topic in aged care. This is a difficult question to answer since the introduction of Ageing In Place, because most Aged Care Homes now have a mixture of high and low needs and staff numbers are rostered according to care needs and work load at any given time. I find the most helpful question to ask of an aged care facility is the availability of Registered Nurses on each shift, including overnight, as well as the availability of Doctors on weekends and overnight.

The second most often asked question is about the quality of food, which is another big issue in aged care homes.  I can understand why it’s so important. Apart from the nutritional value, food plays a major role in the daily life of a resident. The anticipation of meals is an important focus and having a good feed leaves them satisfied. Everyone enters a home anticipating the food will be up to standard and palatable; some are disappointed at the quality, while others find the meals delicious.

Earlier in my career when I worked in Aged Care Facilities I was amused that it was often the people who had lived alone surviving on toast or crumpets who complained the most about the food. I would hear the complaints the Chef received and they were often contradictory, some thought the soup too hot, some too cold, some found the gravy too thick, some too thin. I realised how difficult it was to deliver meals for such a large and diverse population, also taking into account medical conditions, and still please everyone. I can assure you there are many residents who do enjoy their food.

In my experience, the people who choose to enter residential aged care and embrace their new lifestyle thrive and are mostly content. It is a big challenge for providers of aged care facilities to meet the expectations of residents and their families. I seek aged care facilities for my clients that suit their needs and will deliver quality service.

 

 

New Aged Care Facility in Greensborough

 

Trinity Manor Greensborough frontAs an aged care Placement Consultant I am, at times, invited to visit new aged care facilities prior to their opening. Recently I was invited to visit Trinity Manor Greensborough to view the facility before it opened its doors to residents yesterday (16th May, 2019).

Trinity Manor Greensborough reception

There are 112 beds, including 12 in the Memory Support section for those living with dementia needing a secure and safe environment.  They offer these residents a specialist dementia care support program. All residents have access to care by qualified registered division 1 nurses, available 24 hours.

The chef prepared a lovely lunch for me so that I could sample the standard of meals that will be served to the residents. They will have a plentiful supply of food throughout the  Trinity Manor Greensborough meal

day, with a continental and hot breakfast followed by a main meal at lunch with offerings such as Rogan Josh, roast leg of pork with apple sauce, crumbed fish and beef and shiraz pie served with a varied range of vegetables daily followed by desserts such as mango panna cotta and apple strudel. A soup is served in the evening followed by a light meal and dessert. Cakes, devonshire tea or biscuits are served at morning and afternoon tea and supper.

It was intriguing to see a robot in action in an aged care facility; its role is to take the load from carers and kitchen staff. Able to deliver to rooms and various departments, the robot accesses the lift to reach different floors.

Trinity Manor Greensborough robot 2

The robot stops when a resident is near and plays music as it goes along. In my role as a Placement Consultant I have to confess this is the first time I’ve seen a robot in aged care. The facility is using the Lamson Robo, which is easily operated with an IOS mobile app, allowing the operator to call and send the robot via a mobile device. Whilst I was visiting they were mapping the building with the robot. The new residents will be involved in naming the robot, with a competition for its name.

The facility has many great features, with a hairdresser,

Trinity Manor Greensborough haridresser

massage room, gymnasium, cinema,

 

private dining rooms for family meals, outdoor bar b q, multiple dining and lounge areas and balconies and terraces off rooms. The décor and furniture is all modern and tasteful.

Aged Care Service Not Age Friendly

elderly lady at home

Extraordinarily, Australia’s aged home care sector has come under some strong criticism for not being age friendly according to a report from the University of South Australia . Older Australians have been left feeling disempowered and lacking in confidence due to its complexities. Research explored the ability of people aged 65 plus to select and financially manage their home care packages;

“Home-care packages support people to stay in their own homes for longer, so they are a really appealing option for people as they age or become less independent,” said lead researcher, Braam Lowies “But our research found that older people felt insecure about their capacity to manage home-care packages to their best advantage and we wanted to understand why.”

What they found was that, although the government had recently increased total aged care spending to $662 million, including the release of 10,000 additional home-care packages, the environment in which the packages are provided was so complicated that many older Australians were unsure of which options best suit their personal situation.

Clients of mine are currently dealing with this very situation. A 96 year old couple are in need of support, having stayed independent until this year. The husband had a bad fall and is now in a rehabilitation unit and will probably need my help as a placement consultant to find accommodation in an aged care facility. However, his wife is keen to stay at home with support. She has found she needs help from her family to even begin the first step of applying for assistance. Without their support she would not be able to access the service on her own.

“We found a host of problems from a general lack of confidence and lack of knowledge of the system among older people, to overly complicated communications, high staff turnover and inadequately trained staff providing in home care, inconsistencies in package administration, confusing fee structures and even inaccurate billing processes” Dr Lowies said “Unfortunately, the more complicated and inaccessible the programs are, the more it creates a lack of confidence and motivation for older people accessing services.”

The banking and finance industry was also examined in the Financial Capability of Older People report and it came in for criticism too for not being age friendly.

 

Montessori Method Helps Those Living With Dementia

7WaysMontessoriDementiaPatients

American Montessori expert Dr. Cameron Camp has developed a new approach to caring for persons living with dementia. This new approach is known as The Montessori Inspired Lifestyle ® (MIL). It is based on the philosophy and methods of Dr. Maria Montessori, the first female M.D. in Italy and world-renowned educator.

“Within this new paradigm, abilities, interests, and preferences will be respected, encouraged and maximized. Providing choice throughout the day is central to all interactions.” Said Dr. Camp “Central to MIL is the creation of meaningful activities and social roles within the context of a community. This helps to ensure that residents are engaged in life, have a feeling of belonging, have a sense of purpose, have access to meaningful activity, and can have a sense of control and independence.”

Having done a 3 week course with Omnicare Alliance to learn about Montessori and apply the principles and methods in her own home where she resides with her husband who lives with dementia, Susan was blown away by his progress.

“We have a bunch of signs around the house with cartoon pictures for Jim now that ask him questions. ‘Have you taken the bin out?’ or ‘Do you have your house keys?’ she explains “This actually gets him to think and engage with himself which is a big part of learning.” She has realised that if she communicates in a simple way with her husband he will understand and be able to help with chores. Rather than tell him to cut carrots into cubes, for example, she now models instructions, showing him how she wants them cut. He is then perfectly capable of carrying out her request.

The Montessori Method utilises simple, modifiable and practical tasks that utilise everyday items to re-engage individuals and help to retrain skills that may have diminished due to dementia. A person’s abilities are closely tied to their life experiences and passions, and identifying these passions and harnessing them to rekindle and engage a person is the essence of what makes Montessori training and learning effective. For instance, if a woman grew up playing the piano, music may be the key to her learning and engaging, but if she enjoyed gardening instead, then heading outdoors and incorporating seeds and plants into her activities, may be the key in helping her rediscover some old skills.

As an Aged Care Placement Consultant I would love to see this method used in more aged care facilities. With the current strong focus on the quality of care I hope providers are taking note of Dr. Camp’s new approach.

 

 

ACAT Assessment and Specialist Dementia Care Program

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ACAT Assessment

The Australian Government Department of Health has in recent times received a number of enquiries from providers of aged care about when an Aged Care Assessment Team (ACAT) assessment is required. The department states that “A subsidy cannot be paid to an approved provider for providing care to a person, unless the person is approved under the Aged Care Act 1997 (the Act) as a care recipient.

An ACAT assessment is required if a person is seeking access to aged care services that are funded under the Act, such as:

  • Residential Care
  • Flexible Care in the form of Transition Care or Short-Term Restorative Care
  • Residential Respite Care
  • a Home Care Package. “

 

New Initiative Rollout 2019

One of the Department of Health’s new initiatives – the Specialist Dementia Care Program (SDCP) is beginning to roll out.

This program will provide care for people exhibiting very severe behavioural and psychological symptoms of dementia (BPSD), who are unable to be appropriately cared for by mainstream aged care services.

The SDCP will offer specialised, transitional residential support, focussing on reducing or stabilising symptoms over time. I have, at times, been in the position of finding suitable accommodation for people exhibiting behaviour that cannot be managed in the aged care residential service in which they reside. It is a difficult situation and, as an Aged Care Support Consultant, I applaud the introduction of specialist services to accommodate people in this position.

The department has advertised a targeted grant opportunity for a prototype SDCP service, with the next round of 14 SDCP grant opportunities to be advertised early this year. This first phase of specialist dementia care units is expected to be operational in early 2020 with a full rollout in 2022-23. It is expected that there will be at least one specialist dementia care unit (within a broader residential aged care service) operating in each of the 31 Primary Health Networks.

One of the objectives of the SDCP is to generate evidence on best practice care for people exhibiting very severe behavioural and psychological symptoms of dementia that can be adapted for use in mainstream settings to benefit all people with dementia.

Source: Australian Government Department of Health website.

 

New Aged Care Facility in Box Hill

Bluecross Box Hill-gardens.jpg

Bluecross opened its newest aged care residence in Box Hill on October 22nd amongst much fanfare and a family open day with radio broadcasts, Mike Brady, games and a sausage sizzle. I had a quieter intro to this facility, being an Aged Care Placement Consultant I was invited before the opening for a preview.

The residence boasts a host of world-class facilities, including several lounges, dining and sitting rooms, activity areas, consultation and treatment rooms,

a library, hairdressing salon, private dining room, as well as a gymnasium and cinema .

I was impressed to learn they have a memory support environment for people living with dementia. With more people developing this condition as the population ages I am often called upon to find a suitable environment for my clients living with dementia.

The residence is designed with an emphasis on a homelike environment for residents, despite its state-of-the-art facilities according to Interim Chief Executive Officer Robert Putamorsi.

Bluecross Box Hill-suite

The different functional spaces like a number of smaller sitting rooms and dining areas make it more homely and a private dining room is available for residents who want to share a family meal with their relatives. The bedroom suites are generous and feature kitchenettes.

Comprising a basement and three levels, stage 1 boasts 173 rooms and another 43 rooms will be added in the stage 2 development in 2019. $64million was spent on the residence as it becomes part of the stable of 33 aged care facilities owned and managed by Blue Cross across Victoria. With a growing demand for high quality aged care homes in Victoria I welcome this new addition as I source suitable aged care residential places for my clients.

 

The Benefit of Pets in Aged Care Homes

The Animal Welfare League of Australia has undertaken a survey of aged care facilities and so far 90% of respondents to the survey have stated that having pets at the facilities is either very or vitally important for residents. As I source appropriate aged care facilities for my clients I sometimes receive requests for pet friendly aged care homes and found this report very relevant.

Directors of successful pet–friendly aged care facilities report that pets contribute to community feeling, encouraging friendships between residents. One of the benefits to the pet owner is the social interaction with other residents and staff as they stop to introduce their pet.

The Directors say that complaints about pets have been minimal where clear guidelines were adopted and expert community volunteers have provided the needed support and advice to pet owners. The overall benefits to residents who are bonded to their pets when they can reside with them in the aged care facility should not be underestimated states the AWLA. Residents who have a strong bond with their pet and are unable to have them stay experience profound grief, which is layered on their sense of sadness and loss when adjusting to moving from their own home into an aged care facility.

Studies on pet ownership have shown very positive outcomes. Researchers in a US study conducted in 2011 found that pet owners experienced greater self-esteem, had healthier personalities, were less fearful, depressed or lonely and were happier than people without pets whilst a German/Australian study in 2017 found that pet owners were physically healthier than those who did not currently own a pet. Some of the health benefits proven for pet owners are lower blood pressure, lower stress and better survival after a heart attack. Compelling reasons for residents in aged care facilities to keep their pets.