Changes to Increase Quality of Aged Care

Patricia Sparrow of Aged & Community Services Australia (ACSA) has expressed concern about the protocols for hospitalisation of residents of aged care facilities who contracted the Covid-19 virus. In a recent article in Hello Care magazine she was quoted as saying

“Since early in the pandemic ACSA has been calling for a change in hospitalisation protocols for aged care. We want to see governments mandate that the first residents, or index cases, who test positive for COVID-19 be transferred to hospital as a matter of course. Only South Australia and Queensland have adopted the policy that ACSA believes, and international evidence supports, Australia must take forward.”

As The Department of Health announced the ban that prevents Victorian aged care staff from working across multiple facilities has been extended for one month from 25 September 2020 to 26 October 2020 and may be extended further, Patricia also commented that

“There wasn’t enough support, and that support wasn’t timely enough, to ensure that staff were able to take time off or isolate if they had the slightest COVD-19 symptoms. Support and appropriate payments for leave need to be in place for all staff so they don’t need to worry about how they will pay the rent or feed their kids.

She said that the COVID-19 pandemic also exacerbated workforce concerns that the industry has been raising with governments for years. She suggests that the one worker one site initiatives be evaluated, including ensuring that workers are not financially disadvantaged. She noted that during the pandemic it has become even clearer that there is not enough staff in aged care and more need to be trained and recruited. She feels it is time for the government to properly invest in a larger and more robust aged care workforce.

The ban was first put in place on 27 July with the aim of reducing the risk of COVID-19 spreading among aged care residents and staff. The government pays the staff their usual wage but the providers must apply for a grant to receive the monies.

In a Report by Caroline Egan in Hello Care Magazine about complaints the Aged Care Quality and Safety Commission received, she stated that a total of 2,199 complaints in the three months to June 2020 were received, an increase of 800 more than during the previous quarter.

Of those it received 340 complaints about infection control and 270 complaints about communicating with family. In the midst of these complaints, the Commission conducted 782 assessment contacts in the quarter, but no sanctions arose from those contacts.

The Commission put unannounced audits on hold during the June quarter, and instead conducted ‘short-notice’ inspections of aged care homes, with providers given 24-48 hours’ notice.

During the June quarter, the Commission issued three ‘notices to agree’, which set out certain actions a provider must take within a set timeframe. These include the appointment of an independent adviser to provide direction and advice to address any non-compliances and to immediately implement and comply with all advice, recommendations and directions of Victorian local health authorities. Providers are also required to give close, ongoing attention to keeping residents and families informed about the regulatory actions.

With the strong focus on the quality of aged care provision during the Royal Commission into Aged Care Quality and Safety it is hoped the industry will see changes for the better and more ongoing support to the sector in the near future.

How To Fund Aged Care

The Royal Commission into Aged Care & Safety is presently looking at how to fund the future of aged care. With an increasingly ageing population as baby boomers advance in age the demand is set to grow.

Former Treasurer Mr Keating

proposed a scheme similar to the HECS scheme he introduced as Treasurer for university pupils, whereby the government provides a loan to cover university fees, to be repaid at a later date when the pupil graduates and earns the threshold income. In the case of a person needing aged care he proposes the commonwealth government provide a loan which covers costs for home care support or moving to an aged care facility. This loan would only be repaid from the recipient’s estate upon their death. Mr. Keating stated that this scheme would help reduce the long wait times for the elderly waiting on home care support.

Former Treasurer Mr. Costello

told the inquiry that income and assets tests should be part of future funding arrangements, but need to be simplified. He admitted he had trouble filling out aged care forms for his family.

“You all ought to do them you know, I think there are over 120 questions and 27 pages — I had a lot of trouble filling it in,” he said.

As a Placement Consultant,http://www.oasisagedcaresolutions.com.au/about.html assisting my clients to find suitable aged care accommodation, I find many have the same trouble filling in the forms. As part of the service I provide I fill in the forms for my clients when they are applying for a place in an aged care facility. My clients and their families are very grateful for this assistance.

Treasury secretary, Ken Henry

also addressed the inquiry,expressing similar sentiments.

“The system overall is horribly complex and it contains a very high level of uncertainty for people who are elderly, people who are vulnerable, people who are suffering emotional and psychological stress … and they’re bewildered” he said.

He stated he had long felt the system was underfunded, unsustainable and under resourced and that the baby boomers would not stand for it. He suggested a special levy earmarked to cover the expected increase in demand for aged care leading up to the peak in 2030.

The Association of Aged Service Professionals (AASP)

https://www.aasp.org.au/home/

also made a written submission to the Royal Commission. Their submission was specifically in relation to the MPIR, the Maximum Permissible Interest Rate that can be applied as a daily converted amount (Daily Accommodation Payment – DAP) in relation to the advertised/negotiated cost of accommodation. With the fall in interest rates this amount has reduced from 6.69% in 2014 to 4.89% as at 30th June, 2020. With many residents now deciding to pay daily, the effective reduction in cash flow to facilities is becoming significant.

The Association recommended that the Minister, in order to ensure the viability of the sector, use his authority to review a revision to the current method of calculating the MPIR.

Counsel Assisting

Arising from consultations, has recommended the appointment of an independent “Aged Care Pricing Authority”, responsible for care and other costs.

I am President of the AASP and fully support their submission. I sincerely hope to see effective changes to the current funding arrangements arise from the enquiry. All Australians deserve to be assured of quality and timely aged care support in their later years.

Jillian Slade Consultant in Aged Care Placement

Roller Coaster Ride Placement in Aged Care

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Since earlier in the year when Covid-19 made its way to Australia it’s been a roller coaster ride in my job as a Placement Consultant for Aged Care Accommodation. In Melbourne all went quiet with families tending to keep their loved ones at home during the original lockdown in March and April and then it got very busy when restrictions were lifted in mid May. I was suddenly fielding multiple enquiries and arranging tours again as most aged care facilities had recommenced showing their homes to potential residents. They had also relaxed the isolation period for residents entering care on either a permanent or respite basis. Then lockdown restrictions were again enforced on 9th July.

Up To Date Information

Gathering information for my clients about care and fees for each aged care facility and arranging tours (when available) has became more labour intensive as each facility has different procedures for touring and admissions during these restrictions.  As the health restrictions change so do the facilities’ procedures, making it an ongoing task. For prospective residents it is very difficult to navigate and they rely on my gathering the correct information and providing advice.

Of course they wonder if the different procedures will guarantee that they will be safer and less likely to catch Covid-19. It is very difficult to assess the likely outcome between the different procedures in each facility. One can only make an educated guess based on the Health Experts’ advice.

More Seeking Aged Care Accommodation

During this second lockdown I am finding there is a big difference in the number of enquiries I am receiving from families needing to place their loved ones in aged care. I think families held off from having their loved ones admitted to an aged care home during the first wave, and now that we have a second wave they can’t continue to hold out until we are Covid-free, as there is no knowing how long it will be.

However, with such a large developing number of aged care homes in Victoria reporting cases of Covid-19, clients who had chosen their new home last week are now questioning whether it is safer to stay at home until aged care homes are clear of the virus.

Screening Process 

All aged care homes have a similar screening process for residents before entering a home. Everyone must show evidence of a current flu vaccination, submit to a temperature check and answer questions relating to general health and whether they’ve had contact with someone who might have Covid-19.

Restrictions on Touring Aged Care Faciilties

As Victoria is now in Stage 3 restrictions, most aged care homes have suspended all ‘meet & greet’ appointments for tours. Meetings can be arranged so that a client can speak to the staff over the phone, via Skype, Zoom or Face Time. Intending residents can view photos of the home’s interiors and suites and have virtual tours. There are still some aged care homes that provide restricted tours allowing viewing only of the resident’s proposed new bedroom with no interaction with other residents in the home.

Professional Help

I’m finding that now, more than ever, people are seeking my help as a Placement Consultant to find the most suitable aged care facility for their loved one or a client. With so many variables to consider now and a changing landscape it is a comfort to many to be able to use a professional to assist them.

 

 

 

 

New Aged Care Facility Sparkles in Templestowe

 

Arcare Templestowe lounge

A delightful new aged care facility opened in Templestowe, Melbourne earlier this year. Its official opening date was April 4th. I have since placed four of my clients there, who are very happy with the facility. It is a single storey residence, has lovely, large suites including double suites for couples.

Arcare Templestowe suite IMG_1692 (edited-Pixlr)

This is good news for me because, as a Placement Consultant, I often have requests from couples for a double suite and, in the past, it has been hard to place couples in suitable aged care accommodation where they can share a room. Thankfully we can see in the new facilities being built there is more awareness of the need for couples’ accommodation.

IMG_1670 (edited-Pixlr)

 

Intimate dining and lounge areas create a cosy feel for residents and there is a separate dining room where residents can invite their families for a meal. A boutique café caters for casual snacks and drinks through the day and food is cooked fresh daily for meals. There is 24/7 nursing care for all residents.

Feeling good about yourself is important and the hair dressing salon onsite ensures residents can have a bit of pampering and lovey hair styles. Entertainment is at hand with a good sized billiards table, movie room and a wide range of activities and outings.

IMG_1675 (edited-Pixlr)

During the year residents visited the Heide Museum of Modern Art at Bulleen and Montsaalvat in Eltham where one of the residents commented on how the building was constructed in the 1930s by its then residents, mainly out of recycled materials.

arcare templestow montsalvat

Picture from Arcare Templestowe website.

Lifestyle coordinator Noelene said, “It important that our clients to come out on these bus trips, as they enable the clients to feel connected to the community and encourage the clients to socialise with each other. It always so interesting to hear the conversations that come from our outings; the clients have so many quirky stories, history and knowledge that come out.”

Arcare Templestowe also incorporates The Marsden sensitive care unit, a secure area which specifically cares for clients who are living with progressed dementia or Alzheimer’s disease.

I have over twenty year’s experience in aged careand a good knowledge of the facilities available in Melbourne and surrounds. If your client or family member needs support in finding the most suitable facility please contact me.

 

The Rise of Robots in Aged Care

Robots in care

The rise of technology has led to it being used increasingly in health and aged care settings. Infra-red vein finders, nurse-specific smart devices and various monitoring tools are being introduced on wards whilst Skype and iPads and other devices are helping to keep families connected to loved ones who are in aged care. And across the world we are seeing the rise of robots in care.

Lamson, a robot currently being used in residential care in Melbourne, delivers medicine and meals, takes laundry and can even use lifts. I met this robot recently when visiting a newly built aged care facility, Trinity Manor,in Greensborough that opened its doors to residents in May this year. As a Placement Consultant, helping find suitable aged care for clients, I have the privilege of visiting new aged care facilities to assess their suitability for my clientele and I have to confess this was the first time I had seen such a robot in action.

These robots will become more common. The latest innovation are telepresence robots which are controlled by a remote user, in the case of Lamson it was staff, but many used in other places are actually controlled by family members of the resident. A study of these robots in Finland found that for the elderly, telepresence provides benefits over non-mobile video connections as they can interact with it in a more natural manner. The robots also help the elderly to feel secure, as they feel that their relatives or carers can keep an eye on them virtually and interact with them.

Griffith University has been using social robots to interact with people with dementia, and a new start-up out of Sydney has been experimenting with robots that can help patients take their medicine.

Ikkiworks’ new robot, ikki, is part companion, part clinician. Trialled primarily with children living with cancer, ikki can take the temperature of a patient, as well as identify medication and alert the patient if the medication is incorrect. What a boon that would be for elderly people that forget to take their medication. Ikkiworks plan to develop the robot so it could eventually be used in aged care, providing companionship whilst monitoring health.

Wendy Moyle from Griffith University sees the next innovation in robot technology being the development of assistive robots integrated with smart homes, assisting elderly adults to stay home longer.“These are multifunctional robots that are voice activated, can assist a person with activities of daily living, monitor wellbeing and report wellbeing to healthcare professionals and family and can virtually connect the person.” she said.

We are certainly living in the technological age and it’s encouraging to see how these developing technologies can help our ever growing aged population to enjoy better care.

Participants Can Register Online for Dementia Studies

Interesting face

Were you aware that dementia is the second leading cause of death in Australia? More research is needed to better understand this insidious disease and its effects upon an ageing population. However, finding willing people for trials and research can be difficult for academics with a preliminary review of the Australian and New Zealand Clinical Trials Registry finding that of terminated dementia clinical trials, three in five ceased due to recruitment difficulties.

Now a new website has been developed that matches participants and researchers. Using a similar approach as dating apps participants are matched to researchers based on features that academics need for their studies, such as age, location and diagnosis. The site is called Stepup for Dementia Research. Its program director is Yun-Hee Jeon.

Jeon has seen trials fail first hand and believes that the stigma surrounding dementia is hindering recruitment, hurting those who need help the most.“In my own experience I have seen trials delayed by over a year and budgets blown out due to an inability to find the right research participants. StepUp for Dementia Research is set to change this,” she said.

StepUp for Dementia Research is supported by funding from the Australian Government Department of Health under the Dementia and Aged Care Services Fund. It is delivered by the University of Sydney and was developed in partnership with the University of Exeter and University College London.

When researchers register their studies, they define the kind of people they’re looking for and the StepUp for Dementia Research system matches that description to the information provided by registered volunteers. Researchers can only see participants’ details that match their criteria. If they deem a registered participant is suitable they will contact them direct to explain the research and ask if they would like to participate.

Anyone over the age of 18 can register, whether living with dementia or not. Health and aged care providers are encouraged to refer suitable people to the website and a range of promotional materials, such as brochures and posters will soon be distributed by Sydney University.

Jane Thompson was a carer for her husband Alan who had Alzheimer’s. She found the experience very challenging and difficult and now advocates for more research into dementia. She said “I would really encourage people to participate in research studies – and also to consider contributing to the research process more broadly to help ensure that the focus is on areas most likely to impact the lives of whom the research is about.”

For more information call 1800 – STEP – 123 (1800-7837-123) or email stepup.research@sydney.edu.au or visit the website.

 

Thanks to Aged Care Insite.  Listen to their interview with Yun-Hee Jeon.

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.