This Year in The Aged Care Sector

Arcare Templestowe lounge

The year 2019 has been a very important one for the aged care sector. I am an Aged Care Placement Consultant and have shared many of the issues, developments and opinions that are helping to shape the future of aged care in Australia.

Developments in the treatment of dementia have featured quite prominently. In January the Specialist Dementia Care Program (SDCP) was beginning to roll out. Offering specialised, transitional residential support for people exhibiting very severe behavioural and psychological symptoms of dementia (BPSD), which focuses on reducing or stabilising symptoms over time, the program will provide care for those who are unable to be appropriately cared for by mainstream aged care services. The first specialist units are scheduled to be operational in 2020, with a further roll out in 2021-23.

Assistive technologieswere being developed through the year. One example is a prototype called DRESS to help people with dementia dress themselves. The carer initiates the dress sequence via a mobile device and the recorded voice prompts the person to dress themselves, correcting mistakes. Japan is heading to a workforce crisis in numbers with a rapidly aging population, so the government is encouraging the use of technology in aged care. An example is a robotic device that helps frail residents get out of bed and into a wheelchair or ease them into bathtubs.

And talking robots, I met my first robot in May this year, Lamson, when visiting a newly built aged care facility, Trinity Manor in Greensborough. It delivers medicine and meals, takes laundry and can even use lifts. Also, Griffith University has been using social robots to interact with people with dementia.

Ikkiworks has developed a robot called Ikki, who is a companion and a clinician and will eventually be used in aged care. Ikki can take a patient’s temperature and identify medication and alert the patient if the medication is incorrect.

Another approach to dementia care is the Montessori Inspired Lifestyle ® (MIL) developed by Dr. Cameron Camp. “Within this new paradigm, abilities, interests, and preferences will be respected, encouraged and maximized. Providing choice throughout the day is central to all interactions. Central to MIL is the creation of meaningful activities and social roles within the context of a community.” said Dr. Camp.

The aged care workforce was a subject that kept coming up, particularly the need for more nurses to be on call within facilities. I reported on an interesting study by Adelaide University published in April 2018 into the attraction and retention of staff to aged care. There were many reasons why working in the sector was attractive but the perception of this work as low level and underpaid was a negative.

In defence of the work Melanie Mazzarolli, Regional Business Manager, Residential Services at Benetas wrote in an article about the privilege of supporting someone on their journey to death, similar to supporting birth, and that relationships can be formed over long periods, rarely matched in other nursing roles. She also mentioned the passion of those employed in this sector. With the increase in the aging population more workers will be needed in the sector but finding and retaining them will be an ongoing challenge.

The Royal Commission into Aged Care was prevalent on the news for much of the year and painted a very negative picture of the sector. Clearly improvements across the sector are needed and a statement by the AMA this month spoke of using technologiesto assist meet the demands for care for the elderly. These technologies are already being developed and support for more development is needed.

Ending on a bright note the touching and beautifully produced documentary series The Old People’s Home for 4 Year Olds aired on ABC in August and September took a look at an experiment in an intergenerational program. This experiment is the first of its kind conducted in Australia with structured activities used to encourage interactions between the children and adults as they worked together to achieve particular goals. Health measurements were taken before and after the program and showed positive outcomes. Professor Susan Kurrle, who oversaw the program, believes the implications of this successful trial could be huge.

I look forward to a more positive focus on aged care in 2020, with improvements and developments that will assist the sector to deliver a high level of quality care to all our older residents.

AMA Calls For Innovation In Aged Care

japanese robotics

As we draw to the end of a year in which the aged care sector was put under the microscope during the Royal Commission into Aged Care Quality and Safety, it is time to take a deep breath and consider how to improve the operations of aged care facilities moving forward. I am a Placement Consultantand assist my clients to find suitable aged care accommodation so I am always inspecting aged care facilities and keep a close eye on their operations. It was with great interest I saw the Australian Medical Association President, Dr Tony Bartone, has recently issued a statement in which he said the Royal Commission had uncovered an aged care system plagued by “rigid conformity and an absence of innovation”.

He states “Innovation is vital to improve the level of care provided, to deliver consumer-centred care, and enable the sustainability of the aged care system. ”

The position statement contains six principles:

Resourcing

Electronic records

Medication management

Assistive technology

Communication

Data

The AMA is calling for more investment in assistive technologies, citing wearable sensors, virtual reality testing and smartphones have assisted with monitoring functionality in older people and detecting falls. “Monitoring technologies provide opportunities for longer independent living of older people, a better focused and personalised care in both home care and residential aged care settings,” it says. Also highlighted was the need for clear data privacy guidelines around sensor-based monitoring technology, wearable sensors and implantable technologies.

Due to the frequency with which older people move between aged care, primary care and acute care settings electronic record keeping and information exchange between care settings is crucial. “Interoperability between My Health Record, My Aged Care, and clinical software systems would enable electronic health record sharing between the health and aged care systems,” the position statement says. Communication technologies such as telehealth can enhance access to GP services, further improving health care access.

Looking at more resourcing for technological innovation the position statement says “Investment in innovation is needed to ensure that mainstream developments are accessible to all those accessing aged care services, not just those who can afford them.” The AMA stresses that this technology should not replace human care and engagement, confirming that “Adequate staffing numbers and appropriate mix of care staff skills is a continuous resourcing requirement in aged care.”

 

 

Read the full AMA position statement here.

 

 

 

 

 

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.

 

Aged Care As the Population Ages

Bluecross Box Hill-06

It’s a great outcome in health terms that Australians have one of the highest life expectancies in the world. But this presents certain challenges with an increasing ageing population. The baby boomers, those born just after the second world war, are now ageing, with the first of them turning 65 in 2011. As a result in 2017 3.8 million Australians were in the 65 and over age range. This represented 15 per cent of the population. By 2050, 1.8 million people will be over the age of 85.

At the same time we have a decline in fertility rates, with the number of children per woman falling from 3.5 to 1.8.

Healthcare

Naturally, health care is going to become a high priority as the population continues to age. According to a report by the Parliamentary Budget Office, demand for health services rise upon a person reaching their 70s, with the need for aged care services increasing further when they reach the age of 80.

There is a movement away from hospital care to at-home support services. People would much rather be treated and looked after within their own home than spend lengthy periods of time in hospital. It is also a more cost effective method of providing adequate health care to the elderly. So, in terms of primary care costs this is an improvement. However, the system needs re-evaluation to keep up with demand.

Aged care facilities will still be needed for people with high demand needs, such as 24 hour care. Ensuring they are managed and staffed to a level that the community finds acceptable is of utmost importance. I know from my experience as a Placement Consultant that there are many very well run aged care facilities that meet expectations, but there are those that do not. I scrupulously research facilities for my clients and follow up with them to ensure they and their families are satisfied.

We must aim for a standard across the board that provides excellent care and respect for our elderly. After all they paved the way for the rest of us to live in such a privileged society.

Behind The Scenes of The Old People’s Home for 4 Year Olds

ABC-baby-goats

A recent interview by Aged Care Insite with Professor Susan Kurrle, director of the Cognitive Decline Partnership Centre at the University of Sydney, who worked on the recent ABC documentary The Old People’s Home for 4 Year Olds, provides some interesting insights to the program. (Photo from Aged Care Insite)

This experiment is the first of its kind conducted in Australia and Professor Kurrle believes the implications of this successful trial could be huge. The ABC show follows the progress of a group of aged care residents taking part in structured activities with a group of pre-schoolers who visit their aged care home on a regular basis.

The resident-to-resident relationship building that has arisen as a result of the experiment has obvious benefits to health, Professor Kurrle said. It was a surprise side effect of the experiment and those relationships have continued in a healthy way. Some residents felt quite lonely and isolated prior to the trial.

Allowing young children day-to-day contact with their elders can also combat ageism she said. The children who took part also benefited growing in their confidence and interactions and developing of empathy. One particularly touching moment was when one young child, whose parents described him as a “soft soul”, showed empathy for a depressed resident who was not participating or speaking and had his eyes closed, by going up to him and being with him, drawing the resident out until he broke into a beaming smile.

This experiment was the first time that structured activities were used to encourage interactions between the children and adults as they worked together to achieve particular goals. Other intergenerational programs with pre schoolers have not been structured in this way, with the children simply playing side by side with the residents. Professor Kurrle pointed out that humans are pack animals and crave the companionship of family. For residents whose families are far away or unable to visit life can become lonely. This program allowed them the opportunity to interact with young children, as they would with their grand children. The health benefits were proven by standardised health tests before and after the program.

Professor Kurrle assured the interviewer that the children weren’t encouraged by producers on the show to behave in certain ways to develop the story. All behaviour on the show was spontaneous. The only people in the room were the participants, the instructor and some of her assistants to help with the children. The cameras and microphones were hidden.

Suggestions coming out of the success of the program about how to do more intergenerational programs in aged care facilities include encouraging playgroups to set up their activities within aged care facilities. Another was for aged care providers to consider building childcare facilities within their buildings when building a new facility or upgrading an existing one.

Trailer for the ABC program

 

The Matter of Your Will

Will

I am an aged care Placement Specialist and I have an 84 year old client right now who is fighting for a fair share of the proceeds from the house he shared with his wife so he can afford to go into and aged care facility to be cared for. Unfortunately for him they decided many years ago to put the house in his wife’s name so it would not be affected if the business he was running ran into difficulties.  They had mirror wills to protect him. A year ago his wife was diagnosed with a terminal illness and her estranged son came back into her life. When she passed on a new will came to light, in which her husband is disadvantaged.

Although this is a complex case, it made me think about how people could be adversely affected if there was no will at all. Sadly if you don’t have a legally binding will your wishes may not be followed, and the distribution of your estate may become one great bun-fight

This may end up costing a fortune in legal fees and cause more heart-ache to your already grieving family, yet many people put off making a will, which can ensure their wishes are met and bring peace of mind to themselves and those they love.

When making a will it is generally advised to use a Lawyer or the Trustee and Guardian in your state rather than make a DIY will, especially if you have substantial assets or your wishes are complex. It is also important to remember to have your will updated if there are any changes to your wishes or assets. So, now you have your will, what do you do with it?

Keeping it at home can be problematic as it may be difficult to find and there is the risk of it being destroyed by fire, tampered with or stolen. A safety deposit box you would think a good option, but it can be almost impossible for family to get hold of if they don’t have legal access to the box.  Storing it with your Lawyer is another option, but it can be lost in transition if the business is sold or the Lawyer dies, although legally they have an obligation to ensure all documents are transferred to another law firm.

The State Trustees of Victoria have set up the Victorian Will & Powers of Attorney Registry, a free initiative where anyone in Victoria can register information about the location of their will and powers of attorney documents safely or physically store their original documents with them.

The Registry will help Executors and Attorneys find documents with ease, ensuring your wishes are acted upon when the time comes. Their website states “These documents are your voice and it is essential to safeguard them securely rather than leave them to chance.”

More information about Jillian Slade

A New Test To Tackle Falls in The Elderly

david-monje-lady with walking stick

Older people fear having a fall, more than a bag snatch or a home invasion, according to Professor Stephen Lord, a senior principal fellow at Neuroscience Research Australia at the launch of a new screening test for falls, a collaboration between NeuRA and the aged care company, the Mark Moran Group. He stated that the reason they fear this so much is it is often the precursor to losing their independence. Once an elderly person goes to the Emergency Department of a hospital as a result of a fall and into the hospital system, they are often assessed as being unable to continue caring for themselves, resulting in them moving to an aged care facility.

Research shows one in three people over 65 will have one or more falls every year. At that rate the number of new hospitals will have to increase at a rapid rate to cope with falls related injuries.

Professor Lord stated that the cost of falls to the economy is greater than any other injury, including car crashes.

If a fall is serious, 43 per cent of people aged 70 or older who have one will be admitted to hospital. Currently, falls account for 250,000 hospital bed days every year, and will rise to 450,000 by 2050. Of those who are hospitalised, about 10 per cent will move to an aged care facility for the first time.

The new screening test, launched this week, can predict with 75 per cent accuracy the risk of someone over 60 having a fall – and recommend ways to prevent one. The kit, FallScreen +, has nine assessments. These relate to general wellbeing, including pain and mental health; regular exercise; executive function (which includes ability to assess and negotiate hazards in an unfamiliar place), and eyesight, including ability to see light and shade (which helps to avoid trip hazards).

The kit will be trialled at aged care facilities owned by the Mark Moran Group, and will also be released as an app pitched at those who work in aged care, including physiotherapists, psychologists and others. A simplified test is being developed for general practitioners.

As an Aged Care Placement Consultant I highly recommend that elderly people have a future plan in place so that if they do have a fall or several falls and find themselves in a situation where they can no longer stay safely in their home, they have a plan B ready to go. If they have developed a plan, they are in a position of having more choice and being able to move to a facility that suits their needs, tastes and location. This can make a big difference to the outcome; it can be a positive move.

Some facts taken from Julie Power’s Sydney Morning Herald article published Aug 27 2019.