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.

 

 

 

 

 

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.

 

 

Complaints Resolution in The Aged Care Sector

Rae Lamb Aged Care Complaints Commissioner

On April 27th the Aged Care Complaints Commissioner held an event called ‘Complaints Matter’ at the Adelaide Convention Centre. It was interesting to read an interview the day before in the Sydney Morning Herald with the Commissioner, Rae Lamb, in which she challenged the aged care sector to detail the number and types of complaints they received and how they were resolved, both on their websites and at actual facilities.

The aim of the ‘Complaints Matter’ event was for both aged care consumers and service providers to walk away with an understanding of why complaints do matter. The commissioner wanted the event to highlight the processes of a good complaint and provide best practice tips for resolving complaints to the satisfaction of everyone involved. The Presenters at the event were Professor Ron Paterson, former NZ Parliamentary Ombudsman and Health Disability Commissioner, and Maggie Beer of the Maggie Beer Foundation.

In her interview with the SMH the Commissioner said “At the moment, we are in the environment where people are being given a lot more control over their care, but to make good choices, people need more information.”  She explained that the aged care sector is being shaken up right now with the consolidation of a cottage industry by larger, often for-profit providers which means that “relationships between providers and consumers are changing and power balances are changing. That is why people need to get more information. It is about ensuring people are well informed and able to make choices.” As an Aged Care Placement Consultant I assess the quality of aged care facilities on behalf of my clients. Being aware of complaints at the facility and how they are resolved is most important in assessing the culture of the aged care facility being examined and how well my clients will be cared for.