Staffing a Major Issue in Aged Care

In a recent Senate estimates hearing the Aged Care Minister, Richard Colbeck shirked responsibility, citing the outbreak in Victoria as the cause of many deaths in aged care facilities during the Covid 19 outbreak. Aged care staff working across multiple sites arose as an issue during Victoria’s outbreak. Infection control was a major problem with staff moving between facilities, making it harder to keep up effective infection control. The reason staff was moving between facilities was the need for them to work at multiple jobs in order to earn a decent living wage.

Once identified as a problem through the Royal Commission into Aged Care Quality and Safety’s focus on the outbreak of Covid 19 within aged care homes the federal government provided more workforce funding and an industry program to reduce sharing staff.

The Senate hearing was told that as of September, 4.5 per cent of Victorian aged care staff now work across multiple sites, compared to seven per cent in June.

There have been concerns raised for some time about the number of carers and registered nurses on all shifts in aged care facilities. The Royal Commission and the emergency situation under the pandemic highlighted the deficiencies and the serious outcomes from a lack of staff and a lack of properly trained staff. 

The carers and nurses that work in aged care facilities for the most part do their utmost to provide the level of care the residents need.  These needs vary greatly between residents and at time each resident may need a different level of care, depending on the variations of their health. This creates a complex situation and it can be difficult to manage the correct level of staffing for residents’ needs whilst maintaining a viable operation. 

It is encouraging to see the government making changes to support the aged care workforce. As the population continues to age the need for proper care for those older Australians whose needs are too complex to manage in a home setting will increase and it is imperative that aged care facilities are to the highest standard and able to cope with the growing demand. ,

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

Aged Care Minister Colbek’s Response to Covid 19

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On Friday 22nd August the Senate Select Committee on COVID-19 in Aged Care Facilities interviewed the Aged Care Minister, Minister Colbek, for the second time.

He began well by thanking all workers in aged care facilities – personal carers, nurses, cleaners and cooks. He stated that they deal with confronting situations, that they can be scared for their own health but continue to turn up to work.

He said “We need them. They are at times unfairly scrutinised.” He went on to claim that the government …” can always do better.We will continue to work to be prepared to have resources as best we can, particularly to support the Victorian government to get the community transition under control.”

Then he stumbled. As he was being questioned about whether his department was doing its job protecting the elderly from COVID-19 in federally funded and regulated nursing homes the Senator was unable to answer how many residents had died in Victorian aged care facilities and how many current active cases there were.

Eventually a staff member told the inquiry that as of 8:00am on Thursday, 20 August 254 residents in aged care facilities had died due to Covid-19, there were 1811 active cases, with 239 recovered.

According to Anne Connelly of the ABC in her report today the Prime Minister claimed in Parliament Question Time on Monday (24th August) that of the 126 nursing homes affected by Corona Virus in Victoria only 16 have experienced a “significant” impact from COVID-19; four have had a “severe” impact and, as of yesterday morning, the number that have been “significantly impacted has been reduced to three”.

She also reported that Prime Minister Morrison and Aged Care Minister Colbeck spent yesterday’s Question Time arguing that the many plans, emails, guidelines and webinars which were sent to the aged care sector equated to effective preparation and that high levels of community transmission were to blame.

This was obviously in response to the question on Friday in the Senate Hearing where Minister Colbeck was quizzed about what support the federal government gave the aged care sector to help it prepare prior to the community spread of the Corona Virus outbreak.

Minister Colbeck mentioned at the hearing that the federal government were spending $171M for the aged care response to Covid-19 and they had set up a Disability Response centre in Victoria with $15M in funding split between the federal government and Victorian government.

The lives of those most vulnerable in aged care facilities must be given the respect and care they deserve. Ensuring the aged care providers have sufficient information, easy to follow guidelines, staffing support and adequate protective equipment is the job of the government. Both State and Federal governments have a critical role to play and they must work together in harmony to protect the elderly under their umbrella of care.

Jillian Slade is a Placement Consultant for aged care.

 

 

 

 

 

Sudden and Complex Decisions in Aged Care

Arcare Templestowe suite IMG_1692 (edited-Pixlr)

For people either planning for their future or who are at a stage where they need the support of an aged care facility in my role as a Placement Consultant I am often able to help with complex decisions and finding the right place that suits their particular needs.

For example, a couple I helped a few years back were planning for their future as they aged. They were selling their current home and considering moving into a retirement village, using the funds from the sale of their home. However, they were concerned that in the future one or both of them may need the higher level of care afforded in an aged care home and that they would not have enough funds left to buy into an aged care home that has the standard of living they enjoy.

They needed my servicesas they were confused by the vastly differing fees and charges, with inclusions that varied from village to village. I helped them by researching the different price ranges, exit strategies and cost of entering the next level of care. I felt the best solution whereby they could transition into aged care from retirement with the least disruption and loss of capital would be a retirement complex with aged care on site. I found the few facilities that offered this arrangement and set up visits for the couple to choose the option that suited them best geographically, cost wise and to their standard.

When a new aged care facility opened in Templestowe, Melbourne in April, 2019 I placed four of my clients there that year. They were all very happy with the single storey residence, and its lovely, large suites including double suites for couples. As a Placement Consultant, it has often been a challenge to meet my clients’ requests for a double suite as not many facilities catered to couples with shared room accommodation. Thankfully the new aged care facilities being built have rooms with couples’ accommodation, opening up the options.

Moving into aged care accommodation is often an emotional and stressful time for a person and their family, as they are suddenly in a situation where there has been a fall or deterioration to the point that immediate accommodation with high-level care must be found. They are often in hospital, waiting to be discharged and their needs are such high care they can only be supported safely in an aged care facility.

This is where I can offer my services as a Placement Consultant, helping on several levels. Firstly, I interview the client to find out what is important to them and what are priorities and, as I have a good knowledge of the accommodation available, can recommend a short list of the most suitable options. Secondly, I can help with negotiating fees, often saving my clients considerable amounts. Thirdly, I can fill out all the paper work and fourthly, I have counselling qualifications and can help ease the transition for all involved.

If you have a client or family member who needs help finding suitable aged care accommodation please contact me.

 

 

 

 

How Aged Care Facilities Respond to COVID-19

Racecourse Grange entrance

With the corona virus pandemic now in Australia there are changes to how aged care facilities are able to operate.

Trinity Manor Greensborough front

In my role as Placement Consultant I help clients find suitable accommodation in aged care facilities in Melbourne. I’m currently getting frequent updates from aged care facilities on changes to their protocols. Fortunately most aged care facilities still currently taking new residents and, in some cases, respite residents. There seems to be a general requirement for new residents to self isolate for 14 days when they move into their new home. However, the need for this varies from facility to facility, with some making it mandatory for all new intakes, whilst others have made it only for those who answer positively to questions about their symptoms and/or exposure to COVID-19 or carefully check on resident’s health upon intake.

I had a client recently who I had trouble placing into a facility as she was unable to do the 14 day isolation due to memory loss. Fortunately I was able to find another suitable facility whose policy is if a new resident comes from home they will have their temperature taken and be monitored. As my client was coming from home she was accepted. However, this facility requires new residents to self isolate for 14 days If coming directly from hospital. Some facilities can no longer accept people living with dementia or people that wander as they are unable to provide care for them with the social distancing restrictions now in place.

Restrictions around visitors also vary between aged care facilities with some putting in place a total ban for visitors, with some allowance when residents are in palliative care, and others allowing minimal visitors as per the government guidelines of no more than two at a time, once a day.

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Most visits to inspect facilities are now virtual with a range of sophistication there; some have film crews do a professional video tour whilst others film the facility themselves. Some facilities will meet with you and show photos and some will even allow a personal tour but with strict cleanliness and health protocols in place.

Greenview Donvale bed

It is challenging keeping up with all the different protocols in the various facilities and another reason my clients find my services so helpful  as I sift through these frequent updates to keep them informed.

 

 

 

 

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.

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.

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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.

 

When You Must Find An Aged Care Facility

Benetas Hedelberg jpgMost elderly people would prefer to stay in their own home, living independently and the government is currently grappling to provide the level of support that will allow as many people as possible to live safely at home. The long wait times and, in some cases, inadequate service providers have been highlighted in the Royal Commission into Aged Care. As associate tells me of her 97 year old Aunty with mild dementia and some memory loss, but bright in spirit and determined to stay at home alone since losing her husband this year who has a nine month wait for a package. At that age it is debateable whether she will live long enough to receive the support she deserves.

So, apart from the problems of delivering the level of care needed to help people stay in their own homes the reality is there are people whose needs are such high care they can only be supported safely in an aged care facility. These are the people I assist when they need to find suitable accommodation with the level of care needed. It is often an emotional and stressful time for a person and their family as they are suddenly in a situation where there has been a fall or deterioration to the point that immediate accommodation with high-level care must be found.

The pathway is usually that the person has been hospitalised and once their immediate injuries are resolved the hospital needs to discharge them to suitable care. It is assessed that they are not able to be looked after adequately in their home and so an aged care facility must be found as soon as possible.

This places a great deal of stress on the family and the elderly person is often disorientated and grieving at leaving their family home. I help families and their loved one to find suitable aged care accommodation by interviewing them to be clear on their needs and wants and then finding appropriate accommodation options for them to choose from. Some of the more regular requests are: a facility located close enough to the family so they can visit frequently, somewhere that has a good activities program, a double suite for a couple to share, good quality food, nice outlook and garden surrounds and, ofcourse, caring staff. Because I know many of the Managers in the aged care sector and am familiar with the facilities I am in a position to recommend suitable options.

It makes me happy to find a place that makes my clients happy. I received two testimonials recently I would like to share with you:

“Making the decision to have Jillian as our Placement Consultant was like finding a ‘pot of gold’.  From the first phone call we felt a sense of relief as she was very reassuring and caring.Jillian helped our family situation enormously. We highly recommend her services, very efficient, excellent negotiation skills, first-rate knowledge of the aged care homes and the complex aged care system”

Gail and Andrea  2019

“I couldn’t have done any of this without you. You have been wonderful”

Barry, Albert Park 2019

You’ll find more lovely testimonials on my website.

Aged Care Residents’ Communications In The Digital Age

elderly-smartphone

Older adults may be slower in their uptake of internet based technologies, but they are more digitally connected than ever. Tweeting, facetiming and face booking are all popular ways to keep in touch with family, grand kids and friends. As social media has become an ever increasingly important platform for social connections older people are using the medium  more often.

Active social engagement has been shown to be associated with better health and health outcomes across a number of studies over many years. When a person moves into an aged care facility it may be difficult for them to continue their social connections in the physical sense. They may be some distance away from the neighbourhood in which they have lived, they may be unable to travel to maintain relationships. Family visits then become more important, providing social contact and support but geographic distance or work commitments may hinder their ability to make frequent visits.

The possibilities of digital connection to the wider world offer an important avenue for further social connectedness, including connections with family and friends overseas. Aged care facilities are now getting on-board with most providing wifi access to residents. As a Placement Consultant for aged care accommodation, I always check whether wifi is available when sourcing appropriate aged care accommodation as it has become a highly desired criteria, with families asking for wifi. Not all residents wish to take up new technologies, but their families often bring devices when visiting to connect to other family members or friends.

Access to online resources can enhance the well-being of older adults through more frequent social interactions and better access to information. As reported in the Journal of Ageing and Mental Health a small study was done on a group of 80 year old men, with one group learning computer skills and having internet access whilst the control group did other activities. The study found that “Computer and Internet use seems to contribute to older adults’ well-being and sense of empowerment by affecting their interpersonal interactions, promoting their cognitive functioning and contributing to their experience of control and independence.”