Roller Coaster Ride Placement in Aged Care

unspecified-6

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.

 

 

 

 

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.

 

 

 

 

A New Approach To Design of Aged Care Facilities

Aged Care Facility

An Aged Care Facility

A group of design professionals, innovators, planners and seniors came together in a charrette (a workshop devoted to planning a design or solving a problem) to look at a new way of creating aged care facilities. Rather than design just for comfort, or looks, the group aim was to design to aid longevity. Hosted by The University of Queensland and DMA Engineers, the 120 assembled experts considered this a rare opportunity for teams of people from different fields to collaborate in some blue sky thinking.

DMA Engineers managing director Russell Lamb discussed the current dischotomy.

“It’s quite restrictive. In fact, it’s probably one of the most restrictive. I think that’s one of the struggles that the industry’s dealing with at the moment, where we hear terms about ageing in place, but if you go from a retirement living facility, where it’s in most regards an apartment that younger people in their twenties, thirties, forties may be happy to live in, to when you’re actually going to an aged care Class 9C patient room. The amount of services and facilities within that room are fundamentally different.

“One of the challenges the industry is really faced with is how we can have a space which transforms over a matter of years and transforms in a way that maintains the character of the place and doesn’t become too clinical, too quickly.”

The group was challenged to create visionary, innovative and highly connected designs to meet the needs of an intergenerational community in 2050. It was noted that too often aged care facilities are cut off from the wider community by virtue of cheaper land forcing providers to the outskirts of town.

The University of Queensland’s Director of the Healthy Ageing Initiative, Professor Laurie Buys, said

“Older people are thinking and acting very differently than ever before, and we know that future generations of older people will have very high expectations about maintaining their engaged lifestyles.”

The experts gathered into groups and took part in a design competition. The chance to throw the rule book out of the window was appealing for many of the designers who were able to think more generally about how the needs of older people can be met in a hypothetical way, rather than designing to a client’s brief. A common thread emerged of physical and social connectedness, key to promoting increased choice, economic development and job creation. Designs visualized spaces that enabled older people to be creative and productive rather than just existing in places with activities to pass the time away.

 

Thanks to Aged Care Insite for information used in this blog.

 

 

Visitors to Aged Care Homes

musicforseniors690x400

The Prime Minister went on national television last Tuesday to tell aged care facilities in Australia to go easy on their lockdown measures. He said the recommendation from the national cabinet was for a maximum of two visits per resident per day in the resident’s room. He was concerned for the welfare and health of residents in aged care if they were not receiving regular visits from their families.

Several things have come to my notice as an Aged Care Placement Consultant about the situation. Aged Care Facilities seem to vary from one to another with how they are dealing with COVID-19, as mentioned in my last blog. When it comes to visitors some are in strict lockdown, others are following the government recommendations. Staff are busier than ever, as they don’t have the help of volunteers and other support services; for example, they are having to conduct all the activities to keep residents occupied.

General Secretary of the NSW Nurses and Midwives Associations, Brett Holmes, said the government needed to provide additional staff to aged care facilities so they could screen visitors before allowing them in. I agree with this and can understand the difficulties aged care homes will face in monitoring visitors, I’m aware that even at the moment where families are allowed to visit their loved ones in palliative care, in some facilities it is only for 15 minutes, yet when asked to leave they ask for another 5 minutes, then another 5 – this all takes up staff time, adding an extra burden. There will be further calls on staff time when the directive starting in May that visitors must have the up to date flu immunisation comes into effect, as this will need policing.

Brett Holmes went on to say “There are qualified nurses out there looking for work and if the Commonwealth Government wants to open up the aged care facilities, then that should be done in the safest possible way.That should also mean of course the additional resources of PPE to allow that screening to be undertaken in the same way that our public health system is responding to this risk of people from outside the facility bringing in the COVID-19.”

I have noticed when that some aged care facilities are contacting families and asking them if they are content with the precautions the facility is taking and, to my knowledge, most families are generally understanding why the facilities have taken those precautions and that it is for the protection of residents.

Last week I placed a gentleman in an aged care facility and his wife was upset that she couldn’t visit him over the weekend. As I have said before, each facility is dealing with the situation differently. The same goes for retirement villages. I am helping a client to find a suitable retirement village and one place we were interested in would not allow a site visit but also won’t allow a resident to move in unless they have seen the facility in person. Another retirement village will allow a site visit, but only one person at a time.

I am finding that only people in an emergency are now seeking aged care accommodation as they don’t want to self isolate within the facility for 14 days once they move in, they don’t like the idea of no visitors and don’t want to spend the money and make a monumental move to a home site-unseen. Trying times indeed!

 

 

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.

unspecified-6

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.

 

 

 

 

Aged Care Placement During The Corona Virus Pandemic

orlando aged care

As we all face the effects of the COVID-19 virus in our community, it is of particular concern in aged care facilities, where the most vulnerable people reside. Ever more draconian restrictions are being put in place in the wider community to try to control the spread of the virus. Aged care facilities are particularly at risk and so they have to be even more restrictive. The government has introduced a two person only visit limit to each resident and have restricted gathering in communal areas. Some facilities have put in even stricter limits, such as only allowing family to visit or completely locking down, allowing no visitors.

Despite the new regulations, social distancing and self isolation in the wider community, there will still be those elderly people who have a fall or get very ill with heart attacks, strokes, dementia and other health problems who end up needing to go into an aged care facility. Also, due to the self isolating or lockdown situations now being enforced there are elderly people, particularly those living with dementia, who will no longer have the level of care they need. I had three such cases last week that all required emergency placement in an aged care facility.

The first was an ‘at risk 93 year old woman’, living with dementia, alone in an apartment in Docklands,. Her son lives in the USA and her sister in law in Albury, NSW. As she now needed to move into a facility the family wanted accommodation in Albury so she could be near her sister in law. They asked me to find a suitable facility and organize the transfer. I found a suitable facility and the son had to make the decision sight unseen, trusting my judgment. With the help of a case manager and a private carer I arranged for transportation. Due to the changing directions coming from the government, the facility was changing its protocols daily which delayed her being admitted and resulted in her staying a night in Albury and the private carer taking her to the facility, where she had to start a 14 day isolation. Very difficult circumstances for an elderly lady living with dementia. Happily, she is settled and doing well.

The second was a gent with dementia living with his wife who had serious health issues. His behaviour had exacerbated and she was concerned about keeping him locked in the house if the lock-down got worse, which it has. This was a difficult process as her children thought she should keep him at home as she had signed up for ‘better or worse’.  He also had to go in without her looking at the room and undergo social isolation for 14 days.

The third was another woman living with dementia in a fully independent, serviced apartment in Carlton.  This was also an urgent situation as there is no one to go in and check on her and she is living alone and isolated with dementia. Fortunately I have been able to place her as well.

There has definitely been a rise in demand for help in finding suitable aged care.The service I provide means I source a facility that is suitable in terms of location, programmes, affordability, staffing levels, type of accommodation, services offered and outings. Because I research the facilities, visit most of them and know many of the managers I have an inside knowledge about how they operate and how suitable they will be for my clients.

These are challenging times for us all, and for an elderly person living with dementia having to move from their home it is extremely stressful. . I am grateful that now, more than ever, I can be of assistanceto ease this distress, fear and anxiety as I have a counselling qualification, which gives me the skills to really help people going through this transition.

 

Bereavement Can Be A Risk Factor

romeo-and-juliet-1

We know Shakespeare’s tragic story of two young lovers who both lost their lives through bereavement. Romeo and Juliet are the quintessential lovers, forever in love. In their tale they took their own lives due to the grief of losing their loved one, but studies have found that a bereaved person is actually at a higher risk of dying due to health problems. Following the loss of a loved one it has been found that often a person will experience increased heart rate, blood pressure and blood clotting, as well as increases in symptoms of anxiety and depression. The expression dying from a broken heart takes on a clinical meaning.

A randomised clinical trial at the University of Sydney lead by Professor Geoffrey Tofler looked at a total of 85 people and showed that it is possible to reduce several cardiac risk factors during this time, without adversely affecting the grieving process. The oldest person in the study was 85 years of age with the average age of all subjects in the study being 66.

Following on from previous studies on cardiac health risks, increased depression and anxiety after bereavement Professor Tofler noted “However, there have been no interventions to address this with the goal of lowering cardiac risk, so we aimed to provide this with an approach that does not adversely affect the grief process.”

Forty-two subjects received low daily doses of a beta blocker and aspirin for six weeks, whilst the control group of 43 were given placebos. Heart rate and blood pressure were carefully monitored, and blood tests assessed blood clotting changes.

“The main finding was that the active medication, used in a low dose once a day, successfully reduced spikes in blood pressure and heart rate, as well as demonstrating some positive change in blood clotting tendency,” Tofler said.

The investigators also carefully monitored the grief reaction of participants.

“We were reassured that the medication had no adverse effect on the psychological responses, and indeed lessened symptoms of anxiety and depression.”

Professor Tofler advocates the use of this therapy as a risk prevention strategy in those recently bereaved. He also encouraged the medical profession to give extra attention to the health of recently bereaved people,rRobson-and-Jeromeeople, as well as family and friends, who should provide social support and report any health symptoms to medical practitioners.

 

 

Opposition Leader’s Vision for Aged Care

42ebc73c350c5539425b0a5024c352cf

Pictured Leader of the Opposition, Anthony Albanese

The release in recent weeks of the interim report on the Royal Commission into Aged Care has raised responses from both the Federal government and the opposition. Leader of the Opposition, Anthony Albanese spoke this week about Labor’s response. Firstly, he reaffirmed Labor’s pledge from their last election campaign to enact a dental plan for pensioners and also spoke of funding better pay for the aged care workforce. He also said that the ACAT (aged care assessment system)won’t be privatised under his leadership.

COTA chief executive Ian Yates agreed with the Opposition Leader’s assessment that older Australians are a diverse group of people who cannot be treated all the same.

“They require a diverse policy response that addresses issues across employment, health, finance, care, welfare and industrial relations, which I expect Labor’s proposed Positive Ageing Strategy would address” said Mr Yates. He did disagree with Mr. Albanese on one point, however, the characterisation of the Federal Government’s response to the interim report with a planned single aged care assessment system as ‘privatisation’. “A single consumer-focused professional national assessment service with many local access points has been recommended for years by successive reviews and by COTA and the National Aged Care Alliance. This is an essential front door for a reformed aged care system” he said.

Mr. Albanese also spoke highly of the experiment on intergenerational aged care, as documented on the ABC program “ Old People’s Home For 4 Year Olds”. It has given him a vision for the future of elderly people who live at home with their families going to daycare with kindergarten children on a regular basis, brightening their days and, with the proven physical and mental health improvements shown in the experiment, keeping them healthier.

After all my years working in the aged care sectorI am thrilled to atlast see some positive responses coming out of this long, drawn out Royal Commission. We have heard so many sad stories so it gives me a sense of hope that governments will take a strong lead in ensuring aged care is of the highest quality, providing a positive and enjoyable lifestyle for older Australians whether living at home or in an aged care facility.

Aged Care Assessments Put To Tender

Interesting face

Aged care assessments are soon to be put to tender and there are concerns about potential conflicts of interest arising from assessors aligned with single organisations or modes of care.

As a Placement Consultant I was very interested in claims made by HelloCare magazine that voices in the industry have raised concerns with them that conflicts of interest may mean vulnerable older people miss out on the care they need.

According to the Department of health website “Under the new arrangements, a single assessment workforce and a network of assessment organisations will assess eligibility for access to all government-funded aged care services. The new single assessment workforce will replace the two current assessment workforces:

  • the Regional Assessment Service (RAS)
  • Aged Care Assessment Teams (ACATs).”

The Health Department states that under this new arrangement assessments will be quicker, enabling older Australians to access Commonwealth Home Support Programme (CHSP) services, Home Care Packages and residential care faster.

Assessment organisations will be selected through a national tender process which will take place in 2020. The new arrangement will come into effect in April 2021.

The concerns raised are that assessors may be tempted to refer customers only to their own service rather than present a range of options to choose from. In particular, if home care providers do assessments they may encourage the elderly person to stay in their own home when perhaps residential care would be a more suitable option for them.

In these situations, consumers may potentially not receive the most sound advice and level of care they need, putting them at risk. Therefore it is of great concern and importance which types of services are allowed to assess people for aged care.

A statement from the Department of Health to HelloCare received on 9 January 2020 said processes will be put in place to ensure that aged care providers will not be able to benefit from assessments they perform.

“The Government will ensure that companies that run aged care services are not advantaged by being associated with an assessment organisation,” the statement said.

An update on the development of this new aged care assessment arrangement will be held as a webinar by the Health Department on Wednesday 12 February 2020.

As participants will have the opportunity to ask questions I highly recommended anyone in the industry or interested in aged care attend the webinar. More information here 

Fires Force Evacuation of Aged Care Home

Eden fires

On New Year’s Eve mega fires near Mallacoota, in the East Gippsland region of Victoria, forced approximately four thousand holidaymakers and locals onto the beach as a last refuge. Fortunately all survived.

The intensity and speed of the fires was far worse than predicted – and they were soon moving north at a great pace, towards the popular tourist towns of Eden and Merimbula in New South Wales. The fire became known as the ‘border fire’.

People in Eden sheltered on the wharf as they watched the town’s chip mill catch fire. Pictured above: wood chips burn at the local timber mill in Eden (Image:AAP).

The people of Eden were told to leave and evacuate to the next town, Merimbula.
Evacuees flooded into Merimbula’s bowling club (known as the Sapphire Club or the “Bowlo”). After the first day, 3 January, the club was totally full, with 1000 people. The Bega Valley Shire Council then also appointed the town’s other club, the RSL Club and the nearby Country Club, as evacuation centres to take in more evacuees.

Emergency services advised that residents of aged care facilities in Eden should be evacuated and some were moved to the RSL Lifecare aged care facility in Merimbula. They were the fortunate ones as there was room available for them. Others were moved to a newly constructed aged care facility in nearby capital city Canberra that had not yet opened, three hours travel away, whilst the overflow were looked after at a makeshift medical centre at the evacuation centre at the bowling club. A nurse was on duty to attend to those at the evacuation centre.

Whilst the fires in the area have been contained following milder weather conditions and an influx of resources, such as helicopters, planes, the army and extra police, they are not yet out and continue to be a threat to the region. As a precaution many of the Eden residents still remain in the Merimbula aged care facility.

I am a Placement Consultant. My job is to find suitable aged care accommodation for clients. I know how stressful it can be finding the right accommodation for a loved one and my role is to minimise the stress, time and cost to my clients. I feel for all those involved in the bushfire regions and send my best wishes and support for both the aged residents needing to be evacuated and those entrusted with their care and the responsibiity for evacuating them to suitable accommodation.