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

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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

Recommendations Have Been Made To Address Elder Abuse

In my work as an Aged Care Placement Consultant I sometimes come across abuse of my elderly clients and I take this very seriously. I attended the the 4th National Elder Abuse Conference 2016 in Melbourne last year following where they announced that a national enquiry into elder abuse was to be conducted by the Australian Law Reform Commission. The Commission has come up with a range of recommendations and have accepted responses to those recommendations. They will announce the final recommendations in August 2017.  I have been interested to see what these recommendations are and note that some refer to guardianship, enduring documents, aged care as well as Centrelink payments and family agreements.

In life each adult has personal and lifestyle decisions that need to be made and they also need to be able to manage their own financial affairs. However, if the tribunal is satisfied that a person no longer has the capacity to manage those aspects of their life, due to a loss of legal capacity, it will appoint a Guardian and Financial Administrator. Typically, the person’s family member would be appointed if there is one available to perform the role. Only where there is not a family member would an external party like the State Trustees be appointed. I have on occasion been asked to find suitable aged care accommodation for a client by a State appointed Guardian.

Unfortunately, because the Guardian and Financial Administrator has complete control over the elderly person of both financial and lifestyle matters it does make the elderly person vulnerable and there is a risk these arrangements can be abused. This could be deliberate where the Guardian and Financial Administrator uses the powers to take money away from the person under the financial administration order, but the enquiry found that the most common type of elder abuse is really mismanagement of the funds through misunderstanding or confusion.

So the Commission’s recommendations are that more information about the nature of the role is made available in tribunals and that people accepting this appointment sign an undertaking that they understand the nature of their obligation. They believe this would minimise the risk of someone taking on the role without understanding their responsibilities and the scope of the role.

The best way to protect a person when they lose capacity is to be prepared before it happens and put in place enduring documents where the person appoints someone in their family they consider is best suited to make decisions on their behalf. The enquiry found that one of the risks with enduring documents is that they can be used after they are revoked. They made several recommendations, firstly to establish a national online register of enduring documents so documents can be verified to ensure that they only operate when they are genuinely authorised by the person. Secondly, to develop a suite of national safeguards that include enhanced witnessing requirements so a person isn’t under duress when signing, certification to ensure the person understands what they are signing, protections from attorneys’ conflict of interest; so they don’t make decisions to benefit themselves rather than the principal.
Also the language used for these roles was assessed and the Commission proposes that they be renamed representative’s agreements, reflecting that when you’re acting on behalf of someone else under these document you’re essentially representing the person.  Another recommendation was for a mechanism for low cost compensation be available in cases where a person has been financially abused.
These recommendations seem like sensible and simple solutions that would help to offset the risk of elder abuse that can occur when a person loses capacity. Next week’s news blog will explore the problems of elder abuse in aged care and the Commission’s recommendations.

Enduring Powers of Attorney and Guardianship Help Offset Elder Abuse

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Powers of attorney have been used for centuries. The power of attorney gives legal power to a person (attorney) to deal with financial and property matters on behalf of the person (principal) making the power. Originally, under the common law, a power of attorney terminated automatically when the principal lost legal capacity through loss of capacity (such as dementia) because the agent (attorney) could not by law make any decisions on behalf of the principal that the principal could not make themselves.  To rectify this situation legislation was introduced in the 1970’s and 80’s to establish ‘enduring’ powers of attorney, that endure beyond when the principal has lost capacity for decision making.  A person can now appoint a trusted person (or persons) as enduring power of attorney to act on their behalf should they lose capacity, upholding important principles of choice and control. This avoids the need for a tribunal appointed decision maker and may also help protect against elder abuse.

This was a great improvement, particularly for the elderly.  However, under law it was not possible to appoint another person to make lifestyle or personal decisions regarding matters like medical treatment or the most appropriate accommodation for a person who has lost capacity.  Enduring guardianship was first introduced in SA in 1993 to address this, followed by all other states and territories. In my role as an Aged Care Placement Specialist I often work with enduring powers of attorney and enduring guardians.

Currently, although all states and territories recognise enduring documentation from other states and territories there are differences.  For example, in Victoria and Queensland the enduring power of attorney and guardianship are in one document, whereas in New South Wales it is two separate documents. South Australia has a separate process of enduring powers of attorney for financial matters and advance care directives legislation, allowing a person to appoint a substitute decision maker (equivalent to an enduring guardian).

Obligations of the attorney were not set out but were defined by common law and equitable fiduciary duties, such as duties of loyalty, duties of due care and diligence whilst guardians were expected to act in the ‘best interests’ of the principal. Recently, Queensland and Victoria have passed legislation that set out principles to guide decision making by attorneys, seeking to uphold the fundamental rights of the principal. This approach is not applied consistently across the states and territories. The changes made in Victoria and Queensland will certainly help to clarify these very important roles and decision making at a critical time in the principal’s life.

If you seek more detailed information read the document on Enduring Powers of Attorney and Enduring Guardianship by the Australian Law Reform Commission.

Recommendations to Help Curtail Financial Elder Abuse Welcomed

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The Australian Law Reform Commission has recommended a national register of people holding power of attorney in a discussion paper on elder abuse, as they have found that enduring power of attorney is being used by some people as a “licence to steal”. At present the system has no way of verifying attempts to withdraw or transfer money on behalf of an elderly person. The report recognises that “early inheritance syndrome” is a form of financial abuse where children try to get financial gain out of their parents before their death.

Following widespread reports of psychological, physical and financial abuse and neglect of elderly people by relatives, friends and parents the Attorney General, George Brandis, established the enquiry by the ALRC in February 2016. About 6 per cent of elderly Australians become victims of elder abuse annually, suffering harassment, assault, theft, bullying, forced sale of assets and property. Some are forced to pay bills and have their properties taken over.  I wrote of a client of mine who suffered this situation in a blog in June  and have seen other examples of elderly abuse in my role as a Placement Specialist for aged care accommodation. It is distressing to know this sort of abuse is going on and I am relieved to see recommendations coming out of this report which will hopefully help to curtail the abuse.

“In developing the proposals in this discussion paper we have worked to balance the autonomy of older people with providing appropriate protections, respecting the choices that older persons make, but also safeguarding them from abuse,” Professor Croucher said in a statement calling for community feedback on the proposals by February 27th, 2017.

Some of the recommendations include:
 A provision in the Code of Banking Practice to prevent financial elder abuse.
Two people be required to approve access to a person’s bank account.
People who are carers, bankrupt, prohibited from directing a company or have a criminal record of fraud or dishonesty be prevented from being enduring attorneys.
It’s a shame there’s not a greed meter that could be applied to anyone who is appointed as Power of Attorney.  Of course, most relatives are very caring and respectful in this role and, is always the case with abhorrent behaviour, it is only a few that create problems.

It’s Imperative To Have The Right Financial Advice For Aged Care Accommodation

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Before helping a client, family member or yourself to move into an aged care facility it is imperative to obtain the correct financial advice. I had an experience this week with a client that really shocked me and highlighted how important this is. My client Margaret, lives in the family home and has been on a disability pension for many years.  Her father suffers from Alzheimer’s Dementia and has been in care since July this year, in a facility where Margaret had signed an agreement to pay a (RAD) Refundable Accommodation Deposit of $550,000.  The Centrelink form submitted for her father showed assets of $90,000 (excluding the family home) which put him into the partially supported category.
Margaret and her brother, with advice from their solicitor and accountant, were going to sell the family home (valued at just over $1M) and use $550,000 from the proceeds to pay the RAD to the facility, and use rest of the proceeds to purchase a smaller home for Margaret to live in.

Margaret soon realised that the current facility was unable to meet her father’s care needs as he needed a dementia secure facility. She was referred to me by a carer to look for alternative and more suitable accommodation. When Margaret told me the plan to sell the family home the following Saturday I was completely shocked! Although I am not a financial planner I do understand the rules around aged care legislation.  I referred Margaret immediately to an Aged Care Specialist Financial Planner and his first response was to take the property off the market as he understood the consequences for the father and Margaret would not be good if they followed their plan.
Firstly, the house is a ‘protected’ asset as Margaret has been living there for over five years on a Centrelink Pension. Margaret did not have the authority to purchase another property with funds from the sale of her father’s property while he is residing in aged care, even though she had Power of Attorney, as it would not be deemed as using his money for a purpose from which he will benefit, as the law decrees.  Secondly, the assets from the property sale would be attributed to her father resulting in him losing most or all of his pension. As he was already deemed a partially supported resident he could not pay more for his accommodation. Thirdly, Margaret would have nowhere to live!
The story has a happy ending as I was able to find accommodation in a dementia wing of a lovely facility with her father as a partially supported resident and NOT paying a RAD. Margaret had been badly advised about paying the RAD as well, and she now knows she is entitled to live in the family home for the rest of her life.  It was a close call.

It Takes A Team To Move Into Aged Care

Outdoor Area at Modern Facility

Outdoor Area at Modern Facility

It takes a team of professionals to help an elderly person when they reach a stage in life where they need to move into an Aged Care Facility.  This is such a big step in their life and so many aspects need to be considered and advised upon. As an Aged Care Placement Consultant, I am able to assist people move smoothly into an appropriate Aged Care Facility and I always advise my clients to get advice from an Aged Care Financial Planner, as it’s very hard to move forward in the placement process until it is known what is affordable. Once the person has been assessed by the ACAT team as needing care, the next step is to assess what they can afford in Aged Care and how they will finance their needs moving forward.. I have helped many people source appropriate facilities which are within their financial means, but of course it’s important to establish what those means are. Fortunately, I have a number of Aged Care Financial Planners I trust and can refer my clients to for an honest and accurate assessment of their financial situation.
Often clients have utilised the services of a trusted Accountant for many years. Whilst Accountants are very familiar with their client’s finances different legislation applies to Aged Care, and this is an area in which an Aged Care Financial Planner specialises. So the Placement Consultant, the Aged Care Financial Planner and the Accountant can work well together as a team looking after the best interests of the client. Likewise,clients often have a Solicitor who looks after their affairs. Whilst it is not imperative that the agreement between the facility and the client is scrutinized, some clients prefer their Solicitor to check and advise on the agreement.

A Power of Attorney is usually required for each resident entering an Aged Care Facility and either a Solicitor or the Office of Public Advocate is required to draw up a Powers of Attorney document. A Power of Attorney is required to be responsible for the financial affairs of a person if they lose capacity. I also have a number of highly regarded Solicitors I can refer my clients to.

Single Bedroom at Sapphire Oakley

Single Bedroom at Sapphire Oakley

A Placement Consultant can make a big difference to the time taken to find suitable aged care and to the level of stress on the client and their family. As I have worked within this sector for over twenty years I have a vast knowledge of the different Aged Care Facilities, the Managers of the Facilities and I keep up to date with legislation requirements for Aged Care. I am often able to place a client into a Facility much faster than they or their families could achieve and I take care of all the paper work and negotiations on their behalf, thus saving a lot of time and stress.  As I care for each of my clients, I always follow through when they are placed to make sure they are comfortable with their new home.