Improving the Experience of LGBTI People in Aged Care

It is encouraging to see the government moving toward improved aged care services for Australian Seniors. As the government engages with the aged care sector on the development of longer-term reform, they are already taking steps to help improve the experience of elderly LGBTI people entering aged care facilities.

The department’s website MyAgedCare now has a range of resources for providers to help them better accommodate the needs of LGBTI people.  They incude:

  • A 24 minute educational video on LGBTI inclusiveness in aged care
  • A consumer factsheet providing an overview of aged care services available and how to access them, specifically for the LGBTI community
  • A brochure with ‘10 questions to ask about LGBTI needs in residential aged care’.

These resources can be downloaded from the department’s website.

I have written in previous blogs about the difficulties faced by LGBTI people entering aged care facilities. Some sad stories reflect on the lack of understanding of their needs, such as facilities that would not recognize a person’s chosen gender rather than that shown on their birth certificate. Imagine being born male, then bravely living your life as a woman only to be made to live as a man and use male facilities in your old age upon entering aged care accommodation. As an advocate for the elderly, in my role as an Aged Care Placement Consultant, I have met people who have had to face these difficulties.

I therefore embrace the stance taken by the government to improve the experience of LGBTI people entering an aged care facility.  I sincerely hope that Australian aged care facilities will continue to improve their understanding and so provide the right support and appropriate accommodation to elderly residents within this group.

Aged Care Workforce Taskforce and Technology Support Improvements in Aged Care

Ken Wyatt, Minister for Aged Care

The government is taking the care of elderly Australians seriously with the development of the Aged Care Workplace Taskforce, announced on November 1st. It is tasked with developing a wide-ranging workforce strategy, focused on supporting safe, quality aged care for senior Australians.

“Everything is on the table but there are only two things that matter, safety and quality,” Minister for Aged Care, Ken Wyatt AM, said. Despite reservations from the Australian Nurses & Midwives Federation that frontline professionals had been excluded from the Taskforce, the Minister assured that the Taskforce would consult widely, reaching out to senior Australians and their families, consumer organisations, informal carers, aged care workers and volunteers as well as unions, health professionals, universities and the health, education, employment and disability sectors.

“With Australia’s current aged care staffing needs predicted to grow from around 360,000 currently to almost one million by 2050, workforce issues are vital to the quality ongoing care of older Australians.” he added. New thinking and a strong pathway for professional careers in aged care are outcomes the Minister is keen to see as a result of the Taskforce findings and recommendations.

Meantime a state-of-the-art residential aged care facility in Austral, Western Sydney is leading the way in the use of technology to support residents’ safety and wellbeing.

Opening the John Edmondson VC Gardens centre recently, Aged Care Minister Ken Wyatt AM said the innovations would help empower residents and staff.

“Technology will never replace the dedication and service of trusted care and health professionals but it can support them to provide even better and more efficient care,” Minister Wyatt said at the opening, encouraging other aged care facilities to consider using similar innovations.

The new centre, operated by RSL LifeCare, includes:

    • Bedroom laser beam, floor sensor and trip light technology to alert staff
    • Sensors that monitor and report on residents’ locations
    • A smart medication management system to maximise medication safety
    • Access to health specialists through video conferencing
    • A virtual reality social program providing animal therapy through a friendly robotic pet called Seals

My observations of the Aged Care facilities, as I visit and recommend suitable accommodation to my clients, is that many of them have great programs, comfortable and even upmarket accommodation, caring staff and a safe environment but there is a wide range of standards between different facilities.  I, therefore, support any improvements to the care of our elderly citizens, whether through government legislation and guidelines or through innovative initiatives by the facilities themselves.

 

Exploring The Effect Of Music on Creative Ageing

 

Music as therapy in aged care will be examined for the effect it has on creativity and resilience in ageing by Professor Andrea Creech, a professor in music education at the Université Laval in Canada, at the International Arts and Health Conference in Sydney from 30 October to 1st November. Held at the Art Gallery of NSW in Sydney, the overarching theme of the conference is “Mental Health and Resilience through the Arts”.

Andrea makes the point that society recognises the human need to be cared for and to belong, but often forgets how important it is for people to make a contribution, to feel valued and to be creative. “Music builds resilience, is cognitively engaging and is associated with lasting effects on brain plasticity, as well as with non-musical brain functions, such as language and attention.” she said “but perhaps the most important point is that making music is both social and communicative and is strongly related to sustaining a sense of who we are.”

Music has been used for people with dementia to great effect, as it has been found that music triggers an emotional response, tied to a memory.  Emotions and memory work side by side, so when music from a particular era is played it will often trigger memories of the person’s past that they have long forgotten.

Pete McDonald, who works full-time as a registered music therapist at Hammond Care and other aged care services in NSW, always finishes his workshop series with a public concert to which the family and friends of the participants are invited. He ensures participants are involved physically in music making, playing instruments and singing. He told Australian Ageing Agenda “Not only do we see the benefits in the social and cognitive realms, but also physical health benefits such as improved lung capacity.”

I find it heartening to hear that Professor Creech believes “It is entirely possible, given the opportunity and support, to be creative at any age”, but she then questions whether enough opportunities are provided for this. As an Aged Care Placement Consultant I regularly inspect aged care facilities and I always look for positive activities such as music workshops for my clients. It is clear that creative therapies, such as music, are positive on many levels and society’s attitude to older people need to change to allow this expression. One way is through intergenerational activity, and music is a great vehicle.

 

Alzheimer’s Australia Dementia Conference in Melbourne

The 17th Alzheimer’s Australia Biennial National Dementia Conference is being held in Melbourne right now from 17th to 20th October. The title of the Conference is “ Be The Change” – the conference aims to inspire delegates to explore more innovative and creative ways to improve the quality of life and support of people, of all ages, living with all forms of dementia. Being very involved in the aged care sector, as an Aged Care Placement Consultant, I look forward to the ongoing changes and improvements as a result of this conference.

I was very impressed by the great line up of Keynote Speakers that include:

 Dr. Susan Koch, who is currently involved in a project to develop an Australian Community of Practice in Research in Dementia (ACcORD) to improve health outcomes for people with dementia and their carers; Professor Sam Gandy, an international expert in the metabolism of the sticky substance called amyloid that clogs the brain in people living with Alzheimer’s disease; Naomi Feil, developed the now world renowned Validation method and has written two books and numerous articles on the method; Scientia Prof Henry Brodaty AO, one of the world’s leading researchers in dementia, a clinician, policy advisor and a strong advocate for people living with dementia and their carers and Ita Buttrose, National Ambassador of Alzheimer’s Australia, having served as National President from 2011-14, and a former Australian of the Year (2013), she has had a long interest in health and ageing.

 

Dr. Piers Dawes from the University of Manchester is giving the Libby Harrick’s Memorial Oration. Dr. Dawes oration explores the relationship between hearing impairment and cognition, looking at the implications for hearing loss as a biomarker for cognitive well-being and also as a causal contributor to cognitive decline and poor quality of life in older age.

At the Conference research, being jointly undertaken by the University of Melbourne, Dementia Australia and Assistance Dogs Australia, on the affect of assistance dogs on people with early onset dementia was discussed. The research so far has shown that assistance dogs help to relieve loneliness, anxiety and depression for their owners with early onset dementia and gives them the experience of responsible dog ownership. Another bonus is the help they give to carers and family by providing the extra support. This research continues until next year.  I look forward to seeing the final research findings which may be of help to some of my clients who are seeking suitable aged care accommodation.

Helping Elderly Aged Care Residents Improve Well-being Through Technology

A guide to help aged care organisations support residents to use technology and social media to stay connected with their loved ones was launched in Canberra recently. Tech Connect: Staying Meaningfully Connected in Aged Care is a valuable resource using technology to help make the lives of older Australians better. There is a growing trend towards using technology in aged care to support and uplift the lives of our seniors. As an Aged Care Placement Consultant I see the benefit of using technology to help residents in aged care stay connected.

Launched by Meaningful Ageing Australia, the aim of Tech Connect is to support residents’ spiritual wellbeing by helping them maintain important connections with family, friends and occasions. Written by Southern Cross Care spiritual wellbeing coordinator Beate Steller, who utilises technology at SCC’s Nagle Residential Aged Care to keep connections going, it helps to maintain residents’ familial relationships, helping to overcome physical separation.

Ms. Steller said “It is not just the technology but the way you facilitate it and make the connections before, during and after an event.” For example an 87-year-old resident of the facility realised she was too frail to attend her grandson’s wedding, so the wedding was brought to her. Shown on a large screen with residents celebrating with a high tea Pat was able to be involved in the wedding despite her physical limitations. “In the weeks leading up there was all the preparation, the couple skyped Pat before the wedding and afterwards it was all the reminiscing and the memories,” Ms Steller said.

Technology has been adapted in other ways too. Talk2Me aims to fill a gap through the development of a voice-to-voice translation tool, designed with the needs of older people, particularly those living with dementia, in mind. People talk into the device, which translates their message into another appropriate language, forming a communication link with another person. This will be a game changer for people with dementia from culturally and linguistically diverse (CALD) backgrounds as it will improve the quality of care, with their carers able to understand their needs, thus reducing the need for potentially avoidable hospitalisations. The project is by the National Ageing Research Institute (NARI), Curve Tomorrow and Mercy Health and has received funding from the Department of Health.

Even pain can be better monitored through an App called ePAT, developed by Curtin University that assesses pain in people with dementia. A study, recently accepted for publication in the Journal of Alzheimer’s Disease, tested the validity and reliability of the electronic pain assessment tool in people with moderate to severe dementia. The research found strong positive correlation in the psychometric properties between the ePAT App and the Abbey Pain Scale.

Using the camera in a smartphone or tablet to video an individual with dementia, then using facial recognition software to detect the presence of facial micro-expressions that are indicative of the presence of pain the App combines this information with other pain indicators, such as vocalisations, behaviours and movements, to generate a pain severity score. As pain is very common among people with dementia, who often lose the ability to communicate verbally as the disease progresses, this pain can go undetected. An App that can help detect severe pain can only help to make their lives more comfortable.

 

The Picture Of Aged Care In Australia

Jillian Slade with a happy client.

It is fascinating to look at the statistical information gathered about aged care services in Australia. 249,000 (equates to almost a quarter of a million!) people were using these services on 30 June 2016. As I regularly visit aged care facilities on inspections for my clients to find the most suitable facility for their particular needs, many of these statistics are seen as realities to my eyes.

For example, two out three people in aged care are women; ofcourse in my role as an Aged Care Placement Consultant I see this myself. Apparently the reason they outnumber men in aged care services is because on average women live longer and have higher care needs at these older ages. One of the sadder statistics is that Aboriginal and Torres Strait Islander people in residential care are on average younger than non-Indigenous people. The reason for this may be because of their more complex health needs and shorter life expectancies. Interestingly, Aboriginal and Torres Strait Islander people only account for 1% of all people in permanent residential aged care and make up 4% of people in home care.

32% of people who are in aged care services were born overseas. This is in direct correlation with migration statistics, with 36% of people aged 65 years and over in Australia having been born overseas. This stat gives clear evidence as to the need for more culturally appropriate services in aged care for this group.

Statistics on respite care in residential care facilities reflect how important these facilities are for respite in remote regions.  Major cities only recorded 2.6% of the people in residential care facilities being there for respite. There was an outward radiating statistic for this group the more remote the facility was, with inner regional being 3.1%, outer regional being 3.6% and remote and very remote being 4.6%.  One assumes this is because there are not many other respite facilities available in these regions.

 

 

 

Government Stats on Aged Care Provision

Statistics now available from the Australian Institute of Health and Welfare paint an interesting picture about aged care services. Statistics on aged care for 2016 indicate that the number of aged care places is increasing, with 1.4 times as many places over the last ten years from 2006 to 2016. As an Aged Care Placement Consultant these stats simply prove what I have already witnessed, the number of elderly people needing aged care is noticeably increasing.

Occupancy rates tell us how close to full capacity the care system is, so it was interesting to note that residential care had the highest occupancy rate for 2015/16 financial year at 92% . Transition care at 88% was next, followed by home care at 83%. Occupancy rates are calculated by adding together the total number of days that all people spent in care during the year, then dividing that number by the total number of places that were available. The stats around occupancy rates for residential aged care is concerning but information that the highest number of builds in the building and construction industry recently has been for aged care residential facilities does give some comfort.

65% of aged care services were run by not-for-profit organisations in 2016. A trend emerged that most of the privately-owned aged care services were in cities whilst in remote areas services were predominantly government run.

Although aged care services can be delivered by any of the following:

  • government organisations,
  • not-for-profit organisations
  • private companies

the Australian Government contributes towards the costs of care for most aged care places. Around 95% of government spending in aged care comes from the Australian Government, with state and territory governments providing 5%.

So, what are the figures?

The governments spent approximately $17 billion on aged care in 2015/16.

69% of this figure was spent on residential aged care.

Expenditure on residential care was 2.7 times that spent on home care and support.

The break up was – $11.5billion on residential care, $4.3 billion on home care and support.

The government recognises that aged care provision is a growing area with an ageing population. In my role wthin the industry, helping people find suitable aged care accommodation, I hope that the required quality and quantity of residential aged care will be provided well into the future.