New Aged Care Facility in Greensborough

 

Trinity Manor Greensborough frontAs an aged care Placement Consultant I am, at times, invited to visit new aged care facilities prior to their opening. Recently I was invited to visit Trinity Manor Greensborough to view the facility before it opened its doors to residents yesterday (16th May, 2019).

Trinity Manor Greensborough reception

There are 112 beds, including 12 in the Memory Support section for those living with dementia needing a secure and safe environment.  They offer these residents a specialist dementia care support program. All residents have access to care by qualified registered division 1 nurses, available 24 hours.

The chef prepared a lovely lunch for me so that I could sample the standard of meals that will be served to the residents. They will have a plentiful supply of food throughout the  Trinity Manor Greensborough meal

day, with a continental and hot breakfast followed by a main meal at lunch with offerings such as Rogan Josh, roast leg of pork with apple sauce, crumbed fish and beef and shiraz pie served with a varied range of vegetables daily followed by desserts such as mango panna cotta and apple strudel. A soup is served in the evening followed by a light meal and dessert. Cakes, devonshire tea or biscuits are served at morning and afternoon tea and supper.

It was intriguing to see a robot in action in an aged care facility; its role is to take the load from carers and kitchen staff. Able to deliver to rooms and various departments, the robot accesses the lift to reach different floors.

Trinity Manor Greensborough robot 2

The robot stops when a resident is near and plays music as it goes along. In my role as a Placement Consultant I have to confess this is the first time I’ve seen a robot in aged care. The facility is using the Lamson Robo, which is easily operated with an IOS mobile app, allowing the operator to call and send the robot via a mobile device. Whilst I was visiting they were mapping the building with the robot. The new residents will be involved in naming the robot, with a competition for its name.

The facility has many great features, with a hairdresser,

Trinity Manor Greensborough haridresser

massage room, gymnasium, cinema,

 

private dining rooms for family meals, outdoor bar b q, multiple dining and lounge areas and balconies and terraces off rooms. The décor and furniture is all modern and tasteful.

Aged Care Service Not Age Friendly

elderly lady at home

Extraordinarily, Australia’s aged home care sector has come under some strong criticism for not being age friendly according to a report from the University of South Australia . Older Australians have been left feeling disempowered and lacking in confidence due to its complexities. Research explored the ability of people aged 65 plus to select and financially manage their home care packages;

“Home-care packages support people to stay in their own homes for longer, so they are a really appealing option for people as they age or become less independent,” said lead researcher, Braam Lowies “But our research found that older people felt insecure about their capacity to manage home-care packages to their best advantage and we wanted to understand why.”

What they found was that, although the government had recently increased total aged care spending to $662 million, including the release of 10,000 additional home-care packages, the environment in which the packages are provided was so complicated that many older Australians were unsure of which options best suit their personal situation.

Clients of mine are currently dealing with this very situation. A 96 year old couple are in need of support, having stayed independent until this year. The husband had a bad fall and is now in a rehabilitation unit and will probably need my help as a placement consultant to find accommodation in an aged care facility. However, his wife is keen to stay at home with support. She has found she needs help from her family to even begin the first step of applying for assistance. Without their support she would not be able to access the service on her own.

“We found a host of problems from a general lack of confidence and lack of knowledge of the system among older people, to overly complicated communications, high staff turnover and inadequately trained staff providing in home care, inconsistencies in package administration, confusing fee structures and even inaccurate billing processes” Dr Lowies said “Unfortunately, the more complicated and inaccessible the programs are, the more it creates a lack of confidence and motivation for older people accessing services.”

The banking and finance industry was also examined in the Financial Capability of Older People report and it came in for criticism too for not being age friendly.

 

Improving the Quality of Life for Residents in Aged Care

allity-templestowe-indpendent-living-manor

Many approaches are being tried in aged care facilities to improve the quality of life for residents. As a Placement Consultant I like to know that my clients will enjoy a contented and engaging life once they move into an aged care home, that not only will their physical needs be taken care of but their emotional, spiritual and intellectual needs too. Some fine examples of programs that help provide a good quality of life are discussed below:

Music therapist Heather Seyhun at ACH West Park Adelaide, brought in her own collection of drums from Africa and Brazil to begin a music trial she devised. Three months on, she says she’s amazed at how the group has evolved and the positive changes she has witnessed.

“When we started out, people were a bit unsure, because most had never hit a drum before, and felt outside their comfort zone,” she says. “Now they’re loving it, and they’re getting really good.”

Heather has seen improvements in wellbeing, socialisation, self-confidence and mobility. “You can see the enjoyment, the new friendships – playing music with others creates a special bond.” she says “Watching people with physical limitation participating, growing in confidence and supporting each other is so rewarding.”

A Zen Garden has been created at St. Patrick’s Green, Kogarah, NSW, based on the philosophy that a bit of nature is good for the soul and will allow residents to relax and meditate, among the sounds of a water feature and rustling palms.

Other wellbeing rooms are the Spa Room and Reflection Room. Residents can enjoy a soothing massage experience, complete with lavender essential oils, calming music, facials and other beauty treatments for a complete pamper experience.

The Reflection Room provides a tranquil space for residents to reflect on life, away from the bustle of communal areas. It also acts as a private space for residents to meet with the manager of Spiritual and Holistic Care if anything is troubling them.

Some therapies that research have found to be effective are:

Animals and pet therapy;Aromatherapy; Art therapy and craft; Behavioural activation and pleasant events; Bright light therapy; Cognitive behaviour therapy; Cognitive and memory skills interventions; Companion robot; Dance and movement;Dementia care mapping; Humour therapy; Laughter yoga; Life review; Life review therapy; Massage; Music and singing; Person-centred care; Restorative approaches; Simple reminiscence;Yoga.

More indepth information is available in the studyWhat works to promote emotional wellbeing in older people: A guide for aged care staff working in community or residential care settings. Melbourne: beyondblue by Wells, Y., Bhar, S., Kinsella, G., Kowalski, C., Merkes, M., Patchett, A., Salzmann, B., Teshuva, K., & van Holsteyn, J. (2014).

 

 

 

 

 

ACAT Assessment and Specialist Dementia Care Program

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ACAT Assessment

The Australian Government Department of Health has in recent times received a number of enquiries from providers of aged care about when an Aged Care Assessment Team (ACAT) assessment is required. The department states that “A subsidy cannot be paid to an approved provider for providing care to a person, unless the person is approved under the Aged Care Act 1997 (the Act) as a care recipient.

An ACAT assessment is required if a person is seeking access to aged care services that are funded under the Act, such as:

  • Residential Care
  • Flexible Care in the form of Transition Care or Short-Term Restorative Care
  • Residential Respite Care
  • a Home Care Package. “

 

New Initiative Rollout 2019

One of the Department of Health’s new initiatives – the Specialist Dementia Care Program (SDCP) is beginning to roll out.

This program will provide care for people exhibiting very severe behavioural and psychological symptoms of dementia (BPSD), who are unable to be appropriately cared for by mainstream aged care services.

The SDCP will offer specialised, transitional residential support, focussing on reducing or stabilising symptoms over time. I have, at times, been in the position of finding suitable accommodation for people exhibiting behaviour that cannot be managed in the aged care residential service in which they reside. It is a difficult situation and, as an Aged Care Support Consultant, I applaud the introduction of specialist services to accommodate people in this position.

The department has advertised a targeted grant opportunity for a prototype SDCP service, with the next round of 14 SDCP grant opportunities to be advertised early this year. This first phase of specialist dementia care units is expected to be operational in early 2020 with a full rollout in 2022-23. It is expected that there will be at least one specialist dementia care unit (within a broader residential aged care service) operating in each of the 31 Primary Health Networks.

One of the objectives of the SDCP is to generate evidence on best practice care for people exhibiting very severe behavioural and psychological symptoms of dementia that can be adapted for use in mainstream settings to benefit all people with dementia.

Source: Australian Government Department of Health website.

 

New Aged Care Facility in Box Hill

Bluecross Box Hill-gardens.jpg

Bluecross opened its newest aged care residence in Box Hill on October 22nd amongst much fanfare and a family open day with radio broadcasts, Mike Brady, games and a sausage sizzle. I had a quieter intro to this facility, being an Aged Care Placement Consultant I was invited before the opening for a preview.

The residence boasts a host of world-class facilities, including several lounges, dining and sitting rooms, activity areas, consultation and treatment rooms,

a library, hairdressing salon, private dining room, as well as a gymnasium and cinema .

I was impressed to learn they have a memory support environment for people living with dementia. With more people developing this condition as the population ages I am often called upon to find a suitable environment for my clients living with dementia.

The residence is designed with an emphasis on a homelike environment for residents, despite its state-of-the-art facilities according to Interim Chief Executive Officer Robert Putamorsi.

Bluecross Box Hill-suite

The different functional spaces like a number of smaller sitting rooms and dining areas make it more homely and a private dining room is available for residents who want to share a family meal with their relatives. The bedroom suites are generous and feature kitchenettes.

Comprising a basement and three levels, stage 1 boasts 173 rooms and another 43 rooms will be added in the stage 2 development in 2019. $64million was spent on the residence as it becomes part of the stable of 33 aged care facilities owned and managed by Blue Cross across Victoria. With a growing demand for high quality aged care homes in Victoria I welcome this new addition as I source suitable aged care residential places for my clients.

 

The Gap For Older People With Behavioural Problems

Arcare lauriston

This week I was asked to assist two sisters to find accommodation for their 67 year old mother, Doreen.  It was one of the most heart wrenching experiences I have had as an Aged Care Placement Consultant for some time. Doreen had recently been diagnosed with dementia, although the sisters were aware she had been in gradual cognitive decline for some time.

One of the daughters, Rosie, and her 3 year old had moved from Queensland 5 months ago to live with her mother and be her carer.  When I went for the initial visit I found that Rosie and her child had been sleeping in the car in the driveway for the past 2 weeks because Doreen had been screaming at them, banging doors and talking to imaginary people every night.

Doreen was not eating or sleeping and was wandering. Rosie was getting calls from local shopkeepers worried about her mother, but she was unable to stop the behaviour and could no longer cope. So the daughters spoke with Doreen’s neurologists and it was decided to initially admit Doreen to a private hospital for a medication review.

I took Rosie and her sister Kate to visit 4 aged care homes that had dementia care.  They chose a home which they felt was the best fit; flexible and in a great location for friends and family to visit.  The plan was to admit Doreen there once her medication had been sorted at the hospital.

Just as they breathed a sigh of relief they got a call from the hospital saying they could not accommodate Doreen’s behavioural needs and suggested that she be admitted to a psycho geriatric hospital.  Despite frantic calls the sisters found there were no beds available for their mother in a pyscho geriatric hospital and Doreen’s condition was worsening.

There has always been a large gap in our system for older people living with dementia and exhibiting difficult behaviours or psychosis. Aged care homes are fearful of danger to current clients and there are very few psycho geriatric hospitals, leaving very few options for an ever increasing number of people suffering this way.

Having heard the desperation in Rosie’s voice when I called to check in on Doreen I decided there might be one more avenue I could try. Drawing on my many years of experience as an Aged Care Placement Consultant and my knowledge of the aged care system, I contacted the aged care facility they had selected and explained to the manager that the hospital medication review was not going to happen and the daughters’ current circumstances.  I asked her to consider admitting Doreen to the facility in the dementia support section and, if she became unmanageable, transfer her to an appropriate hospital.  This type of transfer is easier to arrange by a manager of an aged care facility than for family.

The great news is that management did not dismiss this out of hand and agreed to Doreen moving into the facility immediately.

The Leisure Seeker Film Opens Up a Moral Discussion on Dementia

It was good to read Phillipa Byer’s review of the film The Leisure Seeker on 12th July in the Sydney Morning Herald. She pulled no punches about her opinion of the ending and its message. The story is about a retired teacher who has dementia and his wife who has cancer. They embark on a journey in their motor home. Spoiler alert – the finale involves the wife giving her husband a drink that brings about his demise then she commits suicide. The husband had earlier said to his wife that when the time came for him to go to one of “those places” (meaning an aged care residential facility) she should equip him with a rifle and remind him how to use it (on himself).

Phillipa was furious at this ending and I can understand her emotion. I am an Aged Care Placement Consultant and help elderly people find suitable accommodation, this includes people living with dementia and I take a keen interest in aged care facilities that support those with dementia. Philippa volunteers at a dementia specific residential facility, has a relative with dementia and is a research associate at the Australian Catholic University’s Plunkett Centre for Ethics and is currently working on a dementia project.

She states “The belief that residential aged care facilities are so bad that killing or suicide are reasonable preferences is apathetic and alarming.”  She points out that there are surely alternative moral imperatives, such as advocating for more funding as a minimum. She also has issue with the wife administering the death juice but not informing the husband that’s what it is. Surely, he has the right to decide in that moment. She is concerned, that as people with dementia live amongst us, we can’t loosen the moral bonds of honesty with them just because it may be uncomfortable or difficult. A new village being developed in 2019 in Hobart reflects the philosophy that, after a full life making their own decisions, people with dementia can have a valid opinion on their day to day life. Koongee Village allows people with dementia to live, roam free and have all the facilities they need in a safe setting.

The butterfly model being introduced to many aged care facilities in Australia is a new culture of care for people living with dementia and focuses on emotional intelligence. People live in smaller homes, are not treated as patients and are involved in daily activities in the home and garden and also learn new skills. There are good news stories about people living with dementia and, as an Aged Care Placement Specialist, I’m pleased to share them.

Read Phillipa’s Review.