Sudden and Complex Decisions in Aged Care

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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

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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!

 

 

Aged Care Placement During The Corona Virus Pandemic

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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

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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

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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.

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.

 

 

 

 

 

 

 

 

Aged Care As the Population Ages

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It’s a great outcome in health terms that Australians have one of the highest life expectancies in the world. But this presents certain challenges with an increasing ageing population. The baby boomers, those born just after the second world war, are now ageing, with the first of them turning 65 in 2011. As a result in 2017 3.8 million Australians were in the 65 and over age range. This represented 15 per cent of the population. By 2050, 1.8 million people will be over the age of 85.

At the same time we have a decline in fertility rates, with the number of children per woman falling from 3.5 to 1.8.

Healthcare

Naturally, health care is going to become a high priority as the population continues to age. According to a report by the Parliamentary Budget Office, demand for health services rise upon a person reaching their 70s, with the need for aged care services increasing further when they reach the age of 80.

There is a movement away from hospital care to at-home support services. People would much rather be treated and looked after within their own home than spend lengthy periods of time in hospital. It is also a more cost effective method of providing adequate health care to the elderly. So, in terms of primary care costs this is an improvement. However, the system needs re-evaluation to keep up with demand.

Aged care facilities will still be needed for people with high demand needs, such as 24 hour care. Ensuring they are managed and staffed to a level that the community finds acceptable is of utmost importance. I know from my experience as a Placement Consultant that there are many very well run aged care facilities that meet expectations, but there are those that do not. I scrupulously research facilities for my clients and follow up with them to ensure they and their families are satisfied.

We must aim for a standard across the board that provides excellent care and respect for our elderly. After all they paved the way for the rest of us to live in such a privileged society.

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

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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.”

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