We have now entered a new year, and a new decade. It has been a very tough end to 2019, and a difficult start for many, with months of devastating fires across the country. Our thoughts have been constantly with all those affected by the devastating fires; the lives, homes, bushland & wildlife lost. We know so many of the people in our beautiful industry have facilities, property, friends and family in the affected areas, and our heart goes out to everyone. We are in awe of the communities that have banded together and all the exceptionally brave people who have had to make incredibly difficult decisions to keep people in their care safe, whilst their own homes and families were also at risk. We cannot fathom the courage that firefighters, volunteers and individuals have mustered, risking their lives to prepare, fight and save. We certainly don’t have the words or actions to match the enormity of the awful situation.
As we enter this year, although we are sure many of you share the feelings of inadequacy in this situation, we continue to be incredibly proud of everything our industry stands for and achieves. We hope to enter this new decade as an amazing industry, proudly continuing on with love and compassion and with the courage to make an impact in the industry we love.
‘If you can’t do big things – do small things in a big way’ – Napoleon Hill
2019 was an extremely busy year for the industry. We saw the launch of the Aged Care Quality & Safety Commission, the start of the Royal Commission into Aged Care, and the new Aged Care Quality Standards coming into effect in July. The Royal Commission was a prominent feature of news throughout the year, with 15 public hearings, a number of community forums, the release of background papers and the Interim report released at the close of October 2019. The events of the year has meant that our industry has had a huge amount of additional work created for all of the amazing teams working in Aged Care and wanting to make a difference. These pressures have been amplified by the media and public scrutiny, changing processes and legislation. The beauty, resilience and hard work of the industry has been evident throughout the entire year. On top of the remarkable people working in Aged Care, we saw advances in dementia research, an enormous number of exciting tech developments to assist in enhancing the quality of life of older people, and a documentary that enthralled the nation, Old people’s home for 4 year olds. Before we leap into the new year, let’s take a final look at 2019, and the events of December.
ROYAL COMMISSION
The final Royal Commission hearing for 2019 was held in Canberra, from 9 – 13 December. The focus of the hearing was the ‘Interfaces between the Aged Care and the Health Care system’. This included the challenges that are faced by people living in care when needing to access health services; the process of hospital transfers to and from care; rehabilitation and transitional care post a hospital visit and if these processes need to be improved; and if there is sufficient access and funding to palliative care services for those living in Residential Aged Care, amongst other issues.
One of the focus points for the Canberra hearings was how the health system works to deliver primary health care to those living in Aged Care. Witnesses shared that although many GPs provided exceptional care, the current system has the ability to ‘break down’, and does not support holistic or continuity of care. Calls for a new model of care were expressed, and an emphasis on the importance of the GP and patient relationship, as many people are forced to change GPs when they move into Residential Care. New funding models were also explored by a panel of health and Aged Care experts, as a way to improve access and quality of primary health care to Residents. The hearing saw the Royal Commission suggest medical response teams to improve health care to either people living in care, or receiving Home Care, which would also ensure access to specialists.
Commissioner Lynelle Briggs AO stated at a public forum in November that the Aged Care system should work to help elderly people enjoy the last 10 to 15 years of their life, and should not accept anything less.
With a great deal of media reports surrounding the Royal Commission, the Aged Care Guide, Australian Ageing Agenda and The Weekly Source are excellent sources of information. You can also access live and past hearings via the Royal Commission webcast channel here.
CONSULTATION PAPER RELEASED
In more Royal Commission news, in December Commissioners Tony Pagone and Lynelle Briggs released their first consultation paper. The consultation paper, titled Consultation Paper 1: Aged care program redesign, is an invitation to both organisations and interested individuals to share their thoughts and submissions on the future design of the Aged Care system. The paper asks the question; “how could we ensure that any redesign of the aged care system makes it simpler for older people to find and receive the care and supports that they need?”
The paper shares a proposed model for the Aged Care system, based on the most effective ways to meet key types of needs, which would separate care from accommodation.
For more information, you can read further on the Royal Commission website here, and view the consultation paper here.
Submissions close on Friday 24 January 2020.
MYEFO & FUNDING
December saw the release of the 2019-20 Mid-Year Economic and Fiscal Outlook (MYEFO). Prior to the release, the impending MYEFO prompted a number of peak bodies and organisations representing Aged Care Providers to call for it to be used to address the funding issues and areas that needed immediate action in the sector. Smaller Aged Care facilities feared that without additional funding, they would be unable to continue operation; and there were continued calls to increase Home Care package funding, to help dent the current 120,000 person waiting list. The release of the MYEFO restated the $537M funding package, to be delivered over four years, that was announced in November in response to the Royal Commission’s interim report, of which $497M is for 10,000 additional Home Care packages. An additional $87M is to be allocated to Aged Care system administration and backend services. Aged Care Providers and peak bodies have expressed disappointment in the budget update, and the Australian Nursing and Midwifery Federation (ANMF) has questioned how the funding allocated to the sector can be guaranteed to provide quality care for older people living in care.
2020 ACAR
Mid-December saw the Minister for Aged Care and Senior Australians Richard Colbeck announce that 10,000 Residential Aged Care places, and 750 short-term restorative places would become available for the 2020 Aged Care Approvals Round. Applications will open in March 2020, and remain open until May 2020. The number of places in the 2020 ACAR has dropped from the 2018-19 ACAR, which saw 13,500 places allocated. Stakeholder consultation, with the aim of identifying specific locations and areas of unmet needs that should be targeted in the 2020, opened on 18 December 2019, and will close on the 31 January 2020.
Possible alternatives to the ACAR process underwent a consultation period in mid-2019. The results have not yet been made available.
To read further information on the 2020 ACAR and the stakeholder consultation, see the government’s website here.
AIHW REPORT
A new report, released by the Australian Institute of Health and Welfare (AIHW) in December, shares the results of surveys conducted over the past two years on the Consumer’s experience of Aged Care. The report, titled ‘Consumers’ experience of Residential Aged Care 2017-19’, is the result of nearly 31,500 Residents interviewed from over 2,000 facilities over two years, 65% of whom were women, and approximately a third of who had proxies for their responses. The report showed that overall, most older people had a positive experience or view of their experience in Aged Care, feeling safe and respected. The independent analysis was welcomed by Aged Care Quality and Safety Commissioner Janet Anderson, as a way to better understand the experience of people experiencing care in the sector.
You can find the report here.
CHEMICAL RESTRAINT
Chemical restraint regulation legislation was further amended, after a mid-November parliamentary committee recommended that the recent legislation, Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019, concerning restraints in Aged Care, should remain in force but be amended.
As announced by Minister Richard Colbeck, the legislation now:
- makes it clear restraint must only be used as a last resort
- refers to state and territory legislation which regulates the responsibility for prescribers to gain informed consent for chemical restraint
- requires a review of the first 12 months of the operation of the restraint regulations to ensure aged care facilities are minimising the use of inappropriate restraint.
A breakdown of the amendment changes and what they mean by Russell Kennedy Lawyers can be viewed here.
AGED CARE QUALITY AND SAFETY COMMISSION NEWS
As reported in our October Industry Update, new legislation that expanded the Aged Care Quality and Safety Commissioner’s functions, was officially passed in December 2019, and came into effect on 1 January 2020.
The Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019 expands the role of the Aged Care Quality and Safety Commissioner to include oversight of:
- approving all residential and home care providers;
- aged care compliance and enforcement actions; and
- the administration of the responsibilities of approved providers to report assaults.
You can read the Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019 here.
December also saw the release of the Aged Care Quality and Safety Commission’s first Annual Report, covering the period 1 January 2019 – 30 June 2019. The report also includes information on the period 1 July – 31 December 2018, covering the last 6 months of the Australian Aged Care Quality Agency. You can read the full report here. The Commission also released a Sector Performance report, for the period 1 July to 30 September 2019, which you can find on their website here.
The Quality Commission released a new Aged Care Quality standards mobile app, which provides information on the quality standards, access to resources, and the ability to email the commission. The mobile app, released in November, . The app can be found in both the App Store and Google Play, by searching ‘quality standards aged care’.
RETIREMENT SECTOR NEWS
The Retirement Living Code of Conduct is now in full effect, as of 1 January 2020. The voluntary code is the sector’s self-assessment tool, and with the new standards launched in October 2019, the Australian Retirement Village Accreditation Scheme (ARVAS), aims to work alongside the standards. The code sets the minimum standards for Retirement Village inhabitants. It does not replace legislation but intends to provide a basis for putting regulation into effect, whilst maintaining high standards and meeting the needs of all stakeholders.
A new Retirement Living model is being offered in Sydney and Canberra by Provider LDK Healthcare, which is set up to have a ‘One Move Promise’ – where Residents will continue to be able to live in the village even after they are no longer independent, as there is a full care team on site 24/7. An initiative to support older people to age in place, the model will enable couples to stay together, even if one person’s needs change.
Finally for Retirement living, another new initiative has been launched by Exercise & Sports Science Australia (ESSA), to encourage inactive older Australians to increase their physical – and social – activity. The Exercise Right for Active Ageing is part of the Move It AUS – Better Ageing program, and encompasses 12 weeks of subsidised activity for people aged 65 years and over. The initiative intends to reduce isolation at the same time as increasing their activity, with a focus on group classes, held in places such as retirement villages.
DEMENTIA NEWS
To December’s dementia news, and a very exciting development in the search of reversing symptoms, where scientists have been able to successfully reverse the effects of dementia in a study on mice. The scientists engaged in the study have also created a new company to develop a drug based on their findings that can be used to help humans, although the chances of being able to replicate the results in humans is not yet known. The study was published on Science Transitional Medicine.
Tai Chi, an ancient Chinese exercise that combines both the body and the mind, has been linked to reducing falls, and improving quality of life for people living with dementia. With people living with dementia twice as likely to both fall and experience injury as a result of the fall, the practice of Tai Chi has been found to be an incredibly safe and beneficial practise. You can read further on the research here.
More dementia research has uncovered a link between air pollution and Alzheimer’s disease, verifying that air pollution changes the brain. Based on data that covered location of participants, as well as considering other factors such as race, smoking cigarettes, income and education, there was an association with exposure to higher pollution levels and changes to the brain that are similar to patterns seen with .
And finally for dementia research, Dementia Australia’s Centre for Dementia Learning launched a new workshop in December, based around VR technology. ‘A day in the life – mealtime experience’ aims to educate Aged Care professionals using virtual reality, by enabling how a mealtime may be experienced by someone living with dementia. The VR technology program was developed by Dementia Australia with Deakin University, and supports Dementia Australia’s demand for the need for dementia-specific training for the Aged Care workforce.
ELDER ABUSE
A new resource with education, resources and tools has been launched, to help both prevent elder abuse, as well as helping people to recognise it. The knowledge hub, ‘Compass – Guiding action on elder abuse’ was launched by the peak body Elder Abuse Action Australia (EAAA) and the Commonwealth Attorney-General’s Department, an initiative funded by the National Plan to Respond to the Abuse of Older Australians (Elder Abuse) 2019-2023. The website intends to enable access to information and resources on elder abuse and be readily accessible.
Another resource for preventing elder abuse was announced by Minister Richard Colbeck in December, that was developed by the Older Persons Advocacy Network (OPAN). A free mobile app, OPAN Elder HELP, and a video ‘Noticed Something?’, are informative resources created by OPAN to help educate and provide information on things such as accessing advocacy services. Find out more about the app and video on OPAN’s website here.
In more elder abuse news, a decision made by the Council of Attorneys General in Adelaide will mean that a base minimum standard is set for Power of Attorneys, along with a mandatory online register, which will help to overcome elder financial abuse. The coalition to fight elder financial abuse, made up of the Australian Banking Association (ABA), OPAN, the Seniors Rights Service, EAAA, National Seniors and the Council on the Ageing (COTA), and backed by Bauer Media, had been campaigning for a national consistency of Power of Attorney laws and register. The ABA has also released a support resource titled Safe & Savvy: A guide to help older people avoid abuse, scams and fraud. You can view the resource here, and the ABA’s elder abuse campaign page here.
VOLUNTARY ASSISTED DYING LAWS PASS IN WA
Following Victoria’s landmark passing of voluntary assisted dying laws, that came into effect in mid-2019, WA passed new legislation in December to legalise euthanasia. The laws will come into effect in 2021 after an 18-month implementation period.
END OF LIFE & PALLIATIVE CARE
Research that has been led by Advance Care Planning Australia (ACPA), has shown that nearly a third of Advances Care Directives (ACD) for end of life care, are invalid. Based on a nation-wide study, the results show that ACDs in Residential Aged Care has been completed by someone other than the person receiving care, as the result of them no longer being capable. An ACD however, is only legal when it has been completed and signed by the person when they were capable of making decisions, therefore putting Residents at risk of receiving, or not receiving, treatment according to their preferences. ACPA have released a position statement that includes recommendations to assist with ensuring the validity of ACDs.
Palliative care was also raised in December’s Royal Commission hearing in Canberra, as it explored the challenges faced when working with the health system and Aged Care. Palliative care was also referenced in the Royal Commissioner’s first consultation paper, which was welcomed by Palliative Care Australia (PCA), stating that that acknowledgement of older Australian’s needs at the end of their life reflected views represented in their submission to the Royal Commission.
Palliative care was also discussed in late November in Parliament House, with PCA, Dementia Australia and the Parliamentary Friends of Dementia meeting to bring attention to the needs of people living with dementia. New resources, titled ‘What Matters Most’ have been developed for workers in both health and Aged Care, which will be sent to all Aged Care Providers. Dying well – Improving palliative and end of life care for people with dementia was also presented and is available to view here.
RELIGIOUS DISCRIMINATION BILL
As reported in our October Industry Update, there continues to be concern surrounding what the federal government’s proposed Religious Discrimination Bill means in the Aged Care sector. The government released a second exposure of the draft Bill in December, with changes to include that Providers in the health sector can make staffing decisions based on faith.
The concern expressed for the Aged Care industry is the challenge the proposed Bill could present to workers, with a current shortage of skilled workers in the industry.
For more information on the proposed Bill, you can refer to the Second Exposure Drafts page here, and view the key changes here. Submissions for the second consultation process will be accepted until 31 January 2020.
NUTRITION NEWS
The Lantern Project, a project founded in 2013 and focused on ensuring people living in Residential Aged Care are nourished and enjoy eating, have launched a new rating tool to help improve food in Aged Care. The evidence-based tool, EpiCURE, collects data on food and nutrition, as well as the experience of mealtimes and Resident’s stories to provide a rating, highlight areas of strength and determine areas for improvement. Once a rating has been provided, The Lantern Project can also develop an ongoing strategy for improvement, as well as ongoing support.
NEW RESOURCE AVAILABLE TO SUPPORT STOLEN GENERATIONS IN CARE
New resources to guide both health and Aged Care workers to support Stolen Generation survivors receiving care have been developed and released by The Healing Foundation. The national Aboriginal and Torres Strait Islander organisation works with communities to address ongoing trauma experienced by survivors. The resources include a number of fact sheets that cover the best ways to provide care services to the Stolen Generations, without triggering trauma. The fact sheets are tailored for each care occupation and are available for Aged Care workers, GPs and dentists.
You can find the resources on The Healing Foundation’s website here.
AWARD-WINNING INDIGENOUS AGED CARE PROGRAM SUFFERS FUNDING CUTS
An award-winning program that provides Home Care services to Aboriginal Elders living in the Batemans Bay area of the south-east coast has suffered funding cuts. Booraja Home Care, which offers Home Care packages that are specifically designed to the cultural needs of older Aboriginal people, had the pilot program initially funded by a grant in 2017. The program won the innovAGEING National ‘Realising Wellness and Re-Ablement’ Award in 2019, but has not been able to secure funding by the close of 2019.
TECH, RESEARCH & INNOVATION
The close of 2019 saw the call for innovations, technology advancements and new research in the Aged Care industry. In December, the Australian Medical Association (AMA) released a position statement, stating the necessity of innovation and greater technology in all existing and future Aged Care planning. The position paper was supported by peak bodies ACSA & Leading Age Services Australia (LASA). The Aged Care Industry Information Technology Council (ACIITC) also released an updated review of their 2017 commissioned report, Technology Roadmap for Aged Care. The new report, Aged and Community Sector Technology and Innovative Practice – A Report on what the Research and Evidence is indicating, focuses on new research from 2016-2019 and explores recent significant technological changes. To access the report, head here.
In December, $22M of funding for ageing and aged care research was announced by the Acting Minister for Health, the Hon. Alan Tudge MP, and Minister for Aged Care and Senior Australians, Senator Richard Colbeck. A number of the research grants can be viewed on the media release page, or for a full list of grants refer to the National Health and Medical Research Council’s (NHMRC) website here. Flinders University has also secured a grant from the Australian Research Council (ARC), to research and develop new software that will assist with enhancing home environments for both dementia and Aged Care to promote healthy ageing.
To tech news, and the cloud and mobile based technology hayylo, that helps Providers to deliver better care and enable older people wanting to remain at home with support, has won a pitch event in Brisbane in December. The event, part of Bentleys CareFactor program, saw hayylo pitch a redevelopment and expansion of their business, which would add new services and value for Providers. The prize for the winning pitch includes a short-term residency at Austrade’s Singapore Landing Pad.
GOOD NEWS
A 102 year old and an 88 year old, who are both Residents in a retirement village in the US state of Pennsylvania, have released their very first music album at the end of 2019. What originally started as a poem that Allan R. Tripp wrote, which a fellow resident, Marvin Weisbord, set to music for Tripp’s 100th birthday, has turned into an eight-song album titled the ‘Senior Song Book’. Neither one have ever produced or released music previously, but professionally recorded their album in a studio at their own cost, engaging Weidbord’s band and singers from their retirement community. It appears that the CD originally sold out, but can still be purchased or downloaded here. We’ll end on this beautiful quote from Tripp, about trying new things no matter what age: “Whether it’s writing, knitting, whatever — it’s wanting to do it well that makes the difference,” Tripp said. “Whatever your skill or hobby is, if you try to do it as best you can, and then a little better than that, that will make you happy.”
Welcome everyone to 2020, and we look forward to sharing this year with you all, as we all strive to continue making an impact in our beautiful industry.
That’s all for this month but check back in with us next month for another industry update!
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LISSIE LYONS – CHAMPION OF EDUCATION & MARKETING Author |
