In July, the industry entered a new period, with the new Aged Care & Quality Standards starting from the 1st of July. As a result, the lead up month of June was extremely busy for Providers, working to prepare for the arrival of the new standards as well as the Charter of Aged Care Rights, and looking to navigate the new world. The standards weren’t the only headlines for the industry in June; with two Royal Commission hearings taking place, voluntary assisted dying laws coming into effect in Victoria, and physical and chemical restraints once again another big topic. Ageing was declared a global risk; the new rates for subsidies and supplements were released and as always there were new updates to dementia research and in the technology space. Let’s review the month that was – here is what happened in June!
POST ELECTION NEWS
May saw the Liberal Government stay in power, but a change in Aged Care Minister with Senator Richard Colbeck taking over from Minister Ken Wyatt. In June, it was announced that Labor Minister Julie Collins will retain her Shadow Ministry portfolios for Ageing, and Senior Australians (with the addition of the Shadow portfolio for women). Ms Collins has stated that she is committed to working with the Government to ensure that they respond to recommendations and actions presented by the Royal Commission. Ged Kearny MP has been appointed as Shadow Assistant Minister. Peak body Aged & Community Services Australia (ACSA) CEO Pat Sparrow welcomed the appointments in the Shadow Ministry, and looked forward to collaborating with the Shadow Ministers.
The Royal Commission Hearings for June kicked off from the 17 – 19 June in Broome, and continued in Perth on the 24 – 28 June.
For Broome, the focus of the hearings were centred around care provided in remote areas, care needs for Indigenous Australians and the issues of providing access to services and a culturally appropriate workforce. The hearings emphasised the issues surrounding care in remote areas and the care that is provided to Indigenous Australians and access to care such as much needed respite.
The Perth hearings focused on Palliative Care, pain management and person-centred care; with case studies presented covering poor pain management and lack of understanding of the kind of needs that Palliative Care entails.
You can read the transcripts for both hearings on the Royal Commission website here.
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.
NEW ACCREDITATION STANDARDS – THE LEAD UP TO JULY 1
July 1 saw the new Accreditation Standards come into effect, and what a busy month June was in the lead up. There was some concern expressed from Providers and Peak Bodies, with delays in the supporting information being released. Along with the New Charter of Aged Care Rights that commenced on the same day, Providers prepared for the new Standards that brings together the four previous sets of standards (Accreditation Standards, Home Care Standards, National Aboriginal and Torres Strait Islander Flexible Aged Care Program Quality Framework Standards and Transition Care Standards).
The new set of Quality Standards are focused on person-centered care, and working with Residents and their families (identified as consumers) to ensure that best practice and dignity and respect are the experiences of all older people living in care. One ACT-based Provider expressed concern that the new standards, having not been put into practice before, may be a matter of trial and error as the industry settles into the new era.
Feedback on Aged Care Quality Assessors was also reported on in June as the sector prepared for the new standards, with comments from both extremes of aggressive assessors on site to assessors continuing to run the old system as normal. Commissioner Janet Anderson responded to these claims, which you can read here.
In other Quality news for June, interim Chief Clinical Advisor to the Aged Care Quality and Safety Commission, Professor Michael Murray, was recognised for his work and service to geriatric medicine, as a clinician and educator in the Queen’s Birthday Honours List. Although no longer holding the interim role, Professor Murray will continue to provide advice and support to the Commission and currently sits on the board of Aged Care Provider Benetas.
You can refer to the Department of Health’s Aged Care Quality Standards webpage here.
To find out more information on how Provider Assist can assist with Accreditation, contact us on 1300 419 119 or email us at firstname.lastname@example.org.
REMOTE & INDIGENOUS CARE
June’s Royal Commission hearings saw an Aged Care expert express disappointment in aspects of the Aged Care system in Australia, a sentiment that came amongst the Broome hearings focusing on Remote and Indigenous care and Aged Care that isn’t culturally safe for Indigenous Australians. Many issues facing Indigenous Aged Care were raised, including lack of access to traditional foods due to regulation, culturally insensitive care and lack of Respite Care offered. Poor access to care and health literacy were highlighted by Dr Kate Fox, a General Practitioner (GP) working in the Kimberly and Broome regions; and Professor Leon Flicker, a professor of geriatric medicine emphasised the need to ensure that the connection to country and culture is not ignored or broken.
NEW MY AGED CARE WEBSITE
A beta version of the new My Aged Care website was released for testing in June, to allow consumers to trial the new layout, prior to its launch later in the month. The redevelopment of a new My Aged Care website was announced in the 2018-19 budget as part of an initiative to improve access to information and navigation of the Aged Care system. The Department of Health listed the enhancements to the website as follows:
- simple navigation and clear steps to access aged care services
- an updated service finder tool (re-named ‘Find a provider’) with faster search results, more filter options, consumer friendly language and improved information.
- use of more white space to help people with vision impairments and people with cognitive decline.
- new content written in plain English that answers common questions people have when accessing aged care services.
The new My Aged Care can be viewed here.
GEN AGED CARE DATA REPORTS
The June release of GEN Aged Care data featured reports on admissions into Aged Care, people leaving Aged Care, the Commonwealth Home Support Program (CHSP) and the My Aged Care region.
The report on admissions has shown that whilst admissions are down for Permanent Residential Care, Residential Respite Care is on the rise.
You can access the latest reports here.
PHYSICAL AND CHEMICAL RESTRAINT
Restraint in Aged Care was once again a big topic for June, with an article released by the ABC demonstrating that the original objective for improvement to regulation to the use of physical and chemical restraints was ‘watered down’ throughout negotiations. The ABC article published a number of emails submitted between senior bureaucrats and the chief advisor to the Aged Care Minister at the time, Ken Wyatt, and suggests that the new laws may not have improved the regulations adequately, not setting a time limit on restraint or enforcing an obligation for Aged Care workers to have family consent prior to providing antipsychotics. You can read a breakdown on restraint law by HelloCare here.
In additional news for psychotropics, the University of South Australia study has found a link between psychotropics prescribed to people living with depression, pain, anxiety and dementia, and an increase in hip fractures. The study participants were an average of 88 years old, and the research demonstrated that particular psychotropic medications doubled the risk of falls and hip fractures. Lead Researcher Libby Roughead highlighted the increased risk with the prescription of this medication, particularly in conjunction with other medications or an already increased risk in falls, such as age. Professor Roughead also highlights the need to consider non-medication interventions.
You can read the study here.
World Elder Abuse Awareness Day was held on the 15 June 2019, and along with it, came a number of conversations surrounding elder abuse in Australia. A keynote speaker for the 2019 National Elder Abuse Conference has stated that Australian laws lack specific laws in regards to elder abuse, leaving older Australians unprotected from forms of abuse. San Diego County Deputy District Attorney, Paul Greenwood, has highlighted the importance of mandatory reporting and specific criminal laws to be introduced in Australia.
A recent Government report, Elder Abuse: Key issues and emerging evidence, has found that there is a vast lack of research and data available in Australia recording the prevalence of elder abuse. The report calls for better support strategies, screening and the development of policies to help protect those at risk of Elder Abuse.
A new guide has recently been developed by ACSA and the Older Persons Advocacy Network, aimed at Aged Care workers, that can assist in the identification of elder abuse, and how to respond. Free copies of the guide are available through ACSA, by contacting email@example.com.
The EveryAGE Counts campaign is also another significant and helpful Australian resource, tackling Ageism in Australia.
VOLUNTARY ASSISTED DYING ACT
June saw the introduction of new assisted dying laws that came into effect in the state of Victoria on the 19 June 2019. It is the first time in over 20 years voluntary assisted dying (VAD) has been legal in Australia, and has 68 precautions to strictly regulate eligibility. Eligibility is determined by two Doctors, and guided by a number of parameters, the base of which being that the person is an Australian citizen or permanent Resident who has lived in Victoria for a minimum of 12 months, is over the age of 18 and has a terminal illness and expected to die within a 6 month time period.
Degenerative brain conditions such as Alzheimer’s disease are considered an eligible terminal illness if all other conditions are met; including the ability to make decisions has not been affected. Dementia, as a condition on its own is not eligible for VAD.
The Perth Royal Commission Hearings began on the 24 June, focusing on Palliative Care, pain management and person-centred care. In the Royal Commission’s latest background paper, Advanced Care Planning in Australia, released in June, a focus on increasing the uptake of Advanced Care planning by older Australians, encouraged by Aged Care workers, is recommended. Latest research evidence shows that it appears that only three in every one hundred older Australians have a statutory advanced care directive, supporting the idea that advanced care planning is uncommon in Australia, despite the benefits it can have – not only for the person receiving the care but their families as well.
Not only was Palliative Care the focus of the Perth Royal Commission hearings; but it was also a media topic in South Australia. Elderly South Australians who are living with a terminal illness and wish to die at home are facing increasing difficulty with making this possible. The issues identified are GPs being unable to afford the delivery of bulk billed home visits, along with the rising ageing population and therefore higher numbers of those requiring care, and lack of funding for Palliative Home Care services.
More in Palliative Care news, an innovative product that has been operating in Queensland specifically for Palliative Care patients has been making a huge impact on the lives of the families and people living with terminal illness. ‘Cuddle beds’ are an oversized bed that has enough room for loved ones to lay down with their family members to maintain physical closeness, warmth and connection. Originally an idea sparked by hospital staff working in Palliative Care and seeing the need for physical closeness between loved ones, currently there are two Cuddle Beds operational in the Gold Coast, Queensland. Coming in at a cost of $10,000 each, the beds are not easily accessible, although there is a plan to roll out two more on the Gold Coast.
1 JULY SUBSIDY & SUPPLEMENT INCREASES, FUNDING & RISING WAGES
Once again, June saw the issue of funding in Aged Care a major topic, with the Fair Work Commission announcing a 3% increase to the National Minimum Wage and Modern Award. Peak Body Leading Aged Services Australia (LASA) expressed concern that despite their support of improved pay in the sector, rising wages can drastically impact facilities and organisations when funding indexation has fallen behind. With the most recent StewartBrown report indicating that the financial decline in the industry is continuing, with more than 45% of facilities continuing to operate at a loss, an increase to wages with no additional funding support is ‘making services unsustainable’, says LASA CEO Sean Rooney.
The two subsidy boosts initiated in the 2018-19 Financial Year – The Quality Care Fund and the Temporary Subsidy increase – both ceased on the 30 June 2019. The 1 July 2019 Government update to the subsidies and supplements saw a 1.4% indexation increase, to which both LASA CEO Sean Rooney and ACSA CEO Pat Sparrow responded to as continuing to be unsustainable for the sector.
AGEING A GLOBAL RISK
The United Nations (UN) has released their World Population Prospects 2019 report – with one of the ten key findings being ‘the world’s population is growing older, with persons over age 65 being the fastest-growing age group’. The recent 2019 G20 Summit held in Osaka, Japan, has announced that the global ageing population is a ‘global risk’ and an issue that needs to be addressed ‘before it is too late’. With the projection that by 2050 there will be more than 2 billion people worldwide over the age of 60 (which is double the number in 2017), experts warn that many economies need to prepare or update schemes, policies and services to handle this.
In Australia, this concern has been flagged by the federal Aged Discrimination Commissioner, Kay Patterson. Speaking at the Royal Commission in Perth in June, Dr Patterson, as gerontologist, said there would be ‘no time to waste’ in ‘fixing’ the Aged Care sector in advance of the baby boomer generation beginning to require Aged Care.
TOOLKIT FOR ORGANISATIONAL CHANGE IN RESIDENTIAL AGED CARE
A toolkit that assists Residential Aged Care facilities to implement organisational change has been released to assist organisations with a step by step and practical approach. TOrCCh – which stands for Towards Organisational Culture Change – is based on research findings and aims to help the industry especially in a period of Policy changes. You can access the toolkit here.
TASMANIAN FACILITY TO OPEN FOR DISADVANTAGED AGED CARE RESIDENTS
A facility will be developed in Southern Tasmania that aims to provide high-quality care at an affordable price for elderly Tasmanians who are financially disadvantaged, homeless or at risk of homelessness. Tenders have now opened for ‘The Wirksworth’ development – a development that is a part of the Tasmanian Government’s affordable housing action plan – and will house 50 beds and is expected to create 31 full-time jobs for workers in the Aged Care industry.
The development has been controversial, with local Residents in the area, Friends of Wirksworth, expressing that they had not been adequately informed by the Government about the plans for the heritage-listed site, and requesting that development is halted.
The World Health Organisation (WHO) has officially recommended, based on the past decade of research, that maintaining a healthy lifestyle is likely to reduce the possibility of dementia (or a decline in cognitive ability) in later life. A current focus of the WHO, dementia is classified as a mounting public health issue with 50 million people globally affected.
With dementia affecting 400,000 people in Australia, and currently the second leading cause of death in the country, the federal Government recently launched a NHMRC National Institute for Dementia Research (NNIDR) 2019 Strategic Roadmap for Dementia Research and Translation, at the June Australian Dementia Forum, held in Hobart. In the official media release, the Minister for Aged Care and Senior Australians Senator the Hon Richard Colbeck has refined the dementia research focus, intending to make priority ‘new and less invasive methods for early diagnosis’, dementia within Aboriginal and Torres Strait Islander communities and supporting those living with dementia in Aged Care facilities.
Over to dementia research, and a study by Macquarie University has revealed that medication that can assist Residents living with dementia has far lower rates of use in Australian Aged Care facilities in comparison to those in the USA, UK and Denmark. The rates of anti-dementia medication, that can improve cognition and quality of life is taken by less than 10% of Australian Aged Care Residents, whereas the rates in the aforementioned countries are close to 40%. Lead author of the study, Dr Kim Lind, has noted that the low rate of prescription may be due to strict criteria. You can read further on the study here.
To Tasmanian dementia news now, and another research project is set to be undertaken by The University of Tasmania’s Wicking Dementia Research and Education Centre. With an aim of recruiting 10,000 participants for the study, this goal will make it the largest study undertaken in the world for dementia. The focus on Tasmanian participants is due to the high rate of dementia risk factors, such as the state having the oldest population and the fastest rate of ageing in the country. The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Project will be exploring who is most at risk of developing dementia and how individuals can reduce the risk of developing dementia. Read further on the project here.
Staffing ratios once again made the news in June, with witnesses at the Perth Royal Commission expressing the challenges of being able to provide person-centred care due to time-constraints and limited staff. A Registered Nurse who appeared as a witness, recounting the experience of her father in Aged Care, called for ‘increased ratios of Registered Nurses in Aged Care facilities, and better training and registration for carers’.
Aged care staff from a facility in Caboolture, Queensland, also staged a public protest in June, rallying for better staffing ratios and increased pay. Backed by the Queensland Nurses and Midwives’ Union (QNMU) up to 30 members of staff gathered outside the facility for the protest.
A recent study has found that although international research shows 85% of Residents living in Aged Care have osteoporosis – a significantly smaller number have the condition reported in Australia. A recent study from Macquarie University showed that only 30% of Residents have osteoporosis recorded on their electronic health record, with the theory that underreporting could be due to additional health conditions that can ‘overshadow’ osteoporosis. Types of health issues such as dementia or heart disease, that are common in Aged Care, could mean that osteoporosis is not recognised or treated as a result of the overshadowing. The study examined nearly 10,000 Residents over 68 facilities across NSW and ACT.
TECHNOLOGY & INNOVATION
To June’s tech and innovation news; and as always another busy month in this space. First, well-known bathroom manufacturer Caroma has partnered with the UNSW Faculty of Built Environment on a research project – Liveable Bathrooms for Older People. The project examined the abilities of older people, as well as their physical proportions to develop solutions for bathrooms that could help overcome issues such as insufficient space, safety and capabilities. Co-designed via workshops with older people, a new bathroom range has been developed by Caroma based on the findings, launching in June. You can read further on the project on Caroma’s website here, and a guide for architects by Caroma here.
A new app that provides information for first aid and assistance in emergency situations has recently been launched, with the aim of helping people to not feel helpless or powerless in an emergency situation. iFirstAid will also help families with a Find My Family feature, to help track loved ones, as well as keep track of immunisation and vaccination records and receive travel information and emergency alerts for different countries. The app is free and can be downloaded via the website here.
It was also a huge month for Virtual Reality and Aged Care news. Alwyndor Aged Care in Adelaide are using virtual reality headsets as a part of their exercise routine, whilst ‘travelling’ around Europe. Residents ride a modified exercise bike whilst exploring the world – across continents and outer space – a practice known as immersive exercise. Not only is the program excellent for wellbeing, with Residents able to explore the world, but it also has many health benefits as well.
Up to New South Wales and a virtual reality trial as a part of a diversional therapy program at Anglican Care Booragul has recently taken place, in preparation for a roll out across all Anglican Care sites. Aiming to allow Residents to be involved in a huge range of activities via VR, the trial had some amazing reflections made by Residents, which you can read in the Aged Care Guide’s article here.
Provider Assist are also thrilled to launch into the VR space with our new partnership with Situ360, a tech company who have designed software that makes creating and sharing virtual interactive tours simple. Interactive facility virtual tours reduce foot traffic, resulting in less disruption in the daily lives of Residents, as well as reducing the time for both facilities and the families of potential Residents spent in physical tours. You can read more about how you can get this for your facility here.
HUMAN TOUCH IN AGED CARE
We have seen many innovations in Aged Care in the tech space; from Paro the Seal to robots working in Aged Care facilities. However, Aged Care has been seen as one industry that will continue to require an increase in the workforce that is always going to be reliant on person to person care. You can listen to ACSA CEO, Pat Sparrow, talking to the ABC on the topic here.
A training tool, Compassionate Touch®, has also been developed by AGE-u-cate Training Institute (offered in Australia via BrainSparks) as a program to help Carers learn how to take a more person-centered approach to care, with touch used as a part of the technique to show compassion and be therapeutic. You can read further on the approach here.
IMPROVING OLDER MEN’S HEALTH
June saw Men’s Health Week run from 10 – 15 June, and highlighted the discrepancy between men and women and the age of death, with men dying 6 years earlier on average. This has prompted a discussion and call for action by The Australian Men’s Health Forum (AMHF), who have asked for more time, funding and resources to be invested by the Government. One of the key points raised is the positive things men can do as they age – one the AMHF have highlighted being social connection. With social isolation being an issue for many older Australians, it is also a major health concern for older men. You can find out more about the initiatives that the AMHF highlighted in the recent Men’s Health Week, or for further information you can visit the AMHF website.
SEXUAL BEHAVIOUR IN AGED CARE STUDY
Generally considered a taboo topic, the sexual behaviour of Aged Care Residents is the focus of an Honours Thesis being undertaken by a psychology student based at Edith Cowan University. Marie Smith, who intends to gain an understanding of sexual behaviour and patterns in Aged Care, has identified that ‘there are not a lot of resources or know about sexual behaviours [in Aged Care]’. Ms Smith also noted that the research available tends to focus on Residents or managers, and therefore she will be looking at the perspective of carers. For those interested in participating in the research, you can find Ms Smith’s contact details in the Great Southern Weekender article here.
MUSIC AND AGED CARE
For the past few years, the power of music in Aged Care facilities has been well researched and implemented in many facilities. In June, we saw some wonderful news stories of music in Australian Aged Care facilities in different forms.
In Western Australian facility Rosewood Care Group, a fortnightly choir session is run with around 20 Residents participating. Run by Choir conductor Dorothy Ebel, the sessions are open to everyone who wishes to join in (including the facility staff). Dorothy also conducts the Alzheimer’s Western Australia choir.
Heading to South Australia now, and a different kind of music therapy course runs weekly at ACH Group’s West Park Residential Care Home. Open to all Residents of all abilities, both physical and cognitive, the class is a part of a wellbeing program, and incorporates playing instruments such as drums originating from Africa and Brazil. The drumming group has been extremely popular and has had a wonderful outcome for a few Residents; who previously had not participated in any activities but were drawn to the drumming classes. As a result, they have begun to take part in other activities since they started drumming.
With many Australians who are currently residing in Aged Care growing up during a time where it was less likely they would have had television, music would have been a major source of entertainment and can be extremely engaging and meaningful for Aged Care Residents.
|LISSIE LYONS – CHAMPION OF EDUCATION & MARKETING