The Perth hearing of the Royal Commission into Aged Care Quality and Safety inquired into the nature of person-centred care, advanced care planning and palliative care services.
As is the case at each hearing there were harrowing stories from poor handling of complaints to abuse. A young physiotherapist told of being so disheartened with the care she was able to provide to older residents in aged care facilities that she ended up working in another health industry.
A Sydney woman spent the final weeks of her father’s life begging hospital staff not to send him back to his nursing home because it was incapable of providing palliative care.
Researcher says it’s difficult to find good providers
The final day of the Perth hearing of the Aged Care Royal Commission heard from a researcher who found it was difficult to identify who was a good provider of aged care.
Dr Lisa Trigg, Assistant Director of Research, Data and Intelligence at Social Care Wales, said many recommended “good providers”, ended up being very sub-standard in their care.
Her findings are telling. She said there was no way of finding out, no information in the sector. Ninety-eight percent of providers passed accreditation but there was no way of identifying genuinely good providers.
Dr Trigg also refers to person centred care as “relationship-based care”, since person-centred care was not being used appropriately by some providers.
In most of the evidence given throughout the Commission, the main factor of relationship-based care came from community focussed involvement. Alongside this, relationship-based care relies on a whole community involvement, rather than just staff of a facility.
Dr Trigg said a quality aged care system needs to have many people involved.
“I also think it’s unacceptable for us as a society, the public, to not support that,” Dr Trigg said.
She said the Aged Care Funding Instrument (ACFI) is focussed on technical needs and activity-based programs, which may lead providers to deliver less than desirable care.
Dr Trigg said there needs to be a set vision of what quality in aged care is, so that people know what it looks like when it’s there and when it isn’t; a change to the ageist language used around residents; and moving away from clinical models, because it won’t deliver relationship-based care.
The problem of a ‘tick-a-box’ approach to care
The Commonwealth Age Discrimination Commissioner, Kay Patterson said it is clear to her that older people are not always valued.
In her statement to the Royal Commission, she said there are a litany of reasons why we are seeing the mistreatment of elder Australians in aged care, such as poor representation in the media. Education and creating contact between generations can reduce the problem.
She said it is important that people are fully aware of the rights of the elderly to ensure that abuse cannot occur. Educating aged care residents, staff and legal professionals about rights regarding power of attorney is imperative.
“It’s looking at how can we educate older people about what their rights are in terms of what they should expect from the community, and it’s about also educating people about the negative effects of ageism, for example, how it impacts on elder abuse, how it impacts on people’s attitudes to older people and their treatment of older people,” she said.
She said there should be a ranking for best practice and a carrot for best practice.
The Commission concluded that good relationships with residents is critical for person-centred care and leadership is crucial to positive results throughout an organisation.
Has this happened to you or a loved one?
If you or a loved one has been subject to issues relating to access and inclusion, restrictive or poor-quality care in an aged care facility you can approach the Commission to provide evidence. Our expert, caring health law and elder law team members can also help you to determine if there is a case to seek justice or compensation. Making formal complaints or litigating is an effective way to force aged care facilities to change poor practices for you, your loved one, and other people.
Next hearings: Darwin and Cairns
The Royal Commission will hold a public hearing in Darwin from Monday 8 July to Friday 12 July 2019, and in Cairns from Monday 15 July to Wednesday 17 July 2019. At these public hearings the Royal Commission will inquire into:
- aspects of care in residential, home and flexible aged care programs, including:
- accessibility and availability
- wound, medication and pain management
- nutrition and hydration
- continence care
- social supports
- rural and regional issues for service delivery of aged care
- quality of life for people receiving aged care.