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Royal Commission must address issues behind the aged care crisis

Did you watch ABC TV Four Corners program investigation into Australia’s aged care sector?

The second part program went to air on Monday 17 and 24 September. The second part featured the story of one of our clients, Alana Freeman. Tragically, her mother died of sepsis three months after going to live at Presbyterian Aged Care Westcott, in Stockton near Newcastle.

It is important for people to understand the extent of the crisis in aged care – the abuse and poor clinical care – and the terrible impacts on frail and vulnerable older Australians who deserve much better. It must be terribly difficult for families to retell those stories and I commend them for bravely doing so to bring about change.

The danger in just looking at footage or reading stories of abuse or neglect by aged care staff is that the root causes of the aged care crisis get overlooked. We tend to focus on the actions of the individual aged care worker or facility.  Abuse always needs to be seen in the context of inadequate staffing and training, inadequate regulation and a lack of transparent data for the public. Regulation of the aged care sector was the focus of the second part of the Four Corners story.

In the many cases we handle for older people or families seeking redress and accountability for poor care or premature death of a loved one in an aged care facility, there are common themes. These were reinforced when I was listening to this preview of the Four Corners program on ABC Newcastle and again when I watched the program.

The need for better education

Overworked staff is expected to look after many residents – one carer for 70 residents is not uncommon. With more elderly people living at home, people living in aged care facilities are more likely to have complex needs. Aged care nursing is difficult. But the care is more than not provided by assistants in nursing with no background or qualifications in community service or health care. At best they do a 12 week TAFE course. How can they be expected to know about wound care and pressure sores or working with people with dementia or who have experienced a stroke?

Those staff is working in facilities, often owned by superannuation trusts and private equity firms, where the focus is more on profit than care. The Aged Care Act 1997 brought about a deregulated system that has encouraged the entry of investors whose only focus is on making money.

Yet, these very profitable facilities with inadequate staffing and poor care of residents have 100% accreditation ratings. That was the case for all of the facilities showcased by Four Corners. Families of aged care residents have made choices about where their loved one should live based on meaningless data on quality. There have been greater sanctions of late but when aged care facilities are found to have provided poor care there is often no change to their accreditation ratings or effective sanctions. The Government’s response has been to announce a bureaucratic merger of three failed regulatory agencies into one.

Better care for older Australians

Last week, consumer roundtables were held in Sydney as part of the Federal government’s consultation to determine the terms of reference for the recently announced royal commission into aged care. Aged care advocates I work with had a key message for the responsible Minister, Ken Wyatt.The royal commission may have a role to play as a forum where older Australians and their families can share their stories of abuse and neglect, in the same way, the royal commission into child sexual abuse did. But, its crucial role is to uncover the systemic issues behind the aged care crisis and recommend meaningful reforms to better plan for and care for older Australians.

The royal commission needs to focus on, among other things:

  • staffing – including mandated staff to patient ratios
  • staff training
  • the regulation of the sector – including accreditation reviews and sanctions for poor performance
  • transparency of data on key performance indicators and primarily quality of care
  • a complete overhaul of the Aged Care Act and the operating environment of the aged care sector
  • a comprehensive plan for Australia to respond to its aging population

We can expect announcements shortly about the terms of reference for the royal commission and the identity of the person(s) to conduct the important role of commissioner.

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