Residential aged care findings ‘horrendous’, says GP

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Only 1.3 per cent of Australian aged care residents are in facilities with ‘best practice’ staffing levels, a new report reveals. And the aged care royal commission says the government needs to spend an extra $20 billion per year – in addition to the $27 billion it currently spends – to give the system a safe, secure and sustainable future.

Australia’s ageing population has long been forecast to swell and now that the future is here, the outlook for many people requiring residential care appears to be grim.

The Royal Commission into Aged Care Quality and Safety commissioned research into staffing levels in Australian residential aged care facilities based on a five-star rating system used in the US.

It found that 57.6 per cent of residents were in care with inadequate (one or two stars) staffing levels.

Slightly more than one quarter (27 per cent) reside in three-star facilities, 14.1 per cent in four-star homes and only 1.3 per cent in facilities assessed to have five-star or ‘best practice’ staffing levels.

In a report analysis from the Royal Australian College of GPs (RACGP), Dr Ken McCroary, a GP with a special interest in aged care, said the findings were “horrendous” and the study was “a really correct representation of what’s actually going on”.

“This information needs to become widespread, seriously,” he said.

“I really support all of the recommendations related to encouraging staff numbers, both allied and nursing. But the deeper picture is that it’s probably even worse than what the star rating indicates, particularly with regard to the work nurses are actually given the opportunity to perform.

“Most of it’s just paperwork and giving out medications and pills, so patients are lacking quality nursing time as well.”

The aged care royal commission has proposed a dedicated levy – similar to Medicare – or a 1-2 per cent increase in personal taxes to pay for reforms to a system it says is in a “shocking state of neglect”.

Other options included a system where people pay for aged care as they need it and mandatory personal contributions similar to Medicare and superannuation and being used in Germany, Japan, Korea and the Netherlands.

In a paper released by the commission this week, an estimate of the cost of an overhaul has been provided for the first time.

“Fundamental reforms” would very likely cost double the $27 billion spent by government, it said.

“With the changing age profile of our working population, and the growing number of people aged over 85 years, the pressure on aged care spending will only increase,” it said.

The Age and Sydney Morning Herald report that about 75 per cent of funding for aged care comes from the federal government and the remainder from users.

The commission’s discussion paper noted the general reluctance of the population to assess aged care needs and planning for the future.

“We tend to think that bad things can’t happen to us and we put things off,” it said.

Chief executive of the Councils on the Ageing (COTA) Ian Yates said the paper provided the first indication on the cost of reforms and also floated changes to income and means testing of payments, which he described as “inconsistent, incoherent and unfair”.

Dr McCroary told GPNews that the high number of deaths – 60,000 per year from a total cohort of around 180,000 permanent residents – means residential facilities should almost be considered an extension of the hospital system.

“Staff are underfunded, undereducated, under-resourced and under-supported by their managers. That causes them to be demoralised and it decreases the attractiveness of a career in aged care,” he said.

“Unfortunately from my anecdotal experience, what seems to be the most important thing for management is filling out the forms for funding, which is so distressing for human beings who are in these facilities and deserve a lot more than that sort of de-personalised quantification.”

GPNews says an estimated 200 Australian aged care providers are experiencing financial distress.

“There obviously needs to be an increase in funding and an increase in efficiency of funding, and then a directed concentration on patient and quality care, not paperwork and administrative tasks,” Dr McCroary said.

The commission is due to provide its final report at the end of the year, but has identified several urgent needs:

  • reduce the wait time for higher level care at home
  • prevent the reliance on chemical restraints in aged care facilities
  • prevent younger people with disabilities going into care
  • provide more and better qualified staff for aged care facilities.

Are you concerned about the adequacy of age care services? Does the government spending during the pandemic suggest assistance in the aged care sector will be some way off?

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Written by Janelle Ward



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