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Wednesday, July 17, 2013

Aged Care Crisis - Australia’s Greatest Shame

And What Will Rudd, Milne and Abbott do about it?

above: The needs of Australia's Aged citizens are just as urgent as the needs of the Disabled - sometimes more.  There is no excuse for not implementing National Aged Care Insurance along similar lines to the NDIS - or 'Disability Care Australia'.

 

In this article ALP Socialist Left activist, Tristan Ewins takes a look at the recent report on Aged Care at ABC's "Lateline" program - and puts the argument for comprehensive Aged Care Insurance - how it should be funded - and the services it should provide...

 

Earlier this week ABC’s ‘Lateline’ lifted the lid on an Aged Care Crisis which I hav e been trying to draw attention to for many years .    

In light of the revelations arising from the Lateline program, we will begin this article by recalling the basic substance of that recent (July 15th ) story.

ABC investigative journalist Margot O’Neil constructed a report for ‘Lateline’ after conducting a year-long investigation that common complaints about the quality of aged care in Australia included residents:

“being left in faeces and urine, rough treatment, poor nutrition, inadequate pain relief, verbal abuse, and untreated broken bones and infections.

And  further:

“one woman has told the ABC that her grandmother, who survived Nazi concentration camps, believes her experiences in aged care are worse than her wartime ordeal.”

Jane Green – daughter of former high intensity aged care resident Margaret McEvoy – recalled her own specific story to the ABC how, explaining how:

“For five days, staff tried to make Ms McEvoy walk. In fact, she had an undiagnosed broken thigh bone, a raging infection, and severe dehydration.”

The ABC further observed that:  “Ms Green, who is also a nurse, had to fight to get her mother taken to hospital, where she was immediately put into palliative care. She died six weeks later.”

In a similar story nurse and health care lecturer Mardi Walker:

“was horrified when she found her [91 year old] grandmother with exposed raw ear cartilage due to lack of turning, and one of her arms immobilised after staff botched injections.”

She recalls that: "They would just keep injecting into the same spot and she would scream. My mother said it was horrific, because she would scream.”

The ABC also made the accusation:  Repeated surveys find that 20 to 50 per cent of nursing home residents are malnourished, and the Australian Medical Association says there are not enough doctors to visit residents.” 

And meanwhile: “The Nursing Federation says there are not enough properly trained carers, while Palliative Care Australia says only one in five residents receive proper palliative care.”

New Aged Care and Mental Health Minister Jacinta Collins responded by reaffirming that the Government had  a “10 year plan.”

When asked by ‘Lateline’ the Minister had no credible answer to why the government has failed to act decisively in response to Aged Care abuses and systemic failures when compared with its response to abuse of cattle in Indonesia. 

Lateline journalist Emma Aberici further pressed Minister, Jacinta Collins on why Aged Care accreditation processes do not include assessments of the mental and physical well-being of aged care residents, including dehydration, malnutrition, depression, bedsores, falls, chronic pain, pain-management, over-use or inappropriate use of anti-psychotic medication, forced restraint and so on.

Collins was uncertain what research was being conducted in these fields.  She asserted that families can discern between different providers in the best interests of their loved ones.

But if there is a SYSTEMIC failure due to chronic LACK OF FUNDS and failure to enforce sufficient standards, then it stands to reason that families often have little choice.   And that is especially so when they are looking for a residence relatively close-by to enable regular visits.

Collins observed that over 200,000 Australians are currently in residential care – and that is going to expand dramatically with the ageing population. She also suggested that staff to resident ratios might be considered ‘in the future’. 

Finally, the Minister proclaimed she would visit Aged Care facilities ‘on the ground’ to see for herself the quality of care.   

But time is of the essence and action needs to be ‘locked in’ now  to be implemented in the near future – as a matter of urgency.   Collins also needs to visit a very wide range of facilities without notice in order to get a better idea of what conditions are really like ‘on the ground’ , while consulting closely with families who have reported neglect and abuse.

While Collins deserves to be given a degree of slack on account of only recently taking the Ministry, the Lateline Report shows that the time for procrastination and empty rhetoric is over. 

Rudd, Milne and Abbott need to immediately form a response to this story, and to the many stories provided by some residents and many families who have been trying – often without success – to bring this issue to the forefront of public discourse for years.  They need to devote new funds – many billions of new funds for every year. 

Alberici observed that most high intensity care resident spend less than 2 years in care.  And yet those can be two years of Hell. Whereas improvements in the standard of care could provide much greater comfort, better health, and perhaps extended (quality) life-spans.

I will now re-iterate what needs to be done; and what I hope others – including our politicians and political parties - will now demand to be done:

Firstly a National Aged Care Insurance Scheme needs to be established along similar lines to the National Disability Insurance Scheme – which in 2010 was estimated to cost $15 billion a year.  ($22 billion by 2020)   

A National Aged Care Insurance Scheme demands a similar commitment of resources; implemented as quickly as possible given the urgency of the suffering of our families and loved ones.  Immediate funding options include further increases to the Medicare Levy, cutbacks in superannuation concessions for the wealthy and the upper middle class, and reductions in the rate of Dividend Imputation. (reverting to 75% would save about $6 billion)

Such funding needs to secure the following outcomes:

·        Official quality control that includes comprehensive ongoing assessments of the mental and physical well-being of aged care residents, including dehydration, malnutrition, depression, bedsores, falls, chronic pain, pain-management, over-use or inappropriate use of anti-psychotic medication, forced restraint and so on .

 

·        Generous nurse/staff to patient ratios – improving the quality of care by freeing nurses and staff to turn residents to avoid bedsores;  wash residents whenever necessary; provide comfort and social interaction; ensure food is of decent quality and is actually eaten;  constantly monitor residents and ensure that health needs are always addressed as a matter of urgency.

 

·        Weekly visits by doctors and immediate provision of dental care for any who have the need .

 

·        Better training, pay scales and career paths for Aged Care professionals including nurses and other qualified staff.

 

·        Privacy for aged care residents including private rooms and other personal space.

 

·        Daily facilitated Social interaction; outings to shops, gardens and churches; access to information and communications technology and services; libraries; facilitated reading; discussions and games – A better life than being sat down to stare at a television, or perhaps just at walls all day!

 

·        Better programs encouraging volunteers to visit residents and provide conversation and comfort.

 

·        Provision of gardens and similar space to provide greater tranquillity and a change-of-scenery; as well as time in the sunlight during the warmer months

 

·        The best quality palliative care for all who have the need

Meanwhile for low-intensity care residents, and those being cared for by loved ones, greater financial support is necessary for Carers, as well as regular respite, and institutionalised support when it comes to health, outings, diverse social interaction, home help, and construction of extensions or ‘granny flats’.

Stop Regressive User-Pays!

For all levels of care, meanwhile, User-Pays mechanisms need to be immediately wound back.  This in itself will cost billions – on top of the cost of actually improving the quality and legislated standards of care.   

Again – we need to see this as a comprehensive National Aged Care Insurance Scheme along similar lines to the National Disability Insurance Scheme. (NDIS)  Those needing care should not be driven to take out tens or even hundreds of thousands of equity against their houses. This operates as a grossly regressive ‘flat tax’.  Residents from relatively poor and working class families especially don’t deserve this ‘final cruel blow’.

Residents who need only low-intensity care, meanwhile, need to enjoy the appropriate level of care, enabling greater flexibility and freedom as long as possible.

Finally Funding for Advocacy groups is necessary in order to empower families; and for purposes of supporting advocates for those not in a position to stand up for themselves against abuses.  (Eg: those without family, and those with dementia)

This issue will resonate powerfully with families: families who love their elders dearly, and those who (legitimately) fear for their own futures.   The mainstream parties – Greens, Labor, Liberals – all need a comprehensive response to the issues raised by Lateline – culminating in a consensus on a National Aged Care Insurance Scheme along similar lines to what occurred with the NDIS.  Procrastination, opportunism or mean-spiritedness on this issue need to be condemned in the strongest possible terms.

For those of us who care about this issue we need to maintain the pressure – and maintain the profile of the cause of reform.  We need to ensure the fullest possible reform over the shortest possible passage of time – as the needs of our most vulnerable are urgent – their sufferings neglected until now - demanding immediate action.

This issue is out in the open now for everyone to see.  There are no more excuses.

References:


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