This paper discusses concerns about the quality of care in a minority of residential aged care facilities, and puts forward strategies to address them.
Executive summary: Over 222,000 people received permanent residential aged care services in 2012 with over 2,700 residential aged care facilities in operation nationally. The ageing of Australia’s population will result in a significant rise in these numbers in the coming years.
Older people in residential aged care are among the most vulnerable in our society, which places them at considerable risk of serious abuse. This risk is due to a host of factors including cognitive impairment and dementia, depression, immobility, limited support and contact with the outside world and difficulties in accessing the appropriate channels through which to raise complaints as well as fear of victimisation for doing so.
We acknowledge that the majority of providers are providing good quality care even if they may be constrained by current levels of funding. But there must be zero tolerance for violations of human rights.
Over the past several years, consumers have shared their experiences with us of poor quality care and the frustrations they have experienced in attempting to navigate a highly complex system that at times affords little transparency. These stories have included the mismanagement of the behavioural and psychological symptoms of dementia (BPSD), chemical and physical restraint, care recipients treated with a lack of dignity and respect, and psychological, physical and sexual abuse. The stories shared by consumers paint a disturbing picture of an aged care system under strain which is in some cases failing to meet the basic human rights of our most vulnerable citizens.
Through the Aged Care Complaints Scheme (the Scheme) and the Aged Care Standards and Accreditation Agency (ACSAA), there are significant protections in place to assist in ensuring a minimum quality of care is provided to residents in aged care services. This report looks at the action that might be taken in the short term to ensure there is zero tolerance of poor care and in the longer term to develop a more consumer oriented care system.
The rights of residents and respect for their dignity is not going to be achieved unless there is a coming together of consumers, providers and staff on the action needed. The aged care reforms represent a shift towards increased consumer empowerment, with the implementation of consumer directed care, expansion of home care services, and greater access to information through the development of quality indicators. It is timely to consider how we can provide consumers with a greater role in monitoring quality and standards within the aged care system.
The strategies put forward in this paper, whether short or long term, are for discussion. Many of the strategies proposed have been the subject of consideration before but the opportunity to make significant changes to the system has not presented itself as it does now with the current aged care reforms. There is now some urgency for action in the view of Alzheimer’s Australia and our consumer stakeholders.