Progressing Towards a Freer Market in Australian Residential Aged Care

2021 ◽  
pp. 1-25
Author(s):  
Susan F Cochrane ◽  
Alice L Holmes ◽  
Joseph E Ibrahim
Keyword(s):  
Current System ◽  
Aged Care ◽  
Care Quality ◽  
Cultural Safety ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Care Providers ◽  
Fit For Purpose ◽  
Market Driven ◽  
Care System

The Royal Commission into Aged Care Quality and Safety has again focussed attention on the failings of the Australian aged care system. Residential aged care in Australia has become increasingly market-driven since the major reforms of 1997. The aims of increased marketisation include providing residents with greater choice, higher quality services, and increasing providers’ efficiency and innovation. However, marketisation is not meeting these aims, predominantly due to asymmetries of knowledge and power between residents and aged care providers. These asymmetries arise from inadequate provision of information, geographic disparities, urgency for care as needs arise acutely, and issues surrounding safety, including cultural safety. We propose a human rights framework, supported by responsive regulation, to overcome the failings of the current system and deliver an improved aged care system which is fit for purpose.

scholarly journals Human Rights and Empowerment in Aged Care: Restraint, Consent and Dying with Dignity

2021 ◽  
Vol 18 (15) ◽  
pp. 7899
Author(s):  
Tiffany Jessop ◽  
Carmelle Peisah
Keyword(s):  
Human Rights ◽  
Aged Care ◽  
Care Quality ◽  
Royal Commission ◽  
Active Player ◽  
Chemical Restraint ◽  
People With Dementia ◽  
Educational Engagement ◽  
Care System

The aged care system in Australia is in crisis and people living with dementia are especially vulnerable to breaches of human rights to autonomy, dignity, respect, and equitable access to the highest quality of health care including meeting needs on account of disability. To be powerful advocates for themselves and others, people with dementia and the wider community with vested interests in quality aged care must be informed about their rights and what should be expected from the system. Prior to the Australian Royal Commission into Aged Care Quality and Safety, the Empowered Project was established to empower and raise awareness amongst people with dementia and their families about changed behaviours, chemical restraint, consent, end of life care, and security of tenure. A primary care-embedded health media campaign and national seminar tour were undertaken to meet the project aims of awareness-raising and empowerment, based on 10 Essential Facts about changed behaviours and rights for people with dementia, established as part of the project. Knowledge translation was assessed to examine the need and potential benefit of such seminars. We demonstrated that this brief educational engagement improved community knowledge of these issues and provided attendees with the information and confidence to question the nature and quality of care provision. With the completion of the Royal Commission and corresponding recommendations with government, we believe the community is ready to be an active player in reframing Australia’s aged care system with a human rights approach.

scholarly journals BUILDING CAPACITY TO CARE FOR OLDER PEOPLE! HOW IS CARE OF THE OLDER PERSON TAUGHT IN AUSTRALIAN SCHOOLS OF NURSING?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S3-S3
Author(s):  
Deirdre M Fetherstonhaugh ◽  
Jo-anne Rayner ◽  
Elizabeth Beattie ◽  
Ann Harrington ◽  
Yun-Hee Jeon ◽  
...  
Keyword(s):  
Older People ◽  
Health Sector ◽  
Undergraduate Curriculum ◽  
Aged Care ◽  
Care Quality ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Older Person ◽  
Clinical Placements ◽  
Schools Of Nursing

Abstract As the Australian population ages the demand for nursing care which focuses on responding to the needs of the older person will increase. Few newly graduated Registered Nurses (RNs) currently enter the aged care workforce and few select a career in caring for older people; yet older people are the largest patient group in most health care environments. This research, conducted by the Australian Hartford Consortium of Gerontological Nursing Excellence (Aus-HCGNE), explored how care of the older person is currently taught in Australian schools of nursing (SoN). The interview guide included questions about: whether care of the older person is taught in separate subjects or integrated across the curriculum; academics’ qualifications; subject content; and aged care clinical placements. The head of each of the 33 Australian schools of nursing was contacted, invited to participate and asked to nominate the appropriate academics (undergraduate/curriculum co-ordinators) who would be the most appropriate person to participate in the interview. These academics were then contacted, written informed consent was obtained, interviews were scheduled and completed. This research is timely given the current Royal Commission into Aged Care Quality and Safety in Australia, one focus of which is nurses in residential aged care in respect to numbers, education and competence. This research will be completed by mid-2019. The results will be fed back to SoN to inform the development of their curricula and the preparation of future RNs who will undoubtably need to be expert in the care of older people across the health sector.

Person-centred Australian residential aged care services: how well do actions match the claims?

2021 ◽  
pp. 1-26
Author(s):  
Sylvia Sing Lynn Seah ◽  
Lynn Chenoweth ◽  
Henry Brodaty
Keyword(s):  
Family Members ◽  
Quality Standards ◽  
Aged Care ◽  
Care Quality ◽  
Care Homes ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Personal Perspective ◽  
Convenience Sample ◽  
Care Services

Abstract Recent inquiries into residential aged care services, including the 2018–2019 Australian Royal Commission into Aged Care Quality and Safety, have informed revisions to the 2019 Australian Aged Care Quality Standards. Reforms to the Standards include a greater focus on person-centred services, consumer-directed care and authentic participation in decision-making on service provision by residents and their family members. In respect of person-centred services, the revised Standards reflect the four elements of the ‘Valuing, Individualised Care, Personal Perspective, Social Environment’ (or VIPS) framework for quality aged (social) care services in the United Kingdom. This qualitative study investigated whether the quality of services in a convenience sample of seven Australian aged care homes, which claimed to be person-centred, aligned with the four elements and 24 indicators of the VIPS framework. Data were obtained via semi-structured interviews with a volunteer sample of people associated with these seven aged care homes: 12 residents, 15 family members and 18 staff members in various roles. Data were analysed deductively with a priori reference to the 24 VIPS framework indicators, achieving data saturation for four common themes which indicated more person-centredness and ten common themes indicating less person-centredness. Only two of seven homes adhered to the four elements and 24 indicators of the VIPS framework across most service offerings. The remaining five homes offered some aspects of a person-centred service. The study findings provide insight to the factors which support and hamper the implementation of the VIPS-informed indicators of a person-centred aged care service and, therefore, what is needed to help meet person-centred requirements as outlined in the 2019 Australian Aged Care Quality Standards.

scholarly journals Women, work and industrial relations in Australia in 2019

2020 ◽  
Vol 62 (3) ◽  
pp. 365-379 ◽  
Author(s):  
Meraiah Foley ◽  
Sue Williamson ◽  
Sarah Mosseri
Keyword(s):  
Gender Equality ◽  
Labour Force ◽  
Industrial Relations ◽  
Labour Force Participation ◽  
Aged Care ◽  
Economic Security ◽  
Care Quality ◽  
Royal Commission ◽  
Political Agenda ◽  
Annual Review

Interest in women’s labour force participation, economic security and pay equity received substantial media and public policy attention throughout 2019, largely attributable to the federal election and the Australian Labor Party platform, which included a comprehensive suite of policies aimed at advancing workplace gender equality. Following the Australian Labor Party’s unexpected loss at the polls, however, workplace gender equality largely faded from the political agenda. In this annual review, we cover key gender equality indicators in Australia, examine key election promises made by both major parties, discuss the implications of the Royal Commission into Aged Care Quality and Safety for the female-dominated aged care workforce, and provide a gendered analysis on recent debates and developments surrounding the ‘future of work’ in Australia.

Potential scope and impact of a transboundary model of nurse practitioners in aged care

2009 ◽  
Vol 15 (3) ◽  
pp. 232 ◽  
Author(s):  
Kasia Bail ◽  
Paul Arbon ◽  
Marlene Eggert ◽  
Anne Gardner ◽  
Sonia Hogan ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Service Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Providers ◽  
Care Nurse ◽  
Residential Aged Care Facilities

Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.

scholarly journals A cross-country comparison of family carers experiences with residential aged care facilities during the COVID-19 pandemic

2021 ◽  
Vol 33 (S1) ◽  
pp. 26-26
Author(s):  
Katarzyna M Lion ◽  
Clarissa Giebel ◽  
Ilaria Chirico ◽  
Monica Cations ◽  
Rabih Chattat ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Aged Care ◽  
Care Quality ◽  
Residential Aged Care ◽  
Care Provision ◽  
Family Carers ◽  
Country Comparison ◽  
People With Dementia ◽  
Cross Country ◽  
The Uk

Background:The number of research projects into residential aged care (RAC) during the COVID-19 pandemic is increasing, however there are limited data on the cross-country comparison of experiences residents living with dementia and their families. Our study aimed to 1) give an overview of the RAC restrictions and changes (visiting policy, governmental & health authorities’ advice, service delivery) implemented during the pandemic in Australia, Italy and the UK and 2) and their impact on people with dementia in RAC facilities and their families.Methods:A total of 56 informal family carers of people with dementia residing in RAC took part in semi- structured interviews over the telephone or via Skype in Australia (n=6), Italy (n=25) and the UK (n=26) between July 2020 and March 2021. The interviews were recorded and translated verbatim. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.Results:Inductive thematic analysis identified four overarching themes: 1) Adaptations implemented in RAC facilities due to the COVID-19 pandemic in Australia, Italy and the UK; 2) means of communication between RAC facility personnel, people with dementia living in RAC and family members; 3) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on people with dementia in RAC facilities and 4) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on families of people with dementia in RAC facilities. While differences between countries and facilities were identified, the restrictions and changes within the residential care system impacted families’ well-being, increased their worries about care quality and safety of people with dementia. The consequences of a lack or modified services for people with dementia included noticeable physical and mental health changes. Although the majority of the facilities implemented some form of video-communication between families and residents, those solutions were unable to replace face-to-face contact.Conclusions:These findings demonstrate the need for implementing safe solutions which might facilitate more frequent in-person contact between families and residents with dementia preventing consequences in mental and physical health in both groups.

scholarly journals Corrigendum to: Who uses residential aged care now, how has it changed and what does it mean for the future?

2020 ◽  
Vol 44 (6) ◽  
pp. 983
Author(s):  
Diane Gibson
Keyword(s):  
Residential Care ◽  
Average Length ◽  
Age Groups ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing Population ◽  
The Past ◽  
The Future ◽  
Australian Bureau Of Statistics ◽  
Care System

ObjectiveThis paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future.MethodsTime series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers.ResultsAlthough the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising.ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future.What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns.What does this paper add?The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future.What are the implications for practitioners?These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.

scholarly journals Who uses residential aged care now, how has it changed and what does it mean for the future?

2020 ◽  
Vol 44 (6) ◽  
pp. 820
Author(s):  
Diane Gibson
Keyword(s):  
Residential Care ◽  
Average Length ◽  
Age Groups ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing Population ◽  
The Past ◽  
The Future ◽  
Australian Bureau Of Statistics ◽  
Care System

ObjectiveThis paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future. MethodsTime series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers. ResultsAlthough the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising. ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future. What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns. What does this paper add?The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future. What are the implications for practitioners?These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.

Quality of life measurement in community-based aged care – understanding variation between clients and between care service providers

2021 ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Participation ◽  
Service Providers ◽  
Care Service ◽  
Aged Care ◽  
Care Quality ◽  
Care Providers ◽  
Community Based ◽  
Care Services

Abstract Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets.Methods A retrospective sample of 1141 Australians aged ≥ 60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e.sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression.Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets.Results Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0–1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected.Conclusion Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support.Trial registration: Australian and New Zealand clinical trial registry number: ACTRN12617001212347. Registered 18/08/2017

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