A Spotlight On Aged Care | Q&A


(APPLAUSE) Good evening, and welcome to Q&A.
I’m Fran Kelly. And tonight we focus on
the aged care crisis with aged services industry
representative Sean Rooney, Sarah Holland-Batt, who gave evidence on the abuse
and neglect of her father to the Royal Commission
into Aged Care Quality and Safety, the Minister for Aged Care,
Richard Colbeck, Shadow Minister for Ageing,
Julie Collins, and celebrity cook Maggie Beer, who’s campaigning for better food
in our aged care facilities. Could you please welcome our panel. (APPLAUSE) Q&A is live in Eastern Australia
on ABC TV, iview and NewsRadio. The Royal Commission into Aged Care was sparked by a series
of ABC investigations into abuse and neglect. Many of us will end up
in aged care one day, and almost everybody has
a close family member who’s already in care. Our first question tonight comes from geriatrician
Joseph Ibrahim. Thanks, Fran. Many people would rather die early
than enter a nursing home. Do you share their fears? And what will our government
and parliament do to change the situation
so that aged care isn’t a fate worse than death? I’ll come to the minister
in a moment, but, Maggie, let’s go to the “Do you share their fears?”
issue of that. Yes, I can see that
that is the perception and the reality
in lots of places. But we can change it, because…
and we must, because there are
a percentage of people that will always need
to go into it. So, the perception is there that people would rather
not ever go into aged care. But…we have to work
on the positive, and just say, “It can be changed.” I know it can.
That’s exactly right. And, Sarah, I suppose…
Your father is in aged care. I’m sure it wasn’t an easy decision. That’s something my dad
always used to say to me – that he’d rather die
before he went into aged care. I’m sure everyone in this room
has heard someone say that. But the sad reality is
that sometimes you’re just dealt an unlucky hand
and you have to go in. And the situation at the moment,
for people who are in there, is so variable
and uneven in quality, that we really do have places where you would actually
prefer to be dead than be experiencing
the kind of negligence and neglect that goes on. Of course,
there are good facilities, but I sort of share the view
of the Commissioner that it is a national disgrace
at present, and that there need to be
really serious systemic changes to address the quality of life
for people in aged care. Richard Colbeck,
what can the government do, and what WILL the government do,
and the parliament – I’ll come to Julie Collins too – to change it,
to do something about this? Well, I wouldn’t share
that view across the board. A bit like Sarah, I think there are
obviously some facilities that probably shouldn’t be
in the system anymore, and that need to improve the care
that they’re providing. But not all facilities
are like that. But we need to continue
to reform the system, as we have done over recent years. But it needs to be
a process of continuous reform, because the reality is
that 8% to 10% of people will need residential aged care. And we don’t want people
to be in a situation where they fear it in the way that
has just been described by Joseph. So, we need to make sure – as we’ve done
with the new standards that we’ve put in place
from 1 July – that it’s resident-focused,
resident-facing, and that the quality of care
and the standard of care is what’s expected by people. We can’t have them fearing it.
And we will… We will come to the issues tonight. We’ve had literally hundreds
and hundreds and hundreds of questions sent in tonight. There’s a lot of interest in this,
and a lot of ideas, and a lot of particular themes
and concerns that come up. But, Julie Collins, what should
the parliament be doing? The reforms the Minister
talked about there – are they a good start? Is it actually changing anything? Well, we have a lot of reports
with recommendations about things that can be fixed
pretty quickly in terms of the aged care system,
and we need to do some of those. And I think that, you know, the government needs
to start moving faster with some of that reform. But I understand
why people feel that way. When the stories come out and you see what has happened
in the royal commission and some of the evidence
that we’ve heard, you know, having had a family member
in the aged care system, like many people, you understand
why people feel that way. But I’ve had the privilege of visiting many residential
aged care facilities around Australia. And some of them are doing
wonderful things, and with great innovation. But there’s also some
amazing staff out there, really holding the system together,
who are doing an incredible job, who are very stressed by
not having enough resources to be able to do their job, who are very stressed about
not being able to provide the care they want to provide to people. OK, we’re going to go to this,
but just before we do… And, Maggie, I can see
you’re dying to jump in. But let me ask Sean, because, Sean,
this is the sector you represent. The Minister’s already said there are some there
that shouldn’t be there. Why are they still there? And if there are some good ones, why isn’t every one a good one,
if we know how to do it well? Yeah, look,
thanks for the question, Joe. And I think there’s undoubtedly been
failures in the aged care system, and they’re unacceptable and, certainly, something that we know, as a system,
we need to do better. And I’m sorry that
these things have happened. I think what’s going on
in Australia’s aged care system is the settings around policy,
regulation, funding, workforce training, et cetera, they have not kept pace
with the needs or the expectations of older Australians. And it’s been mentioned
by other panellists. There’s been any number of inquiries and reviews
and reform recommendations, but unfortunately we just
haven’t been able, as a system, to be able to embrace
and adapt and adopt those. And part of that, as we’ve said,
or Julie has said, there are extremely…any number
of great examples of people that work very, very hard
in our sector, and the organisations
that employ them do a good job in meeting the needs
and expectations of older people they care for. But we know we need to do better, and our sector
is committed to doing that. OK. And we are…
We are going to come to that. It’s set us up for the next question. But, Maggie, I could see you
champing at the bit there. Just…
Yes. We do have some great organisations, and we should be shouting
from the rooftop about them and using them as benchmarks. And we have so many people
working so hard with all of their heart, but without
time, or permission, often, to do a job
as well as they can do – that’s what we have to change too. And on that very point, our next question
comes from Gabi Pearson. Hello. A recent report by
the Nurses and Midwives’ Association found 94% of aged care workers
in New South Wales had transferred a resident
to hospital following a fall in the past year, putting an additional burden
of around 3 million on the state’s already
struggling public hospitals. 75% of those same aged care workers said that falls could
have been avoided if there were better staff ratios
in their facilities. Minister, when will the government
stop pandering to the profiteering
aged care companies and introduce mandated
staff to resident ratios? (APPLAUSE) And, Minister, I should tell you, Gabi is from the New South Wales
Nurses and Midwives’ Association. I should also say we had literally
probably 100 questions from nurses, RNs,
or people working in the system, making the same point. Ratios – when are we going
to get to it? And why not? Well… ..I understand that
that seems to be a simple way to look at trying to change
the way that the system works, but it’s not necessarily,
on the evidence that we have, the thing that’s going
to provide the answer. What is that evidence?
What would be wrong with it? Well, there is no evidence
to suggest specifically that just ratios are going to
make all the difference. No.
And so we don’t support that. But what we’ve done in the new
residential aged care standards that we introduced –
and I mentioned before – on 1 July 1 is…is a requirement to provide the level of care
that’s required, including clinical care, which is one of the issues
that comes up as a part of this process,
particularly around nurses, that provides an effective,
high-quality level of care across the sector. So, we don’t support ratios. There are variabilities
between facilities, based on the needs
of the residents in each of the facilities. So, a simple and blunt instrument
like providing ratios within the facilities isn’t
necessarily…across the board, isn’t necessarily something
that’s going to be, in my view, sustainable, but it isn’t necessarily,
on the evidence that I’ve seen, going to provide the answer
towards providing care. Alright, a blunt instrument. Sean? Thank you so much for your question. And thank you for your service,
for you and the other RNs, and all the other people
that work in our sector. Look, good-quality staff
with the right skills, and the right training
are fundamental to good care. Every provider I meet – whether it’s an RN,
a facility manager, a care manager – I haven’t met one
that hasn’t said to me, “We don’t want more staff, “we don’t want them better skilled, “and we don’t want them
better remunerated.” Mm. So, there’s something to say
we know we need more staff. Now, a mandated staff ratio is
one way to achieve that outcome, but it’s not universally supported. Now, we know the Workforce Taskforce
did a strategy last year. We know the AMA and ANMF
have come out and recommended this. What the strategy recommended,
and what the AMA have recommended, is to conduct research
for optimum staffing models for the Australian system
across all different models of care, and that’s a piece of work
that we’re currently doing, and we’ll be looking forward
to working with the ANMF and others when we can share that,
because we’ve got to get this right. But if that…
It’s fundamental to get it right. ..if that piece of work
comes back and says, “Yes, you need mandated ratios,” and you need, for instance,
a registered RN 24 hours a day, which I think is what the AMA
and the nurses recently came up with, will you then support ratios? Well, I think we’d have to. I mean, the outcome we want here is good-quality care
for older Australians. And if that’s the best way
to realise that outcome, then that’s what we should be doing.
Sarah? Can I just say, you know, on that topic of
the blunt instrument, of ratios being a blunt instrument, another synonym for blunt instrument
is bare minimum. We’re talking about a bare minimum
number of staff here. And as someone whose parent
has suffered repeatedly from lack of staffing,
that’s caused… Dad’s…Dad broke his hip.
He broke six ribs from falling. Both of those incidents were because
no-one was there to help him, and so he had to help himself
and tried to get himself around. When you have been, with respect, on the receiving end
of those kinds of injuries, the first thing
that comes to mind is, “How can we get
a bare minimum number of staff?” And I frankly think the fact
that there’s not an RN on site in aged care facilities in Australia
24 hours a day is…is outrageous. These are people with complex needs.
(APPLAUSE) And, Minister, just to your point, “It won’t solve every problem –
it’s a blunt instrument,” I mean, do you think it’s acceptable
to not have an RN on staff? There might be 50 patients,
100 patients, no RN? Well, it depends on the care needs
of the residents. I think that’s the critical point.
(AUDIENCE GROANS) Yes, but there will always be a mix,
won’t there? And it’ll always change. It will always be a mix, and it will
always need…always change. There will always be
high-care residents. And what the standard says
is that the facilities need to have the appropriate staff on site
at all times. What’s the appropriate number
of staff for 50 people in a ward? Well, that…that…that’s…
that’s a matter for the facility… ..facility to determine. They need to have
an appropriate level of staffing on site at all times to provide the appropriate care
for the residents. OK.
That’s what the standard says and that’s what
they’re assessed against. Julie Collins,
what’s Labor’s position? ‘Cause you haven’t come down
for ratios either, have you? Well, what we’ve said is we believe
there needs to be more staff. They need to be better trained
and better paid. We’ve been very clear about that. We’ve also said that we think there should be a nurse on
24 hours a day on site because I think
there’s a community expectation, as Sarah has said, that,
when something goes wrong, particularly
in the middle of the night, that there will be a nurse there
to help your loved one. That is people’s expectations
and the community’s expectations, and I think that
we can deal with that. But the workforce issue
is a really serious one because the Workforce Taskforce
does make 14 actions of government, and one of those is about
a minimum qualification of a Cert III – Certificate III –
for aged care. I am very concerned
that some of the staff don’t get enough training
and enough support, in aged care, to do their job. They want to do it
really, really well, and they’re working so hard
to do the best possible job, but they don’t have
the training they need to do their work in every situation. Maggie, I’m going
to leave you there for a minute because I’d like to do
a fact check here, if I can, with… Maybe use Joseph there
as a fact checker. Joseph, you’ve been in this industry
a long time. You’re a geriatrician. What’s your response
to what you’ve heard here, in terms of from our politicians and the people, um,
representing the sector? So, I think ratios
is a simplistic approach to a complicated problem. We need a bare minimum of staff. There’s…there’s no question
of that. It’s not just more nursing staff. We don’t have enough
physiotherapists, occupational therapists,
speech pathologists, psychologists, mental health. And you need to have a staff ratio that matches the mix of residents
that you’re looking after. There’s no point having
a whole lot of nurses if you need… ..if the residents need
allied health support. What we don’t have
is enough staff to start with. If we accept
that ratios are the answer, then that will not solve
the problem in the future. I think the important thing is… Everyone’s been talking about
the football. Both teams have
the same number of players. How well they work together
is how well a facility runs. It’s not just about numbers. And I think we get…
we become delusional if we think numbers is the answer. But I think Julie’s right – if we don’t have that minimum
to start with… But we’ve got to be able
to think through, “What are the needs
of the residents? “What are the professional groups
that are needed? “And how we…how
do we deliver that?” And the government missed
an opportunity over 10 years ago when we trained
more doctors and nurses instead of training people with the skill sets
that are needed for the future. And we continue to go back
to old ways of doing things, and it’s the old ways
of doing things that have led us to the problem
that we’ve got today. OK, let’s go to, um,
the next question, which is a video from Isobel Fischer
in Banksia Park, South Australia. I’m a 17-year-old aged care worker
currently studying at high school. I have seen half a hamburger patty served to residents
for their main evening meal, but it is somehow acceptable
for aged care facilities to spend $6 per resident
on food and beverages each day. To the panellists, I ask whether
you think this standard of care would be acceptable
for your mother or father? I also ask whether you think there should be
government regulations that force facilities
to improve meal qualities that will also improve
residents’ quality of life? Thank you.
Thanks, Isobel. Maggie, that one’s got your name
written all over it. Yes, it certainly has.
JULIE: She’s itching. But everything to me comes
to culture, leadership, training, um, and it’s a very complex arena, uh, and it’s so highly specialised
for food. Cooks and chefs –
there’s nowhere in Australia that has a proper education,
um, for the cooks and chefs who are dealing with
much more difficult issues than, um, being a cook
in a restaurant. So, the training needs are huge, um, and there are new ways. There are better ways
and there are new ways, and we… We know, through our masterclasses
we’ve been doing for nearly… well, for four years, nearly five, that we can turn around
the cook and the chef to be a champion with knowledge if we have a CEO
as the other champion, and then you can start
to change a culture, but not without a great deal
of work and money. Money is essential to increase. $6 a day is absolutely… It can’t happen.
You cannot get proper food. Can I ask you about…? You’ve been going into nursing homes
over the last few years and having a good look at this. Is $6 a day…? Isobel mentioned it. I know you’ve talked
about this before. $6 or $7 a day – is that
what nursing homes are working on? And what sort of food
are you seeing served up to people? Alright.
What is making you so worried? Well, I guess we have had
200 cooks and chefs go through our training program, and we have seen their budgets
from as low as $4.50 a day to $15 a day, um, and… Yet it’s not just money
that will make the difference. And what worries me is
you cannot do real food with the scent of home cooking… Even if you’re cooking
for 100 people, you need the scents, because
we need our saliva to be increased because, as we age,
we lose less…lose more of it. And…and the scent of food
is what gives you the cues to eat and helps the pleasure of eating. And at $6 or $7 a day, you can only have processed foods
and…and frozen foods, um, and so it’s impossible to give
the quality of life, the well… ..um, the quality of life
that we must give to our people in aged care homes –
and in society, by the way. That’s right.
Let’s, um… I’m going to continue this discussion
about the food because I know
there’s a lot of interest, but we do have a follow-up question
from Ian Poalses, who’s the New South Wales manager
of Leading Age Services Australia. That’s the peak body
that Sean is in charge of. Um, Maggie, since nearly half
of Australian care homes are running at a loss, what services
are you willing to see reduced in order to pay
for more expensive meals? (CHUCKLING)
It’s a very difficult question. Because everything
ultimately comes… Everything comes down to money.
..down to dollars and numbers of people. But for me, this new way
of thinking that we need – we need to step back and see
what we can do, being simple, and bringing in
the reality of…of… With knowledge,
you can do really beautiful food, where everything else is right,
for about $10.50 a day. So, from $7 to $10.50 is going
to make what percentage difference? And when you have… When you have beautiful food, you don’t have the need
for pharmaceutical supplements, you have a positive workforce,
because they’re proud. So, what we do
is spend money differently, um, and raise the bar. OK. Sean, $10.50 a day
is what Maggie says is required to provide something that is going
to be good for you, basically. Is that doable? And do you accept that
you could spend that extra $3 there and that would relieve you of
the need of some other sort of care? Yeah, I think, um,
what Maggie will tell you – a flavour, aroma, nutrition – all of that wrapped up
in a dining experience is what we would all desire. And being able to do that well in an aged care setting
is challenging, and…and certainly,
Maggie understands some of those challenges. But notwithstanding that, I think Maggie’s on to
the thing here – that getting that right has a whole range of other benefits
for the residents. Yes. Yes. Emotional, social, psychological –
all of these types of things. So, potentially, you will
be able to actually realise some…some economy in that. But to be honest, I think
it’s a bit of a false economy to say that, somehow, we’re going
to have to trade off a meal to, um, you know,
a physiotherapist session or something like that. I mean, at the end of the day,
we want the system that meets the needs
of older Australians that require that support. This is what the country
is screaming out for, and this is what…this is why
this conversation is so important. Sarah, what was the experience
for your dad in the nursing home, in terms of food? Um, it’s… His…his… The food in his home
is actually fine, but, you know, when you actually
look at the news stories and the stories coming out
of the commission about the food, you do see some really,
really grim realities. So, for my dad,
the food has not been the problem. The staffing – the chronic
understaffing – has been the issue. There is a connection from
some of the questions we’ve had and the point that
Joseph was making too, in terms of numbers of staff,
Minister. Because a lot of the questioners
came in and said, well, you know, food is… ..the food is often designed around
what’s easy to serve, and that’s why
party pies are served up – because you can just lump it
on the plate and people don’t need help
eating it so much – or that the food is just served
and left out of the range of people and they can’t get to it,
and that’s a problem. So, again, it’s coming back
to staff numbers. Well, the… Leaving food out of range,
really, would be, in my view, a complete breach of the regulations and the new standards
that we’ve just put in place. And I think Maggie’s point
that she made earlier about transferring knowledge
between the really good facilities and those that aren’t so good is one of the really valuable things
that we can do. Really important. Yeah.
We’re doing it in other areas. And I’d commend her for the work
that she’s been doing over a number of years now
around teaching chefs, cooks, within aged care facilities to, um…to provide
a high-quality product. Uh, because,
as she quite rightly says, uh, good food
is a really important part of the overall provision of care. It’s a really important part
of that. And, again, as she correctly says,
it actually can also help to mitigate
some of the other issues. And when she was talking about
aromas and smells, I mean, I…I related
to that immediately because that is part
of the food experience. OK, but if we know this…
So, transferring that knowledge, which is what
the government’s doing… ..working with Maggie to do,
is a really important part of this, so that the good practice can be transferred across
to the rest of the sector, so that they can put those sorts
of things in place as well. I was looking at the books
of a facility on…on Saturday, and they were spending
about $12 on their meals. So, it’s something
that I take an interest in. I was looking at the figures
that they were talking to me about. But transferring that knowledge
across the sector, I think, is one of the things that…ways
that we can continue to improve it. Just to finish on this, Maggie, your experience
in terms of the transfer – how much eagerness
and enthusiasm is there, from the institutions, to learn? There is a huge eagerness. Everyone wants to do better, but a lot are struggling
with the how, and that’s that lack of education, that lack of very specific training
that is needed. Um, and that can… It turns people around and it makes them
the most excited champions ever, and it has… The food is the centre of the plate,
but everything else comes around it. It’s not just the food,
uh, but the food is complicated. Um, and in terms of having
to look after vulnerable people and…and, um,
those with dysphasia, you know… And that training
just isn’t happening unless we’re doing it, and… And there are a lot of other people
doing wonderful things, and there needs to be a conduit. We try and be a conduit,
as the foundation, for sharing good information,
science that’s up to date, tips, things to empower
the cooks and chefs. Because, give them the respect,
the kudos that they deserve, they can do more than anyone else
to make a difference. Uh, and often, they’re not respected
in their own arenas, let alone
in the wider world of food. And they are the ones that can really make the difference,
with knowledge. And Fran, I’ve had a number
of other people come to me, talking to me about exactly what
Maggie’s been talking about – uh, that have expertise in food, who want to use that knowledge
and transfer it into the industry. Uh, and, in fact, I had an email
just yesterday about it, so… OK, well, looks like
one of those things that at least the regulators
are going to need to make sure that everyone IS learning it, everyone IS subscribing to
the online standards and all of that. Remember, if you hear
any doubtful claims on Q&A, let us know on Twitter, and keep an eye
on the RMIT ABC Fact Check and The Conversation website
for the results. Our next question
comes from Judy Muir. Hi. There are over 50% of residents
in aged care facilities that suffer from dementia. Many of these residents exhibit
perceived challenging behaviours because their needs
are not being met. And, unfortunately, these behaviours
are controlled at the moment, too often, by chemical
and physical restraints. How do you suggest that
we resource the aged care sector so that the people
with dementia receive not only adequate personal care but quality care that ensures
their individual needs are met? Now, this is a huge issue,
because something like 52% of people living in our aged care facilities
have dementia. Um, Sarah, let me start with you,
because I think your dad has – and this is quite a common thing –
developed dementia during his time in the home. Was there… Did you get a sense
that that was recognised, anticipated and the support and the training
is there? No, absolutely not. And I think the issue
is that, predominantly, care is being delivered
by personal care workers who can have as little
as a five-week TAFE certificate to undertake the caring. And so, these are not people
who have medical expertise. They don’t really understand. And I’ve had people say to me –
Dad’s carers say to me – “Oh, well,
the trouble with your dad is “he just doesn’t retain
instructions.” And I sort of say to them,
“I’m sorry – um, he has dementia. “He has cognitive decline
and Parkinson’s.” And so, that kind of fundamental
ignorance, um, of what’s required is really alarming. And so, that is why, of course, I’m
in support of more medical knowledge in these places, in that skill mix
that’s required in the aged care sector. I think there is such
a dearth of people who genuinely understand
these conditions, and know how
to care for them properly. But I think we need to train
everybody in the system from the cooks and the chefs
to the gardeners, to the personal care workers…
Absolutely. Everybody along the whole system that that person comes into contact
with needs to understand dementia. And we need to do more
in the community to get other people
to understand dementia so that people understand
the behaviours and how to respond,
to encourage people with dementia to continue living in their
community for as long as possible, but when it’s not possible that they’re getting
the best possible care. I was absolutely shocked
when I read the numbers of people being chemically restrained
in nursing homes. Um, I’ve read a lot of the
transcripts of the royal commission, and I was gobsmacked. I couldn’t believe it. And, you know, the government
has since put some regulation in around that, but what that’s doing
is measuring the number of people being chemically restrained, it isn’t reducing
the number of people being chemically restrained. So, I think we’ve got
a lot more work to do yet. Um, and clearly some of this
medication also is not really very effective
for treating people with dementia either. Uh, all it’s doing is,
essentially, putting people in a princess chair all day,
drugged up, which means that the carers
have to deal with them less. And that’s not OK.
May I… And I’ve been into some facilities
and seen that. Let me ask Maree McCabe,
who’s the CEO of Dementia Australia, in the audience tonight. Maree, the, uh…
the numbers of people being physically
and chemically restrained – I think we’ve all been shocked
to hear these stories in the royal commission. The government has brought in
regulations that are guidelines. Has anything changed? And is there a better way of managing so that we won’t need
this kind of restraining? Absolutely, Fran, and
I think some things have changed. One of the challenges,
we know the research shows us that anti-psychotic medication, which is often used for restraining
people living with dementia, is ineffective in 80% of cases. It increases the risk of heart attack,
of stroke, and of death. In 20% of cases, it is effective. But people, unfortunately,
are unaware of other interventions
that are supportive of people, and the challenges that they face when their responses are interpreted as being aggressive
or inappropriate. Sean Rooney, if…
Maree gave us that statistic – in 80% of cases,
the chemical restraint is ineffective for the people. Why are the institutions using it?
Do they not know this? Well, I mean, there is no medication that is administered
in an aged care facility that isn’t prescribed
by a general practitioner. So, there is a…
The starting point here… This is an integration issue
for primary care or general practice, acute care
hospitals, and aged care. So… And that’s writ large in a lot of the issues coming out
from the royal commission. And I know, indeed, with Sarah’s
father, that was an issue. I think the point to note
with respect to, um…to Maree is that we…industry has argued
for mandatory training for all care workers. This is fundamental.
That’s what you need. Yes. One of the things that we’ve been
doing with one of our members is we brought to Australia
the virtual dementia tour, which is actually
an experiential training tool for… We want to see every
aged care worker trained to actually feel and sense
and experience what it is like to have dementia. Because when they
go through that process, they have so much more empathy
and understanding for the condition and the people they’re caring for. And then there’s
lots of other things. So, Microtowns
and dementia villages. There’s lots of innovation
in…in models of care. But I think Maree
would also tell you, this is not just an issue
for aged care. JULIE: No. This is an issue for the nation.
MAGGIE: Yeah. Because we know that it’s such an insidious,
debilitating, uh, condition that will rob people
of their memory, of their confidence, of their
identity and…and of their dignity. And this is something that
as a community and a society we need to be able to do better. And we’ve seen…
We see this already… And it’s talked of in terms
of an epidemic in Britain, and we’re using the same
sort of language here. Minister, are you
getting the feeling…? We’re talking about, we need
more training of the carers. We need more people involved. It might not be ratios,
but the numbers – as Joe said,
we need more people generally. We need more money per head
spent on meals. Are you getting the feeling
that you’re going to need to put a lot more money in here,
to aged care? (CHUCKLING, MURMURING) Well, it’s clear that the industry
is under pressure. The whole sector is under pressure. And the numbers confirm that. And Sean and I and Julie
have had a number of conversations around that. But in the context of dementia, I agree that the entire aged care
workforce needs an uplift. Um, the broader community needs
better understanding of dementia – I think that comment’s true. The medical profession
needs to understand it better. I’ve done the experience that
Maree’s got at Dementia Australia. And, um… ..it’s quite confronting.
JULIE: It is, indeed. Fran, can I just say, if we want
a world-class aged care system, it’s going to require
world-class funding. Yeah. So, when the Minister
says an “uplift”… (APPLAUSE)
So… SARAH: Yeah. Yeah. ..what sort of numbers
are we talking about? Well, so, currently, we spend less
than 1% of GDP on aged care. The OECD average is 1.5%. So, surely, that’s telling us
that we’re behind the eight ball. We know there’s 50%
of residential care facilities are currently operating at a loss. This is not a sustainable, viable
system as it currently stands. And we need to come up with
a solution right now. So, again, what sort of figure
are you anticipating? I mean, I imagine – and I could be putting words
into the Minister’s mouth – that at some point he’ll say, “Well, we’ll wait until
the aged care royal commission.” But a lot of people have made
the point we’ve had 20 inquiries, we basically know the issues. Yeah, and, Fran, we can’t wait. Uh, the Minister knows we’ve said
$1.3 billion is required over the next 18 months… $1.3 billion. ..in addition to what’s currently
in the budget in order to maintain, uh, standards up until we get an outcome
from the royal commission. Now, that’s just
in residential aged care. That doesn’t deal
with the 120,000 people looking for support in their homes
on the Home Care… We’re getting to them. Joseph? I just want to be clear
that the issue about physical and chemical restraint’s
been known for over 10 years, been involved with
both…both parties, parliament’s known about it,
medical staff have known about it, and nothing has changed. And so to say that we’re dealing
with it as a new problem is wrong. It’s been there for a long time. And so, the problems that allow it
to have existed remain in the lack of leadership, in terms
of the whole country, on that topic. And stating a law that says
that we should not restrain people, I think, was really…
(SIGHS) ..not very helpful. Because people know you’re not
meant to restrain or shackle. So, simply saying it’s now illegal
is not a help. The help that’s needed is to get
to the root cause of why it occurs. And we lack respect
for older people. We lack bipartisan approaches to it. And the parliaments generally
have been gutless about addressing aged care issues for the last
10 to 15 years. JULIE: Can I say on that, Fran…
(APPLAUSE) ..the Living Longer Living Better
reforms in 2013 were bipartisan. And we have spoken to the government
over the last three or four years about bipartisanship,
in terms of long-term reform. We are up for the conversation
of long-term reform of aged care, because we do have to get it right. But we also need to act soon. Labor is not in government. You know, Richard
is the Minister here. Um, we need leadership to change
this and change it quickly. The problem we have had,
in my view, is that we’ve had six years
and four ministers. And they’re taking time
to get across their brief, which you understand, but what
it’s done is it’s delayed the reform that is necessary. And we need to act faster.
RICHARD: Just…just… Hang on. Hang on. Maggie?
Just to respond. You will get to respond – trust me.
Good. Thank you. (LAUGHTER) But I want to bring food
into dementia. You mentioned unmet needs, and aggression that can happen
because someone is agitated. We have examples of homes
that have cottages, where there is a carer
and 10 or 12 people in a cottage, and they actually cook
with the carer. They go shopping. They’re not confined by four walls
where they can’t open a door. We have to look
what’s happening there. And food can help, um, stave off
cognitive decline as well – the right food.
JULIE: That’s true. The Mediterranean diet,
the huge amount of protein and dairy and all the things we need. So, food and dementia
should be linked together as one of the paths to help. And the way we design our
institutions probably too can help. Yes! But, Minister,
yes, you can have a word. Yeah, look, I just want to dispel
this perception that we’re not doing anything. Because I’ve made a very conscious
decision not to pause any of the changes
that my predecessor put into place. So, we started acting particularly on the Carnell/Paterson
Reviews last year. A new Aged Care Quality
and Safety Commissioner started on the 1st of January this year. New aged care residential standards
came into place on the 1st of July this year. And they are very much more
resident-focused. It’s about the resident, effectively looking through
the facilities to the resident and they’re the focus
of the new standards. The new Residents’ Charter, which came into place
on the 1st of July as well, and, of course, the new regulations
around restraint, which I think are not…
OK. So, we if accept… So, there are a range of things
we’re continuing to do… ..accept there has been some
regulatory change… ..as the royal commission continues
and we will continue. There’s another tranche of
legislation… But I started this
asking about funding. And we just heard Sean say
$1.3 billion is needed within the next 18 months. We know the government
is about to come up with some kind of additional
drought response because action is needed now. Will you go and say,
“We definitely need $1.3 billion, “we can’t wait for
the royal commission”? We are…we are looking at all of
the reports and the numbers right now.
(LAUGHTER) I can’t come on here and make
a commitment to something that hasn’t been decided
by government. No, no, I said will you go…
That wouldn’t be the right thing… ..and ask?
But I… I’ve… I’m very cognisant
of the circumstance of the industry right now. The comment that Sean also made
around Home Care places, very alert to the timing
around that. So, it’s not something
that we’re not considering, we’re not cognisant of. We are very, very aware of
the circumstances of the industry. Alright. Let’s go now to all
those people who are hoping to not go into
an aged care facility. Our next question
is from Anita Calcutt. Thanks, Fran. Many elderly people
wish to remain in their homes and have services delivered to them. Why can’t the funding
of Home Care Packages be like the child care funding, and be available as soon as the ACAT
assessment’s been completed? Waiting times for the higher
packages are in excess of 12 months, so people actually die waiting, carers are burnt out, or the government goes
into full-time residential care, because they can’t get
the Home Care packages. Now, that seemed like
a really sensible suggestion to me. We know what happens in child care – people get their subsidies
straightaway. The positions are there.
Why can’t it happen? JULIE: Good question, Fran! And I guess that the point is, is… The question Anita had, actually!
..what do we…? Anita! Yes! Anita. I get 91-year-olds
contacting my office who are a carer of a loved one
who are blind. And they’re saying, “We’re being
told we have to wait two years “for a Home Care Package.” In Australia today,
I don’t think that’s acceptable. I think we need to do better. I’ve raised, with the Minister,
personally, some of my ideas about how to deal with
the National Prioritisation Queue. I think there’s some issues
around that. I think that we should
be giving people in their 90s some sort of priority, or people with terminal illnesses who have less than three
or six months to live, who are being told,
“You have to wait two years.” It’s just not acceptable today,
and we can and should do better. I’m going to come to the Minister ’cause it is about dollars again,
to some degree, and a model. But, Sean, you represent those
who also provide home services. I mean, is it just about resources? Why are people assessed
and then left? Good question, Anita.
And to follow it too, Fran. Look, we have a situation where we’ve had a policy in place
since 2012. One of the key objectives
of that policy is to realise support for older
Australians to age in their homes. There are 90,000 funded packages
that are fully subscribed. There are 120,000 people
who have been assessed as requiring care in their homes,
but are unable to access that care, either at their assessed level
or at all. Now, for seven years,
we’ve been working on trying to get a program in place to support people to age in place,
and we are failing. So, what’s the problem? And it’s because we have capped
the number of places, and they are being slow
to be released. We have put forward to government that there should be
a 90-day maximum waiting period from the time you are assessed to the time you receive care
and services. (APPLAUSE)
It should be no longer than 90 days. And how much would that cost? We have costed that out to say if we were to reduce
that 120,000 waitlist over to something more manageable
that came down to that 90 days, it would probably take
two to three years. And we think that’s half a billion
dollars a year – additional. Richard Colbeck, what do you think
about the notion of uncapping? And what do you think
about Anita’s point about modelling it
on the child care model? Well, we obviously need to continue
to reduce the waiting lists. Quickly.
I’m a bit more ambitious than Sean. I think 30 to 60 days is probably
a reasonable time frame. But now, currently,
people are waiting a year or two. Yeah. I’m a little bit jaundiced
about Julie’s claim, given that they didn’t put
an extra dollar in for Home Care Packages
at the election campaign. Not an extra dollar…
JULIE: You didn’t either. (LAUGHTER)
..from the Labor Party. Let’s be blunt about it. But we put 25,000 additional
packages into the system last year, which was an increase of 25%. So, since last year’s budget,
we’ve put $2.2 billion… ..into additional… OK, but it’s still not enough,
clearly. So what’s the answer? No, and we’re still not there yet.
I agree with Sean around the model. I’ve got some concerns
around the structure of the model. And I think that we can
activate a lot of money that’s locked up within the system that’s not being utilised
at the moment. So, I’m actively looking at that
at the moment. And not necessarily
like a child care situation, but the model that we use for NDIS, I have to say,
has more attraction to me. But we’re still working our way
through that process. But at the end of the day, it is going to continue
to require additional resources, and on the current projections,
we’re at 125,000 packages. We’ll go to 157 by ’22-’23. But we’ve got 128,000 people waiting. Yes, but not all of those
are not receiving care. 95% of those are receiving care
at some level. Maybe lower than what they are. But 95% of them are either receiving
a package at a lower level, or receiving care through
Community Home…a CHSP package. So, it’s not that they’re
not receiving any care at all, they’re receiving some care, but not necessarily at the level
that they’ve been assessed… Sarah. ..which is the issue
we’ve got to deal with. I think something
that’s just been lost in this discussion about funding is the transparency
about where exactly it’s going. You know, we are hearing…
(APPLAUSE) Some…
This year, I suppose, roughly, we’ll be spending $20 billion
on aged care funding, which is a lot of money when you consider there are around
200,000 people in residential care, and then people
with Home Care packages. We know that Home Care packages
are being rorted, we know that people
are using that money for admin…exorbitant
administration fees. We also know that,
with aged care funding, with residential aged care funding, that, yes,
some providers are struggling. But other providers
are paying out gigantic dividends and making huge profits
for their shareholders when they’re primarily being funded with Commonwealth government
funding. So I really think that, in order to be given these cheques
for more taxpayer funds, we need radical transparency
about where this money is going. (APPLAUSE) Our next question is
from Shirley McLaren. Hello. I’m Shirley, and I’m 87. MAN: Whoo!
(APPLAUSE) In… In 1951,
when the Korean War broke out, I was selected to join the
Women’s Royal Australian Air Force, and I served for 4.5 years. Recently, I was on Old… ..the ABC program
Old People’s Homes For 4-Year-Olds. Thank you! So, I know firsthand how beneficial these
intergenerational activities can be. Richard Colbeck and Julie Collins, if intergenerational activities can
help delay the onset of dementia, and help reduce the severity
of dementia symptoms, then what plans
does the government have to fund
intergenerational activities… ..in the future? (APPLAUSE)
Thank you very much. And I’m pretty sure everyone’s
going to want to have a go at this. But let’s start with
the two politicians on the panel. So, Julie. Thank you, Shirley.
And it was a wonderful program. And I’ve seen many similar programs
with intergenerational at many facilities
that I have visited. There are a number of facilities
in my own electorate where they have schoolchildren
come in on a regular basis and do intergenerational work. And it’s wonderful, I think,
and very rewarding for everybody. And I think
it’s a terrific, terrific thing. Whether it costs
additional money or not, I don’t know
what the cost may or may not be. But, certainly, I think
it’s a very worthwhile activity, and every time I see it,
it warms my heart in every facility. And it’s wonderful that you’re able
to participate. It’s terrific! Maggie?
Well, it’s… Does it cost money? Or is it opening people’s minds
to the opportunity? And that show, and others
on the ABC, have done that. And you’ve done it so brilliantly. And it just takes people
looking at things differently. And we have… I went to the opening
of a Montessori school in South Australia two months ago
in the middle of an aged care home. Can you believe it?
That’s what we need. We need to encourage it,
talk about it, and show how great it is. Sean, does it cost money? Look, thank you so much
for your story. Thank you for the program.
Thank you for your war service. It doesn’t cost money.
What it costs is time. And as…
Are the providers interested? Oh, this is happening every day
in aged care. And I think what we’re… ..what the value of the program
that Shirley was involved in is it’s actually opened the door
inside an aged care facility and shown the value of this
intergenerational connectivity. And what we’re seeing is
new models of care emerging. So, instead of having
aged care homes or nursing homes behind high brick walls,
you know, in leafy streets, this is actually trying
to create a space for the community. It opens it up,
and allows intergenerational and, I guess, community engagement
and interaction. And that’s part of the future, that’s part of seeing things
differently, as Maggie says. Richard Colbeck,
you’re the minister now. That program has had
an enormous impact on people. People mention it to me all the time.
JULIE: It’s wonderful. So, has it changed the way
you’re thinking about things? Are you determined to sort of try
and move this forward, this…? Or broaden this take-up
of intergenerational…? Well, like Julie, I’ve been
into a number of facilities that have been doing this
for a while. What this wonderful show
that Shirley participated in – and, again,
thank you for your service, Shirley, and thank you
for your participation in the show – has opened people’s minds
and thoughts to the…to what is possible. And this is
a great demonstration of that. It’s given publicity to something
that’s been happening in facilities. I’ve had a look at one in Hobart. They have the kids come in
for 12 months. JULIE: Yep. They came in a day a week
for 12 months. So, is it something you’re going
to try and drive further? So I would encourage facilities
to continue that sort of engagement. And I know that some facilities are
looking to build childcare centres. In fact, I was at one in Victoria
only a couple of weeks ago. They’re looking to build
a childcare centre next door, so they can build
that sort of engagement. And I think that is fantastic. And if the ABC show
has opened up people’s minds to that level of engagement
and opportunity, it is a fantastic thing.
Can I just ask Shirley…? Shirley, just tell us
a tiny little bit about what you got from it. Well, the interaction
of the older adults with the four-year-olds
was just absolutely superb. And I think that we learnt
from the four-year-olds… What did you learn? ..just as much
as they learnt from us. What did you learn, though? What difference did it make
to how people were feeling? Well, I think
that the four-year-olds had a great deal of care
and compassion for the older people
on the program. But also we had
a different viewpoint on how to relate
with four-year-olds, how to talk with four-year-olds,
how to interact with four-year-olds. And it was a great benefit
to both young and old. And, Sarah, just finally, did you have anything like this
in your dad’s nursing home? And would it have made a difference,
do you think? I think it would make
a huge difference. There was nothing like that
in Dad’s… There is nothing like that
in Dad’s nursing home. But I think what’s underlying
why that was so powerful for you and why it sounds so transformative
is that the reality is most people are spending
all of their days alone. They’re depressed. They’re lonely.
They’re bored. Sometimes they’re just parked
in front of the television and just sat there. You know, I think the… And underlying all of this
is just ageism. It’s just this idea these people…
(APPLAUSE) JULIE: It is. Ageism. That’s one of the things
I think that we can actually change. I think – it’s been mentioned
a couple of times tonight – the attitudinal natural change
that we require in our society around older Australians. In fact, when I…
Kids don’t discriminate. And kids don’t discriminate.
That’s right. But I talk
to Indigenous communities, and they talk about their elders. And I think that sort of
thought process and culture around the way that we engage
with older Australians is a real change in thinking
that we need to encourage. And something like this can
actually start that process, because it will take time to build
its way through the community. But this is a really great way
to start. 40% of people in aged care homes
have no visitors. So, that loneliness issue
must be an enormous one. Yeah, and… Look, we will move on, because
there’s so much to get through. Our next question is
from Helen Williams. (SPEAKS INAUDIBLY) My parents’ aged care facility
failed two accreditation reviews, receiving
a serious risk notification, and yet they are allowed
to continue to operate. I’ve worked in aged care and witnessed the same issues
in many facilities, and I believe the issues
are systemic. With so much evidence
that many provide substandard care, why isn’t immediate action
not taken to protect the most vulnerable
people in our society? Sean Rooney,
why are there still places operating that have all these complaints
made against them, they fail the accreditation
all the time, they go after warning and warning
and they are still open. Thanks for the question, Helen, and thanks for the work you do
in the sector. I think we all need
to have confidence in the aged care system. That comes from good regulation and
good performance and good behaviour. And how would you describe it
currently? Well, I think what we are finding
is we have a system that’s in transformation, where the regulator is learning
how to do their job better, whilst the aged care providers
are doing their best to do their job better. Getting back
to the actual process of, I guess, assessment
and accreditation, when a service
has a non-compliance – when they’re not meeting
the standards – the best and most
appropriate outcome is to get that service
back into compliance. That is the most appropriate way
to deal with it. The problem we have, though, is that
there can be providers and services that are repeat offenders. And it is in nobody’s interests to
have repeat offenders in our sector, because, firstly,
they’re putting at risk the people that they’re caring for. But they’re also damaging
the reputation of all the other providers
that do a good job. Yeah, and we have all seen
recent reports of, for instance, one of the major providers, Bupa… In fact, we’ve got a question here
from Yumi Lee. Last year, Bupa in Australia
and New Zealand posted a pre-tax profit
of $585 million while, at the same time,
60% of its facilities are failing basic standards and 30% are putting the health
and safety of its elderly at serious risk. Can the panellists justify
the profiteering of these companies on the backs and lives of
our vulnerable elderly population, and explain why it is
that they are best placed to care for our elderly? Richard Colbeck, that is linked
to the question earlier too about the accreditation. I mean, why…
Is profiteering too strong a word? And is it simply that we have
got ourselves into a situation where some of these providers –
and Bupa is one of them – are too big to fail? How do we deal with that
and enforce standards? Look, I don’t put Bupa in
the classification of too big to fail. I put them in the classification
of big enough to conform. And that’s what I expect
that they should do. But they’re not doing it.
They’ve got 72 homes and 45 have failed to meet
health and safety standards. And that’s why my department is meeting
with their management weekly. That’s why we have required them
to employ additional staff and particular management – nurse
managers – in their facilities, each of their facilities
that are not conforming, and in their main office
to bring them back to conformance. I expect an organisation
such as Bupa should be complying
with the regulations. That’s their role. So, rather than being
too big to fail, big enough to comply and to conform. And that’s what I expect
that they should be doing. And that’s why,
in a couple of circumstances where they have lost accreditation, they’ve actually had
to provide services without getting
any Commonwealth money, so the Commonwealth fees
get taken out when they lose their accreditation. I expect them
to come back to compliance. That’s their responsibility. And there’s no question about that. That is what we expect of providers
in the system. And, as I said earlier,
if they’re not going to comply, we don’t want to see them
in the system, if they are not going to provide
a service that is adequate. Sarah, let me ask you about
your experience with your father because you made complaints. What was your sense
of how those complaints were treated and how the regulators responded
to you when you went further? The regulator was useless.
Completely useless. The regulator…I found through Freedom of Information
documents that I got that the regulator
decided on my first phone call that Dad’s case
was suitable for early resolution. Before they’d even done
an investigation. Before they’d even gone
to the provider. I get the sense that the regulator is very interested
in having statistics like, “Oh, so many cases
are resolved within 30 days.” As though that means everything
has been robustly investigated, wrapped up and everyone is happy. That’s not the case. So, I had an appalling experience
with the regulator. And on the issue of accreditation,
can I just say, Dad’s facility passed
all 44 standards of accreditation in both of the last reviews. So, the entire time he’s lived there
and lived through these horrors, the facility has
been fully accredited to the absolute maximum standard,
which to me is just outrageous. And most people don’t know
your story. But just give us a small sample
of the horrors. Well, I think
the very worst thing for me was a whistleblower came forward. Dad has had a number
of horrors there. Medication mismanagement,
all sorts of stuff. But a whistleblower came forward and told us that someone had been deliberately victimising
and abusing Dad, let an infection get so bad
that he had to be hospitalised, verbally abused him, told him
that she was sick of his shit, left him in soiled incontinence pads
for hours with the door closed. It was a horror show. And that was the substance
of my complaint to the then Aged Care
Complaints Commissioner. And that was suitable
for early resolution on the first phone call. Julie, I’ll come to you in a moment. But, Sean Rooney,
isn’t the reality that that complaint and that person,
who was known to behave like that, could, if they were fired –
and we don’t even know if they were – could then get a job
in another institution and there
would be no record of them? You’re right, Fran. And this is one of
the shortcomings in the system. Shortcoming?
Is that what we call that? Well, there is not
a national database, which we have advocated for
and fully support for personal care workers so we can actually track
their accreditation, their qualification,
and also their work history. Because, at the moment, if you’re employing somebody
into the sector, you’re relying on all the usual
police checks and referees. But if you don’t have that, I guess,
professionalisation of the sector, then we can’t be assured
that these people aren’t actually moving
to other locations. And that’s why it is fundamentally
important to get that right. We keep hearing what is fundamentally
important to get right. We know what they are. We allegedly
have got the reforms in place. But we keep hearing
these stories, Julie. And the stories
are not acceptable. I mean, it comes back
to the point that Sarah made earlier about transparency of funding,
and where does it go. I think that if we are going to talk
about future funding of the aged care system, if we are going to talk about
what is quality aged care and how are we going to pay for it, we have to have transparency
on where the money goes. If it’s taxpayer money,
we need more transparency, but we also need transparency
around the complaints system. And I said on the very first day
when the legislation came through about combining the safety
commissioner and the regulator that I wasn’t convinced
that the new safety commissioner has enough powers to intervene
and arbitrate early. And I think that the commissioner
needs more powers to intervene and arbitrate much earlier, in any of the complaints
that it is receiving. I mean, if your complaint,
at the very first phone call, was “Requires early investigation
and decision,” then why didn’t that happen? That is my question. It should be able to happen and they should be able
to arbitrate and make a decision and rectify it quickly. The other thing is, for repeat offenders that
continually breach accreditation, I think we need to consider
some form of penalty. Criminal penalty? I think we need to consider
some sort of penalty. (APPLAUSE)
There are so many issues. There are so many burrows to go down. Maggie, I know you want
to have a say, but we only have time
for one last question, and I know you will want
to have a say on this one. It’s from Kate Radcliffe. Oh, fantastic. Firstly, I would like
to say, Maggie, I want to be you when I grow up! (LAUGHTER) So, I’m really glad
I got this last question! Maggie, you represent
a wonderful, caring, accomplished person
in her senior years, who is still doing what she loves, and you always take an interest
in everyone you encounter, which I am sure we all agree. And I really admire that. You’re a recognisable role model
for ageing well. Do you think we,
as a community, need to make more of an effort
to celebrate ageing, so that we do not forget our elders, nor subject them
to substandard healthcare and, as a society,
allow them the best quality of life in their final years? Absolutely. Celebrating age
is what we should be doing. And what we should be doing is
making sure we’re all connected, that we’re doing something
that we love, and that we encourage
everyone around us to do this. And, um… ..and see the respect for those
that have lived long lives and gone through so many things that, you know, have made
this country what it is today. And, you know, there has got to be
joy in life. There’s got to be pleasure and so I bring so much back to food,
where… (LAUGHTER)
Nutrition is not enough… You bring it all back to food!
Nutrition is not enough. Pleasure. Pleasure and the will to be engaged and be part of a community
and multi-generational… And, you know, getting back to what
we’re talking about in this sector, professionalism. We have to raise these standards so everybody that is part of it has got to show that they know
what they are doing and to be so registered, and look at every good bit
of information that is around, and utilise it and change
your thinking, and love life. That’s what we all should be doing!
(CHEERING AND APPLAUSE) And on that note, that is
all we have time for tonight. Could you please thank our panel – Sean Rooney, Sarah Holland-Batt, Richard Colbeck, Julie Collins, and Maggie Beer.
(APPLAUSE) And thank you, all of you,
for your questions tonight and the hundreds of questions
we received in anticipation of this. It was really overwhelming,
the interest in this. You can continue this discussion
on Facebook and Twitter. Next week on Q&A, Hamish Macdonald will be
in the chair with journalist,
comedian and researcher at the Australian Strategic Policy
Institute, Vicky Xu, Ethics Centre CEO Simon Longstaff, The Financial Review’s
national affairs columnist Jennifer Hewett, Liberal MP Tim Wilson,
and Labor Shadow Minister Tim Watts. Until next Monday, goodnight. Captions by Red Bee Media Copyright Australian
Broadcasting Corporation

9 thoughts on “A Spotlight On Aged Care | Q&A

  • Maggie Beer is a beacon on the hill! Thanks to her, the conversation with the aged care providers regarding diet is finally legitimised.

    The question of chemical restraint has been raised by the Amana aged care nurses for my father, who is an Alzheimer’s survivor. They tried to have us sign authorisation for them to use chemicals to effectively knock him out so he won’t be a bother to them. It sickens me.

  • If all the old people organise into a voting bloc then perhaps these penny pinching puke politicians might listen for once. Attack a politicians career stability and their ears suddenly start to work.

  • This has been an issue for more than 30 years or more, yet again Governments over complicating uncomplicated issues.

    It's time we hold Governments accountable under jail time for mismanagement across the board.
    There is currently no accountability for poor policies, they waste millions and the worst that happens is they may or may not be voted out of controlling Government.

    These people have built this nation and the very least we can do is provide a world leading aged care. We have the money, we have the skills to make it happen, WTF? Beyond disgusting.

  • The atrocious incentive structure of the privatized aged care industry has to be addressed immediately. We heard the horrors inflicted on Sarah's dad and the many other horrors inflicted on our elders, I often wonder if the abusive carers realize that their turn in an aged care facility is on the cards, do they imagine for a minute that they will NOT face the same horrors in old age for which they are setting a precedent.

    Some laudable ideas put on the table, inter generational environments…etc. However as a technologist, software development & robotics, the best approach to aged care initiatives would have to be Japan. Japan's solution to growing their economy and addressing their 'aging population & declining birth rate' is to research & develop AI directed autonomous humanoid robotic systems for among other thing age care. Much of their robotic research is also spurred by needing non-human intelligent physical access to the Fukushima Daiichi nuclear power plant that went into meltdown when destroyed by a tsunami.

  • Simple, Get inspectors to check these homes without any warning and fine or jail the homes that do not meet the minimal standards.

  • "challenging behaviour" aka hitting, spitting, biting and scratching. dementia residents cannot be reasoned with alot of the time and chemical restraints are often the only thing that stops them from injuring themselves let alone the staff and other residents. with staff to patient ratios often as low 20 to 1 how much personalised attention can you honestly expect. you can't squeeze blood from a stone.

  • As a student, in the 1980s, I worked in the kitchen of a nursing home, the food was excellent and the staff ate the same food as the residents. It was all cooked on the premises, from fresh ingredients.Dinner was at midday and was three courses, soup, main and pudding, with a lighter meal at "tea" in the evening of fish, chicken or eggs .The residents were well cared for, and there was always a registered nurse on the premises, and a gp on call for more serious concerns or illness. There were regular inter – generational activities organized by Scout's, Girl Guides, Sunday Schools etc. Nursing homes were funded by the residents paying most of their pension payments. They did not sell their homes.
    I think this is all another example of how Australia has sunk to the level of the third world.

  • Focus migration on aged care workers and pay anyone who helps old people do things nobody else wants to do well so the care level stays where it's needed.

  • it's not an ideal situation at all for elderly folk who have to go into nursing homes because they don't have family who will care for them or are too much of a hazard to be on their own.

    back in the day, even the english, pre-industrialisation, lived as extended families along with their elders under one roof and it's a shame that that isn't really emulated today.

    for starters, the industry has difficulty attracting people to the industry of care-work and in any event, no-one really wants to be cared for or be with a bunch of strangers.

    the whole thing is very unfortunate for all involved.

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