The latest ABC TV Q&A program was dedicated to aged care discussions, with the panel consisting of Maggie Beer, celebrity cook; Shadow Minister for Ageing, Julie Collins; Sarah Holland-Batt, aged care advocate; Leading Age Services Australia (LASA) Chief Executive Officer (CEO), Sean Rooney, and Minister for Aged Care and Senior Australians, Richard Colbeck.
Given the opportunity to ask her question on behalf of the New South Wales (NSW) Nurses and Midwives’ Association, Gabi Pearson asked the panel, specifically addressed to Minister Colbeck, whether the Government would “stop pandering” to the aged care providers and introduce mandated staff-to-resident ratios.
Mr Colbeck says ratios was a “simple way” to address the issue and that the Government evidence does not support that ratios would provide answers to the problem.
Mr Rooney says that a mandated staff ratio is one way to achieve an outcome of more staff in aged care facilities, however, it is not universally supported.
Speaker Kelly threw the question to Professor Joseph Ibrahim, a geriatrician who asked the first question for the night.
Professor Ibrahim said, “I think ratios is a simplistic approach to a complicated problem. We need a bare minimum of staff. 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.”
Later in the show, Mr Colbeck refused to give numbers on what acceptable staffing looked like in aged care, putting the responsibility back on the providers to make that decision. His comments were laughed at by the audience.
Worse than death
Professor Ibrahim asked the panellists whether aged care is something to fear and how will the Government change aged care so the sector isn’t “a fate worse than death”.
Ms Beer believes there is a perception in aged care that it is a place to be feared, however, she says people need to focus on the positives of aged care and the fact that it still has the ability to be changed in the future.
Ms Holland-batt says that her father used to ask for death rather than go into aged care. She agreed with Aged Care Commissioner Lynelle Briggs AO, who said aged care was a national disgrace.
Food quality and costs
Isobel Fisher, a 17 year old aged care worker, asked the panel how “half a hamburger patty” could be considered acceptable in aged care when $6 is spent per resident on food and beverages each day.
Another follow up question about food was asked, directed at Maggie Beer, by Ian Poalses, New South Wales manager of LASA, who asked what services should be reduced in order to pay for more expensive meals when nearly half aged care homes are running at a loss.
Ms Beer believes everything comes down to money in aged care, with her position that $10.50 a day is required to provide good food to older Australians.
“There is a huge eagerness [in aged care]. 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,” says Ms Beer.
Judy Muir asked the panel how aged care services can ensure those with dementia receive adequate personal care and quality care to meet their needs.
Minister Collins believes training for dementia needs to be given to everyone in aged care, from the chef and cooks, to the gardeners, to the personal care workers.
CEO of Dementia Australia, Maree McCabe, was in the Q&A audience to talk about chemical restraints briefly.
Ms McCabe says, “We know the research shows us that anti-psychotic medication, which is often used for restraining people living with dementia, is ineffective in 80 percent of cases. It increases the risk of heart attack, of stroke, and of death.”
Mr Rooney adds that all medication in aged care has been prescribed by a General Practitioner (GP), so he believes the starting point is in the integration between primary care or general practice, acute care hospitals and aged care.
Mr Colbeck agreed that the whole industry is under pressure to make changes and needs an “uplift”.
Speaker Kelly asked for a rough estimate from Mr Rooney of how much this would cost.
Mr Rooney says it would cost $1.3 billion over the next 18 months in addition to the current budget in order to maintain the standards to the end of the Royal Commission, which Minister Colbeck is aware of.
Questioner, Anita Calcutt, asked why Home Care Packages isn’t like the child care process, where the funding is available straight away once an assessment is completed.
Straight off the bat, Minister Collins says that wait times for a Home Care Package is unacceptable in Australia. She suggested priority for people in their 90s or people with terminal illnesses.
Mr Rooney mentioned that LASA had recommended to the Government that there should not be a longer wait time than 90 days from the time you are accessed to when you receive care and services.
Funding wise, Mr Rooney says to reduce the 120,000 waitlist to 90 days, it would take two to three years and an additional half a billion dollars a year.
Minister Colbeck disagreed with Mr Rooney, saying he was a “bit more ambitious” and wanting a 30-60 day wait time frame for receiving a Home Care Package.
Accreditation system and profit over care
Helen Williams asked the question, if there is so much evidence that providers are providing substandard care, why has there not been any immediate action to protect Australia’s most vulnerable people?
Mr Rooney says, “ 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.”
Immediately following the accreditation system topic was another question from Yumi Lee, who asked if the panellists could justify the profiteering of aged care providers on the lives of the elderly population and why they are the best place for our elderly.
The topic turned to conversation around Bupa and the current issues around their substandard care at multiple aged care facilities.
Minister Colbeck says, “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.”
He continues that his Department is meeting with the management to make sure they get back to that accreditation standard.
Ms Holland-Batt called the aged care regulator “useless”, saying her father’s aged care passed all 44 standards of accreditation but was still a horror nursing home to live in.
Mr Rooney agreed that this is a shortcoming in the system, especially with no national database to reference when hiring a personal care worker.
Kate Radcliffe was the last questioner of the night, asking if the community need to put in more effort celebrating ageing so society allows older Australians the best quality of life in their final years.
Ms Beer says, “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.”