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ROYAL COMMISSION: Special needs groups struggle with aged care

This week the Royal Commission into Aged Care Quality and Safety explored issues in aged care for special needs groups and investigated why providers don’t have to prove they can provide specialised care to special needs groups.

<p>CEO of RSL Care SA, Nathan Klinge, says veterans are ageing quickly and entering aged care sooner than the general population. [Source: Aged Care Royal Commission]</p>

CEO of RSL Care SA, Nathan Klinge, says veterans are ageing quickly and entering aged care sooner than the general population. [Source: Aged Care Royal Commission]

On Tuesday, Chief Executive Officer of RSL Care SA, Nathan Klinge, outlined issues facing veterans in aged care, including their ageing process, need for specialised care and the difficulty finding specialised care to train their staff.

In Mr Klinge’s statement to the commission, he says that veterans are ageing quickly and entering aged care sooner than the general population.

Mr Klinge says, “There’s a number of factors across a resident’s life history, a veteran’s life history that will impact or can impact on their sense of wellbeing, their physical health and their mental health.

“Fairly common, in terms of post-traumatic stress disorder (PTSD) and the impact that PTSD can have on a person’s physical health and their mental being, and studies show that people with PTSD do age quicker. 

“They age younger. The ailments of age tend to hit them a little bit earlier. It’s a very similar thing with the homeless population.”

He adds that a 60 year old homeless person shows ageing symptoms and medical issues of a person 20 years older.

Mr Klinge outlined issues RSL Care had finding appropriate specialised training for their staff to take care of their residents, including trauma-informed care to help inform the interactions between staff and residents.

When they found an appropriate trainer, the training helped staff understand how to engage with residents, what was going on behind the scenes, and how to de-escalate situations.

“To help our own staff at RSL Care to look after the veteran cohorts that we’re responsible – not just veterans, I mean, there’s a – the reality is that 70 percent of people who make it through to an aged bracket have an experience of trauma in their life,” says Mr Klinge.

“So this is not a veteran issue; this is a residential aged care issue, but certainly our piece of the mission and object centred very much around the veteran piece, to give our staff the skill sets they needed. But we also felt a responsibility to help the industry a little bit more.”

Manager of Growth and Development at Helping Hand in South Australia, Helen Radoslovich, explained the in-depth research and training the organisation has undertaken to help Forgotten Australians get comfortable in aged care.

“Culturally safe care is providing an environment which is safe psychologically, emotionally, physically for everybody to be able to be who they are, express themselves and have a sense of identity,” says Ms Radoslovich.

“Identity is core to who we are as humans. It is also a place that people can feel that they can have some control over about what is happening in it. So that they can enter that, continue to be who they are and make changes when the environment around them doesn’t support them. When I say environment, I don’t just mean physical, I mean the whole sense of service and place and feeling.”

In terms of research around Forgotten Australians, people that were institutionalised as a child, Helping Hand has actively engaged with Relationships Australia South Australia, Flinders University, and the Forgotten Australians Group, to create guidelines around the most appropriate way to provide services to Forgotten Australians in aged care.

“The most important thing I think we learnt was trust. This is a group of people who have been abused and mistreated by organisations and institutions,” says Ms Radoslovich.

“There is absolutely no reason why they should trust that the care they get this time around will be real care compared to the care they got first time round, and that’s why the project is called Real Time – Real Care the Second Time Around

“That’s their words, and that’s our guiding light. So the activity, anything we do needs to build that trust with them, to prove that we can be trusted with their stories, with their lives.”

Providing a safe environment isn’t only for Forgotten Australians, but also from anyone in the Lesbian, Gay, Bisexual, Transgender, and Intersex community, people from culturally diverse backgrounds or any other special needs groups.

Providers claiming they have specialised care blindsiding special needs groups

At the next day of the Commission, First Assistant Secretary of Residential and Flexible Aged Care Division at the Department of Health, Jaye Smith, admitted that providers don’t have to prove they are able to provide specialised care to special needs groups.

At the moment, in the back end of My Aged Care, providers are able to tick boxes saying they can provide care to certain groups, like LGBTI groups or culturally diverse groups.

A recommendation from a 2017 aged care system review stating providers need to pre-qualify, or prove, they could provide specialist services was never implemented.

While functionality for special needs groups to find providers suited to their needs has improved, it doesn’t necessarily mean they are finding providers who are actually able to provide those specialised services.

Mr Smith says, “The Department agrees that we need to do a lot more to be able to quality assure the information that is on My Aged Care in terms of providers indicating that they’re able to service particular special needs groups.

“What the nature of that pre-qualification would be is something that we haven’t yet resolved,

whether it’s a formal accreditation or a way in which providers can provide additional information on My Aged Care that could point to the particular resources they have in their organisation.

“I think that we are stepping along a path of giving consumers better information. I absolutely accept that quality assurance of that information is critical and that we haven’t done that yet.”

Counsel Assisting raised concerns from the sub-group who developed diversity action plans, which included a specialisation accreditation process.

The subgroup had received push back from peak bodies over what they believed to be more “red tape”.

Mr Smith says he wasn’t aware of any consultations between the sub-group and peak bodies, formal or informal discussions, but either way, specific options haven’t been developed to consult on.

While Mr Smith agreed that better verifiable information is important, he wasn’t sure what would fix the current problem and whether that should fall under the accreditation process or not.

The Royal Commission is running between October 7-11, covering different aspects of diversity in aged care.

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