A full year has passed since the findings of the Royal Commission into Aged Care Quality and Safety were published.
The commission declared: “This cruel and harmful system must be changed… older people deserve so much more.”
They found major quality and safety issues and “inadequate prevention and management of wounds… poor continence management… dreadful food, nutrition and hydration”.
Shocking evidence emerged of assaults by staff on residents and by residents on staff and “patchy and fragmented palliative care for residents who are dying.”
Anyone visiting aged care homes, in whatever condition, will acknowledge the enormous challenges faced by staff. These are not jobs for anyone, no matter how well-trained in health.
These largely thankless tasks require special people. The jobs have often fallen to ill-trained or poorly-conditioned and poorly-suited staff. Many are migrants who, while meaning well, struggle with communicating in English, which can create barriers for aged and mentally-troubled residents.
They are also among the lowest paid people in Australia.
The enormous and costly challenge for Australia to provide high-quality, decent treatment is one of the tasks facing successive governments as more people join the ranks of the aged.
Just to maintain current standards, Australia needs a net increase of 17,000 aged care workers, according to the Committee for Economic Development of Australia. And, of course, these people need to be paid properly for the day-by-day, minute-by-minute responsibilities they face.
The days of shoving elderly, mentally-troubled and dying citizens behind closed doors should have passed decades ago. We are now ill-prepared to cope with existing aged care numbers, let alone the burgeoning numbers of aged people to come.
Ita Buttrose is among the campaigners for improved conditions, including designing care facilities, so they don’t resemble gaol blocks or ancient, sterile hospital wards. Changes are afoot in the better-ranked care homes but capital costs and operation expenses are enormous. Wages and salaries adjustments have yet to be fully-embraced.
Getting enough fully-trained staff will take money and time, especially with shortages resulting from pandemic restrictions on migration. Dedicated state and federal ministers for aged care are needed to oversee what is nothing short of a revolution. Existing systems have failed, as the royal commission emphasised, and the industry has not satisfactorily self-managed its standards.
There are many reputable, high-quality care facilities in all States but self-regulation in the wake of the Royal Commission will clearly not be enough to maintain the pace required for the next waves of seniors. Who will make the decisions for the overhaul and how will it be implemented and policed?
Every nation’s health costs are at the top of budget outlays, boosted in recent decades by the demands from disability and mental health sectors. Aged care comes as a whole new layer, no longer to be ignored.
Perth professor of politics, Peter van Onselen, pointed out: “As the oldest members of the baby boom generation start to enter aged-care homes, their children are experiencing the trauma of the sector, too. Generation X therefore is starting to sit up and take notice of the problems afoot.”
Aged care is finally getting the attention it needs. The solution is nothing short of one of Australia’s greatest-ever challenges.
Standards, thankfully, are rising but the extent of the revolution and slow government machinery driving change means the reforms won’t be fully in place until the next wave of the aged, Generation X.
What do you think?
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