Australia’s aged care system is a ‘shocking tale of neglect’ and the ‘cruel and harmful’

Australia’s aged care system is a shocking tale of neglect that needs a complete overhaul and not mere patching up, royal commissioners say.

The system designed to look after older Australians is woefully inadequate and failing, the royal commissioners concluded after hearing horrifying evidence of widespread substandard care.

They plan to recommend a fundamental overhaul of the whole system including its funding in their final report in November 2020.

But the commissioners want urgent action to stop people dying while waiting for home care support, the overuse of drugs to ‘restrain’ aged care residents and younger people with disabilities being stuck in aged care.

Aged care services are underfunded, mostly poorly managed and all too often unsafe, the aged care royal commission’s scathing interim report said.

Australia’s aged care system is a shocking tale of neglect that needs a complete overhaul and not mere patching up, royal commissioners say (stock image)

‘It is a shocking tale of neglect,’ commissioners Richard Tracey QC – who died earlier this month – and Lynelle Briggs wrote.

‘The neglect that we have found in this royal commission to date is far from the best that can be done.

‘Rather, it is a sad and shocking system that diminishes Australia as a nation.’

The cruel and harmful system must be changed, they said.

‘Our work over the past year has shown a system that needs fundamental reform and redesign – not mere patching up.’

Stakeholders have repeatedly argued significant increases in government funding for aged care cannot wait for the final report and recommendations, which will come from Ms Briggs and new commission chair Tony Pagone QC.

But Mr Tracey and Ms Briggs made it clear that limited interventions, of the type that had ‘haunted’ this area of government policy for far too long, are not enough to deliver an aged care system that meets the needs of older people.

They said short-term solutions at best temporarily stave off the worst problems and, at worst, produce another set of unintended outcomes requiring further inquiries, reviews and public funding, without addressing the underlying issues.

They also criticised a sector-wide focus on the need to increase funding and a culture of apathy about care essentials that had helped enable the aged care system to hide from the spotlight.

Older people and their families are left isolated and powerless in the hidden-from-view system, they said in rejecting the notion that most care is ‘consumer-directed’.

‘Despite appearances, despite rhetoric, there is little choice with aged care.’

The shameful list of problems included dreadful food, distressed residents being left sitting or lying in urine or faeces, a high incidence of assaults and inadequate prevention and management of wounds that sometimes led to deaths.

Residents were commonly physically restrained to make them easier to manage, and there was widespread overprescribing of drugs to sedate them.

At the heart of the problems was an aged care system that depersonalised older people.

The royal commission said there was no reason to delay action on chemical restraints, younger people being stuck in aged care and in providing significant additional funding to immediately increase access to home care.

The system designed to look after older Australians is woefully inadequate and failing, the royal commissioners concluded after hearing horrifying evidence of widespread substandard care (stock image)

The system designed to look after older Australians is woefully inadequate and failing, the royal commissioners concluded after hearing horrifying evidence of widespread substandard care (stock image)

Waiting times of up to a year or more for higher level home care are unacceptable, with many people dying waiting, the commission said.

Federal Aged Care Minister Richard Colbeck said the government was working to improve all three urgent areas identified by the commission, with a focus on ensuring funding for home care places was flowing through and not sitting in government coffers.

One of the points the government copped the most criticism for was failing to get young people out of aged care homes, with the interim report calling it a ‘national embarrassment’.  

It said efforts – over more than a decade – have failed to reduce the almost 6,000 Australians under 65 who are living in residential aged care.

And it has savaged the government’s existing action plan to halve the flow of younger people into aged care by 2025.

The plan – released in March this year – lacks ambition, is unlikely to achieve its ‘limited’ targets and should not be relied on as a solution, the commission said. 

The failure to understand the needs of younger people in aged care combined with the relentless flow of younger people into facilities for the elderly ‘indicates a lack of sufficient interest by the government in the plight of these people and a level of complacency about the capacity of existing policy settings to solve the problem’. 

In September, Lisa Corcoran who is paralysed and confined to a wheel chair, told the inquiry of her desperate desire to get out of the nursing home where she’s lived for the past six years.

The 43-year-old described her sense of isolation increase as residents died around her, and of being forced to live away from her family – her grandkids too scared to visit because of the screaming and crying.

‘My number one goal is to get the f*** out of the nursing home,’ she told the inquiry.

Ms Corcoran is now waiting to move into supported disability accommodation through the NDIS.

She said life in aged care had made her feel like her rights and sense of respect had vanished.

She wants to live the life she wants, but feels her rights have been taken away.

‘We are human, every one of us and humans crave respect and we are all equal. I feel like I have lost that respect. I have.’

Another major issue is the fact some older Australians are dying while waiting for access to aged care. 

Those in charge of the royal commission slammed the aged care system as a ‘cruel lottery’.    

‘For that is in effect what the current system of prioritising and managing waiting lists is: a cruel lottery in which some people can die before they ever find out if they have, in fact, ‘won’.’

Even getting through the ‘front door’ to Australia’s aged care system is far from a welcoming and easy-to-navigate experience, the commissioners said.

Many people in their 80s and 90s trying to use the telephone and internet-based My Aged Care entry system find it frightening, confronting and confusing, the report said.

The commissioners labelled My Aged Care a costly exercise that had failed to provide adequate information to people about aged care and how to access it.

People were left to fend for themselves to navigate their own way into the system, but faced limited choices.

Useful information is the exception, not the rule, the commissioners said.

Older people deemed eligible for home care support face long waits before a package is assigned, before they then have to find a service provider.

The commissioners were alarmed that more than 16,000 people died waiting for a home care package in 2017/18.

Others prematurely moved into residential care.

‘By any measure, this is a cruel and discriminatory system, which places great strain on older Australians and their relatives,’ the report said.

‘It is shocking that the express wishes of older people to remain in their own homes for as long as possible, with the supports they need, is downplayed by an expectation that they will manage.

‘It is unsafe practice. It is neglect.’

Those who made the challenging transition into residential aged care often grieved for all they had lost.

‘They become “just a resident”, just another body to be washed, fed and mobilised, their value defined by the amount of funding they bring with them,’ the commissioners said.

REACTION TO THE AGED CARE ROYAL COMMISSION INTERIM REPORT 

THE FEDERAL GOVERNMENT:

Aged Care Minister Richard Colbeck said the government is already putting more home care packages into the system but the way they are delivered needs reform, there are new regulations about restraints and there could be quick action on young people going into aged care.

Senator Colbeck and Health Minister Greg Hunt said: ‘The problems raised today in the interim report have challenged governments, industry and the community over many decades and require a coordinated response from all involved.’

INDUSTRY:

Anglicare Australia said the interim report is a wake-up call for the sector and for government. Its acting executive director Roland Manderson: ‘We need a national commitment to end these years of neglect, and make the profound investment needed to build a system that will value people and care for them properly.’

Peak body Leading Age Services Australia CEO Sean Rooney: ‘This is a beacon for immediate reform, a critical pointer to ensure older Australians receive quality care and respect they need and deserve.’

Non-profit providers peak body Aged and Community Services CEO Patricia Sparrow: ‘Strengthening and improving aged care in Australia will require more than just new rules. Absolutely critical will be new funding solutions and large-scale community education about ageing and aged care.’

UNION:

United Voice’s Carolyn Smith: ‘This report must be the impetus for urgent action to save our aged care sector and save the workforce.’

THE FEDERAL OPPOSITION:

Shadow aged care spokesperson Julie Collins: ‘It is shameful that in a wealthy country like Australia older people can’t get the care they need.’

 Source: AAP

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