The Australian aged care sector, led by Aged Care Minister Anika Wells, continues to implement stringent care minute mandates without adequately considering the detrimental impact on lifestyle services and, consequently, the well-being of aged care residents.
Despite mounting evidence from within the sector, both quantitative data and anecdotal accounts highlight the adverse effects these policies are having, the government appears reluctant to acknowledge and address the issues.
Central to these changes is the Australian National Aged Care Classification (AN-ACC) funding model, which mandates that residents receive at least 200 minutes of care per day.
While this requirement aims to enhance the quality of care, it has inadvertently led to a crisis in the provision of lifestyle services—those vital activities that bring joy, social interaction, and mental stimulation to residents.
Historically, lifestyle and leisure programs have been crucial in aged care. They are designed to keep residents engaged, active, and socially connected, addressing both their mental and physical health needs.
These programs include a wide range of activities, from art and music therapy to exercise classes and social outings. However, the focus on meeting the 200-minute care mandate has resulted in a troubling shift: lifestyle services are being cut, staff are being asked to take on dual roles, and in some cases, entire lifestyle teams are being replaced by personal care assistants (PCAs).
The impact of this shift cannot be understated. Residents who once looked forward to engaging, tailored activities now face a reduced quality of life, with fewer opportunities for social interaction and mental stimulation.
The staff who provide these essential services are being stretched thin and forced to cover additional duties without adequate training or support. This situation has far-reaching implications for the overall well-being of residents and the sustainability of the aged care workforce.
Kayla Garside, a Board Director for the Australian Recreational Therapy Association (ARTA) and a recreational therapist with over 15 years of experience in aged care, provides a detailed account of how these changes are affecting the sector.
According to a survey conducted by ARTA in December 2022, encompassing 139 recreational therapists and lifestyle staff, 36% of respondents reported being asked to diversify their roles or acquire additional qualifications, including personal care (PCA) certifications. This change aims to reclassify them as care workers, making their time claimable under the 200 care minutes mandate.
Furthermore, 14% of respondents cited proposed changes within their teams due to this requirement, and 15% observed a reduction in staff hours dedicated to leisure and recreation, with some reporting a decrease of up to five hours per week and others stating that they had been made redundant altogether.
Garside explains the crux of the issue: “Lifestyle isn’t simply finding people something to do. Aged care residents need engaging activities, not just something to fill in time. Your activities need to come from the assessment, from what the residents like to do.”
The shift towards having PCAs conduct lifestyle activities undermines this personalised approach. PCAs, although essential for personal care, are not trained to deliver the kind of specialised, engaging activities that lifestyle staff are trained to provide.
The ripple effects of this shift are profound. Many lifestyle staff, now required to obtain PCA qualifications, find themselves covering PCA shifts when personal carers call in sick.
This dual responsibility often means that lifestyle staff are spending their time on personal care tasks like showers and medication administration, leaving little time for their primary role of conducting multiple, meaningful activities throughout the day.
Garside voices her concern: “When lifestyle staff are taken away from their shifts to fill in PCA roles, it directly impacts the residents. There is less one-on-one time, leading to increased social isolation and the health issues that come with it, such as anxiety and depression.”
The quality and availability of lifestyle programs are further compromised by the economic pressures on aged care facilities. Garside notes that with AN-ACC funding and new quality indicators, the sector seems to be trending towards offering lifestyle activities as additional services that residents must pay for.
“It feels like we’re moving towards aged care residents needing to pay extra to receive comprehensive lifestyle and recreation care. Which would create a scenario where only the rich can afford to have hobbies or a social life and integration with the community, while those who can’t afford it get just the bare minimum,” she laments.
Despite these concerns, ARTA has struggled to get a response from the government, with Aged Care Minister Anika Wells proving to be particularly elusive.
In fact, ARTA had to resort to voicing issues publicly under the Aged Care Minister’s social media posts to get a response as previous letters and emails fell on deaf ears.
Eventually, ARTA was granted an opportunity to speak with Anika Wells’ advisor, but the meeting was not as fruitful as ARTA had hoped it would be. “They have said there is no identified issue with the current AN-ACC system,” Garside states, expressing frustration with the lack of acknowledgement from the authorities.
With the government taking a head-in-the-sand approach to the issue, the long-term effects of things continuing as they are in residential aged care could be dire.
Garside predicts high staff turnover due to job dissatisfaction among PCAs being forced to conduct lifestyle activities they are not trained for or interested in. The dual roles and increased workload also contribute to burnout, leading to more sick leave and staff leaving the industry altogether. Additionally, customer dissatisfaction is likely to rise as residents’ true leisure and recreation needs go unmet, and the quality of care declines.
The future of aged care, if these trends continue, looks bleak. Garside concludes, “You’ll find that the residents won’t be accessing services that meet their true leisure and recreation needs. When programs fall apart, residents are forced to mould themselves to try and enjoy what’s being provided, rather than feeling fulfilled in who they are by being able to do the things that they enjoy.”
*HelloCare reached out to Ms Wells for comment who had not replied at the time of publishing
This summary is spot on and endemic of what is happening across the industry. The government’s blinkers on approach to focusing purely on nursing is causing problems in more than just the lifestyle space. The disregard for the efforts of the hospitality, cleaners, laundry, administration and maintenance staff makes for a very unhappy workforce. This lack of understanding of what makes an aged care home tick demonstrates how out of touch the minister is and how she and the government are being played as puppets by the nursing unions.
This aspect of care has always been under funded, under recognised and under delivered. Instead of increasing care minutes to 200 they could have increased funding for lifestyle to give providers the opportunity to have Diversional Therapists assist homes develop meaningful programmes for residents which would have improved outcomes for residents including care outcomes.
The 200 minute absolute madness.
Where are the RNs coming from??
EENs must be included with the RN.
ACF struggle now to fill their rosters.
Is this 200 minute the thin end of the wedge to close rural facilities??
Get people into the cities, the 15 minute cities I wonder!