There is a saying that change is the only constant in life, and that has certainly been true of aged care this year: the change has been constant, and that is likely to remain the case for some years.
Many of the changes that have occurred this year in the aged care sector have been heroic attempts at progress – a new regulatory body, a new quality and safety commissioner, greater mandatory reporting requirements, and tighter controls around physical and chemical restraints.
But these steps have been taken against the backdrop of the Royal Commission into Aged Care Safety and Quality, which has exposed deep and profound systemic problems, and the commissioners have forewarned they will recommend yet further significant changes in the future.
Structural changes in the industry commenced from 1 January, when the Aged Care Quality and Safety Commission replaced the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner.
Combining the two functions was intended to streamline regulation and make it easier for both consumers and providers to navigate the system. The Commission was a recommendation from the Carnell-Paterson Review, which was conducted in the wake of the Oakden scandal.
Janet Anderson was appointed to lead the new commission from 1 January.
Announced accreditation visits were replaced by unannounced audits, and the number of audits was ramped up. Audits were also extended to take place outside regular business hours.
The Morrison government was returned to power in May, and a new Minister for Aged Care was appointed, Richard Colbeck. Under his stewardship there have been claims the government is “missing in action” from the sector.
The new aged care quality standards came in from 1 July, leading to significant changes, including a consumer focus and how we refer to people who live in residential aged care.
A theme throughout the year was the significant financial pressure facing many aged care operators.
We wrote about the sorry case of Earle Haven, a name that will always be synonymous for the emergency evacuation of 68 residents after a dispute over commercial arrangements.
Bupa was also in the news often, for all the wrong reasons. With a number of homes under repeated sanction, and many more failing accreditation audits, questions were asked about the effectiveness of the assessment process and whether tougher penalties might generate greater compliance.
There was a crack down on the use of psychotropic medications in aged care, and despite the government injecting millions and millions of dollars into releasing home care packages, the waiting list remains stubbornly at around 120,000.
Voluntary assisted dying became legal in Victoria in July, and laws were passed in Western Australia in December that will see a similar process in place there likely next year.
The revelations from the royal commission have made for a steady flow of headlines during the year.
In the first witness hearing on 11 February, Barbara Spriggs told the commission about her husband’s harrowing experiences at Oakden, how difficult it was to find answers about his death, and how hard it was to get the matter investigated. Her family’s quiet perseverance and determination led to two enquiries and, eventually, the royal commission.
Ms Spriggs said her husband’s nursing home was “like a prison”, and it passed accreditation on several occasions, even though it was obvious something was wrong at the home as soon as you walked into it.
The commission also heard of underpaid staff, malnourished residents, assaults, excessive excessive fees, poor record keeping, murder, inappropriate chemical and physical restraint, maggots in wounds, people dying while waiting to recieve their assessed level of home care, lack of staff, and aged care providers putting profits before care.
Half-way through October, the commission opened with the tragic news Commissioner Richard Tracey had passed away. With many of his family in the room that day, Commissioner Briggs said Commissioner Tracey “was wise. He was admired. He knew the law like the back of his hand. He was prepared to take a punt if it meant we got the best outcome.”
“His kind words to our witnesses after their presentations gave them comfort and let them know that they had been heard. His gentle guidance and direction to Royal Commission staff always helped, and made our collective lives so much easier.”
Later in October, the royal commission released its interim report, which was largely written by Commissioner Tracey on this deathbed.The report states “this cruel and harmful (aged care) system must be changed”.
Here at HelloCare, we haven’t shied away from tackling some of the difficult questions in aged care.
Is it okay to give medication to older people by hiding it in their food? Is turning residents every two hours ‘abuse’? Should there be a camera in every room in aged care? Should alcohol be served in aged care facilities? Is it normal to grieve before someone dies? It is safe for personal care workers to be able to give out medication? Should there always be a nurse on duty and present in residential aged care facilities? Do we need to introduce tougher language requirements for aged care workers? How do you wash genitalia when someone is seated on a shower seat? Is it better to use bedrails or low beds with sensor mats? Do grandparents need consent before kissing their grandkids?
We wrote about new ways to approach death, for example, with the assistance of a death doula.
Amid all the change and negative stories, here at HelloCare we have also focused on telling the ‘good news stories’ that are out there. There is so much goodwill in aged care; so many good people who do their best for older Australians every day. We strongly believe in telling these stories, in sharing the inspiring ways many are providing care, and we try to be uplifting for all those who try so hard.
Our readers love hearing about homes that have recreated setting from the past, for example an old-fashioned main street, a 1950s diner and a traditional UK village. We also wrote about a radio station that plays only ‘golden oldies’ and a nightclub from the 1920s that has been readapted for older people to boogie the night away.
We wrote about aged care providers coming up with creative ways to comfort and entertain residents, for example with manicures, kittens, chooks, pubs, pets and ponies.
We looked at the benefits of managers spending time on the floor.
We couldn’t get enough of these amazing door decals featuring pictures of residents in their youthful prime. The residents said the images made them feel proud, brought back memories, and gave them lots to talk about!
We wrote about the ways staff and residents farewell someone when they die.
We wrote about successful innovations in aged care – the Butterfly model of care and the Eden Alternative. Plates that are easier for people with mobility problems to eat from, and wheelchairs that allow those with mobility issues to go down to the seaside and put their feet in the water, no matter how bracing.
Our readers enjoyed the idea of students living in aged care facilities, helping to keep residents company and entertained in return for subsidised food and board.
Cuddle beds set the internet on fire! So did our article about staff wearing PJs at night to help put residents in the mood to snooze.
The ABC’s ‘Old people’s home for four year olds’ was a runaway success, and showed us the benefits of young and old spending quality time together. It was also a wake-up call that challenged our possibly ageist attitudes.
New technologies that can improve the lives of older people were also popular among our readers. We loved this device that prompts people to tell their life story, and turns the recordings into a podcast or written document.
The mother of a child with disabilities who also cared for older family members, adapted pretty scarves that can be worn at meal times, and our readers loved them.
Our article about Denmark’s most famous nursing home was also popular with HelloCare readers.
We loved the Dutch idea of a ‘chat checkout’ for elderly people who aren’t in a rush, and might be lonely at home. The staff on the checkout take the time to ask how the customer is going, without the pressure of others waiting in line hurrying them along.
The ABC’s Q&A dedicated a whole episode to aged care, but some said the debate was constrained by there not being aged care workers on the panel.
We spoke to some legends in the industry, including centenarian Ellie Mann and Australia’s oldest beauty queen, Robbie Canner.
Teepa Snow is a name so revered in dementia circles, it seemed almost unbelievable when I chatted to her over the phone one weekend. She was as warm and lovely as you would imagine.
Dawn Quick told us about her popular dance classes for women, many of whom once dreamed of dancing but only found the courage and opportunity in their advanced years.
Margarita Solis spoke to HelloCare about her sexual assault at the age of 94. Tragically, Ms Solis passed away during the year, but her courage in speaking out has inspired many to speak more openly about this heinous crime.
And we spoke to Lenny as he zoomed around in his adapted van, on his way to set up his next ‘dementia-friendly barber’ in an aged care facility. His wildly popular service has been lauded all around the world.
We spoke to artists who helped up understand ageing and dementia in new ways.
Tony Luciani’s photographs of his mother were not only thought-provoking and beautiful, they were funny.
Dick Lau took wonderful portraits of aged care residents in locations that were special to them. Families were so thrilled with the result, and enjoyed the process so thoroughly, Mr Lau hopes to take the concept global.
We wish our readers all the best for the holiday period. Please keep safe, and we hope you enjoy spending time with friends and family. Many will be working over the break. We applaud you for your dedication to older Australians and your tireless work to improving their lives.
We hope you will continue to check in with HelloCare over the break and enjoy our ‘Best of 2019’ articles on Facebook.
We look forward to informing and entertaining you in the new year with all the latest research, news and stories about aged care from all around the world.
Merry Christmas from all at HelloCare.
