‘Enough is enough’: Aged care sector unites to demand reform

It’s time to care about aged care.
 
That is the tagline of a new campaign launched by the Australian Aged Care Collaboration (AACC), a new national coalition joined by more than a thousand aged care providers who are calling on politicians to take action to ensure better standards and funding.
 
The calls are accompanied by a report that lays bare the industry’s problems, almost two weeks ahead of the expected release of the final report from the Royal Commission into Aged Care Quality and Safety.
 
‘After 20 years of missed opportunities, Australia cannot let the release of the final royal commission report later this month pass without taking real action,’ Aged and Community Services Australia CEO and AACC representative Patricia Sparrow said.
 
‘Enough is enough: Australia should no longer accept the drip-feed of piecemeal rescue packages and ad-hoc changes.’
 
Professor Dimity Pond, a GP with 20 years’ experience in aged care, is ‘very happy’ to see the sector demanding action.
 
‘There’s no doubt that aged care has been underfunded for decades,’ she told newsGP.
 
‘We need to engage, we need to make plans and we need to action those plans – there is absolutely no doubt about that.
 
‘It is not fair, it is not morally correct and, what’s more, it actually puts a huge burden of cost on the states because elderly people spend much longer in hospital when they’re sent to hospital, and that could be avoided if they had adequate care at home, in the community or in the facilities.’
 
According to the AACC’s report, Australia allocates just 1.2% of GDP on aged care – less than half of what comparable countries spend (2.5%), and just a fraction of Denmark and Sweden’s 4%.
 
Total Australian expenditure on aged care in 2019–20 was close to $26 billion, $21 billion of which was spent by the Federal Government. That number would have to at least double to reach global standards. 
 
Professor Pond says this lack of funding comes at the cost of best practice and care for patients.
 
‘As a GP visiting aged care in the past, I was struggling to find nursing staff who are able to understand what I want to be done because a lot of the staff on the floor are not clinically trained,’ she said.
 
‘There’s quite a lot of concern now about the number of medications that we prescribe older people in residential care that are sedating, and that actually have been shown to be life limiting in many cases.
 
‘The alternative is a good behavioural program, where the person is involved in activities and the staff pay attention to their needs, rather than just giving tablets. But that takes time, effort and training, and at the moment, many facilities really can’t afford staff who have that sort of training.
 
‘So we’re stuck with really sub-standard band-aid measures, which have negative consequences, and as GPs we’re caught in the middle of that.
 
‘No wonder facilities struggle to find GPs willing to visit them.’
 
While the majority of funding is injected into residential care, most Australians access care in their homes.
 
About 16,000 Australians died in 2017–18 while waiting for a government-subsidised support package. While 100,000 people are waiting for home support at their approved level, with typical wait times at least 12 months for those in need of the highest-level packages.
 
Professor Pond says these wait times are unacceptable, and are often detrimental for patients and their carers alike.
 
‘I recently had a situation where a woman with really quite advanced dementia, who has actually got a level four package approved but not accessible yet, is being looked after by her 89-year-old husband who’s frail and stressed,’ she said.
 
‘He shouldn’t be required to be toileting his wife, getting all the meals and everything. They don’t have respite funded, so if he goes out, she has to come.
 
‘People like that get depressed. So then we’re looking after a whole lot of carers who are stressed, depressed and anxious because the system isn’t meeting their needs either.
 
‘This can’t go on.’
 
The report notes that challenges for aged care are only expected to grow in coming years, as the population continues to age.
 
There are currently more than 4.1 million Australians aged over 65 – a figure that is expected jump to 8.8 million by 2057 and 12.8 million by 2097.
 
To meet demand in the next 10 years alone, a further 88,000 places will be required in communal residential aged care at a cost of $55 billion, along with 78,000 extra workers.
 
As part of its efforts, the AACC’s campaign aims to target key marginal electorates, where more than 800,000 older Australians live, in an attempt to encourage the national parliament to address the sector’s many challenges.
 
Leading Age Services Australia CEO and AACC representative Sean Rooney said it is the responsibility of all parliamentarians to recognise the ‘injustice and inequity’ of maintaining a system the royal commission described as a ‘shocking tale of neglect’.
 
‘The 30 members of parliament who represent Australia’s “oldest” electorates have the greatest opportunity to represent the needs of their communities, so that older Australians are finally given the respect, resources and support they deserve,’ Mr Rooney said.
 
‘The Australian community looks to these elected officials to stand up for them in the national debate and to help influence positive outcomes on behalf of their constituents.
 
‘These MPs have the opportunity to truly achieve something great – and avoid the mistakes of the past – by creating a sustainable and equitable aged care system that will stand the test of time.’
 
Professor Pond agrees, and says the ongoing COVID pandemic adds further urgency.
 
‘The pandemic has highlighted the failings of a system that’s been creaking under lack of funding for many years,’ she said.
 
‘And obviously, this isn’t over yet. We need to start doing something about it.’
 
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