Aged Care in Australia – 2013 style

It is becoming increasingly difficult for aged care organizations to meet their obligations to provide quality care for elderly Australians. Why? Changes to the Aged care Funding Instrument (ACFI) funding arrangements in 2012 have resulted in $80 million being clawed back from funding of aged care homes throughout Australia. The government released news of their aged care spending in 2012 but then quietly pulled back $80 million.

These funding changes have caused many aged care providers to pull back on existing training commitments, new projects for care quality improvement, planned expenditure and education initiatives that they would normally fund in the course of satisfying their obligations under the accreditation principles.

The Productivity Commission established that the aged care industry is underfunded. While we wait for the new model of aged care to be established and new funding arrangements to be created through the new legislation we must now watch as the current funding becomes tighter and tighter.

In the short term we will not notice much change in care quality. However, with the relatively high levels of staff turnover in aged care there is a constant need to provide training to new staff to ensure at least a basic level of understanding of dementia, how to communicate with people with dementia, how to respond to difficult dementia behaviour, infection control, etc. Many organizations are doing the bare minimum. And we know from bitter experience that the bare minimum of ticking the training box with a one hour session is not sufficient to avoid behavioural crises in dementia care.

We know also from bitter experience that when people with dementia are not cared for with sufficient numbers of staff, or staff do not spend enough time documenting their work, or understand what to document, care quality suffers and that means vulnerable elderly people entrusted to our care suffer.

It is only a matter of time before the consequences of the ACFI pullback are felt in a drop in care quality for residents of aged care homes in Australia. And when this happens bureaucrats will hold the cash strapped aged care provider and its underpaid and undertrained carers responsible. Sanctions will be applied and they will be deprived of new funds for six months. All while Channel Seven’s Today Tonight slates another rogue aged care provider for not caring for our elderly!

When is Canberra going to understand that quality care requires money to be spent on staffing, training staff and on maintaining these staff so that care quality can be ensured. This means that aged care must become more of a priority than it is electorally. Maybe the new model of aged care will ensure a better outcome. I doubt it. The forces that have shaped this model will still be at work minimizing funding and making decisions on short-term, narrow thinking.

And what of person centred care? It is simply not possible to provide person centred care with the funding model that currently exists under the existing ACFI algorithm. Policy pressure is applied by Department of Health bureaucrats on aged care providers to be doing “person centred care” and so providers say, “Yes we are doing person centred care” but they kidding themselves. Perhaps it is individualised care (maybe), or even kind and thoughtful care, but it is not person centred. We are in danger of watering down what constitutes person centred care just to keep the department happy and so tick the boxes.

Meantime the reality of daily life in care homes continues to slide to an inevitable crisis. The generous hardworking staff who give their time and effort well beyond their $18 per hour (you get more stacking shelves in a supermarket) will continue to hold the system together.