There is a sadness and weariness within the Aged Care sector by providers and anger over the Government’s swift leap to accusations of wrong doing yet again, before the facts are checked and the full story understood. Once again, providers have proved an easy target for apparent ‘failures’ in the aged care system.
The reality is vastly different to what is being portrayed in the latest round of claims by the Aged Care Minister Sussan Ley, which includes a focus on the management of pain being experienced by older people. Providers have been accused of over-prescribing pain medications and apparently making unwarranted claims for care costs amounting to fraud.
According to all the studies, the reality is elderly people are consistently under-treated for pain compared with younger patients. According to studies conducted around the world, 40% to 80% of elderly residents in aged care suffer needlessly due to inadequate pain treatment. Pain is misunderstood and misrepresented in the media, in health care and in ensuring a high quality of life for those who are at the end of life. Consequently, doctors, family members and Governments are clearly ill-prepared and do not understand how to respond, nor accept the level of care being provided and the increasing level of pre-acute care being made available in residential and home based aged care services, now replicating in many circumstances, the care provided in the acute sector.
We know elderly people are entering care much later in life, as they choose to stay at home as long as they can. This means they require a much higher, more complex level of care on entry; and the needs for a wider range of care is increasing, hence the increasing claims for reimbursement by providers. No longer are hospitals willing to take elderly customers to provide ‘long term’ care; instead care is provided in the Aged Care facility as ambulances do the round trip from home to hospital and back. Residential aged care is significantly cheaper than a hospital. Hospital care costs between $626 – $996 per day; in residential aged care the government pays a maximum of $212 per day. It is also very obvious each resident’s circumstances and health status is different. However, consistently, the claims being made are for much frailer customers reflecting this care requirements shift in customer profiles. This reality is not reflected in the data collected by the Government. While the focus on the budget and managing the financial costs of the provision of aged care is critical, this must not be done at the expense of customer care and health needs and by misreading the limited data collected, nor as a consequence of poor understanding and the rush for the quick fix.
The current misunderstanding has arisen because of the Government’s inadequate data collection processes through the Aged Care Funding Instrument (ACFI) has led to the Government’s poor management of the issues. In particular, the ACFI currently is not required to be repeated once the highest level of care has been assessed and is being provided. Given the wide range of conditions and complexity of care provided, to focus on only one or two care components is to misread and misunderstand profoundly the nature, breadth and depth of the clinical care being provided. Aged Care providers are making their claims for care needs on the increasing frailty of older Australians on a day by day basis, not simply on episodic and time limited ACFI data. The Government has a lot of work to do to catch up on the realities of providing care.
In the meantime, providers are being threatened with fines and further damage is caused to the sector’s reputation. The Government continues to frighten and make more anxious those in care or seeking support. All in all, this perspective is unjustified and is an irresponsible response by the Federal Government to a major transformational change being made in the provision of services to the elderly in our society. It appears once again the Government has misread the changes and the type of care now being provided in the aged care services.
Just as Prime Minister Turnbull is seeking to change the language and discussion on the multi-cultural nature of our society to shift social and cultural attitudes, a similar focus needs to be made on the relationship the Government has with its aged care providers and the vulnerable elderly across the sector. The blame culture and accusations made so swiftly when any difficulty occurs is at odds with the deep commitment the sector and it’s people have made to work with all Governments to provide the best possible care to elderly Australians, particularly those of us in the Community Benefit Sector. At this time of year, we are so mindful that our staff work 24 hours a day, 52 weeks of the year with our older Australians and Christmas is a particularly sensitive time for staff and families working in these essential services. It is time the Government grew up and dealt professionally and appropriately with this very professional and compassionate sector to ensure the best possible care and quality of life for those who deserve the best we can provide for those at the end of their lives.