Aged care crisis - Australia's greatest shame

Alberici observed that most high intensity care residents spend less than 2 years in care. And yet those can be two years of hell. Whereas improvements in the standard of care could provide much greater comfort, better health, and perhaps extended (quality) life-spans.

I will now re-iterate what needs to be done; and what I hope others – including our politicians and political parties - will now demand to be done.

Firstly a National Aged Care Insurance Scheme needs to be established along similar lines to the National Disability Insurance Scheme – which in 2010 was estimated to cost $15 billion a year. ($22 billion by 2020).

A National Aged Care Insurance Scheme demands a similar commitment of resources; implemented as quickly as possible given the urgency of the suffering of our families and loved ones. Immediate funding options include further increases to the Medicare Levy, cutbacks in superannuation concessions for the wealthy and the upper middle class, and reductions in the rate of dividend imputation (reverting to 75% would save about $6 billion).

Such funding needs to secure the following outcomes:

• Official quality control that includes comprehensive ongoing assessments of the mental and physical well-being of aged care residents, including dehydration, malnutrition, depression, bedsores, falls, chronic pain, pain-management, over-use or inappropriate use of anti-psychotic medication, forced restraint and so on .
• Generous nurse/staff to patient ratios – improving the quality of care by freeing nurses and staff to turn residents to avoid bedsores; wash residents whenever necessary; provide comfort and social interaction; ensure food is of decent quality and is actually eaten; constantly monitor residents and ensure that health needs are always addressed as a matter of urgency.
• Weekly visits by doctors and immediate provision of dental care for any who have the need.
• Better training, pay scales and career paths for aged care professionals including nurses and other qualified staff.
• Privacy for aged care residents including private rooms and other personal space.
• Daily facilitated social interaction; outings to shops, gardens and churches; access to information and communications technology and services; libraries; facilitated reading; discussions and games – a better life than being sat down to stare at a television, or perhaps just at walls all day!
• Better programs encouraging volunteers to visit residents and provide conversation and comfort.
• Provision of gardens and similar space to provide greater tranquillity and a change-of-scenery; as well as time in the sunlight during the warmer months.
• The best quality palliative care for all who have the need.

Meanwhile for low-intensity care residents, and those being cared for by loved ones, greater financial support is necessary for Carers, as well as regular respite, and institutionalised support when it comes to health, outings, diverse social interaction, home help, and construction of extensions or 'granny flats'.

Stop regressive user-pays!

For all levels of care, meanwhile, user-pays mechanisms need to be immediately wound back. This in itself will cost billions – on top of the cost of actually improving the quality and legislated standards of care.

Again – we need to see this as a comprehensive National Aged Care Insurance Scheme along similar lines to the National Disability Insurance Scheme. (NDIS) Those needing care should not be driven to take out tens or even hundreds of thousands of debt against their houses. This operates as a grossly regressive 'flat tax'. Residents from relatively poor and working class families especially don't deservethis 'final cruel blow'.

Residents who need only low-intensity care, meanwhile, need to enjoy the appropriate level of care, enabling greater flexibility and freedom as long as possible.

Finally funding for advocacy groups is necessary in order to empower families; and for purposes of supporting advocates for those not in a position to stand up for themselves against abuses (eg those without family, and those with dementia).

This issue will resonate powerfully with families: families who love their elders dearly, and those who (legitimately) fear for their own futures. The mainstream parties – Greens, Labor, Liberals – all need a comprehensive response to the issues raised by Lateline – culminating in a consensus on a National Aged Care Insurance Scheme along similar lines to what occurred with the NDIS. Procrastination, opportunism or mean-spiritedness on this issue need to be condemned in the strongest possible terms.

For those of us who care about this issue we need to maintain the pressure – and maintain the profile of the cause of reform. We need to ensure the fullest possible reform over the shortest possible passage of time – as the needs of our most vulnerable are urgent – their sufferings neglected until now - demanding immediate action.

This issue is out in the open now for everyone to see. There are no more excuses.