The Royal Commission into Aged Care has found significant fault in the aged care system as a whole and uncovered neglect, abuse, indifference, and poor leadership. It says one-third of aged care residents received substandard care.
While money alone does not solve these problems, current expenditure on aged care is about half that of the average spent by OECD countries with Denmark and Sweden’s expenditure at 4% of GDP, funded by a universal tax base.
The inescapable challenge is that Australia spends less than half of what comparable countries do on aged care, at 1.2% of GDP versus an OECD average of 2.5%.Australian Aged Care Collaboration (representing the not-for-profit aged care providers).
More staff, more training, higher wages, and better oversight are needed for this. The Royal Commission concluded that an extra $10 billion a year would be required.
The Federal Government responded to the Royal Commission’s final report on the day the 2021-22 budget was handed down. See here for our take on the budget for aged care.
What’s needed urgently
|A universal right to high quality, safe and timely support and care, free from mistreatment and neglect, inhumane treatment and any form of abuse|
|Aged care services as a right rather than capped arbitrarily|
|Supports for people to live as independently as possible, at home or in residential care|
|Mandatory minimum qualifications and national registration for aged care staff|
|Care delivered by a qualified, well-trained, well-paid workforce of nurses, personal carers, allied health, and palliative care teams, all with a good understanding of dementia care.|
|One registered nurse on-site at all times, an appropriate mix of skills, and daily minimum staff time of at least 200 minutes for each resident.|
|An increase in overall funding of $10 billion a year|
|Home care packages that are assessed independently and not capped|
|An independent Inspector-General of Aged Care for better oversight|
|An NDIS-style program for over 65s for rehabilitation and disability|
|A reduction in the over-reliance on chemical restraints|
|A stop to the flow of younger people with disability going into aged care by providing specialised accommodation|
|Quality of care indicators to be made publicly available and include staff hours, standardised statements of care for home care, and more transparent financial reporting.|
Aged care can also be substantially improved by:
|Community-based residential and home services that are inter-connected, auspiced by local government, and with local government playing a role in oversight|
|Residential aged care that is, as far as possible, home-like, familiar, stimulating, and welcoming for visitors, informal carers, children, and animals.|
|Music, the creative arts, access to gardens, fresh air, and sun – all essential for well-being|
|Greater integration of aged care with health care system and hospitals better equipped and trained for geriatric care|
|A rehabilitation first approach so exercise and activity, function and autonomy are maintained for as long as possible|
|Standards set for dementia-friendly building design and layout|
|Aged care staff who are patient, kindly, and trained in best practice in working and communicating with people with dementia and other cognitive impairment|
|A systematic, sector-wide approach to addressing linguistic and gender diversity and using inclusive practices|
|Respect for end of life decisions made by people in aged care|
|A simpler and fairer approach to means-testing|
|Stronger governance, regulation of the quality of care, prudential regulation, and an independent mechanism to set prices and a system for filling gaps in services.|
|Establish a council of elders with membership to include diverse voices with lived experience of aged care|
|Adopt principles of collaboration and co-design to inform, guide, and review aged care reforms.|