Aged Care Insite Issue 111 | Feb-March 2019 | Page 17

industry & reform there’s no requirement for continuous monitoring”. “Counsel, I would suggest that was not the intent of the suggested change to the standards,” Rooney replied. The issue of ACFI indexation was again raised. Nicolas Mersiades, director of aged care at Catholic Health Australia, said the indexation formula is “particularly harsh” and is not keeping up with the economy. Dementia Australia chief executive Maree McCabe told the commission that by 2056 there will be an estimated 1.1 million Australians with dementia, adding “there won’t be anybody that is not impacted in some way”. McCabe called for mandatory dementia training for the 240,000 aged care workers in Australia. “Seventy per cent work as personal care workers, and their Certificate III does not provide any education around dementia, not as mandatory or even optional training,” she said. DAY 6: DEATH BEFORE RESIDENCY Some people would rather die than go into residential aged care facilities. This is according to UnitingCare Australia’s Claerwen Little, who told the commission about the findings from Uniting’s research into community perceptions of aged care. They found, among other things, that although it is in people’s minds, aged care is not seen as the most pressing issue for the government to fix. However, the research did find that the wider public had a number of misconceptions about the sector. “People thought that it was dominated by the for-profit sector, that … the big for- profits were making a lot of money out of aged care,” Little said. “That it was mostly residential care … And the sort of nuances of the community home support program and home care program really weren’t part of their … understanding of the aged care system and sector.” The research also showed that people’s understanding of who funds aged care is limited, and what’s more, they don’t want to pay for it themselves. “They think that more money is needed from government. And I think one of the other key findings is that people don’t believe that they should be paying for aged care. “They do believe they’ve paid their taxes and they’ve contributed to the community all their life and that they should be supported in old age,” Little said. When asked what their findings say about perceptions of aged care, Little did not sugar-coat her response. “Sadly, some people suggested they would rather die than go into a residential aged care facility. They would rather poke their eye with a pencil than have to enter a home,” she said. DAYS 7 AND 8: HOME CARE PACKAGES In the final two days of the first hearing of the royal commission, we heard from the people affected by the system itself and had a summary of the proceedings to date. Kaye Warrener described to the commission the near two-year wait she and her husband Les have endured while waiting for assistance from My Aged Care. Warrener is her husband’s full-time carer, and they contacted My Aged Care for the first time in November 2017 in relation to a Home Care Package. “We were told at the very beginning that it could be 12–18 months for the package,” she said. “And up until today, we’re still waiting for the Home Care Package Level 3”. Warrener described how this wait for adequate care has seen a decline in her husband’s health, and this has been hard for her too. “It’s hard to watch your loved one – I mean, we’ve been married for 56 years – to watch their health deteriorate. And I just feel with the extra support financially we would be able to help perhaps delay some of those onset things that are happening with age,” she said. Margot Harker, who is currently on a Level 4 Home Care Package, spoke of her frustration with the level of care she receives. “With one of my providers at the moment, the one that’s handling most of my evening care – so that’s paid for by the package – I’ve had at least 12 months, probably the two months of this year and going back 10 – nine or 10 months of last year, in which there was, frankly, incompetence,” she recalled. “That people who were on a roster didn’t know they were on the roster; I hadn’t got a copy of the roster. So those standard procedures where a coordinator will ring round the carers and say, ‘Would you be able to take Margot’s shift on Thursday?’ They then say yes or no.” She also spoke about the loneliness a Home Care Package engenders, with no scope for companionship. “I think it’s emotionally very crippling, in the sense that it overtakes you quite a lot at certain times. I’ve also discovered – because I was 64 when I had the stroke and I’m now 72 – that there has been a kind of accelerated ageing that has gone on in this time,” she said. We also heard from Barrie Anderson, aged care resident, whose wife has advanced dementia and is nearing the end of her life. He had an overall positive view of his and his wife Grace’s time in care but did talk of the need for more dentists in the system and the problem of nursing staff turnover. For the positives, he cited the original facility they stayed in for its house-like layout and the various music programs they have taken part in. “I think it’s very important in terms of not only Grace’s wellbeing but mine. And in theory, music, I believe, touches the soul. With the music that Grace is provided with at the moment, we can reminisce Sadly, some people suggested they would rather die than go into a residential aged care facility. about past times. And I think that music is underestimated in its ability to enhance people’s lives.” On the final day of the hearing, counsel assisting Dr Timothy McEvoy spent over an hour summing up the thoughts from the eight days of evidence. He identified several factors affecting the provision of aged care in this country: population growth, increasing dementia levels, increases in the demand for home care, workforce issues, the difficulty obtaining public health services in aged care, and the economic sustainability of the system itself. “The dominant narrative too often casts older Australians as a burden, rather than a blessing. The royal commission rejects that narrative and calls for a culture of appreciation and respect for older Australians. But this must be more than a mere statement of aspiration,” he said. The next hearing will be held in Adelaide starting on Monday, 18 March. It will focus on home care and the community. The following round, focusing on quality, safety and dementia, will be held in Sydney on 6 May. ■ agedcareinsite.com.au 15