Aged Care Insite Issue 114 | Aug-Sep 2019 | Page 12

news People Care director Arthur Miller outside the royal commission in Brisbane. Photo: Darren England, AAP Commission rundown Hearings bring focus to remote and rural access to care. By Conor Burke MILDURA: ‘MAYBE I JUST END IT’ “I just cried silently all the way home so Don couldn’t see. And I just thought, ‘Well, maybe I just end it for both of us’,” said Rosemary Cameron, describing a low point she experienced as an informal carer. Cameron, 69, cares for her husband Don, who is living with Lewy body dementia, and she was one of many carers who told the commission of the realities of informal care in Australia. As of 2015, almost 2.7 million Australians identified themselves as informal and unpaid carers – that’s 12 per cent of our population. Of those, around 420,700 are primary carers of people over the age of 65. Females make up 68.1 per cent of all primary carers, and this has a massive impact on income and employment opportunities for women. Deloitte Access Economics estimated that carers provided 1.9 billion hours of care in 2015. This is equivalent to each carer providing 673 hours per year or 13 hours per week. Cameron, and others, spoke about the difficulties in dealing with respite, loss of earnings and the effects of all of this on mental health. BRISBANE: FALSE HAVEN The commission also heard evidence from the players involved in the closing of the Earle Haven facility in Queensland. The sudden closure left 68 residents temporarily homeless, and during testimony there was confusion, due to the 8 agedcareinsite.com.au complicated nature of the arrangement between People Care and subcontractor HelpStreet, as to who bears responsibility. Further confusion reigned when the question was asked why Earle Haven was still able to operate after frequent sanctions and who was responsible for dealing with complaints, be it the Health Department or the Aged Care Quality and Safety Commission. Also giving evidence was Professor Ron Paterson from the University of Auckland. He was damming in his assessment of providers who “pay lip service” to resolving instances of poor care and more so on the lack of transparency surrounding complaints and investigations in the sector. “These are publicly funded providers, and they are providers who are caring for the most vulnerable members of our community. Why would the default position be secrecy of information about the providers? That strikes me as odd,” he said. BROOME: MAGGOTS FOUND IN PATIENT’S MOUTH Maggots were found in the mouth of a respite patient at an aged care facility in Broome and the incident was reported anonymously to the aged care complaints commissioner. The Broome hearing of the Royal Commission into Aged Care Quality and Safety was told that one evening during the wet season, flies entered the mouth of the patient – who had a poor ability to chew – and laid eggs, which produced maggots. The commission was told that the incubation period for maggots is usually about eight hours. The commission also heard from Martin Laverty, chief executive of the Royal Flying Doctor Service (RFDS). He told the commission that the excuse of small populations and workforce shortages is not good enough to explain poor care to remote communities. “Medicare is one of this nation’s greatest assets, but it does not serve the health interests of remote Australians, and because of the interdependence of primary care access with aged care, we are letting older Australians down by a failing primary care system in remote Australia,” he said. “Until we articulate an expectation as to what is a reasonable standard of access to primary care, in both volume of access [and] quality of access, it is insufficient to just have access to GPs without palliative care, without geriatrics, without dental care in remote Australia. And the commission has an opportunity to articulate a reasonable standard.” Laverty told the commission that in the opinion of the RFDS, there was insufficient “prevention, primary and rehabilitation healthcare access in many parts of rural and remote Australia”. He pointed to statistics that show remote areas have half the coverage of doctors compared with cities – with 459 per 100,000 people in cities compared with 225 per 100,000 people in remote areas. The commission heard about the issues specific to the Aboriginal and Torres Strait Islander community in Broome and surrounding areas. Lack of access to respite, poor cultural safety and awareness in aged care facilities, and staff turnover were recurring issues. Leon Flicker from the University of Western Australia told the commission that although Aboriginal and Torres Strait Islanders make up 3 per cent of the population, they only occupy 1 per cent of aged care beds. In his opinion, this could be due to a number of reasons. The Aboriginal population often develop age-related syndromes at a younger age and therefore aged care might not be appropriate. Remoteness is another problem, as well as a belief among the community that residential care is not culturally safe as, in his opinion, “racism is commonplace”. Navigating My Aged Care is another barrier to care, he said. “It’s tortuous for a literate middle-class Melburnian. It’s impossible for a remote Aboriginal Kimberley person who may not be literate, may not own a computer, may not even own a landline or a mobile phone … The idea that this is a system