Aged Care Insite Issue 134 Nov-Dec 2022 | Page 10

industry & reform

Human rights

OPAN pushes for law to stop abuse in aged care .
By Elise Hartevelt

The nation ’ s top advocacy group for older people has called for new laws to give aged care residents more power over the care they receive .

The Older Persons Advocacy Network ( OPAN ) released a position paper highlighting how substituted decisionmaking can lead to the abuse and neglect of older people .
OPAN ’ s chief Graig Gear said it ’ s a fundamental right that older people , like all adults , should be allowed to make decisions about the care and services they want .
Aged Care Insite spoke with Gear about how Australia can safeguard older people by giving them a voice in the care they receive .
ACI : What are currently the laws around substitute decision-making regarding older people and aged care ? CG : We ’ re living in a society that assumes older people don ’ t have the capacity to make decisions about their life . We must retrain the system to think about older people ’ s daily decisions and ensure their wishes and preferences are reflected and heard .
So , occasionally , there ’ ll be times when an older person needs or wants to have a substitute decision-maker . However , that will usually be for minimal
decisions in their life , such as medical or financial decisions , when they can ’ t communicate . These instruments should only be used as a last resort . And even when these instruments are in place , people should still be working with the older person to record their wishes and preferences . You always have to work with the older person to take their direction .
So , what issues does OPAN have around substitute decision-making ? There ’ s a multitude of issues at the moment and misunderstanding . We end up saying that either providers or family members , by default , have a power of attorney in decisionmaking for an older person . But , then , this also happens when that person is still able to communicate and make decisions for themselves .
We also see cases where the older person has previously expressed their preference , for example , about the treatment they want or what type of care they want . But , there are times that preference is completely overwritten by the family member or by sometimes the provider as well . So , it ’ s making sure older people are understood and protected and that we always assume that they ’ ve got the capacity to make those decisions for themselves .

“ It ' s making sure

older people are understood and protected .
Who do you hope this report will influence ? We ’ re looking for this report to start a conversation about a framework of supportive decision-making . And what role decision-making has in the way we interact with older people in daily interactions and deliver care . In the framework , we should put in place measures to protect the most vulnerable at the centre .
We want the government and aged care providers to think about why they ’ re representing older people , how they interact and how they ’ re supporting people to take charge of their own decisions — and so calling on a national framework to be implemented in legislation to require that to happen .
Do you think there has been an overall improvement or progress in this issue over the past years ? There ’ s been a number of policy documents , frameworks and talks . It ’ s mainly for the supported decisionmaking tool kit . But it needs to be in daily practice if care is delivered . Under our framework , there ’ s a good decision-making model that would work . We need to fund and train people to use these tools and get them used to the game . ■
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