And What are Rudd, Milne and Abbott going to do about it?
above: The needs of Australia's Aged citizens are just as urgent as the needs of the Disabled - sometimes more. There is no excuse for not implementing National Aged Care Insurance along similar lines to the NDIS - or 'Disability Care Australia'.
In this article Socialist Left activist, Tristan Ewins takes a look at the recent report on Aged Care at ABC's "Lateline" program - and puts the argument for comprehensive Aged Care Insurance - how it should be funded - and the services it should provide...
Last night ABC’s
‘Lateline’ lifted the lid on an Aged Care Crisis which we have been trying to
draw attention to for years at ‘Left Focus’ and “ALP Socialist Left
Forum’. (for example, there was the following article
in 2009 – the first of many at ‘Left Focus’ – see: http://leftfocus.blogspot.com.au/2009/02/another-look-at-aged-care-crisis-call.html )
We will begin by
recalling the basic substance of that recent (July 15th ) story.
Following the observations from the ‘Lateline’ Program, Margot O’Neil reported for the ABC after conducting a year-long investigation that common complaints about the quality of aged care in Australia included residents:
“being
left in faeces and urine, rough treatment, poor nutrition, inadequate pain
relief, verbal abuse, and untreated broken bones and infections.
And further:
“one
woman has told the ABC that her grandmother, who survived Nazi concentration
camps, believes her experiences in aged care are worse than her wartime
ordeal.”
Jane Green – daughter of former high intensity aged care resident Margaret McEvoy – recalled her own specific story to the ABC how, explaining how:
“For
five days, staff tried to make Ms McEvoy walk. In fact, she had an undiagnosed
broken thigh bone, a raging infection, and severe dehydration.”
The ABC further observed that: “Ms Green, who is also a nurse, had to fight to get her mother taken to hospital, where she was immediately put into palliative care. She died six weeks later.”
In a similar story nurse and health care lecturer Mardi Walker:
“was horrified when she found her [91 year old] grandmother
with exposed raw ear cartilage due to lack of turning, and one of her arms
immobilised after staff botched injections.”
She recalls that: "They would just keep injecting into the same spot and she would scream. My mother said it was horrific, because she would scream.”
The ABC also made the accusation: “Repeated surveys find that 20 to 50 per cent of nursing home residents are malnourished, and the Australian Medical Association says there are not enough doctors to visit residents.”
And meanwhile: “The Nursing Federation says there are not enough properly trained carers, while Palliative Care Australia says only one in five residents receive proper palliative care.”
New Aged Care and
Mental Health Minister Jacinta Collins responded by reaffirming that the
Government had a “10 year plan.”
When asked by
‘Lateline’ the Minister had no credible answer to why the government has failed
to act decisively in response to Aged Care abuses and systemic failures when
compared with its response to abuse of cattle in Indonesia.
Lateline journalist
Emma Aberici further pressed Minister, Jacinta Collins on why Aged Care
accreditation processes do not include 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.
Collins was uncertain
what research was being conducted in these fields. She asserted that families can discern
between different providers in the best interests of their loved ones.
But if there is a
SYSTEMIC failure due to chronic LACK OF FUNDS and failure to enforce sufficient
standards, then it stands to reason that families often have little
choice. And that is especially so when they are
looking for a residence relatively close-by to enable regular visits.
Collins observed that
over 200,000 Australians are currently in residential care – and that is going
to expand dramatically with the ageing population. She also suggested that
staff to resident ratios might be considered ‘in the future’.
Finally, the Minister proclaimed
she would visit Aged Care facilities ‘on the ground’ to see for herself the
quality of care.
But time is of the
essence and action needs to be ‘locked in’ now
to be implemented in the near future – as a matter of urgency. Collins also needs to visit a very wide range
of facilities without notice in order
to get a better idea of what conditions are really like ‘on the ground’ , while
consulting closely with families who have reported neglect and abuse.
While Collins deserves
to be given a degree of slack on account of only recently taking the Ministry,
the Lateline Report shows that the time for procrastination and empty rhetoric
is over.
Rudd, Milne and Abbott need
to immediately form a response to this story, and to the many stories provided
by some residents and many families who have been trying – often without
success – to bring this issue to the forefront of public discourse for years. They need to devote new funds – many billions
of new funds for every year.
Alberici observed that
most high intensity care resident 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.
For a long time we have
championed this cause at ‘Left Focus’ and ‘ALP Socialist Left Forum’. We will now re-iterate what needs to be
done; and what we demand 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, 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 equity against their houses.
This operates as a grossly regressive ‘flat tax’. Residents from relatively poor and working
class families especially don’t deserve this ‘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 the profile of this issue.
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.
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