Peter Vincent, Director and Principle Consultant of Aged Care Management Australia addressed attendees at the Aged Care Standards and End of Life Care forum held on Tuesday 11 December 2018 at UniSA’s Hawke Centre.
Set against the current Aged and Community Care context, Peter discussed the Aged Care Roadmap developed by the Federal Government which sets out to systematically address the current status of the sector which is constrained by growing demand, reducing numbers of providers, inappropriate funding for end of life care in residential and community care settings with limited access to specialist palliative care, and poorly trained staff with limited time and physical resources to provide end of life care.
The ‘roadmap’ sets out the path to a system where people are valued and respected, including their rights to choice, dignity, safety (physical, emotional and psychological) and quality of life. They (together with their families and carers) will have access to competent, affordable and timely care and support services through a consumer driven market based sustainable aged care system. Add to this the funding shift from provider back to consumer; the intent is to provide the consumer the flexibility of choosing the type of care and provider who can best meet those needs.
Lofty aims indeed. Peter explains that Aged Care was never established to provide palliative care, and asks how it is possible on just $219.32 per day. “There is simply insufficient funding to meet the full cost of planned end of life care. Overall current Aged Care Policy in respect to supporting palliative care in Aged Care is dismal,” he said. “The cost for providing palliative care admission in an acute care setting is estimated at $2,995 per day. It’s not difficult to see that there is an imbalance” he said.
“The roadmap is all very well but it will take more than simply ‘hopes and prayers’ to effect change. There are currently over 7000 clients assessed for home care waiting for a ‘package’ in South Australia” he said and suggests if we are to improve this current status we must:-
- remove the barriers to admission and discharge between Public Acute Care services and residential or community care without financial penalty or the need for reassessment or new contracts.
- Remove the barriers that have been created by the MyAgedCare process
- Allow movement of residents from within the residential sector to move to the home care model for palliative care purposes without boundaries
- Improve respite options
- initiate and apply more rigid training for all aged care staff
- fixed classroom training
- entry and exit examination standards
- increase the number of Nurse Practitioners
- quarantine funding for palliative care.
It is clear there are many people concerned about the Aged Care sector and its ability to meet the needs of citizens in it. In discussion time there were more questions than answers, and great concern about the delivery of palliative care in a market driven system. Where would one purchase palliative care from in such a system and how will quality be measured?