The Royal Commission into Aged Care Quality and Safety’s Interim Report has found the aged care system fails to meet the needs of its older, vulnerable, citizens. The report, entitled Neglect, was tabled on Thursday 31 October 2019. It indicates that a fundamental overhaul of the design, objectives, regulation and funding of aged care in Australia is required. While the interim report does not include recommendations, it did identify three areas where immediate action could be taken:
- to provide more Home Care Packages to reduce the waiting list for higher level care at home
- to respond to the significant over-reliance on chemical restraint in aged care, including through the seventh Community Pharmacy Agreement
- to stop the flow of younger people with a disability going into aged care, and speed up the process of getting out those young people who are already in aged care.
The Interim Report is in three volumes and is now available to read on the Royal Commission’s website. It covers much, but not all, of the work of the Royal Commission through to September 2019. Most of the Royal Commission’s work on quality and safety considerations will be in the Final Report.
Volume 1 covers the information gathered to date dealing with the current structure and processes, demography and perception of our ageing population, the experience of the users of the system, and key findings. In the opening chapter a number of safety and quality issues identified by the Royal Commission were summarised including… patchy and fragmented palliative care for residents who are dying, creating unnecessary distress for both the dying person and their family. p7
In addition, Volume1 highlighted several specific issues related to palliative care and/or end of life. They are:
Interface between sectors and services: Palliative care was identified as a particular issue, highlighting the issues with the interface between State, Territory and Australian Governments in relation to the provision of services to people in residential aged care. p244
End of Life and Residential aged care: People suffering from a terminal illness, or nearing the end of their life’s span, may need palliative care while they are in residential care. For some people, their whole experience of residential aged care is in palliation, or in dying. The report notes that residential aged care is a place where people will and do die, and that experience should be as free from pain and fear as possible for the person. p117
Waiting for Care: Estimated wait time is around three to six months for a Level 1 Home Care Package and more than 12 months for a Level 4 Package. Waiting can have many impacts – increased mortality risk, additional system costs associated with hospital use and entry to residential aged care, and impacts on families and carers The report notes that during the 12 month period ending in June 2018, more than 16,000 people died waiting for a Package on the national prioritisation queue. p154
Diversity and Culture: With respect to Aboriginal and Torres Strait Islander communities, the Royal Commission heard that it is important for providers to understand local practices or ask for advice from local communities on appropriate practices. p182
Workforce needs: Much of the evidence to the Royal Commission indicates that, despite their best efforts, aged care workers and professionals too often have limited training and insufficient knowledge to do their jobs as well as they potentially might do. The Commissioners noted that there is also a shortage of staff who are qualified and experienced in providing good palliative care. p222
Younger people in aged care: Of the sizeable minority of younger people in residential aged care who are ineligible to receive National Disability Insurance Scheme supports, many are likely to be in the category of people who have palliative and end of life care needs. The report notes there is an urgent need to improve the availability of palliative care for younger people nearing the end of their lives. p234
The interim report notes the Australian aged care system is failing and needs fundamental reform. Steps to achieve this transformation will be a focus of the Final Report due to be presented in November 2020.
Page created 04 November 2019