What we can learn from aged care Royal Commission

LETTER TO THE EDITOR   The Royal Commission has uncovered some scandalous practices and huge gaps in the provision of care packages for clients who have been assessed as needing them.    But have we raised expectations too high and ask for more than can be provided?    Take one instance - if someone has complex care needs which require 24 hour attention, that means that at least three people have to be rostered each day, with a back up person on call.   This will be costly but necessary in some cases.    Such work is hard, demanding and not always rewarding, so selection and training is vital, not just taking on someone sent from Centrelink.    If a client is obese, incontinent, intellectually handicapped and does't want to be showered, how does the carer cope with this without being accused of using undue force or neglecting the client if the work cannot be done?   While this sounds extreme, it is not.   People try hard to care for their dependents as long and as effectively as they can, but they wear out in time as age comes on them, so they are desperate to know what kind of care will be there for their loved ones once they can't do this.    This needs long term assured funding, not just three-year cycles, which can leave the person stranded once funding runs out.    Too much seems to be diverted to administration costs which means that the client cannot receive full value from the allotted amount.    Administration costs are necessary but should not exceed more than 10% of the package.    Our family has been blessed in the quality of care given by Cabanda Aged Care Complex to our parents at the end of their lives but I have heard stories of other centres that are not so good.   Staff are expected to do too much in too short a time to be able to give quality care to each client, and their work is often heavy as they try to manoeuvre people into chairs or onto toilets.    This is not work for school leavers or older unemployed, but needs people who have enough life experience to be compassionate and strong enough to do the work, as well as cope with the hours.   More staff and better training are keys to improvement, as is the provision of an RN at all times in each Centre.    If actual nursing care is not needed, the RN could spend time on observation of changes in clients and note any necessary changes of care and medication.    Much more money will be needed as the population ages and expectations of care are high, but this has to be done to avoid abuse and scandals in future.    Do we have politicians daring enough to propose this?   J.A.Holznagel Rosewood

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