“Palliative and end of life care are absolutely critical parts of aged care,” Sean Rooney, Leading Age Services Australia CEO, told Good Grief! as the Federal budget with its big investment in aged care was announced. This follows the Royal Commission into Aged Care Quality and Safety The Commission reported “confronting personal stories of under-resourcing, neglect, abuse, and staff shortages in aged care facilities”. Sean’s statement might seem obvious. But his strong and affirming message is needed from such an important leader in the aged care sector right now. “We represent providers in metropolitan, regional and rural Australia – 54% of our Members are not-for-profit, 38% are for-profit and 8% are public providers,” LASA’s website says. LASA forecast in March 2021 that up to 65 percent of aged care homes will record operating losses in the next financial year. “The latest independent StewartBrown report says 58 percent of homes surveyed were operating at a loss in the first six months of this financial year, with an average operating deficit of almost $2,750 per bed per annum.” Under this type of financial pressure, in Australia in the past, palliative care has tended to be deprioritised most.  Sean is also spokesman for the newly formed Australian Aged Care Collaboration. This brings together more than 1000 organisations responsible for delivering 70 per cent of the aged care services in Australia. It includes other big organisations similar to LASA – Aged and Community Services Australia (ACSA), Anglicare Australia, Baptist Care Australia, Catholic Health Australia, and UnitingCare Australia. The Australian Aged Care Collaboration has proposed a 15 point plan: “to ensure older Australians get the most benefit in the quickest time from an improved aged care system,” – its response to the Royal Commission. It recommends the Australian Government should immediately focus on:Human rights, access and choiceWorkforceTransparencySustainability. Radical shifts in investment in palliative care are included in its discussions about each of these points. “The Royal Commission made it clear we need to put older people, their needs and a rights-based system first. To make that possible, big picture reform of the entire system is necessary. As part of this big picture reform we must see the critical aged care workforce grow and be well supported through better pay, conditions and training,” the Collaboration said. More money needs to be spent on more people to provide not just more but better services – after 20 years and more than 20 reviews that have recommended to the Federal Government major reform of the aged care sector. See more about this in It’s time to care about aged care here: Sean says the Royal Commission has acknowledged how important palliative care is “by increasing training requirements, and reviewing the standards in relation to palliative care. Funding increased staffing will also assist with palliative care support.” Among the Aged Care Collaboration’s suggested steps to achieve reform, are for example: “Fund a workforce program to support training, clinical placements, scholarships and other initiatives to respond to workforce challenges in a targeted manner (including dementia and end of life care), and commit the development of a 10-year workforce strategy to ensure a sufficient supply and distribution of health and aged care workers for the aged care sector and to inform future targeted workforce initiatives.” Good Grief! has found distress over the reporting of the Royal Commission, as we’ve talked to nursing home directors and staff over the last few months. “It’s been very demoralising for staff and our residents have been very frightened by it,” said one manager, a typical comment. But even though dealing with bad publicity and listening to the shocking case studies that came out of the Royal Commission is painful, this scrutiny will help the aged care sector to lobby the Federal Government for the needs of those elderly people in their care – most of whom, realistically, will face the end of life in their facilities. “LASA recognises there are efficiencies to be realised by investing in training and resourcing aged care and primary health networks/community palliative care teams to support early palliative care assessment and intervention in response to deterioration trajectories,” Sean told Good Grief! “Ultimately, this will help reduce expenditure associated with hospital admissions that lead to reactive low value procedures that occur in hospital during the last days of life,” he said. We outlined the Commission’s recommendations on palliative care in the last Good Grief! newsletter. We’ll keep watching what the stakeholders do – including the Federal Government which funds much of aged care. “Economic analysis recently undertaken by KPMG on behalf of Palliative Care Australia argues for additional palliative care investment across Federal and State Governments,” Sean told Good Grief! It’s a pity it needs an accounting firm to write a report so Palliative Care Australia can lobby the government about this, but we Australians have let the quality of aged care slip. A study published in the Medical Journal of Australia in 2020, prepared for the Royal Commission, showed that: “The expenditure estimates indicate that many other nations spend a much great proportion of their GDP (gross domestic product) on long term care for older people. The data indicates that in Australia a comparatively high proportion of older people live in institutions, with a relatively low financial investment in the whole aged care sector.” For this report, see https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50670 The Royal Commission’s recommendations don’t just cover the aged living in residential care. It also raises questions about the end of life care for those living at home. Sean says a focus for LASA has been on “ensuring that end of life care is given due attention in home care as well as residential care.” “We implore the Government to lead fundamental change in our aged care system. Funding is a key part of this reform so we are looking forward to the full Government response in the May federal budget,” he said. The Government will be responding to the Royal Commission on May 31. So we’ll look at what it has to say about end-of-life care in its response and we’ll match this with what it announced in the Federal Budget last Tuesday (May 11). Look forward to sharing more about this with you. |