TThe government has finally announced a royal commission for elderly care. Although the terms of reference have not yet been announced, the Royal Commission must focus on nursing home and nursing home care providers.
In response to all the heartbreaking media reports, government and utility leaders continue to describe Australia's aged care sector as "world class." They claim that a consumer-driven, free-market system of care for the elderly ensures the highest possible standard of care. However, the so-called "consumers" are often frail, older people, many with dementia. How did you expect such vulnerable people to demand a quality service in the open market?
Worrying media reports have undoubtedly contributed to the government announcement of a Royal Commission. It is important to report cases of inadequate personal care, negligence, neglect, abuse and assault. However, we hear much less about elderly people living happily in a retirement home.
But the effect of hearing only horror stories makes older people afraid to move into a retirement home. An elderly woman recently told me that she preferred to kill herself as "going into one of those hell holes."
Satisfying the media with negative stories also demoralizes employees who are often hard-working, dedicated people who do a very difficult job for little pay. Many employees tell me that they work in old people's homes because they "take care of the residents".
My parents moved to a retirement home together. They chose the retirement home because they could sleep together in the same bed. They were both happy, especially because the staff treated them with respect, kindness and love.
Mom and Dad made lifelong friendships with multiple residents – though many of these new friends did not live long. After daddy died, I visited Mum most days around lunchtime. Mama did not have a big appetite – but she always got a full portion for lunch, so I could eat her leftovers. The meal was excellent.
When Mum was sitting in the lounge, employees passing by often stopped for a moment to talk to her briefly. This indicates that enough staff were on duty so they were not all on their feet.
My research highlights the variability of care standards in retirement homes. In a recent survey, employees are asked if they would recommend the retirement home where they work to their parents. About half answered yes and the other half answered no.
This calls into question the overly optimistic picture of the "world class" in the elderly care sector – in some nursing homes the needs of the residents are not covered. Complaints are made when residents are not taken to the toilet or incontinence pads are changed regularly, when ringing bells are not answered in time, when bruises or skin tears occur, and when pressure sores are not adequately treated, in some cases even gangrenous. Complaints are also made when the residents suffer from malnutrition and / or dehydration and are chemically restrained.
My research also questions the idea that old people's homes are all "hell holes". Relatives describe nursing homes, where residents are happy, well-fed and cared for, looking forward to seeing staff and calling the nursing home their "home". These retirement homes prefer social commitment and physical activity. They offer an extensive range of activities that are not only fun but also meaningful.
The difficulty is to distinguish between good geriatric care providers and dodgy care providers. Rebekha Sharkie's private affiliate bill is an important step. This bill stipulates that every nursing home publishes and publishes quarterly employee / resident relationships.
This design will provide certainty about the number of employees in each shift, including the nurses. There is undeniable evidence that residents working in old people's homes are getting better results. They have less pressure sores, lower rates of urinary tract infections, and are less likely to lose weight. Caring for nurses also means that fewer residents need to be transferred to a hospital.
Currently, nursing homes do not have to disclose their staff. How can people make informed decisions about care standards for old people's homes if they do not have access to this important information?
A key to quality care in a nursing home is the staff. Like all health and community services, well-trained, empathetic employees are the cornerstones of a retirement home. Unlike hospitals and childcare facilities, however, there is no federal statutory obligation for nursing homes, staff-to-resident ratios or qualification requirements. The decision on whether a nurse is on duty, at the discretion of the provider.
Ken Wyatt, the Minister of Elderly Care, claims, "There is no clear evidence or research that suggests improving care quality." However, studies in the US provide clear evidence of a positive relationship between the number of employees and the quality of care.
Old nursing homes with a high number of well-trained employees have nothing to fear from the account of this private member. It is only unscrupulous providers – especially those who at no time have a trained nurse on the ground – who vigorously campaign for this bill to be rejected or buried in another investigation.
The claim that the circumstances are a blunt instrument is correct. However, it is nonsense to say that passing on staffing data will be another job for the staff. Government and financial authorities are already collecting data on headcount and other quality indicators such as medication errors, pressure ulcers and falls. But these data are currently hidden from the public.
More transparency is important for evidence-based discussions to deliver the best possible care to frail elderly people living in retirement homes. It will also ensure that good providers flourish, while those unscrupulous providers who value profits beyond care will not.
If you need help with a geriatric care company, the Elderly Advocacy Network (Opan) offers free counseling at 1800 700 600
• Sarah Russell is a senior researcher