Media focus on poor care of residents in aged care homes – bad apples or systemic issues?

The recent media focus on alleged poor care of residents at some Opal aged care facilities in August 2017 where some residents were apparently badly treated and were too old or cognitively impaired to put up much of a fuss, is indicative of either an industry that has not matured sufficiently and is throwing up a number of poor operators, or possible systemic issues for residents and their carers in aged care facilities generally, or both.

The Australian Aged Care Quality Agency is responsible for accrediting the growing number of aged care facilities in Australia. The agency audits all aged care facilities and according to the Agency, its assessors speak to around 50,000 residents each year about the quality of care received. They also make at least one unannounced visit to all facilities each year.

Aged Care homes are accredited against four major criteria: Management systems, staffing and organisational development; Health and personal care; Care recipient lifestyle; and Physical environment and safe systems, with 44 expected outcomes to be met overall (you can check how well your local aged care home performed during its last audit at http://www.aacqa.gov.au/publications/reports).

As an indication of how sensitive the Agency is to complaints about the quality of aged care facilities, in the wake of the ABC’s 7.30 program on Opal, the Agency introduced a new report, the Consumers’ Experience of the Quality of Care and Services: Aged Care Homes (Consumer Experience Report) that will be used when interviewing aged care residents. The questions cover a resident’s experience with staff, feelings of safety, staff responses to issues, the quality of the food, the approachability of staff and the efficiency of staff. The results of these reports will be published along with the audit reports on reaccredited facilities on the Agency web site.

There will always be care issues in aged care because of the vulnerability of the residents. A recent report in the Medical Journal of Australia (1) indicated that of the 20,000 deaths in nursing homes in the 13 years from 2000 to 2013, 3,289 premature deaths resulted from falls, 261 from choking and 146 from suicide. The incidence of premature deaths from these external causes rose over the period of review from 1.2 per 1000 admissions in 2001–02 to 5.3 per 1000 admissions in 2011–12 – a significant change. The authors concluded that a national policy framework is needed to reduce the incidence of these premature deaths. However, this will not reduce the media focus and operators who receive bad press are likely to be subject to lower demand for their services as carers become better informed and act accordingly.

1. Joseph E Ibrahim, Lyndal Bugeja, Melissa Willoughby, Marde Bevan, Chebiwot Kipsaina, Carmel Young, Tony Pham and David L Ranson, Premature deaths of nursing home residents: an epidemiological analysis, Med J Aust 2017; 206 (10): 442-447.

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