Attwood Marshall Lawyers Wills and Estates Senior Associate Debbie Sage and Associate Larisa Kapur, both Accredited Aged Care Professionals, come together to discuss the latest news and developments that are impacting the aged care sector.
Overview
This past month the aged care sector has seen a raft of new initiatives being rolled out, all aimed at improving the health and mental wellbeing of care residents.
Among the numerous reforms are new principles for the construction of new aged care homes or retrofitting of existing homes, the start date for mandatory reporting of care minutes, a virtual reality tool that helps staff have greater empathy for people living with dementia, and survey results showing volunteer programs need more support.
Government releases new national design principles and guidelines
The Federal government has released new design principles for residential aged care accommodation aimed at making the living conditions more accessible, dementia-friendly, and homelike.
The guidelines set a gold standard for future aged care builds. They are based on international consensus that residents who live in small households of less than 15 with a sense of community are healthier and happier.
The step away from the traditional model of large, multi-bed institutions and towards a more homelike environment was a key recommendation from 2021’s Royal Commission into Aged Care Quality and Safety.
The newly published 63-page report includes checklists for practical infrastructure changes focused on four design principles:
- Enablement: To support people living in a healthy and fulfilling environment,
- Cultivate a home: To create a familiar and private space where people feel safe and in control,
- Access to outdoors: To help people spend time outdoors and connect with nature,
- Connect with community: To encourage people to stay connected with family, friends, and community, and to continue participating in activities they enjoy.
All refurbishments and new builds will need to reference the design principles and guidelines from 1 July 2024.
It will be a “living document” so that the health department can respond to any changing evidence that emerges in the field. The current iteration incorporates learnings from the COVID-19 pandemic. The overarching idea is to promote residents’ independence and enjoyment – allowing them to maintain their sense of identity – while also delivering high quality care.
Some organisations have called for the design guidelines to be incorporated into the Aged Care Quality and Safety Commission’s star ratings system. This integration would enable members of the public to compare facilities and put pressure on institutions, encouraging them to strive for best practices.
Care minutes targets are now in effect
Since 1 October 2023, providers have had to make sure certain categories of care meet a minimum standard of time with each resident for quality and safety.
Registered nurses, enrolled nurses (ENs) and personal care workers and assistants in nursing (PCW-AINs) need to log 200 care minutes per resident per day. The care minutes need to be included in providers’ quarterly financial reports.
Out of the mandatory 200 minutes, 40 must be undertaken by a registered nurse daily. In cases where approved providers have a higher-than-average proportion of high-needs residents, they are required to engage additional staff and meet a higher minimum number of minutes.
The mandatory minutes have kicked in after a parallel requirement for all residential aged care homes to have a registered nurse on duty 24/7 took force on 1 July 2023.
Earlier this year, the Department of Health and Aged Care released a guide that explains in more detail the two requirements – including definitions, activities, targets, reporting, and quality assurance.
Using virtual reality to train staff and digital strategy update
Aged care workers, carers and members of the public can experience what it is like to live with dementia thanks to a virtual reality tool from Dementia Australia.
The peak body has been promoting its Educational Dementia Immersive Experience (EDIE), which entails a three-hour immersive training workshop designed to give people an understanding and greater empathy for their patients.
The workshops take place onsite and are based on the life experiences of 20 people living with dementia. Aged care workers told ABC News that when wearing the VR headset, they see patterns start moving, they cannot differentiate between a table and a floor, or see a light switch. The heartbeat and breathing of the character they are inhabiting also starts racing when shadows flicker and they hear loud noises.
They then get to experience the same scenario in a more dementia friendly environment, with clutter and decorative patterns removed, and contrasting colours and written labels added to the space.
Dementia Australia says that the workshops better equip staff to develop support plans for people living with dementia.
Also in the technology space, the health department recently hosted a webinar providing updates on its digital transformation strategy for the aged care sector.
In addition, Aged Care Research and Industry Innovation Australia (ARIIA) is surveying users on its technology and aged care knowledge hub, to understand how it’s being accessed and valued.
Pets in aged care
Facility owners are coming under renewed pressure to allow pets, amid reports that some people are opting to stay at home to the risk of their health than be separated from their furry friends.
According to the Companion Animal Network Australia (CANA), only one in five aged care homes in Australia will consider allowing pets, despite 86 per cent of people with pets in aged care experiencing improved mental and physical health.
Many of the homes that do allow pets, however, carry out case-by-case assessments that are often denied due to any benefits from companionship being outweighed by concerns around hygiene, trip hazards, frailty of residents and risks to staff.
Some facilities offer animal therapy programs, or allow their residents shared access to re-homed pets adopted by the facility. Others allow family members to bring in pets when visiting.
It’s a complicated issue and is likely to become more of a problem because of our ageing population, as more people move into aged care homes in the future.
CANA, which works with aged care homes to come up with policies and procedures to allow pets in home, conducted a survey earlier this year and found that one of the main reasons for the refusal of pets was the facility owner’s lack of education on the benefits that pets can bring residents. Other reasons included a lack of funding for design changes to accommodate pets, or a shortage of employees or volunteers to support pet programs.
The treatment of pets will be outlined in the agreement that residents enter when they decide to move into a nursing home or a retirement village. These agreements can be a very detailed contract, which is why it is important for a lawyer to review them.
Volunteers in Aged Care Survey
In September the Department of Health and Aged Care released the results of its Volunteer in Aged Care survey.
It found that more needs to be done to meet the needs of aged care through volunteers and volunteer managers.
“While volunteers are altruistically motivated, many do not feel supported, valued or recognised for their volunteering work,” the department said.
Providers said they are having trouble keeping existing volunteers or recruiting new ones, leading to a decline in volunteering numbers despite how essential they are to facilities.
While 75 per cent of surveyed volunteers felt “extremely valued or very valued by the service they volunteered for,” 21 per cent said they had never received formal recognition of their efforts and 25 per cent felt “only somewhat, slightly or not at all valued.”
The survey ran from April to May 2023, and had nearly 1,600 responses. It asked questions about recruitment, training, time pressures, barriers and support. The results will help the government come up with strategies for aged care volunteer programs and the managers that oversee them.
Respondent volunteers cited the need for more recruitment and awareness campaigns, with more support for diverse volunteers and the sharing of stories to attract younger people. They asked for more hands-on learning, shorter online training programs, and greater support from supervisors and organisations.
Food nutrition
The Australian Minister for Aged Care has teamed up with the Maggie Beer Foundation to fund a program providing free education and training for aged care workers on nutrition and ways to improve the food experience in aged care.
The program includes online learning modules, short courses by chef trainers and access to food satisfaction questionnaires that you can send out to your staff, residents and their families.
“Food is nutrition not just for the body, but also for the soul. It fires our appetite for life, no matter what age,” Anika Wells MP, Minister for Aged Care, said on 21 September.
Click here to find out more about the program.
The government’s push for better nutrition and food choices in homes comes after the 2021 Royal Commission identified it as an area for urgent review. The commission also called for measures to increase transparency and accountability for the food provided in homes.
The government has put together useful fact sheets for aged care residents that set out the minimum standards that apply to their food and their dining experience. You can find them here and here.
Attwood Marshall Lawyers – helping people at every stage of life
With in-depth knowledge of the aged care sector, we are one of the few law firms boasting not one, but two Accredited Aged Care Professionals.
At Attwood Marshall Lawyers, we are deeply committed to the aged care sector and vigilantly track and assess the evolving changes that impact both aged care providers and the individuals they care for.
Transitioning to aged care involves complex financial and legal considerations, such as a comprehensive review of service agreements and the individual’s estate plan.
We want to guide clients through the complexities of the aged care sector, offering insights into the many options available and tapping the resources of our other specialist departments that can help with any overlapping matters that arise.
To explore your options, please contact our Aged Care and Wills and Estates Department Manager, Donna Tolley, on direct line 07 5506 8241, email dtolley@attwoodmarshall.com.au or free call 1800 621 071.
