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By Sophie Cuttriss
WHEN I was teaching aged care, I took my students to visit an aged care facility operated by Dutchcare. The facility's manager was very happy for us to visit because they were proud of their facility and their staff and the wellbeing of all their residents.
My students were fascinated to see the comfortable practical rooms that felt like home, not a luxury hotel or hospital, and person-centred care based on the Eden Alternative Principles which acknowledge and address the three plagues of residential aged care: loneliness, boredom and helplessness.
WHEN I was teaching aged care, I took my students to visit an aged care facility operated by Dutchcare. The facility's manager was very happy for us to visit because they were proud of their facility and their staff and the wellbeing of all their residents.
My students were fascinated to see the comfortable practical rooms that felt like home, not a luxury hotel or hospital, and person-centred care based on the Eden Alternative Principles which acknowledge and address the three plagues of residential aged care: loneliness, boredom and helplessness.
They had small dining rooms and kitchens for small groups of residents, home-cooked, high quality meals, a dog who lived there (and had its own care plan), a family-friendly workplace for staff and a big dementia-friendly garden.
The facility was more home-like than any I have seen and proved that great aged care is possible.
There are wonderful examples of building design that support home-like care in The Netherlands, Denmark and Germany – we don’t have to reinvent any wheels.
The facility was more home-like than any I have seen and proved that great aged care is possible.
There are wonderful examples of building design that support home-like care in The Netherlands, Denmark and Germany – we don’t have to reinvent any wheels.
Yet many aged care facilities in Victoria are large, institutionalised rabbit warrens that do not resemble anyone’s home. Gardens are tiny and poor quality – it drives me crazy when a facility is called “Twilight Gardens” and the garden is little more than a tiny paved courtyard.
Dining rooms are sometimes huge noisy Coles cafeterias where music is played or the television is on (sometimes both), often with no regard to the preferences of the demographics of the people who live there.
Dining rooms are sometimes huge noisy Coles cafeterias where music is played or the television is on (sometimes both), often with no regard to the preferences of the demographics of the people who live there.
The burden of care
Aug 13, 2020 - Despite the rosy ads, something has gone amiss in Australia’s aged care system. writes Sophie Cuttriss in the first part of her series.
Aug 13, 2020 - Despite the rosy ads, something has gone amiss in Australia’s aged care system. writes Sophie Cuttriss in the first part of her series.
Aged care is one of the most important purchases you will ever make, and may be the second most expensive after a home, so don’t rush into it.
When people visit an aged care facility to enquire about accommodation, they are usually in a state of stress, tying to find care for a loved older person who can no longer live at home. Families may feel very guilty about this decision. Often they feel they are breaking a promise to their loved one.
Very few people approach aged care in the same way they would make other major purchases. Most leave it till the last moment, when they are faced with limited options and will accept whatever is available.
Families will often be stressed and overwhelmed and may focus on cost and urgency. They will be easily persuaded by the manager/ salesperson who gives them the guided tour.
Few people seeking residential accommodation have any previous experience or knowledge of the sector. People are often swayed by superficial designs such as a luxury foyer, chandeliers and extras such as a bar, café, cinema. I’m not saying these aren’t welcome, but beware – often all that glitters is not gold.
The following is a guideline to what you should be asking and looking for.
When people visit an aged care facility to enquire about accommodation, they are usually in a state of stress, tying to find care for a loved older person who can no longer live at home. Families may feel very guilty about this decision. Often they feel they are breaking a promise to their loved one.
Very few people approach aged care in the same way they would make other major purchases. Most leave it till the last moment, when they are faced with limited options and will accept whatever is available.
Families will often be stressed and overwhelmed and may focus on cost and urgency. They will be easily persuaded by the manager/ salesperson who gives them the guided tour.
Few people seeking residential accommodation have any previous experience or knowledge of the sector. People are often swayed by superficial designs such as a luxury foyer, chandeliers and extras such as a bar, café, cinema. I’m not saying these aren’t welcome, but beware – often all that glitters is not gold.
The following is a guideline to what you should be asking and looking for.
- What are the staff ratios? How many registered nurses per shift? Does the doctor have geriatric training? Where did the Certificate 111 staff do their training? Where does the food come from? Is there a dementia friendly garden that can be accessed by the person with dementia whenever they wish?
- Can family and friends visit any time that suits the resident’s routine? Can they share meals with them, bring in the dog, take them out for a walk/drive/visit?
- Do they practise the Eden principles as these are intended or is there merely a token gesture such as a bird in a cage?
- Can residents access other health professionals such as a dietitian, speech pathologist (crucial when there are difficulties with swallowing and eating), occupational therapist, physiotherapist, diversional therapist?
- Are there meaningful activities available for all residents including people at various stages of dementia?
- Are extra trained staff employed during late afternoon/early evening so people who are sundowning can be given purposeful activities and distractions?
- Have staff completed extra current dementia training with reputable educators?
- Can they access support and expertise from Dementia Australia and Dementia Support Australia for (formerly Dementia Behaviour Management Advisory Service)?
- What are the organisation’s philosophies regarding sexuality and intimacy needs? Yes, this always goes down like a bomb!! And the topic deserves its own article one day.
- If the facility is a secure lock up, does it have subtle security measures or does it feel like a prison?
- Do they understand and uphold advance care planning and enduring powers of attorney and guardianship?
- What care is provided when someone is at the end of their life? Are the family able to stay with their loved one who is dying? Do they have enough staff on every shift who are authorised to administer the appropriate medication for all symptom relief? Or will they die in pain and discomfort, as reported by one of my students, who watched a screaming resident and was told “We’ve done everything we can”.
Next issue: We need to be more honest and courageous sooner about the realities of ageing and the inevitability and normality of death, writes Sophie Cuttriss in the final part of her series on aged care. Sophie has had a nursing career of more than 40 years, including many years working in aged care. She worked as an aged care educator at Chisholm Institute’s Bass Coast campus for 10 years.
Comments are closed.
Several of us are planning to form our own mini care home. Would that work?
I worked in Aged Care in the late 1980s when they took registered Nurses out of the system. As a weekend Supervisor for another 12 months I was horrified at the downturn in care and spent all my weekends trying to get essential medical Care to people who had been neglected during the week. I also had worked in Palliative Care for many years and am pleased to see that you have highlighted the need for specialized end of life care. Our current system is badly broken and needs immediate attention. Thank you
Speaking personally as a now senior citizen, the prospect of moving into aged care as a result of declining independence simply terrifies me.
The beautifully scripted and illustrated advertisements for some of the privately operated for profit aged care establishments look too good to be true, and the impact of pandemic on aged care generally in this country suggests that the advertising is optimistic to the point of being downright misleading.
Overall, the pandemic came quickly, unexpectedly and with drastic consequences. In this country, so far we have got off very lightly compared to many other nations. Our often harangued state and territory leaders are to be applauded for guiding us through this catastrophe so effectively.
Yet the federally controlled aged care sector has not coped nearly so well. Despite countless royal commissions, hugely expensive investigations and expert reports the kindest comment one can make is that the aged care industry was utterly unprepared, underfunded and understaffed for any crisis, let alone a pandemic. Yet, if you’ll pardon the pun, our PM has largely deflected attention from his own governments incompetence and got off Scott-free.
Sophie’s article clearly demonstrates that aged care can and should be done well, rather than merely profitably for the canny investor/party donor.