The growth in the volume and acuity of respite cases in residential aged care is proving challenging for services and has become an area of increased focus for the Aged Care Complaints Scheme, the head of the scheme has told providers.
In a number of recent cases providers had failed to understand or manage the complexity of respite care recipients and this had contributed to adverse outcomes, Bernadette Walker, manager of the scheme within the Department of Social Services, told the Leading Age Services Australia National Congress on Tuesday.
The number of respite admissions to residential aged care increased from 56,000 to 64,000 between 2008-09 and 2012-13, representing a 13 per cent rise. This meant most residential aged care services were likely to see more people receiving respite care, Ms Walker said.
While respite was previously more common for low level care that is no longer the case, with 50 per cent of respite recipients now requiring high level care.
“We all know that from a legislative perspective you have the same duty of care to all your care recipients but we are finding that respite is particularly challenging,” she said.
There were several key challenges with providing respite care, she said.
The care recipient is transitory not permanent; services might question how much effort they put in to assessing the needs of someone who will be with them for a short time, she said.
The care recipient’s regular doctor may not be linked to the aged care facility, or any aged care service. Similarly, staff, the care recipient and their family do not know each other, and Ms Walker said she wondered whether the short-term nature of the stay meant less effort was made in forming relationships.
Compounding this was the fact respite care recipients were becoming more complex and likely to have evolving needs. “Increasing numbers of respite care recipients with increasingly complex needs create a set of circumstances that can create the perfect storm.”
The complaints scheme had taken a sample of 30 complaints involving respite care recipients and identified a number of common factors, including:
- gaps in communication with carer or nominated GP
- issues with developing comprehensive care plan, and
- gaps in record keeping.
Ms Walker noted that the Aged Care Commissioner had recently discussed “the power of an apology” coupled with a positive approach to complaints. “[The commissioner] noted that what appears to be missing in some cases of complaints handling is evidence of acknowledgment and apology… where it has been established that there have been failings in care an apology is important to an individual as receiving an explanation of what occurred.”
The commissioner pointed out a good apology was not an admission of liability, Ms Walker noted.
Ms Walker said that the scheme’s data showed that the average respite recipient received on average 1.4 episodes of respite and the average stay was around 23 days. “The idea that people have multiple and frequent admission to residential respite is not necessarily accurate, there may be some instances but on the whole that is not that case.”
Around half of those who use respite go on to enter permanent care, which is a change from its original intention, she noted.