The Coalition has announced it will provide $7.5 million for the establishment of specialist care units to care for people living with dementia and very severe behaviours.
The funding comes in response to calls from experts and providers for such units, ever since the controversial dementia supplement in aged care was axed in June 2014 and the subsequent debate about care for those with severe behaviours.
On Thursday, Minister for Aged Care Sussan Ley told the HammondCare International Dementia Conference that in addition to the care units funding, a re-elected Coalition government would also provide $3.9 million to support the development of dementia-friendly communities.
Speaking after the minister, Stephen Judd, chief executive of HammondCare, welcomed the announcement and said that special care units were needed to care for residents with very severe behaviours as they had a “disproportionate impact on their surroundings” that made it unsafe for them to be in normal aged care environments.
While the Severe Behaviour Response Teams (SBRTs) and the Dementia Behaviour Management Advisory Service were providing a range of expert clinical support and case management, special care units were needed to provide additional specialist support, said Dr Judd.
They were the “missing link” in the system of dementia care, he said.
After a year, on average, such residents would be able to move to less intensive dementia-specific care environments, he said.
SBRTs providing ‘valuable data’
Elsewhere, Dr Judd told the conference that the SBRTs, which HammondCare was the lead provider of, had been in operation for eight months and were already providing valuable data that showed the two most common triggers for behaviours referred to the program were unidentified pain and inappropriate environments.
Over time that data would provide a clearer idea of how many severe behaviours were related to the underlying dementia and how many were related to pain or the person’s inability to communicate, he added.
More broadly, Dr Judd called for epidemiological research to provide accurate statistics of how many Australians were living with dementia, noting that current figures were “estimates largely based on old data extrapolated from other countries.”
Focus on compliance has led to ‘institutions’
Elsewhere, Dr Judd said that while the introduction of the accreditation standards had led to improvements in clinical care, a downside was a preoccupation among providers on regulatory compliance, which too often led to facilities being run as “highly disciplined institutions.”
This focus on systems and compliance drove a demand for economies of scale. Despite the evidence supporting smaller, more domestic aged care facilities – which had emerged in the 1980s and 1990s and positively changed how care was delivered – there had been a marked trend towards bigger facilities in recent years.
“The average size of the individual Australian residential aged care service has grown by 60 per cent between 1996 and 2015 – from 46 residents to 72,” he said.
“But as nursing homes get bigger and bigger, it becomes harder not to have institutional buildings which are less homelike and more regimented… Today, the public areas of some aged care ‘facilities’ look more like airport lounges than lounge rooms,” Dr Judd said.
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