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Poor access to aged care in regional areas doesn’t add up


There should be more aged care services in regional, rural and remote Australia purely because there is a greater proportion of older people in these areas, the royal commission has heard this week.

This week’s hearing of the Royal Commission into Aged Care Quality and Safety is looking at aged care service access and delivery in rural and regional areas with a particular focus on the Mudgee region, 260 kilometres northwest of Sydney.

Senior Counsel Assisting Peter Gray said it was known that rural and remote settings posed transport and other challenges for aged care delivery due to widespread dispersion of populations, geographical isolation and insufficient people and scale for many support services to be viable.

Peter Gray

“Equity of access to quality aged care for Australians who live outside the cities is a matter of simple fairness,” Mr Gray said in his opening address.

Mr Gray said there should be better access to aged care services in regional, rural and remote areas as there is a greater need because of the proportion of older people in these areas.

“The principle of equity of access according to need should mean that rural populations receive better access to aged care on a per capita basis than the national average. That is because the need in rural Australia is greater,” he told Commissioners Tony Pagone and Lynelle Briggs.

Mr Gray used Mudgee as an example, which has higher percentages of people over the ages of 65 and 85 than the national average.

“2.4 per cent of jobs in the town are in aged care, higher than the national 2 per cent,” he said.

Nurse reports feeling insignificant, unheard in mother’s care

Monday’s hearing of the royal commission heard a direct witness account from registered nurse Ruth Hamilton about her experience with her mother living in aged care in a regional area.

Ms Hamilton’s mother, who began using a gastronomy tube for feeding after the brain tumour was removed in 1991, entered residential aged care in 2012.

Ms Hamilton said at the beginning she was happy overall with her mother’s care, but there were issues with the gastronomy tube because staff didn’t know how to use it.

“Mum has a gastrostomy tube, which the beginning or the end of 2018 had [been] changed and what was happening with the staff when they were feeding mum, unfortunately, it was getting broken,” Ms Hamilton told the inquiry.

She spoke to the manager, who told her that the staff were new, but were being trained in using gastronomy tubes. The manager suggested Ms Hamilton provide training to staff about using the tube to ensure it did not break.

Ms Hamilton said she was prepared to provide training, however “I didn’t want anyone to do it until I had… supervised them.”

Staff at the facility were later involved in a training session, which didn’t involve Ms Hamilton. A few days after the training session, her mother’s tube had been changed. Ms Hamilton was not informed about it until her mother told her.

Ms Hamilton said she told the team leader that evening she wasn’t happy and called the CEO the following day to ask why she wasn’t contacted and to reiterate her concerns about it being done without her.

“I said, ‘you knew that I didn’t want it done until I had supervised someone doing it’ and she said to me, ‘what is your problem? Nothing happened, nothing went wrong and your mother wasn’t hurt’,” she said.

She said the CEO told her “you’re nothing but a bully and no one wants to look after your mother because of you.”

Ms Hamilton said she felt she wasn’t able to do anything after that. She said she felt “insignificant” and that her “concerns weren’t listened to and they didn’t mean anything.”

It is difficult having a clinical background and being the daughter of someone receiving aged care services, she said.

“[B]eing a nurse I have certain expectations and they’re probably more than what people can provide there, so it is hard,” Ms Hamilton said.

The Royal Commission into Aged Care Quality and Safety Mudgee hearing wraps up on Wednesday. The next hearing takes place 11-15 November in Sandy Bay, Tasmania, and will focus on the operations of selected approved providers.

To stay up to date on the latest about the Royal Commission into Aged Care and Quality go to our special coverage. 

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