New Act needs a ‘rulebook’

The new aged care Act must include a rulebook that explains the scope of practice and ensures that older people get the same rights as others, Professor Joe Ibrahim told an industry conference. 

Professor Ibrahim, who is head of Monash University’s Health Law and Ageing Research Unit, appeared on a “Senior Wisdom Council” panel at the ACSA National Summit in Canberra on Tuesday. The discussion included the new aged care Act, its rights-based approach and the relationship between health and aged care.

“I think first thing is that we’d all agree we need some sort of rulebook that tells us what the scope of practice is and what’s meant to happen,” Professor Ibrahim told delegates. 

“The royal commission talked about rights-based but it didn’t talk about an actual human rights-based Act and so I make a distinction between the two.  A human rights Act would have had the resident front and centre of every decision and every action and that’s not the case with the royal commission’s approach,” he said.

“They’ve given the government of the day a great deal of scope to simply reinforce that older people have the same rights as every other citizen. And one of the things that’s been missed is that older people – particularly those in residential care – do not have the same rights as others in the community,” Professor Ibrahim said. “The new Act ought to rectify that, but it doesn’t bring us to a human rights basis where the person’s quality of life, decision-making and choices are respected.”

Professor Ibrahim said the idea of a free market basis had to go because it has failed, adding that some people prefer to die than to go into aged care. “It’s an indictment on the system. We fail to recognise that a highly functioning aged care system has enormous benefits to the community in the same way a highly functioning childcare or school system brings enormous value to society, whether you do or don’t have children. We’re missing the value of having a good aged care system for everyone else. It’s not just for the older person,” he said.

On market forces, fellow panellist Maureen Lyster said many people in their 80s and 90s did not want to go to residential aged care due to negative stories. “They’re going to do something else even if it is to sit at home and die. They’re just not going to come. They’ll refuse,” said Ms Lyster, a former aged care CEO.

‘Employ the best’

Elsewhere Ms Lyster stressed the importance for providers to focus on workforce planning, training and employing the best staff. “Make sure that you’re employing the best care manager you can. Get one who’s clever enough to work out how to backfill places so that existing staff can go and do training,” she said.

“Employ the best services and finance manager you can so that every income stream that comes into your facility is maximised and that the money you’re spending on food, laundry,  general refurbishment and services is open, transparent and accountable to your residents, firstly, to your community and to the government,” Ms Lyster told delegates.

“That transparency and accountability is going to mean that when you negotiate with the government on the royal commission recommendations, you’re going to have to be resilient and you’re going to have to give weight on a few things. Because without that transparency and accountability, the reputation of the industry is going to suffer further and you can’t afford that,’ she said.

More than clinical care needed

Aboriginal Community Services CEO Graham Aitken told delegates that residential care needed to be able to do “everything” for residents, not just clinical care. 

“When our [facility] had COVID one of the biggest things that the old people were looking for was our residential services manager, an RN, putting a fire on the ground and cooking kangaroo tail when they were getting better and recuperating from COVID. So our staff, nurses, they do everything and they are so important and they do such a good job.”

Mr Aitken – who spoke to Australian Ageing Agenda in the lead up to the conference about a lack of adequate service provision for older Aboriginal people in regional South Australia – said it’s also important for aged care residents to stay connected to community.

“They need to go out into the community. They need to go onto country especially in remote locations to get out into the bush, into places where they used to go all their lives and these types of things. It’s not just about the clinical care. It’s about everything else, including connection to community, connections with family,” he said. “And food is also a really big part of what keeps the older people happy.”

Main image: The “Senior Wisdom Panel” at the 2022 ACSA National Summit (from left) Maureen Lyster, Peter Mares, Graham Aitken and Professor Joseph Ibrahim

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