Report addresses lack of allied health care

The federal government is being called upon to amend the Quality of Care Principles to support equal access to allied health services.

The recommendation features in a policy brief published by the Deeble Institute for Health Policy Research, such an amendment would, say the authors, “minimise service disruption and support equitable access to allied health services.”

Under the Quality of Care Principles – which sit within the Aged Care Act – lay the Aged Care Quality Standards which require residential aged care facilities to provide care recipients with allied health services such as recreational therapy, speech therapy, occupational therapy, physiotherapy, and podiatry.

However, as the authors of the Deeble Institute policy brief state: “This does not guarantee residents receive allied health services and the restorative and wellbeing care they provide.”

As the document – Restorative and wellbeing care in Australian residential aged care facilities – points out, providers are unable to claim subsidies for allied health services under the Australian National Aged Care Classification funding model nor under the Medicare Benefits Schedule. “This creates additional barriers to affordable restorative and wellbeing care.”

As a result, allied health services in residential aged care are underfunded and underprovided and, say the document’s authors, “hampered by the high turnover and third-party contract-employed nature of the workforce.”

Lead author of the policy brief Isabelle Meulenbroeks told Australian Ageing Agenda that – with limited access to allied health professionals – general care staff are left to provide restorative and wellbeing care. “Some care staff may take it upon themselves to perform allied health service activities, creating additional stress on very busy and care burdened care staff, or the allied health care may get missed altogether,” she said.

Unlike direct care, there are no mandatory care minutes for the provision of restorative and wellbeing care in aged care homes.

“Minimum standards of allied health service delivery should be amended to quantifiable outputs,” say the policy brief authors. “Quantifiable minimum allied health service requirements should necessitate all Australian residential aged care facilities to demonstrate weekly lifestyle and leisure activity above zero hours per resident per day.”

The authors are also recommending that existing allied health service funding for aged care residents be consolidated under AN-ACC.  “In the future I’d like to see a simplified system where allied health funding is collapsed under the AN-ACC and there is greater investment in multidisciplinary practice in residential aged care. After all, multidisciplinary practice is considered the gold standard in other health care settings, why not residential aged care?” said Ms Meulenbroeks.  

Allied health professionals are champions of restorative care

As well, the authors of the policy brief want the government to “clarify which allied health services” should be provided by an aged care home “and how much care facilities are obliged to consistently subsidise.”

“Allied health professionals are champions of restorative and wellbeing care in residential aged care facilities as they support people to maintain function and quality of life,” said Ms Meulenbroeks. “There are, however, system and funding barriers that prevent allied health care professionals from being more involved in aged care centres and thus enabling better outcomes for residential aged care residents.” 

Funding should be allocated to provide a variety of evidence-based allied health care, say the authors, including, but not limited to:

• dieticians
• oral health practitioners
• mental health practitioners
• speech pathologists
• exercise physiologists
• podiatrists
• physiotherapists
• occupational therapists
• music therapists
• art therapists.

“Greater investment is required to ensure residential aged care residents can access evidence-based quantities and a range of allied health services which support function and quality of life,” say the authors.

Other recommendations in the 49-page document call for:

• residential aged care facilities to provide a high-intensity short-term restorative care program for residents’ post-acute care
• the resourcing, trialling, and evaluation of partnerships between allied health professionals and providers
• trialling workforce employment strategies to improve multidisciplinary care
• analysing allied health service and resident outcome data to inform evidence-based delivery of allied health services in residential aged care
• the collection and reporting of data on all allied health services in residential aged care.

“Transparent reporting of allied health service availability and quantity in residential aged care settings is important to ensure that consumers can choose a facility which meets their restorative and wellbeing needs,” said Ms Meulenbroeks.

“To date, a lot of the conversation is about care minutes but, ultimately, we want a system that improves consumer wellbeing and restoration, not just activity. To achieve this, we need to focus on harnessing the improved data collection in the residential care sector so that we can design evidence-based models of allied health service delivery that support resident restoration and wellbeing.” 

If the recommendations contained in the policy brief are acted upon, the authors say it will significantly address the “underservicing” of allied health care in Australia’s residential care homes.    

“Improving allied health input in residential aged care, including their ability to work closely with other health professionals such as nursing staff, will improve the restorative and wellbeing care people receive,” said Ms Meulenbroeks. “Residential aged care residents need to consistently participate in allied health care activities to achieve the benefits associated with these services.”

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