A research team from Monash University has made 104 recommendations for preventing deaths in residential aged care, many of which individual services can implement immediately.
Other recommendations including a new program for improving quality of care and safety for residents and staff require government action.
Many of the recommendations, particularly those relating to training and staffing, will require substantial funding to be implemented.
The Recommendations for Prevention of Injury – Related Deaths in Residential Aged Care Services (RACS) report focuses on deaths from and related to choking; medication; physical restraint; resident-to-resident aggression; respite; suicide; and unexplained absences.
The research group headed by Professor Joseph Ibrahim, who is head of the Health Law and Ageing Research Unit at Monash University, reviewed existing international research, examined deaths among aged care residents reported to Australian coroners in the fourteen years from 2000 to 2013, and drew on the knowledge and experience of experts and key stakeholders for each of the seven areas.
They made 104 recommendations aimed at reducing the risk of death in aged care for consideration by government, residential aged care providers and professionals with a mandate or interest in the health and safety of residents.
“Residential aged care services can consider each recommendation and either introduce, change or improve their practices to reduce the risk of resident deaths,” Professor Ibrahim told Australian Ageing Agenda.
“We also proposed another eight recommendations based on our observations that older people in residential aged care services suffer preventable harm and that the relevant workforces in the community, law, health and aged care sector are ill-equipped to address the issue,” he said.
Professor Ibrahim said the underlying cause was systemic factors rather than individuals, and compounded by knowledge gaps to inform evidence-based policy and practice in aged care.
“The lack of academic discourse and absence of leadership for improving quality of care in residential aged care services means the status quo is not being challenged,” he said.
Professor Ibrahim said a program for improving quality of care and safety for residents and staff was needed.
“This program would promote organisational leadership, a respectful, transparent, resident-centred culture and continuous learning, and the use of standardised nationally gathered empirical data.
“Together these elements will provide residents an opportunity to thrive and enjoy their lives,” he said.
Professor Ibrahim said the report didn’t put a cost on providing the training and staffing needed to implement the recommendations because there wasn’t any research showing how much was needed.
“It is up to governments and the community to decide their priorities and to allocate sufficient funding to provide the safety and care needed for older people in residential aged care.”
Government, department response
AAA asked Minister for Aged Care Ken Wyatt about his response to the report and recommendations.
“This report will help to inform the development of guidance material to assist providers to implement the quality aged care standards,” Minister Wyatt said.
Australian Aged Care Quality Agency CEO Nick Ryan said the quality agency noted with interest Professor Ibrahim’s work to better understand and respond to causes of premature death in aged care.
“The report covers some important issues on safety and quality of care for the sector,” he said.
Professor Ibrahim is seeking additional funding to continue the analysis into the deaths in aged care that have occurred since 2013.
The full report is available here (PDF).
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I looked for the term, ‘counselling’ and was glad to read Recommendation 88. While G&L counselors may be available to the broader community, I don’t believe that the aged care sector (residential or community) has sufficiently invested in counseling as an option for both staff, residents and/or family. Suicide, as an event, is relatively rare among older adults and occurs both in a RACF and non-RACF setting. We need to invest resources in both spaces when it comes to suicide. It is not enough to monitor staff or residents in relation to a suicide but to provide ongoing offer of counseling as a real option. It is also important to recognize that counseling is a skill that needs to be validated in its compensation.
I am aggrieved there is little discernible effort to reduce PREVENTABLE deaths from dehydration.
Minister Ken Wyatt was handed a poisoned chalice, with ref to essentially underfunded aged care services… a difficulty compounded by further withdrawal of funding to the aged care sector by the federal treasurer. This is not simply frightening, it is deadly. Thanks for nothing, Australia.