Older people receiving aged care are feeling dismissed or ignored and not listened to, according to a new report from the national advocacy peak.
Published by the Older Person’s Advocacy Network – and analysing data from OPAN members based on their experiences dealing with almost 40,000 advocacy cases during 2022-23 – the report highlights communication issues as a key complaint among older people receiving home and residential aged care services.
According to the report, one of the most common concerns observed by advocates working in aged care homes has been residents and their families or others “communicating a care need and not having this heard or actioned.”
Some older people, say the report’s authors, “feel no longer listened to.” In some cases, requests have been heard “but have not been communicated with frontline staff.”
“To improve communication, we must ask older people what they want and actively listen to what they have to say,” said OPAN chief executive officer Craig Gear.
Speaking to Australian Ageing Agenda, Mr Gear added: “It’s equally important to come back to them with proposed actions or solutions, to tell them what you intend to do to resolve a specific issue or concern.”
OPAN’s report cites instances where communication has been poor following a fall or hospital admission. “These types of cases typically involved the provider not communicating important details with families or representatives in a timely manner,” say the report’s authors.
Poor communication can cause “frustration and anger” for the resident and their families, they add, “and can lead to a breakdown of the relationship with the provider.”
This in turn, say the report’s authors, “can impact the older person’s care, and their ability to feel safe and cared for in their residential aged care home.”
As well as a feeling of not being listened to, feedback from advocates suggests that aged care residents and family members are often hesitant about raising concerns and are fearful of retribution.
As the report’s authors note: “An older person living in residential aged care reported staff had ignored call bells and told them to shut up when they called out for assistance.”
Turning to home care, according to the report: “Advocates were involved in numerous cases where an older person had concerns and made multiple attempts to address these concerns with their provider with no success.”
Clients reported having difficulty reaching their home care providers by phone, say the authors. “Older people report leaving a message, but these are often not acknowledged or returned.”
“Particularly troubling in this report are the number of calls that went unanswered,” said Mr Gear. “Having your call returned is a fundamental human right.”
Other issues include providers:
- failing to contact the client when there has been a change to their service time or scheduled worker
- listening or responding to the client’s expressed needs
- following through on actions they had agreed to with the client
- communicating or consulting the client on changes to their care plan in a clear and transparent manner.
The report’s authors blame staff shortages across the sector for the communication issues. “OPAN members have reported some providers have said they are struggling to retain the administrative and rostering staff who would typically communicate changes with the older person.”
Lack of choice and control
The 81-page report – Presenting Issues – also identifies a lack of choice and control as a top issue for older people in home and residential aged care settings.
In many cases, aged care residents were unhappy that they “were simply not consulted or included in decisions relating to their care,” say the report’s authors.” They add: “It’s important that residential aged care providers understand that exercising choice and control allows older people the opportunity to live the life they choose.”
Home care clients also reported being unhappy with their provider but having no alternative options available to them.
“One OPAN member reported a provider was advising their clients that if they were not happy with the fee increases, then they could find another provider,” say the report’s authors.
The lack of choice is most apparent in rural and remote locations and in circumstances where the older person is receiving services in high demand.
“It’s important for providers to understand what older people’s priorities are. We need to ask older people who they would like to visit them, for example, or how often they would like to shower – and when,” said Mr Gear. “Older people have the right to make decisions about the care and services they receive and the risks they are willing to take.”
Mr Gear told AAA, OPAN would like to see supported decision-making principles embedded into the new Aged Care Act.
“The Statement of Rights will be the bedrock of any change. It’s imperative for it to be legislated. All of us – older people, advocates, the regulator, providers and families – need to know we can reference these rights and ask for them to be upheld. Most importantly, providers must examine their own policies and procedures culture to see how they can translate that Statement of Rights into their day-to-day experiences and processes.”