Report highlights issues in aged care

National aged care advocacy group OPAN received almost 28,000 calls from older people and their families and carers in the 12 months until June 2022. What they told the organisation forms the basis of their latest issues report.

The Older Persons Advocacy Network (OPAN) is a national network comprising nine state and territory organisations that have been delivering advocacy, information and education services to older people across Australia for almost 30 years.

OPAN’s National Aged Care Advocacy Program: Presenting Issues Report includes 45 in-depth case studies spanning January–June 2022.

“The case studies documented in this report fall far below what older people, their families and carers, and the wider community would expect,” said OPAN CEO Craig Gear.

“There are harrowing stories of abuse and neglect, multiple instances of financial mismanagement, cancellation of crucial services and calls to service providers that went unanswered.”

In publishing this report, Gear said, OPAN’s intention was not to point the finger of blame, but to hold everybody in the aged care sector to account.

“By shining a light into the darkest reaches of our aged care system — taking a good, hard look — we can identify the areas that still need our attention and work together to address them.

“Sometimes it’s families. Sometimes, it’s the provider. And sometimes, it’s the failure of the guardianship system,” Gear said.

Five key themes emerged from the most frequently raised issues in the report:

• Workforce shortages, due to COVID-19-related issues such as illness and immigration restrictions and changes to the Social, Community, Home Care and Disability Services Award (SCHADS), have had a severe impact on older people at home and in residential care.
• Poor quality care is still a major problem. Wide-ranging concerns presenting in residential care include reports of substandard and neglectful care, restrictive practices, inadequate food and nutrition, and care plans not being adhered to.
• Fees and charges are an ongoing area of concern for older people. OPAN’s new team of financial advocacy officers have played a key role in resolving many of these issues.
• A lack of communication and transparency between service providers and those receiving aged care.
• An emerging issue in this period is the number of troubling incidents of the inappropriate use of guardianship and attorney powers.

Accessing Aged Care

When considering access to care, advocates noted that there are significant waiting periods for assessment by the Aged Care Assessment Team (ACAT) and that many individuals felt the process caused significant anxiety as they worried they had been overlooked.

Delayed access to Home Care Packages, with wait times sometimes as long as 12–18 months, has meant more older people have been relying on the Commonwealth Home Support Program (CHSP). A sample of quantitative data from OPAN Member reports indicates that 41% of advocacy cases for CHSP relate to service access.

Across the nation, OPAN Members reported that CHSP service supply is not meeting demand. Providers have also suggested that staff wages remain a key influencing factor and have noted that NDIS support workers are paid considerably more than aged care workers and this can make it challenging for the aged care sector to attract and retain staff.

Across the reporting period, OPAN Members started to observe an increase in calls and cases relating to CHSP fees. A sample of quantitative data from OPAN Members indicated 13% of CHSP advocacy cases related to fees. Some of the cases related to provider invoices for CHSP being unclear and confusing. There were also some reports of it being difficult for consumers to find information on CHSP fees, including information on financial hardship and the lack of a fee comparison tool for CHSP services on the My Aged Care website.

In several cases, clients had allocated funds available to spend in their Home Care Packages but could not get approval to purchase items that had been specifically recommended because they didn’t appear as an included item in the Home Care Package Operations Manual.

Quality of residential care

Residential care also presented challenges for the aged community, especially when navigating the fluctuating COVID-19 restrictions. Facilities were responsible for implementing their own COVID-19 plan, but many advocates felt that the regulations often did not reflect those imposed on the wider community or were not communicated clearly.

Quality of care concerns were prevalent in residential care with 47% of cases concerning this issue. There were stories of residents sustaining injuries that were not adequately addressed, sexual assault allegations, poor hygiene standards and residents’ requests being ignored.

Diverse and marginalised groups

Advocacy issues raised amongst diverse and marginalised groups were often similar to those presented in other sections of the report; however, many of the cases involved added layers of complexity associated with language, cultural factors, family and community dynamics and/or elements of social disadvantage.

Abuse of older people

Abuse of older people was evaluated within the report as OPAN Member organisations supported over 700 people between January and July 2022. Financial abuse presented as the most common type of abuse, but was often seen alongside instances of verbal, social and emotional abuse. Advocates were able to assist clients to access appropriate guidance and legal advice where necessary.

Recommendations

Overall, the report includes 15 key recommendations to address the issues raised. These include, but are not limited to, addressing workforce shortages, reforming fees and charges, improving access to care and related services, provision for Aboriginal and Torres Strait Islander people to return to Country and developing an education system for older people and aged care providers to understand the attorney role in more detail.

“Older people’s human rights are being impacted and we need to collectively do better in aged care, in the legal sector and in the community.

“OPAN will work collaboratively with all levels of government and their agencies to better protect older people,” Gear concluded.

To access the full report, visit this link: https://bit.ly/3gqJNVG.

Image credit: iStockphoto.com/izusek