The gift of dignity 

16 December 2021

By ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM.

This Christmas season is a time to finally give our elderly a truly special gift - the dignity they deserve.

This Christmas, nurses and personal care assistants will try and make Christmas a special time for the residents in their care. They will decorate the facility, wear tinsel in their hair, put the carols on and give small gifts to try to make residents and family members feel as special as they should be at this important time of year.  

I know this because I have worked both as a personal care assistant and as a registered nurse in Residential Aged Care.

Sadly, the one gift that both residents and the nursing workforce both desperately need is not arriving. That is a guarantee of quality care. 

For many nurses and personal care assistants, Christmas Day will be another day they work themselves ragged trying to provide dignified care. Many of them will leave their shifts feeling a sense of despair, knowing that despite their best efforts, they were unable to deliver on their professional and moral commitment to the residents they serve. 

Again, I know this not just by my own experience, but by listening to our members who suffer with this tragedy every single day. 

For many frail Australians, Christmas Day will be another day in a system that has failed them.

The Royal Commission into Aged Care Quality and Safety found two-thirds of nursing home residents are malnourished or at risk of malnourishment, with as little as $6 a day spent on average on food for each aged care resident, to cover the cost of three meals and snacks. As has been publicly exposed, this is happening at the same time as some of the more unscrupulous providers enjoy a lifestyle of excess. Profits should not be put before people. 

Inexplicably the Morrison Government still refuses to implement many of the Royal Commission recommendations, including the need for financial transparency – to ensure that the $21 billion of tax dollars invested in aged care annually is spent on care. 

Despite being trapped in a system that fails to care, those who work in or connect with aged care, care deeply. I have heard countless stories of nursing and personal care staff reduced to tears of frustration at not being able to provide the level of care they want to. Frustrated by a system and successive governments which refuse to provide the resources and funding needed to fix this.

Having met just recently with members working in Residential Aged Care and with my colleagues at the federal level, I know these experiences are occurring every day across our state and across our nation. 

Members are overworked, overwhelmed and undervalued. It is little wonder that the aged care sector is chronically short-staffed. And it will get worse, much worse, if serious action is not taken.

Estimates regarding the number of Australians currently living with dementia range from 386,200 to 472,000. Under the Australian Institute of Health and Welfare’s estimate of 386,200, this figure is expected to more than double to 849,300 by 2058 given our rapidly ageing population.

The anticipated impact on aged care is simply too frightening to comprehend, particularly in light of a report that Australia is facing a shortage of at least 110,000 direct aged-care workers within the next decade - ballooning out to 400,000 workers short by 2050 - unless urgent action is taken to retain and attract staff.

This problem also affects our acute hospital system. There are many occasions where residents are transferred to hospital because their care needs are not and cannot be met in the residential aged care facility that they call their home or in the community. 

Also, elderly Australians are often unable to return to their homes once their acute phase has ended, again for the same reason - a lack of resourcing including inadequate staffing and skills mix.

This situation will only worsen with the recent announcement by the State Government demanding that RACF retain residents diagnosed with COVID. It is a terrifying prospect given the current staffing levels and what we have seen in Victoria with more than 355 deaths in private RACFs but no deaths in public RACFs, where staffing levels and mix were significantly better. 

These are the many reasons why the Australian Nursing and Midwifery Federation is urgently calling for action on four key fronts:

  1. Registered nurses 24/7 – at least one registered nurse on site at all times
  2. Mandated staffing ratios and the right skills mix (including RN, EN and PCA numbers)
  3. Greater transparency of funding tied to care
  4. Improved wages and conditions.

I hasten to emphasise that adequate numbers of Personal Care Assistants, Enrolled Nurses and Registered Nurses are absolutely essential to achieving a solution to this problem.

Many politicians have pledged their support for our Fix Aged Care campaign and as we gear up to celebrate Christmas and the spirit of giving we also ask the community at large to please give their weight to this worthiest of causes at:

It's not too much to ask

At Christmas time, let us continue to press for the gift our elderly community needs and deserves. That is the only way our community can truly achieve a ‘Happy New Year’.

May I take this opportunity to thank each and every one of you, our members, for the important work you do each and every day and for the care and compassion you deliver it with.
May you each have a peaceful and safe Christmas and New Year.