18 July 2022
Article from July 2022 edition of INPractice
After enduring decades of neglect, an Anthony Albanese-led government brings renewed hope for our demoralised aged care sector.
The statistics have been staggering. And damning. Despite the repeated warnings and desperate appeals from aged care advocates, COVID has cut a brutal swath through our older community.
More than half of all the aged care residents who succumbed to COVID-related illnesses during the pandemic died in the first 3 1\2 months of 2022. That's 1,107 reported deaths as of April 14 for this year, compared to a total of 2,024 since the beginning of the pandemic in early 2020.
By late May, that figure had ballooned to 1,418 in 2022 (2,335 since 2020) with more than 60 aged care residents dying every week.
The former Morrison government had rightly been pilloried for its failure to ensure an adequate vaccination roll-out among the most vulnerable cohort in the community.
"But then this was a government bereft of even one politician prepared to commit to our aged care pledge, to put in place measures we absolutely know would go a long way to ending the suffering of both residents and staff alike," ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM said.
By contrast every single federal Labor politician in South Australia committed to the ANMF's national Fix Aged Care campaign that addressed:
- The need for RN 24fl cover in all aged care sites;
- Safe staffing ratios and the right skills mix;
- The need for greater transparency for funding tied to care in the sector;
- The need for better pay and working cond1t1ons so that we can attract and retain the workforce that is needed.
The Greens and key in dependents also supported central elements of the cause.
Labor powerhouses Anthony Albanese, Penny Wong, and Mark Butler all pledged support for the ANMF's campaign to overhaul a system the Royal Commission declared “a shocking tale of neglect'".
Despite the litany of horror stones, the hundreds of deaths in a sector swamped by COVID, the chronic staffing shortages that have left existing staff simply unable to meet the needs of older Australians, Scott Morrison, Barnaby Joyce and their Coalition colleagues are yet to put their names to meaningful change," Ms Dabars said when the Coalition was in power.
"It begs the question WHY?"
ANMF Federal Secretary Annie Butler said at the time: "The only conclusion I can draw is that older Australians living in nursing homes don't matter to this (Coalition) Government".
By contrast new Prime Minister Anthony Albanese's pledge to mandate staffing ratios by introducing, in law, minimum care hours requirements for nursing homes and to fund real wage increases for all aged care workers, could finally bring hope to exhausted nurses and care workers in the troubled aged care sector.
In March Mr Albanese announced that, if elected, the ALP would implement the critical recommendations of the Royal Commission into Aged Care Quality and Safety, including mandated standards for nutrition in nursing homes. The measures Labor says it will implement if elected included:
- 24-hour registered nurse care in every nursing home;
- A mandated minimum 215 minutes of care per resident per day;
- Funding real wage increases for aged care workers;
- Ensuring accountability across the sector.
"This is the thrilling news the sector has been desperately seeking for so long," Ms Dabars said at the time.
"Hopefully this will be a historic turning point for the future of aged care in this country, one which will bring so much relief to residents and aged care workers alike".
In April Mr Albanese went further, saying Federal Labor will introduce tough new penalties, including jail time, to "dodgy" aged care providers neglecting and mistreating their residents, if it wins the upcoming federal election.
Back in April, Juliane Samara, a Palliative Care Nurse Practitioner and ANMF member, shared nightmarish stories of what happens in a residential aged care facility/'nursing home' that doesn't have registered nurses 24/7, 365 days of the year" She then reeled off horrific tales of residents dying slow, excruciating deaths, some screaming in agony, simply because there were no registered nurses onsite to administer medications or staff qualified enough to tend to their needs.
"I could go on and on. So many real examples of people who live in aged care and suffer at end of life because there is no mandate to have a registered nurse on duty 24/7. No staff ratios to ensure adequate care," Ms Samara wrote.
"The failure of the LNP Government to act on the recommendations of the Royal Commission, that they themselves ordered, is astounding. The unwillingness to bite the bullet and initiate real reform for the aged care sector is negligent, cruel and abhorrent.
"I see people asking how Anthony Albanese will fund the promises he made in his budget reply speech. The answer is really not that hard. If you give proper nursing care, by registered nurses, you can reduce repeated hospitalisations, which costs bucket loads of money for each visit".
Writing in the Guardian, Ms Samara said: “As a palliative care nurse practitioner I have looked after thousands of people who have died in residential aged care. I've seen and heard things you could never imagine. Things that keep me awake at night, dreading the day my family might have to find a place for me in residential aged care".
The Royal Commissions Final Report into Aged Care Quality and Safety found that half the people living in nursing homes have dementia, yet "we are deeply concerned that so many aged care providers do not seem to have the skills and capacity required 10 care adequately for people living with dementia".
"We have found many examples of substandard care in providing for the most basic of human needs, such as diet and nutrition, oral health, skin care, mobility, medication and prescription management, continence and incontinence, infection control, social and emotional needs, and diversity and cultural needs,” the report said.
"The Royal Commission into Aged Care Quality and Safety heard evidence from countless people who relayed the suffering of their loved ones in residential aged care," Ms Samara wrote in The Guardian. "Time and again, the issue of staffing skills and ratios was raised. The Final Report recommended that from July 2024 at least one Registered Nurse be always on site in residential aged care facilities.
“As a society we must value and respect older people and guarantee they have equitable access to the clinical and personal care they need, no matter where they live. We need to ensure that resources such as Registered Nurses around the clock are mandated and funded across the aged care sector.
"Not in July 2024. Now. We cannot afford to delay. People’s lives, and their deaths, depend on it. It's a huge task, and 1t will cost money, but we need to start somewhere".
In Adelaide, one Registered Nurse of 20 years also spoke of the appalling impact of inadequate staff numbers and skills mix.
"Only a Registered Nurse can administer pain relief medication, many of which are opiate-based. The lack of RNs on site has made this a huge problem in the sector. Residents are left to languish for hours in unspeakable pain because there is simply no one qualified to effectively assess and treat pain. I see this all the time," the nurse said.
"I have known residents who have aspirated their food (breathed it into their lungs) and have suffered terribly for hours due to Jack of appropriately skilled staff".
"Call bells are going unanswered, residents are left badly dehydrated, left to sit in their own waste, simply due to appalling staff shortages.
"Issues with oral health are not being picked up, which contributes to a host of other problems such as malnutrition.
"This kind of neglect has been ongoing for many years. It's not the fault of staff who can only do so much with such limited numbers and suffer terribly emotionally as they cannot provide the care they want.
"The fault lies squarely with providers and ultimately the previous Commonwealth government who, despite the damning findings of the Royal Commission, continued to ignore calls for transparency.
"An ordinary working taxpayer can be audited over piffling amounts of money. It seems absolutely outrageous that billions of tax dollars invested in aged care can go unaudited. From the evidence thus far not much of it seems to be invested into the actual care of our ageing population.
"Hopefully that will all begin to change now that we have, in the form of an Albanese Government, the promise of real action and commitment to reform".
Click here to read the July 2022 edition of INPractice.