Managing risk, preserving freedoms key in aged care preventable deaths debate

Reduction in freedoms and quality of life could be an unintended consequence of calls for further regulation in aged care that follow research into preventable deaths, according to HammondCare Chief Executive, Dr Stephen Judd.

Dr Judd was approached for comment by the Medical Journal of Australia's MJA Insight in the lead up to the publication of research led by Professor Joseph Ibrahim into preventable aged care deaths, based on coronial records between July 1, 2000 and June 30, 2013. The research shows an increase in external-cause deaths in this period.

In releasing the research, Dr Ibrahim called for a new national framework and further 'strategies' to prevent these deaths but Dr Judd raised concerns that focusing on just this small segment of nursing home deaths, regrettable as each one is, could skew policy and regulation so as to add more process, reduce quality of life and do little to improve care for the vast majority of residents.

"We don't want to create a situation where nursing staff become fixated on compliance rather than fostering a good quality of life for the people they are caring for,” Dr Judd said.

“If staff think they are going to get rapped over the knuckles if Mary falls over when she goes outside, they’ll lock the door so she can’t get out,” he said. “All life is about risk; we have to encourage people to enjoy life, not just keep themselves hermetically sealed in a life of boredom.

“Rather than trying to eliminate risks, we must manage risks intelligently.”

Dr Judd said that while there had been "incredible" improvement in aged care provision in the past 15 years, he agreed that there was more to do.

"But better care will not come through greater regulation or process but through market competition. If the federal government uncaps supply of nursing homes by scrapping current licensing arrangements, this will allow operators to establish new services wherever needed, as has been done in the home care market.

“This would enable greater true choice for prospective residents and ultimately lift the standard for residential services.”

HammondCare has advocated for quality of life, freedoms and citizens rights in aged care with an individual approach to care, management rather than avoidance of risk, removing of residential caps to provide people real choice and a moving away from generic approaches to aged care that often lead to mediocrity in service delivery.

In the area of food, Dr Judd kicked off a revolution in aged care food delivery after his comments about food regulations that he said denied residents access to food as they might choose to eat it.