One size fits all aged care leads to 'exhausted mediocrity'

Australia's one size fits all aged care system fails to produce excellence, rarely builds competency and instead results in 'exhausted mediocrity', according to HammondCare Chief Executive Dr Stephen Judd.

Australia's one size fits all aged care system fails to produce excellence, rarely builds competency and instead results in 'exhausted mediocrity', according to HammondCare Chief Executive Dr Stephen Judd.

Dr Judd was speaking as part of a panel at Alzheimer's Australia's Consumer Summit at Parliament House, Canberra today, on the topic 'Improving care and support for people with dementia - what are the issues?'.

Other panel members included consumer advocates Gina Shaw (UK), Joan Jackman and Kate Swaffer, Council on the Ageing Chief Executive, Ian Yates, and Alzheimer's Australia National Policy Manager, Dr Ellen Skladzien. The panel, chaired by Ita Buttrose, was part of the two day summit on 'Supporting people with dementia and their families - The consumer perspective'.

Diverse and differentiated

Dr Judd said that just as we expect specialisation in health services - "we would think it extraordinary if a new-born baby was in the same room... as someone receiving dialysis" - aged care needed to be a diversified system with providers offering differentiated services.

"We must get away from the fiction that every service should be the same, supporting all comers regardless of cognition or frailty or clinical condition. We must get away from the unsustainable fiction that a government subsidy is anything more than a baseline of recurrent funding," Dr Judd said.

"There is a lack of focus in residential aged care now - and that lack of focus lets down people with dementia."

Dr Judd said that in mainstream aged care, we should expect base competency in dementia care which could be achieved through education programs such as Dementia Care Essentials together with support from DBMAS consultancy services.

Alongside, special care programs were needed for people with dementia behaviours "we find more challenging". These specialist services were recommended in the 2008 Murnane report and by the current government's Dementia Forum in late 2014.

"Indeed I would argue that they should be included in the 2015 ACAR round as [first] promoted by the Deputy Secretary of the Department in 2008! Without these services we will continue to let down these individuals, their families and other residents and staff."

Thirdly, Dr Judd said he believed it was possible, where special care units did not exist, for their to be excellent, smaller services in regional Australia that are focused on people who have behavioural and psychological symptoms of dementia (BPSD) - "a horrid term".

Teams must show up

In the mean time, Dr Judd said the severe behaviour response teams recently announced by Assistant Minister for Social Services, Senator Mitch Fifield, must respond to crises by "showing up".

"They must be immediate, local, expert and personal. Whereas DBMAS is advisory, the response teams must respond to a crisis. The key word is 'respond'. People in a crisis want someone to show up. They want a person," Dr Judd said.

Don't romanticise home care verses residential

Dr Judd began his talk by reflecting on personal experiences of care for loved ones that occurred across both living at home and in residential aged care.

He said there was a risk in being romantically swayed to thinking that "at home is good, residential care is bad."

"Life at home with dementia is not perfect - the social isolation, boredom, personal care challenges are all there. Similarly I am only too aware that residential aged care is not perfect - far from it! Providers of residential care, including our own organisation, make mistakes every day.

"But if we buy the line that 'at home' is good and residential care is by definition bad, there is simply no prospect of improving our residential care services for people with dementia."

Alzheimer's Australia Consumer Summit continues until tomorrow (Wednesday, March 4) with responses and results presented to the Parliamentary Friends of Dementia.

HammondCare is a leading provider of dementia specific aged care and for younger people with dementia, both residential and at home, and operates a special care unit for dementia in Hammondville. HammondCare also operates DBMAS NSW.

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