Critical Analysis Of Aged Care: Assessment Answer

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Title: Critical analysis of Aged Care

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Introduction

The purpose of the study is analysing a critical problem of Australia that is aged care. Hence, the research involves examining the condition of aged care and associated concepts within Australia. After carrying out a critical analysis of the issue and related concepts, the way they resulted in policy is analysed. In general, practice, aged care is the supervision and care of the health of the ageing population. The phase ‘frail aged’ is used for describing older people needing a sustainable standard of support and care. Although the ageing process is related to rising levels of incapacity, maximum aged people have an optimistic view of their fitness with the most of Australians of 65 years and more scoring their health as good, better and excellent. 34% of people report their health condition as being poor or fair. The definition of aged differs between communities, cultures and individuals. For instance, aboriginal and Torres Strait Islanders have lesser life expectancy comparing to non-indigenous people. Hence, they require aged care at an earlier age. The current assignment therefore focuses on understanding the issues associated with aged care and tried to show the way the issue of aged care has translated into policy. 

Explanation of concepts 

The concept of aged care- 

According to Kalogianis et al. (2016), aged care refers to a special-purpose offering that delivers lodgings and other supports comprising assistance with everyday activities, intensive care and support toward liberated living to old and feeble residents. The Aged Care Standards and Accreditation Agency Ltd recognises facilities for obtaining funds from the Australian government by the subsidies of residential elderly care. The Aged care Act 1997 defines aged care as nursing or personal care or both that is offered to an individual in a suburban home in which the individual is also provided with housing. It includes proper staffing for satisfying personal and nursing care needs, cleaning and meals services, furniture and equipment for delivering that accommodation and care.

The difference between life expectancy rate between native and non-indigenous populations is slight at old ages. For instance, the life expectancy rate at the age of 65 years is projected t be 10.7 years for aboriginal males and 12.0 years of aboriginal females that is near about eight years less for females and six years less for males than that of non-indigenous females and males (The conversation, 2019b). In this context, Coyne et al. (2016) commented that due to this difference between the life expectancy rate and a lower ratio of indigenous people of 65 years aged and more, the term ‘older Aboriginal and Torres Strait Islanders' is usually regarded to incorporate all the people of aged 50 years and more.  

Types of aged care- 

The subsidised care provided by the Australian government to the old people contains residential care, home care and flexible care. Attention is raided by funding contracts with care providers that includes flexible aboriginal care and home support. The different types of care are outlined below (Wilson et al. 2016):

Residential care- It is offered in aged care homes on a interval or permanent basis. It is for the service users, who require additional attention that cannot be provided in their own homes. Such services comprise of accommodation, personal care, nursing care, support services like real, laundry and some associated health care services. The government and residents both fund residential aged care services. The government provides supplements and subsidies for approving providers for every resident obtaining care under the ageing act. The Aged care Funding Instrument tool is used for calculating the allowance for primary responsibility of each of the permanent resident. 

Care at home- The Commonwealth home Support Program gives entrance-level support for aged people and prearranged interval actions to revive carers. CHSP services can be delivered at the society or in the home. Such services consist of backing with domestic responsibilities, transport, meals, social support, home maintenance, personal care, nursing care, home modification and related services. Service users contribute to the service cost, and CHSP provides get funding from the government by grant contracts.  

Flexible care- Harrison et al. (2019) commented that it caters for the aged population, who may require a distinguished care approach comparing to the services offered by residential and home care services. The four categories of flexible care include innovative care program, short-term restorative care, transition care and multi-purpose services program. Flexible consideration is given to the aboriginal people by endowments managed outside of the act. The National Aboriginal and Torres Strait Islander Flexible Aged Care Programme provide funding for the services.

Guideline for action- 

The first part of the legislative framework was attained by identifying in a revolutionary piece of regulation, aged people and their importance. The second part was to establish an agency for directing the action and ensuring it has a very high summary. The ageing act is very stimulating for recognising the importance of aged people, accord them with respect, dignity and appreciation and for certifying that social structures enabled them to realise their potential. It mainly identifies the multifaceted nature of the ageing group. Section 7 of the ageing act needs the commissioner to guide on services and programs, support in their management and monitoring specific activities, spreading information, accumulating data and identifying and preventing discrimination against the aged community. It is on the commissioner to plan policies for the application of the motivational legislation.

Critical analysis of aged care

All people within Australia deserve to age healthily. However, at present, the system it has means an old individual can be evaluated as requiring a specific level of care, but that level of care might not be available, as the government just assets 112 services for each 1000 Australians of more than 70 years. Some people do not get any aged care due to the extremely long waiting list. Other older patients only receive little care they require. It is a critical issue, which put pressure on families and partners to bridge the gaps. It makes people going without transport, without a shower or any assistance in the home.

Another critical problem is the place of accessing care. Maximum Australians report that they would instead of age in their positions compared to move from what they are aware of a residential care ability. However, most of the capital invested on aged care is used for supporting service users live in residential care. If an equal amount of money were available to care for people living in their own homes, many aged Australians might not have the upheaval of shifting into residential aged care (Agewellcampaign, 2019). As commented by Hugo et al. (2018), it is undeniable that consecutive governments have made inordinate paces towards enhancing aged care within the last few years; however, may stage are remaining there. Therefore, the government requested the Aged Care Committee to create the aged care road map that highlights the government where aged care should transpire over the upcoming five years. However, no response from the government’s end was received to the roadmap with solid actions in the current Federal Budget.

Moreover, the opposition did not make any specific commitment to execute the proposals too. Therefore, the Age Well Campaign is named on all political parties to pledge to a way that provides quality age care to the older Australians, when they require it. With a growing rate of ageing populates, an assurance needs to be in place now for supporting these people at present and in the future.

In an investigation conducted by the ABC, four concerns were aired regarding the poor treatment of aged people in care homes across Australia. It was found that poor care standard had resulted in authorities departing one aged care home every month since the scandal about the Oakden old mental health home. The houses closed in 2017 due to revelations of neglect and abuse courting back a time. While the standings of orientations are no determined yet, the royal commission is likely e-check out problems highlighted by prior investigations into the industry. These comprise of staffing ratio, shifting demand of aged people in Australia, mental health, funding levels, safety and wellbeing requirements of residents in nursing homes. The problems that led to the inefficient standard of care of the aged people are as follows (The conversation, 2019b):

Lack of health care- 

The part of old populaces needing great care for composite requirements including support with all the actions of everyday living like bathing, eating, is multiplied from 13% to 61% within 2009 to 2016. No regulatory need is there for the facilities of aged care to offer 24*7 registered nursing service.

It has become over 20 years of the Aged Care Act 1997 imposed by the government for providing an improved model of care for the ageing population, who were unable to live any more at their home and needed help with daily life activities. The act was focused on promoting independence and choice for aged people and guiding services to the elders with the greatest needs. However, the constitutional modification also rendered with a time of modern elderly and complicated requirements in the elderly. People entered in low-standard residential care previously, are cared within the community later. Since the year 2008, the portion of aged adults entered to a residential elder care centre of Australian has stayed stable. However, the number of people with higher needs for care has amplified gradually (The conversation, 2019a). Over 170000 aged people live in elderly care homes in Australia. 83% of this group are categorised as needing great care. A predicted 60% of them have dementia, 50% have urinary incontinence, 40-80% have lingering pain, 30-40% have depression, and 45% have a sleep illness. The management for these critical situations and a combination of conditions need the skill of knowledgeable authorised nurses, supported by health care professionals and allied health providers like physiotherapists and psychologists. The case is becoming worse, as the nursing homes are trying to reduce costs by avoiding the listed nurses and hiring less-abled care assistants, who are not proficient sufficiently for the work role. Hence, Federal regulation is immediately needed for ensuring that at least one registered nurse is there in the aged care homes on the place all the times. 

Investment for aged Australians to stay at their home- 

It has been found that more and more aged people want to live in their place, as they get older. The government declared an additional A$1.6 billion in the 2018-19 budget over the upcoming 4 years for an extra 14000 Home Care Packages. These provide an approved group of facilities to fulfil the particular requests of older adults, who are not intended to spend their lives in care homes. The government supported about 283000 of residential care sites for aged people incapable of living autonomously. Elderly care aids are assigned by a proportion that aims to offer 113 grants care paces for every 1000 people of age 70 years and more. This proportion will grow to 125 places for every 1000 people by the year 2021-2022. In the whole sum of residences, the government decides sub-targets too for the number of residential care homes and Home Care Packages. The government is focusing on modifying the proportion supportive to numerous care packages. The target for home care packages is expected to rise from 27 to 45 for every 1000 by 2021-22, and the residential goal is likely to decrease from 88 to 78 for every 1000 within the same period. However, the rise will still not be enough for fulfilling the needs of the aged people who live in Australia (The conversation, 2019b).

Poor emotional health- 

Elder Australians spending their lives in care homes cover one of the most susceptible populations of society. Over 50% of the patients in a care home have depression comparing to 10-15% of the adults living in the community. Recent research has revealed that almost 140 residents of Australian nursing homes committed suicide in 2000-2013. It was found that around 70% of these people were male and among them, 66% were diagnosed with depression and approximately 80% were facing different types of life stresses like health deterioration. Near about 43% were feeling lonely, isolated, and near about 30% had difficulty adjusting to the lifestyle in a care home. The little part of the adults more than 65 years of age experiencing despair in the society represents that sadness is not a regular part of getting old (Hugo et al. 2016). After examining the records available in hard copy and an electronic copy of every territory and state of Australia, it is found that aged men having depression entering elderly care are at a developed risk of attempting suicide and the Australian aged-care system is not fortified to offer the assistance to safeguard them. Over 170000 aged people are living in 2700 care homes of Australia. It is equal to near about 6% of 65 years and over old people. Suicide is one of the significant reasons of death in several countries for people of 15-29 years of age. Many people think that it is mainly the problem of adults. However, adults more than 65 years old, especially make have one of the top suicide rates of all age groups in numerous nations of the world. It is difficult to know the way the suicide rate for people living in the society relating to those living in care centres, as these figures are reported inversely. There is a direct connection between suicidal attitude and depression. However, not all depressed people attempt suicide.

Similarly, not all people admitted to aged care homes have an unsatisfactory response or experience. Most of the old care facilities strive to offer safety and sound quality of lifestyle and care for their service users. However, it is clear that the present approach of providing aged care is not sufficient for preventing suicides. According to Holloway et al. (2018), changes are needed at the level of national policy to lift the overall quality of elderly care with a particular focus on promoting access to psychological health services. Increased acknowledgement of the suicide risk among older adults is also needed so beset suicide preclusion framework. The providers and owner of the aged-care services need to examine their admission analysis for screening of thoughts and depression or not managing adequately with changes to their living conditions. Besides medical care, support from friends and families looking to managing the feelings and social connections of being valued and advocating for professional evaluation and treatment if a resident feels lonely, withdrawing and sad.   

Pitiable oral health condition- 

Incidents of exploitation and abandonment in care homes have emphasised the problem of unfortunate oral health and nutrition. In 2017, November, the terrible condition of this was published in a report about a resident of NSW care home, who was spotted with worms inside her mouth afore she died. Researches have shown that people are in elderly care facilities are significantly deprived oral health state and the possibility of tooth falloff for not treated is three times more comparing to the people living in the society (Coyne et al. 2016). Oral health is n tony about the health of gums and teeth. It also includes up keeping areas like tongue, cheeks and lips. Most of the aged care people with age of 85 years and over are weak and have critical health conditions, are on numerous medications and depend on care workers to satisfy their care needs. Besides this, other factors like limited access to oral care services increase the risk of poor oral health highly. Several medications can lead to a dry mouth leading to painful cracks in the tongue or lips and an increased possibility of infection. A dry mouth can result in making swallowing and chewing food even more challenging. Other issues include gum disease, tooth decay and a highly increased risk of growing aspiration pneumonia, where gulped saliva or food flows germs into the lungs. Dentures that no more fit makes speaking and eating more challenging, but can also cause the death of the residents because of choking. These issues affect the wellbeing, health and quality of life of the persons and their social inclusion and dignity because of bad breath and a hideous mouth.

Due to all these critical issues regarding aged care in Australia, the government plays the role of the main regulator and funder of the structure. Overall government spending on old care services was near about $15.8 billion within 2014-2015 including government offering around 95% of the subsidy. The Aged Care Act 1997 and related Aged Care Principles set out the regulator guideline by contractual preparation outer of the Act. The Department of Health is accountable for the procedures of the Act. This rapid guide offers a brief synopsis of elderly care in the country. It explains the are offered, provisions for retrieving subsidised care, data on aged care, the organisation that provide care and the legislative arrangement for confirming the quality of care. The quick guideline does not explain care that is offered outside of the formal aged care structure like care provided by families or housing in retirement villages. 

Conclusion 

Aged care has been a severe issue in Australia that is not resolved yet. Although many initiatives are taken and policies are developed at times, they are not adequate to uproot the problem and cater to the needs of all the older Australians. A large arrangement of aged care service is still needed for overcoming the problem. Australian ageing residents and the emphasis on supporting the aged stay at home for as much as thinkable. It means when the older adults enter into an old care centre, and they become sicker and older than before. Near about half of the people live in an aged care home suffering from depression, dementia and other behavioural or mental health issues. Therefore, for tackling these problems, intensive care is needed by recruiting adequate number of registered nurses, who can take good care of the older people.