My submission in relation to the Foundations of the new Aged Care Act

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Submitted on 28 August 2023

Dear Sir/Madam

Thank you for the opportunity to outline my thoughts in relation to the ongoing aged care debate and the relatively poor conditions that remain prevalent within the Australian aged care sector.

I acknowledge your reference material provided via the following URL (and elsewhere):

https://agedcareengagement.health.gov.au/aged-care-act/

My background is one as an individual whose elderly parents both, sadly, spent the final phase of their lives in aged care facilities in Australia. I’m now, all too quickly, heading in the same direction. Other items written by me, some relevant to the topic of aged care, are listed at https://www.aust-thai.com/writing.htm

My siblings and I spent a considerable amount of time researching the options available to our parents, and studying the relevant government laws and guidelines. This included speaking to numerous staff or representatives of facilities and/or gov’t and non-government agencies. We couldn’t find anywhere suitable, and our parents quickly grew tired and disappointed whilst trialling possible alternative facilities.

One of the things that struck me during this process is the chasm between what was said/written/believed regarding services available for the aged, versus what is actually available to them on the week in question. Many of those working in the industry, and who appeared competent and well-meaning, appeared to have no knowledge or understanding of this discrepancy. The relevant factors here included the following:

  • Considerable geographical variations in services available, in associated waiting lists and time-frames, etc.
  • Changes that had occurred in guidelines or regulations or administrative procedures, subsequent to their last industry seminar/workshop attendance
  • The complexity and the time frames involved in *real-world* accessing of services or facilities or financial support, etc.

Another factor that was very apparent was the complexity – especially from the perspective of the aged – of the steps, stages and paperwork required to be completed to access services. This was magnified by the seemingly almost ongoing re-structuring of the relevant agencies, which meant that relevant individuals and their contact details changed. Change doesn’t mesh at all well with the needs and preferences of the aged.

My parents were fortunate (at least in others eyes) that they had sufficient assets to select the best available care options. The problem was that even the best available, excuse the French, sucked.

Indeed, my mother who passed away most recently, paid something in the order of $220 per day for what was an unpleasant and very much unwanted experience. Unfortunately for mum, her time here culminated with the Covid-19 pandemic.

On various occasions we had to ask to have her soiled sheets changed. Her facility was modern and relatively new. It had all the routine ‘nice things’ written on pastel-coloured posters on the common-area walls, e.g. ‘we respect our guests. ‘Please tell us if you’re not happy’, etc. It turned out that there were month (or more) long waiting lists to access services like podiatry or haircuts, promoted in the glossy brochures for the facility (the services, not the waiting lists).

In reality, the thinly disguised hospital ward look and feel, staff shortages, cost-savings and the continual squeal of patients’ in-room call-buttons. Even the quality of meals was variable from inedible to the occasional ‘good’. But brightly-coloured cordial was routinely served <face palm>. Never fresh juice. Thus they couldn’t even get right the one thing most likely to brighten an elderly person’s day. Their meals!

Another common problem was housing patients with dementia in general wards, where sooner or later their behaviour caused anxiety amongst other patients, and more work for already over-worked staff. When challenged, the facility manager’s invariably first say that dementia patients were only accommodated in designated wards (for which there was always a waiting list to enter). Then they said that any variations to this were purely temporary measures. Even though the same patients were still in general wards six months later.

Old folks are anxious about people coming into their rooms (esp. at night). They can’t see who they are (low lighting, eyes sleepy, blindness, etc.). Staff turnover means that even if their eyesight is ok, they may not recognise them anyway, and staff don’t introduce themselves.

On one occasion a male patient walked into my mother’s room at night and sat on her bed, without her consent. My mother pressed her alert button, and after a quarter of an hour or more, staff eventually came and escorted the man back to his room. This prompted my mother to begin eating meals in her room instead of the dining room. On other occasions a ‘cranky’ woman who lived on the same floor also entered my mother’s room, threatening her. Guest weren’t allowed to lock their doors, and in fact they were encouraged to keep them open. (Just a reminder: My mother paid $220 per day … are you with me on that?)

Some other general points regarding aged care IRL:

  • The single use ‘God’s waiting room’ / Hospital Ward Lite, style of aged care facility is so out-of-date and uninviting that it’s appalling that people are still building and selling that style of property. In this archaic environment, even a fat affectionate cat which occasionally visits the common areas, is seen as a lavish cutting-edge treatment option.
  • Old folks like to deal with as few agencies/facilities/people as is possible (ideally only one), and to deal with them for years, not merely months. The opposite is happening.
  • Old folks are anxious about complaining (e.g. advertised services not being provided, services being provided by staff who are physically rough with them, etc.), for fear that there will be some form of retribution. They mostly remain silent, even asking their kids not to intervene.

Clearly there are no easy or quick fixes to the problems facing the aged, and those now trying to assist them. I would however mention one small step that could assist some of the aged, at little cost, and in a short time frame. This would simply involve allowing elderly who are in receipt of financial support via welfare, to relocate (either temporarily or permanently) to suitable lower-cost countries without losing whatever payments they were receiving in Australia. If you love them, set them free.

I would invite you to read my thoughts regarding this issue in a paper available at https://www.aust-thai.com/blog/uncategorized/government-to-further-impinge-on-the-rights-of-pensioners-to-travel-or-live-overseas/

In closing, don’t entirely believe everything you read about the current conditions with regards to the provision and availability of aged care services in Australia. There is a very high chance that – despite to best intentions of the majority of service providers – there will be *very* many exceptions to the rule. If in doubt then recruit some elderly folks and shadow them in their quest for care and support via hidden video. You will be surprised, and occasionally dismayed, at what you see and hear. It will certainly differ from that which is written.

Please, please, do what you can – as soon as you can – to advance the living conditions and the safety and happiness of Australian elderly people. They deserve so much better.

Sincerely

Bruce Bickerstaff  

Thanks to California first-responders

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Officer in Charge, California Highway Patrol – Redwood City

Dear Sir

I am writing to you about an automobile collision that occurred in your area on 23 December 2017, and which was attended by several oficers from your station (local report number 9330-2017-15942).

My wife, myself and our son were in one of the two vehicles that were involved. We were on our way to Big Sur where we had booked to stay overnight in a cabin as part of a what was to be a very special overseas holiday.

We parked briefly beside the highway to adjust clothing after we put the roof up on our rented convertible. That moment basically marked the end of our ‘holiday of a lifetime’ as only a few moments later a vehicle drove into the rear of our car at high speed.

I was rendered unconscious and have no memory of either the crash nor the next week and a half. That collision has been a major factor influencing our lives since then, and we have been kept busy with medical testing and treatment, insurance claims, as well as managing everyday life.   

My wife has told me that she was very impressed with the manner and conduct of the officers who attended the crash scene, particularly Officer Gavin Hursh, and we wanted to pass on our thanks. We would have sent this note earlier but thought it perhaps best not to do so whilst the court case was still underway.

The care and compassion shown to my family by your team, from the moment they first arrived on site, was very much appreciated. This included not just attention given at the crash site, but also transporting my wife and son and our belongings to the hospital, and subsequently providing information and support at the hospital which even included providing a small gift for my son on Christmas Day.

To have something like this happen to your family in a foreign country was very unfortunate and especially stressful for my wife and son. God forbid, but if something similar ever happens to any of you & your families then I hope your trauma will be eased through someone stepping in and helping the way things happened on this occasion. 

Finally, in closing and on a more general note, we offer our heartfelt thanks to you and all your team for your ongoing and valuable contribution to maintaining order and safety on the streets. Take care and be well.

Sincerely

Bruce & U-sa Bickerstaff
Queensland, Australia
26 July 2018

Some work-hard, play-hard people I’ve met

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The sort of people that I would characterize as being of the work-hard/play-hard type, are a rare breed. Many of us would have met the ‘work hard’ and/or the ‘play hard’ folks, but finding a workable combination of the two? Not at all common. In fact for most of us I suspect, we’d be lucky to encounter any more that a handful.

Did you ever get an inexplicable urge to google someone you’ve met in the past, but perhaps not kept contact with? Yes? Well it happened to me just the other day.

I moved to the Eastern Suburbs of Sydney when I began my career way back in the 1980’s. As many do, I began by living in a variety of share houses. In the first of these share houses I bunked with two medical students. Their names were Greg and Rick and their lifestyle was a real opener to yours truly. In fact I ended up bailing out of that household after not too long, seeking a home environment that was a little more vanilla. And no, I don’t think I’ll elaborate 🙂

When I googled their names the other day, here are two of the articles I came across. As you’ll see, they both went on to enjoy considerable success. Sadly however I learnt that Greg passed away in 2021.

In memory of Greg Kesby (1 November 2021)

Always be learning: the key to Dr Richard Tarvin’s business success (12 July 2021)

In closing now, a wave to another work-hard/play-hard classic from my even further distant past – Paul Murphy who recently retired as a science teacher at Nowra High School.

It’s time we offered the elderly a better choice of care than that which is currently available. No, it’s well past time actually

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Readers may have noticed that I have already written a couple of posts about care for the elderly. That was partly because my mother was, until recently, in an aged care facility. Sadly, she passed away last week. And I’m going to be writing more on this topic. Perhaps much more.

We here in Australia, recently conducted a Royal Commission into aged care. We’ve had earlier inquiries. We need some positive action. This is an issue that will eventually be faced by every single Australian, barring those who die young. That necessary changes are continually being shelved for further consideration, etc, whilst time and resources are found to ruminate over navel-gazing issues like gender pronouns, or problems faced by 1% of the population (think confusion re: gender) is worse than ridiculous … it’s simply appalling.

I have to confess that I have yet to study the final report of the last big inquiry, and I’m not sure when I will. What I’m going to delve into in this post is my own experience with navigating the Australian aged care system, looking at both its positive and negative aspects.

(21 December 2021: Note that what follows is only a working draft at this stage. Feel free to submit comments and/or make suggestions)

The positives

Many of the people that work in the industry – from some of the carers at the aged care coalface, to some of the public servants in relevant agencies, to many of those working in related charities and non-government organisations.

The outward appearance of most of the newer aged care facilities.

The considerable amount of money that’s already made available each year by the government

The negatives (Phew, get ready for this lot)

The cost of living in an aged care home if you don’t qualify for full government support. By way of example, my mother paid more that $200 per day, as she had appreciable savings/investments.

The difficulty in accessing and understanding information about aged care services that are currently available. And that’s even in those cases where the elderly are being actively assisted by family members.

The out-of-date, conflicting, and impractical information being provided by those working in the industry, even when the information/advice provided is often entirely well-meaning.

The limited social interaction for residents, for example, regular visits by family members, voluntary visitor schemes, etc.

The big gap between the posters on the walls, and in web sites, etc, about how a facility is run, the services it provides, about listening to the needs of residents via regular meetings, etc … and what actually happens in real-life.

Staff turnover, staff rotation (and staff shortages) with regards to those providing face to face care for the aged.

The level and nature of social and recreational activities available for the aged. The social/living environment in the homes, e.g. residents wailing, the continual noise of call-buttons pressed and beckoning carers to come and attend to specific residents.

The growing problem of intermixing residents with intellectual/ emotional/behavioural problems (incl. dementia) with the mainstream resident population. This is due in part to the increasing age of residents and hence the increasing incidence of Alzheimer’s and related problems.

Lack of sufficient attention by nursing staff leading to problems that include the assault/intimidation of residents by other residents, residents being routinely told to relieve themselves into their adult diapers rather than staff taking them to the bathroom (which may require 2 or even 3 staff for larger unsteady residents). This then leads to further problems such as residents being left to lie for extended periods of time in urine-soaked bed sheets.

On Ceramics and Airships

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Well now folks, may I present you with a tale of a pottery teacher, one of his creatively challenged students, and doubtless but one of their many obscure interests.

Once upon a time a university student in Armidale, NSW, Australia, enrolled in a pottery class at a local community college. For some reason or another. Aside from functional woodwork at school, he had never done anything creative. It was a relatively short course culminating in the production of a pottery item of choice. OK, I confess, the guy is me. And this is what I produced. It was meant to be somehow reminiscent of a kookaburra. Ewww. Enough said about my pottery abilities. Let’s move on.

My teacher, whose name is Rod, endured my rambling whilst I tried to smoothen the Mars-like surface of my pot. Amongst other things I told him of my interest in airships, and sometime later invited him to a film night at home with some friends. I borrowed a film from the national library. I think it was called ‘Shadow in the Clouds’.

Scroll forward a few more weeks and to my amazement Rod presented me with a high-tea setting of Zeppelin-inspired pieces. Now that’s what I call a teacher! It was fabulous, but he was apologetic about cracks in the glazing. Four decades later I am still waiting for bits to fall off.

I never did follow my pottery calling, but I did wind up at the Stadtisches Bodensee-Museum in Friedrichshafen, Germany for the Zeppelin-Sammlung Heinz Urban exhibition in 1986. And yes, it even included some crockery from one or more of the famous zeppelins. If only I wasn’t worried about bits falling off, I might have packed, and lent them, some of Rod’s work. It would have rounded-out their exhibition rather nicely, I think.

Now without further ado, here are some pics of the R800 airship collection comprising five plates, nine cups, one tea pot, one sugar bowl and lid, and one toast/cake rack.

G’day Roderick! Stay well

The following are related online links:

https://www.zeppelin-museum.de/

https://www.facebook.com/ZeppelinMuseumFriedrichshafen/

https://www.facebook.com/140461206033615/posts/welcome-to-rod-bamford-click-on-the-link-to-read-about-rods-research-interests-a/2328174813928899/

https://soad.cass.anu.edu.au/people/rod-bamford

Aged care – there has to be a better way

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I recently made a brief submission to the Australian Royal Commission into Aged Care Quality and Safety.

The quality of aged care facilities in this country is miserable and we must, and surely can, do better.

The new facilities are cosmetically rather good, and the marketing material is fabulous. But the reality for residents is different. They really are just ‘god’s waiting rooms’ with a better range of colors and designs. But, as the Royal Commission will no doubt discover, even the newer style facilities are plagued with problems. These include poor maintenance (e.g. air conditioners not working properly and lengthy delays with repairs), variable and often quit poor food quality, patients with behavior programs mixed in with general patient population due for dedicated wards being full, and high staff turnover.

Furthermore, if you don’t qualify for government financial assistance then your stay might be very costly.

I am concerned that the Royal Commission will just fiddle around the edges of a real solution, with more regulations that may or may not be consistently and uniformly monitored and enforced .

What we need though is a reinvention of the design of facilities especially with regards to the creation of mixed use facilities.

Here’s couple of references I came across. No wonderful solutions here but these, and papers like them, might be useful in at least getting the conversation started:

Terry Robison’s ‘US$59.23 per night’ Holiday Inn retirement plan goes viral (27 February 2019)

‘Why a hotel is not a viable retirement option‘ (11 March 2019)

(This blog post is a working draft – please check back again later)

About taking your cat from Australia to Thailand

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What follows is a copy of an article I wrote for August 2013 edition of MelbThai magazine.

A Cat’s Tale: Monte the ‘meow farang’

A difficult decision faced by many people moving to Thailand is whether or not to take the family pet with them. Our cat ‘Monte’ travelled with us, and I wanted to share a little about what we learnt during that process. Much greater detail is provided in several posts that I contributed to an online discussion thread at http://www.thaivisa.com/forum/topic/88593-importing-a-pet-into-thailand/page-4 (see posts #91, #92, #95 and #114).

The next decision to be made is whether to make all the necessary arrangements yourself, or to use the services of a specialist pet transportation company. The latter option is more expensive, but may be essential if you don’t have a lot of free time and/or the skills and patience needed to navigate bureaucratic ‘red-tape’. Brace yourself, because you’ll need to deal with regulations and procedures mandated by the Australian Government, the Thai Government, and the airline/s of your choice.

Below I’ve listed the key steps to be followed should you choose the Do-it-Yourself route:

1. Obtain an IATA approved cage of adequate dimensions, plus a suitable water container

2. Obtain an animal import permit for Thailand

3. Apply for an export permit from the Australian Quarantine & Inspection Service (AQIS), and organize a time to meet with relevant staff to discuss the process

4. Undergo a pre-trip medical examination at an AQIS accredited vet, including a flea bath and worm treatment. You’ll need to have your vaccination certificates with you

5. Attend a meeting at AQIS to present your papers and collect your export permit

6. Obtain the necessary papers from your chosen cargo company (NB: separate from the airline), including sticker for the cage, air waybill, etc. They will need a copy of both your import permit and export permit.

7. Deliver your pet to the freight depot at least six hours prior to your flight.

  1. Submit your pet and paperwork for inspection by Quarantine and/or Customs staff at the point of entry into Thailand.

Further information and forms are available from:  http://www.environment.gov.au/biodiversity/wildlife-trade/live/household-pets.html

http://www.dld.go.th/dcontrol/move/imex_e.html#L1

You will naturally worry about your pet suffering trauma but I can report that our furry companion emerged unscathed. He quickly settled into his new surroundings and was soon discovering the joys of ‘pla tu mow’. Happily he also appeared to pick up ‘pasa Thai’ much faster than his owner, and thus experienced no undue difficulty in communicating with his Thai brethren.

A final factor to consider is that your pet’s journey will probably be a one-way trip. The prevalence of rabies in Thailand means that many countries will only allow the entry of animals (that have been living in Thailand) after very lengthy and costly stays in quarantine facilities in one or more intermediary countries.

Addendum 2016:

Monte lived happily in Thailand and managed to avoid the soi dogs, etc, until passing away in his sleep aged 16 years, lying down at the base of a statue of Buddha.

monte

Official complaints to federal and state advocates about age discrimination are starting well before retirement age

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A national inquiry has heard that society’s obsession with youth and looks is driving down the age when bosses consider employees to be past their use-by date.

Official complaints to federal and state advocates about age discrimination start well before retirement age, with Queenslanders complaining that they are being sacked and passed over for work from their 40th birthday.

Cases include an employee in the 45-54 age bracket who was told they were too old to use the stairs at work and fired for safety reasons.

Another was made redundant because the company needed “fresh faces”.

More at http://www.couriermail.com.au/news/queensland/official-complaints-to-federal-and-state-advocates-about-age-discrimination-are-starting-well-before-retirement-age/story-fnihsrf2-1227610109469

The Injustice of the Portability of the Australian Age Pension

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With the decision by many Australians to take early retirement or being affected by redundancy we find people moving overseas and living off savings or investments for their final working life years.

Most are not aware that this can cause problems when they reach the Age Pension age qualification and return home to claim this.
People who may have spent over 40 years in Australia working and paying taxes can find themselves in a position where although they are entitled to the pension, or part of if they have investments, it is not portable for 2 years.

Another person who stays in the country until he is 65, or whatever age he now needs for the Age Pension, can cheerfully leave the country the day he qualifies and be paid while overseas.

This is not a situation where people who have worked overseas for years can claim a full pension outside of Australia, the Australian Working Life Residency law makes sure of this, you must have spent 35 years in Australia at working age to take a full pension offshore for any length of time.

I can see no rhyme or reason to the 2 year portability law, a person who returns to Australia for a few years before he applies for the Age pension will qualify for portability while someone who does not wont, even though they may have worked longer in Australia in total.

To make it even more unfair, the decision whether the time spent overseas is too long to qualify for the pension portability is not in any legislation, it is made by Centrelink.
Someone who spends the final 12 months of his working life period can possibly be at the same risk of portability loss as someone who may have been away for 10 years.

Most people I know who have been forced into this situation have accepted it and returned to Australia for 2 years, often undergoing considerable hardship with partners or family left behind and finding themselves placed in a position of having to make a new home for a 2 year period while trying to spend as little as possible.

I think everyone effected should appeal and complain to the highest level, become a serial pest, write, ring and email the relevant ministers, camp on your MP’s doorstep and in particular ask WHY????

It is a law that benefits no one, self funded retirees are not restricted and the taxpayer support their pensions through tax breaks to the same extent as the Age Pension.

Stay safe,

Banjo