Tag Archives: aged care

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

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):


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.


Bruce Bickerstaff  

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

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.

Aged care – there has to be a better way

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)