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