By Scott Willis, national president of the Australian Physiotherapy Association
The rights of older people in residential aged care have been neglected for far too long. Basic rights of maintaining their physical and mental health, enjoying a decent quality of life and choosing who cares for them and how, are being left by the wayside.
This isn’t news to anyone. When Prime Minister Scott Morrison announced the Royal Commission into Aged Care Quality and Safety in September 2018, he said: “We are committed to providing older Australians with access to care that supports their dignity and recognises the contribution that they have made to society… If you care about aged care, which those who work in the sector do, you will want it to be at its very best.”
Mr Morrison rightly told Australians that “we expect high standards for the quality and safety of aged care services. This royal commission will be about proactively determining what we need to do in the future to ensure these expectations can be met.”
The current prescriptive funding of residential aged care services, in place since 2007, is woefully inadequate. The Aged Care Funding Instrument (ACFI) specifies the types of therapies aged care residents can have and how often. Under the ACFI, physiotherapists can only deliver massage and electrotherapy to residents either once or four times per week in accordance with the strict rules set by the Government.
The Australian Physiotherapy Association (APA) is disappointed by confusing claims in the media that physiotherapists have ‘over serviced’ older people in residential aged care, despite adhering to the dictates of this outdated system and the contrary findings of the royal commission.
The APA has advised the Government, the royal commission, and aged care providers that the current system falls well short of meeting the complex healthcare needs of older people. We’ve urged them to adopt more effective therapy as the system is flawed.
After two years of hearing expert evidence, including from numerous older people and their advocates, the royal commission recommended that access to “critical allied health services such as physiotherapy” in residential aged care be increased.
It did so with a strong belief that the “system should be based on a universal right to high quality, safe and timely support and care to assist older people to live an active, self-determined and meaningful life, and ensure older people receive high quality care in a safe and caring environment for dignified living in old age”.
While a new funding mechanism, the Australian National Aged Care Classification (AN-ACC), is scheduled to be introduced in October and is an improvement on what we have now, it is still unclear how the royal commission’s recommendations to increase physiotherapy services will be implemented.
We have been heartened by recently received reassurances from Minister Hunt’s office that increased scope and funding for the engagement of physiotherapists in both residential and in home care settings will be delivered, with a greater focus on restorative care.
Every recipient of health services, but especially elderly people in residential care, should have access to evidence-based treatments and support.
Physiotherapists are highly trained allied health professionals who work with aged care residents to improve mobility, reduce falls, and provide rehabilitation after illness and injury. Physiotherapy care plays an integral role in providing real gains in the quality of life of aged care residents.
The APA is working with the sector, including providers, to ensure aged care residents are able to choose high value health care services that meet their clinical needs.
As one long-time physiotherapist who is contemplating leaving the sector after many years told me, families “understand that their loved ones in care rely on our input in so many ways to provide quality care and quality of life. Physiotherapy and allied health providers help residents maximise the potential for the final chapter in their amazing lives.”
Government and aged care providers should be talking with us about building up a quality and sustainable workforce to help older people live their best lives as long as possible.
As Mr Morrison rightly said when initiating the royal commission, “Australians must be able to trust that their loved ones will be cared for appropriately and the community should have confidence in the system”.
That is what the APA is working towards.