With the dust now settled on the Aged Care Royal Commission, providers are grappling with the major changes needed to ensure older Australians get the quality of life they deserve. The $17.7 billion package of support in the May budget was welcome, but there is a growing realisation that the substantive changes needed will not be driven by government alone.
Instead, current circumstances provide an historic opportunity for the aged care sector to work together to achieve change, from increasing innovation to sharing knowledge, developing the future workforce and educating the public on the role of aged care.
The notion of greater cooperation was front of mind for many aged care providers when Nous Group brought them together in late June for a virtual roundtable. The discussion – which included aged care providers and representatives from state governments – revealed a strong appetite to confront major challenges but a hesitance to go it alone.
The Royal Commission has left the sector feeling besieged. Expectations for change are high but the funding to deliver them is not (yet) available, and the role of the Aged Care Quality and Safety Commission is often regarded as punitive. The close scrutiny is understandable, but such glare may stifle the bold moves required to achieve real improvements.
One participant said we are in the midst of a capital strike, with uncertainty over regulation and future funding models prompting aged care providers to halt spending. “Residential aged care is not investible,” they said.
Aged care has historically been fragmented, with around 3000 residential and home care providers divided between community-based, private and government providers. This has prevented sharing knowledge and expertise on common challenges.
As our roundtable revealed, better cooperation between providers can be vital on several fronts.
For starters, there is the need for innovation. The sector has previously been slow to respond to shifts in consumer preferences, opting for a few standardised models of care. But older people are making clear that they want greater control over their own lives and will not be content with institutional models of care.
Thankfully there are many creative thinkers in the aged care sector who are willing to try different things, often through co-design with users. These creative thinkers need a space to swap ideas and push boundaries, as well as regulatory settings that welcome rather than repel these innovations. Innovative ideas to support older people in rural and remote areas are particularly suited to this creativity.
“If we keep putting everything at the feet of government, we will never be innovative enough to do what we need to do,” one roundtable participant said. “The minute we say it’s government’s fault we lose all our power to transform the quality of life for older people.”
Then there is the role of knowledge sharing. Fear of regulatory backlash or commercial disadvantage does not create an environment conducive to cooperation.
Aged care providers and residents would all be better off if practitioners in the sector could talk frankly with each other about their experiences. The extensive use of anti-psychotic medications for Australians living with dementia has put at risk their human rights – and in some cases their lives.
Changing this practice to only those limited situations where it is beneficial is essential. By practitioners prioritising this issue, sharing experiences and collaborating, the sector can make the required changes.
The perennial challenge of workforce development is another that could benefit from cooperation. Aged care providers are struggling to access and retain trained staff, and workforce shortages in rural and remote areas can fairly be described as a crisis. The lack of incoming foreign workers has exacerbated problems caused by undervalued work and unclear career paths. While expanding home care packages is welcome, as one participant noted, “if we cannot get the workforce into aged care, we cannot deliver those packages.” Now more than ever the sector is relying on the work of the Aged Care Workforce Industry Council.
And finally, there is a shared need to improve care literacy: the understanding older people and their loved ones have for the system that can support them.
Right now, many older people and their families are unfamiliar with the aged care system, leading to distrust and lack of awareness of options. As one roundtable participated noted, “Once care literacy is raised about what can be done in the home, people will demand it.” The sector has a common challenge in helping more people understand what is available to them so they can make informed choices.
The Australian Medical Association speaks with a united voice for the nation’s doctors, but who speaks for aged care providers? A roundtable participant asserted that a unified peak body would enable more sophisticated advocacy.
The latest Intergenerational Report reminds us why aged care remains vital – Australians are living longer than ever and the ratio of working-age people to those over 65 is projected to fall from 4.0 to 2.7 over the next 40 years.
If the sector waits on government to turbocharge spending and deliver transformation, it may never come. Instead, while advocacy is important, the sector needs to find ways to offer services that meet diverse needs of older people.
The time is right for the sector to come together. If we miss this moment, many older Australians will be worse off – and so will the organisations that seek to care for them.
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This article was first published in Australian Ageing Agenda.