The aged care puzzle

The aged care industry continues to be dogged by scandal with almost daily reports of facilities failing accreditation and frequent reports of abuse of older people making national headlines. In an election year aged care is also shaping up to be a major political issue. In February, the announcement of a $1.5 billion funding injection into aged care so early in the 'unofficial' election campaign indicates just how sensitive the issue is for the incumbent government. The funding boost to the aged care sector has generally been welcomed but is the government shying away from addressing some of the complex fundamental problems in aged care?     

An investigation of aged care mental health knowledge of Queensland aged care nurses

Older people are at risk for developing psychiatric disorders and require highly skilled and knowledgeable nurse practitioners to provide early recognition and intervention of psychiatric problems. This study sought to identify the aged care mental health knowledge of registered nurses (RNs) employed in long-term aged care and test the validity and reliability of a North American tool for use in an Australian context. The Mary Starke Harper Ageing Knowledge Exam (MSHAKE) was sent to RNs (n = 350) in 70 long-term care facilities (LTCF) in Queensland, Australia, and 107 surveys were returned (30.5% response). Participants were found to be unprepared for the reality of caring for the mental health needs of an older population and to have knowledge deficits related to suicide, prevalence of mental illness, mental health and ethnicity, and a number of issues regarding dementia.     

Advance care planning in residential aged care facilities

A person's right to self-determination in health care is now a fundamental principle of health care provision. As a consequence Advance Care Planning (ACP) is a critical issue in health care including palliative care as it is seen as a way of ensuring a person's right to participate not only in future health care choices but in end of life decision making.To date there have been few reports of successful ACP programs. In 2004 and 2005 a program of advance care planning, known as Respecting Patient Choices was introduced in 17 residential aged care facilities in metropolitan Melbourne, Australia. This program consisted of a system-wide approach that included education for aged care staff; information for residents and families as well as changes to organisational processes to ensure that residents have opportunity for self-determination in their future health care.This paper will report on the lessons learnt from this implementation and identify strategies which foster sustainability of ACP.