Aged Care Australia Voice of the aged care industry
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44 eHealth In Aged Care 47 eHealth – Personally Controlled Electronic Health Record
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Winter 2011
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National Update CEO’s Report President’s Report State Reports Congress 2011 Speaker Profile: Andrew Larpent Speaker Profile: Dr. Nader Robert Shabahangi
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Profiles Claude Choules David Wren – Riding 22,000km for Dementia Foundation for Spark of Life Francis W Cook – Cook Care Group
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Technology Cloud gains traction in Aged Care eHealth in Aged Care and the National Privacy Principles
ACAA OFFICE HOLDERS PRESIDENT VICE PRESIDENT DIRECTORS EDITOR PRODUCTION
Bryan Dorman Francis Cook Tony Smith Mary Anne Edwards Viv Padman Geoff Taylor Kevin O’Sullivan Rod Young Jane Murray
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Workforce Give Your Employees Hundreds of Extra Dollars Every Year For The Effective Cost Of One Extra Cent Per Hour! Good News Stories – Industry Feedback
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Sponsor Articles Energy Contract Discount Offer (ACAA Preferred Supplier) New online courses – Increase your CPD hours Moving towards a National Framework for Advance Care Directives
79 Calendar of Events 81 Product News
Editorial 57 We All Face the Same Dilemma
ACAA - NSW
ACAA - WA
PO Box 7, Strawberry Hills NSW 2012 T: (02) 9212 6922 F: (02) 9212 3488 E: admin@acaansw.com.au W: www.acaansw.com.au Contact: Charles Wurf
Suite 6, 11 Richardson Street South Perth WA 6151 T: (08) 9474 9200 F: (08) 9474 9300 E: info@acaawa.com.au W: www.acaawa.com.au Contact: Anne-Marie Archer
ACAA - SA Unit 5, 259 Glen Osmond Road Frewville SA 5063 T: (08) 8338 6500 F: (08) 8338 6511 E: enquiry@acaasa.com.au W: www.acaasa.com.au Contact: Paul Carberry
AGED & COMMUNITY CARE VICTORIA
FEDERAL
ACAA - TAS
AGED CARE QUEENSLAND
PO Box 335, Curtin ACT 2605 T: (02) 6285 2615 F: (02) 6281 5277 E: office@agedcareassociation.com.au W: www.agedcareassociation.com.au
PO Box 208, Claremont TAS 7011 T: (03 6249 7090 F: (03) 6249 7092 E: smithgardens@bigpond.com Contact: Tony Smith
PO Box 995, Indooroopilly QLD 4068 T: (07) 3725 5555 F: (07) 3715 8166 E: acqi@acqi.org.au W: www.acqi.org.au Contact: Nick Ryan
ACAA OFFICES
Distinguishing the difference between Aged Care Facilities and Retirement Villages National electronic Resident Agreement – New Innovative National Service Aged Care facilities – The gap between the rich and poor to grow? Changes to the Accreditation Grant Principles Compulsory reporting – A guide for facility managers from Hynes Lawyers Industry reflects on Vic and Qld Floods In Her Own Words Green Clean Stock Take
Level 7, 71 Queens Road MELBOURNE VIC 3000 T: (03) 9805 9400 F: (03) 9805 9455 E: info@accv.com.au W: www.accv.com.au Contact: Gerard Mansour
Aged Care Australia is the official quarterly journal for the Aged Care Association Australia
Adbourne PUBLISHING
Adbourne Publishing PO Box 735 Belgrave, VIC 3160
Advertising Melbourne: Neil Muir (03) 9758 1433 Adelaide: Robert Spowart 0488 390 039 Production Claire Henry (03) 9758 1436 Administration Robyn Fantin (03) 9758 1431
DISCLAIMER Aged Care Australia is the regular publication of Aged Care Association Australia. Unsolicited contributions are welcome but ACAA reserves the right to edit, abridge, alter or reject any material. Opinions expressed in Aged Care
Australia are not necessarily those of ACAA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Aged Care Australia may be copied in whole for distribution among an organisation’s staff. No part of Aged Care Australia may be reproduced in any form without written permission from the article’s author.
www.agedcareassociation.com.au
www.adbourne.com
Front Cover: The Hon Mark Butler, Federal Minister for Mental Health and Ageing
national update
CEO’s Report Summary of findings The report examines the financial viability of aged care services under recommendations made in the Productivity Commission’s draft report Caring for Older Australians.
Rod Young CEO, ACAA
The viability of residential aged care providers And the potential impact from Productivity Commission recommendations on changes to the aged care system Prepared by Deloitte Access Economics for ACAA and ACSA
The findings are based on several data sources including publicly available information, a survey of aged care providers, interview with aged care providers and financial institutions, and internal data and modelling. A forecast and model of proposed funding changes, including supported and nonsupport accommodation payments have been developed to assess future financial sustainability. Costing has been developed using the “weighted average cost of capital” (WACC) – the average rate of return providers must pay to satisfy its equity owners and creditors. A different WACC was calculated for high and low care beds and for for-profit and not-for profits providers allowing for different tax treatments for both groups. A base formula was developed incorporating bonds and periodic payments, occupancy rates, CPI, building life-span, and returns on investments. The report also examines some possible options taking into account demand and supply, room size, geographic location, and access to capital. PC recommendations including removing caps, high and low care distinctions; supported places and prudential regulation have also been considered alongside recommendations concerning bonds and periodic payments.
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The impact of proposed new rules governing accommodation bonds and periodic payments is addressed, pointing to the need for new business models
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The impact of proposed new rules governing accommodation bonds and periodic payments is addressed, pointing to the need for new business models. Risks associated with the consequent need to raise commercial debt and equity investments are also canvassed. These findings have been provided to the PC to assist in its preparation of the final Caring for Older Australians report. ACSA/ACAA will also use the data in ongoing advocacy and negotiations.
The report reached the following conclusions and makes eight recommendations: The Productivity Commission’s recommendations could make high care facilities viable again, by increasing Government subsidies for supported places to reflect the cost of supply, and by removing price caps so that the market can competitively determine the price of unsupported places. However, clarity is required in relation to the Productivity Commission recommendation and, in addition; there is the need to specify a definition of the cost of supply. Moreover, basing the cost of supply on a two-bed room does not reflect the facility mix currently or going forward. • Recommendation 1: Clarity should be provided in Draft Recommendation 6.4 of the Productivity Commission draft report to enunciate that it is only the subsidised element of the accommodation payments and charges that should reflect the cost of supply, while abolition of the caps is designed to enable demand side factors to operate in determining prices above the cost of supply, with the difference being resident copayments. • Recommendation 2: The definition of the cost of supply should include the cost to finance commercial debt and equity (i.e. the WACC) and the cost of land. Cost of supply should not be based on a two-bed room but, rather, on a ‘typical’ new construction. Then a number of factors would influence the market value of any individual bond or periodic payment – including geography, income and wealth, ‘quality’ of facility/ room (age, beds/room, fitout, view etc), and resident preferences. • Recommendation 3: Reflecting factors such as geography, income and wealth, ‘quality’ of facilities and rooms, and resident preferences, there could be a range of (market) bed and bond rates published by a facility which reflect the interaction of the cost of supply with the different demand elements. Additionally, providers could
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national update
CEO’s Report (continued) schedule a decrease in the real value of the daily accommodation charge over time as the facility ages. There is uncertainty about the equivalence of periodic payments and accommodation bonds since it is not known the proportion of people who will elect bonds relative to periodic payments, and this reduces the WACC at which the two are converted. • Recommendation 4: Any decision to require accommodation bonds to be equivalent to periodic payments must ensure that the costs of debt financing when moving to a cash flow model is fully captured in determining the equivalent amount. In addition, a formulaic approach to determine equivalence should be avoided, as residents will have alternative appetites for periodic payments versus accommodation bonds, and these should be reflected in alternative market prices. Given the cost of care may no longer be cross subsidised by income earned from accommodation bonds, the price for care is expected to rise. Some paying cocontributions to their cost of care may face an increased cost of care as a result of the removal of cross subsidisation. Residents who are not supported but cannot afford the average accommodation bond amount (e.g. people with assets above the minimum assets limit of $39,000 currently but below the average accommodation bond) may find
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Given the possibility of a dilution in the bond market arising from a move towards daily accommodation payments, this major issue should be addressed as part of proposed changes to the aged care industry.
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it difficult to access residential aged care under the recommendations. This may lead to a ‘middle class’ gap in access to appropriate residential aged care services. • Recommendation 5: The contribution of the Australian government to the cost of care for supported residents should cover the full costs of care and provision for the potential need to step in and help support the cost of aged care accommodation for these low-middle income residents. Given there are additional challenges in the delivery of care to special needs groups such as the homeless and people with poor mental health, these should be more specifically recognised in contributions made by the government to the cost of care for these people. What happens to the overall amount and value of bonds is unknown, but will depend in part on the income and entitlement impacts of the Pensioner Bond Scheme, the attractiveness of the Aged Care Equity Release scheme, the average value of bonds, and the scope to differentially price them. The equivalent bond under the recommendations is higher than the average bond currently, suggesting that the stock of bonds may fall, and providers (particularly) may have to adjust to a more expensive cash flow model. This generates substantial risk for exposed providers – notably low care, small scale and not-for-profit providers. Competition from non-traditional players is also likely to increase as barriers to entry are removed. While providers can mitigate against this risk to some extent, by changing their business models or diversifying, there is a need for more discussion in the Productivity Commission draft report in relation to these impacts and transition arrangement to ensure the sector is not cataclysmically disrupted. • Recommendation 6: The Productivity Commission needs to address transition arrangements flowing from its recommendations – such as gradual phasing in, grandfathering, or support mechanisms to providers to assist with restructuring or with diversifying into community
care, respite care or transitional care. To minimise structural change costs, transition should be implemented progressively and in partnership with the industry to avoid unintended incentives and consequences. Establishment of an Australian Pensioners Bond fund is expected to have a negative impact on the supply of accommodation bonds to providers, and will therefore increase the possibility of bond dilution under Productivity Commission recommendations. Given the negative impact bond dilution would have on investment (through an increase in the cost of capital), any competitive advantage in attracting lump sum payments for the Australian Pensioners Bond fund should be avoided. However, the potential impact on the supply of lump sum payments to providers will crucially depend on the treatment of income derived from the Australian Pensioners Bond fund as it relates to pension entitlements and the income test for the daily care fee and income tested fee. Currently this is unclear within the Productivity Commission draft report. • Recommendation 7: The Productivity Commission should ensure recommendations avoid providing any competitive advantage in attracting lump sum payments for the Australian Pensioners Bond fund. It should also clearly outline the treatment of income derived from the proposed Australian Pensioners Bond as it relates to pension entitlements and the income test for the daily care fee and income tested fee. Given the possibility of a dilution in the bond market arising from a move towards daily accommodation payments, this major issue should be addressed as part of proposed changes to the aged care industry. Access to bond lump sum income streams have been a key part of the growth of aged care infrastructure in Australia, as they offer benefits to residential aged care providers and residents. A move away from a strong lump sum stream will compress a facilities valuation, and may reduce a loan to valuation ratio below an acceptable threshold, putting some providers in breach of their debt contract. • Recommendation 8: Any aged care reform process should recognise and build upon the positive features of the lump sum bond income stream. n
national update
President’s Report Bryan Dorman, President, ACAA
To Merge or Not to Merge? – That is the Question As most providers in the aged care industry would be aware, ACAA has for over five years supported the merging of the major industry peaks to form one organization with a single voice representing the broad sweep of interest within the aged care industry.
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CAA has been delighted by the broad level of consensus across the industry to the draft report.
At that time, the ACAA national and state affiliated boards determined that having “One Voice” was in the best interests of members and of the industry to be able to efficiently apply maximum and focused resources to:
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manage government liaison, influence industry policy and strategy, deliver member services, maintain a media profile and, deliver community education and understanding of the role and place of our unique industry.
Within the ACAA federation, this decision though it initially generated a good deal of robust discussion about its appropriateness and the alternative options available to the organization, was ultimately unanimously endorsed as the correct direction for both us as an association and for the broader aged care industry. This decision was taken by ACAA, in full recognition that there would need to be ongoing discussion and debate about an appropriate spread and breadth of member representation along with the need to recognize the respective and diverse not-forprofit and for-profit interests and that these would be adequately reflected in any future amalgamated organization. It is interesting therefore to compare the ACAA position with the considerable debate happening elsewhere in the industry about future directions and whether or not there should be a coming together of the industry peak bodies. In the states of Queensland and Victoria where the industry peak bodies have operated as merged entities for quite some time, the results are self evident, with both operating effectively and efficiently, achieving industry representation and service to all parts of the industry right through continuum of care for their members. Probably more importantly, their level of representation has not diminished. In fact, the evidence certainly points in the opposite direction, where, after amalgamating resources and efforts and uniting energies, the activities of each state association has in fact enhanced the services and the capabilities of the two states. Both ACSA and ACAA have successfully convened under the banner of the Aged Care Industry Council (ACIC) for more than ten years. Through this forum, each association has developed an agreed position on a wide range of industry policy and responses to government initiatives at the Federal level.
With no notable exceptions, industry policy and strategy addressed in this forum has facilitated closer and stronger ties and relationships of the respective bodies, as well as a united front to confronting the ongoing challenges of the industry and all its stakeholders. It has also enabled a mutual understanding of the real issues we face as an industry. The work of ACIC can therefore be offered as a demonstration of member interests being able to be addressed in a common context across the breadth of the ACSA/ ACAA membership without creating a loss of involvement or engagement by subsectors within the industry. ACAA remains committed to continue the dialogue which will lead to the eventual creation of a single industry body. In the meantime, and as part of an evolving process, ACAA recognizes that a merger of the two organizations will require both bodies to hold a common view as to its benefits, purpose and objectives. At the moment ACSA is undertaking a survey to evaluate member views on this issue. Concurrently, ACCV and ACQ have produced a review of the respective benefits and structure of a national organization and of the federal and state structures of the organization therein. In this context, I thought it appropriate to restate the longstanding position of ACAA as I have above, whilst recognizing the jurisdiction of the ACSA federation in deciding its future direction and whether it wishes to pursue one of merger or continued separate activity. ACAA will be interested to see the outcome of the current ACSA membership survey on this and other issues. In any event, ACAA remains committed to work collaboratively with ACSA and all industry stakeholders, in the broad interests of achieving the best outcomes for the respective organizations and the industry as a whole. n
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national update
ACAA – SA Paul Carberry, CEO ACAA - SA
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The trend towards an ageing population is clearly established, and the reasons are well understood. What is less clear is how we will deal with it.
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Australia’s ageing population has been the subject
Utilising the Skills of Older Australians
of more discussion, debate, inquiries and reports
This is about two things. Firstly, keeping older people healthy, with better programs and support to promote healthy lifestyles and good mental health.
than almost any other social trend.
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o much so that we know the numbers by heart: According to the Australian Treasury, in 1970 only 8% of Australia’s population was aged over 65. By 2001 the proportion was 13%, and by 2040 one quarter of our population will be aged over 65. There are two underlying reasons for this. Firstly, since the 1960s Australian families have been having fewer children. The second contributing factor to the ageing population is that we are living longer. For example, in 1960 life expectancy for Australian males at birth was 68 years, and today it is 79 years. So, the trend towards an ageing population is clearly established, and the reasons are well understood. What is less clear is how we will deal with it. Certainly, the ageing of our population brings with it big challenges, which people in our industry are more familiar with than most. For example, in 1970 there were 7.5 people of working age for every person aged over 65. Today there are only five, and by 2050 the ratio will drop to 2.7. In short, we’ll have increasing numbers of people over 65 who will need greater financial support, greater levels of healthcare and, eventually, personal care. While, over the same timeframe, there will be proportionally less people in the workforce to provide these services and to pay the taxes which fund them. The inquiry by the Productivity Commission has put aged care reform firmly on the national agenda. It sets the scene for aged care to become the sustainable, competitive and responsive industry it will have to be, to cope with a quadrupling of client numbers by the middle of this century. But, our demographic trends require action beyond aged care per se; we need serious debate and reform across a range of issues. Here are two important ones.
Immigration Policy A planned and targeted immigration policy could help offset the declining workforce numbers and worsening skills shortages Australia faces. Yet the population report released by the Government in May avoided a discussion of immigration, and the debate in Canberra continues to be centred around “boat people”, who comprise less than 2% of overseas arrivals.
Secondly, if older people can avoid premature illness, they will consume less healthcare, and can contribute economically for longer, something which many are obviously willing to do. According to the Australian Institute of Health and Welfare, almost a quarter of men and 13% of women in the 65-69 aged range are participating in the workforce. The Government has recognised the payoff in keeping older people healthy and productive, but more has to be done in terms of health promotion, retraining, tackling ageism in the workforce, and providing incentives for people to work longer. n
national update
ACAA – NSW Charles Wurf, CEO ACAA-NSW
Aged Care Industry Council (NSW & ACT) Building Conference | Wednesday 27 July 2011 The biennial Building Conference for aged care providers in NSW is on again in 2011.
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his will be the third Building Conference devoted exclusively to building and development issues in NSW. The Building Conference is a joint initiative of ACAA-NSW and ACS NSW & ACT, and is conducted through the auspices of the long standing Aged Care Industry Council (NSW & ACT) Building Committee. The Building Committee is particularly pleased to be working in partnership with Paynter Dixon in the Building Conference in 2011. The mission of this joint initiative is to provide a conference where members can share experiences, insights and know-how, and inspire and foster innovative development works for the ageing population.
Design & Construction for an Ageing Population - what are your options? reflects the rich opportunities presented in designing and constructing the living environment for the ageing Australian and will be held: 9.00 am to 4.00 pm Wednesday 27 July 2011 Novotel Brighton Beach, Brighton Le Sands Conference sessions will be devoted to Capital Investment in Aged Care; Designing and Building for Market Segments; and concurrent sessions dedicated to procurement planning and reviewing existing projects with the implications for future building. In an environment dominated by proposed policy and market realities of increasing consumer choices the Building Conference will conclude with a focus on current research and recommendations fostering these choices. Full details of the program will be provided separately to all members in NSW by both Associations and is available through the ACAANSW office. n
national update
Joint State Report Aged & Community Care Victoria Gerard Mansour, CEO Aged & Community Care Victoria
Is the sum greater than the parts? The value of a single industry aged care association State-based aged care associations Aged & Community Care Victoria (ACCV) and Aged Care Queensland Incorporated (ACQI) have joined together to ask the question: Can our industry have greater impact with a single national association representing aged care providers?
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hrough the launch of the report, Is the sum greater than the parts? The value of a single industry aged care association, we are exploring the value of a single industry aged care association.
Commissioned jointly by ACCV and ACQI, the report was conducted by business consultants PricewaterhouseCoopers (PwC) to consider whether the business models these merged State associations have developed would be beneficial, when replicated at a national level, to better represent the interests of aged care providers nationally. Currently there are 10 industry associations representing providers at a State level and three national associations representing for-profit, not-for-profit providers and retirement villages. The report proposes two new models for consideration: a Federated Model throughout Australia, and a National Model, both of which significantly outscore the current model in terms of assessing the key indicators. The Federated Model would be of similar structure to the current model. Members would join their State-based association which operates with a State Board and CEO, and their existing assets would continue to reside at a State level. Nationally however, the three current industry associations would come together as single voice which would be the conduit to the Commonwealth.
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Aged Care Queensland Nick Ryan, CEO Aged Care Queensland
A National Body model would be quite a different structure from the current model. Members would join the national body directly, not at the State level, and this would be represented by a single CEO. There would still be a State presence and the State arms or branches would report nationally. Both of the models provide the foundations for a more sustainable industry advocacy voice, while still maintaining the local State-based support services valued by aged care providers nationally. The main difference of the National Model compared to the Federated Model is that, it is the extra leap to the national body model that sees a significant layer of duplication removed from the model that exists currently. The biggest benefit of having a single representative industry association is the ability to be more impactful at a national level. Awareness of the needs of the industry as a whole is much greater when there is a very simple, consistent message coming from the sector. Brands like the Australian Medical Association (AMA), the Pharmacy Guild of Australia and Alzheimers Australia are very strong brands which represent a unified voice, and they show how effective an association can be if it is unified at a national level. As examples, ACCV and ACQI have proved successful as the single representative bodies in their respective States with member satisfaction levels continuing to increase since their mergers in 2006 and 1998 respectively. PwC examined “the synergies created by the association mergers in Victoria and Queensland to provide information and evidence on the potential value to members of single aged care industry association,� (page 3). Of course all existing associations, and association staff, provide great support, and advocate for members. Yet the report outlines the opportunity to harness the passion, skills and competency of all associations, both State and national, to create an organisational model that is both more efficient in advocating for its members. Member surveys in many States show that members are demanding a strong advocacy voice. The report also considers that current Association structures can be streamlined to better serve member needs. “By reducing the processes around association to association liaison, both management and administrative processes can be streamlined.
This would increase resources available to deliver member services, improve the efficiency of representation and lobbying, increase member satisfaction and ultimately improve outcomes for members,” (page 6). The report highlights that efficiencies can be put in place that can be utilised in areas where there are gaps. For example, the PwC report finds (page 3-4): •
The existing national offices are currently under resourced to deliver the services they provide at the national level
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The current level of spending on national advocacy is lower than it would be under a more unified model
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The public profile of aged care issues is lower than it should be
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There is duplication of messaging from the industry
The State association mergers also demonstrate learnings that can be used to manage the risks associated with making a significant structural change to the operation of the industries national representation. The existing structure has been there for a long time and exists for certain reasons. Therefore any change must be mindful of what the issues that matter to the existing associations are now, and make sure that they’re provisioned for going forward.
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The existing structure has been there for a long time and exists for certain reasons. Therefore any change must be mindful of what the issues that matter to the existing associations are now, and make sure that they’re provisioned for going forward.
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The key risk areas with this proposed change may be around leadership and representation as well as the procedural factors of a merger. What’s important is to make sure the key risks are identified and a strategy to manage this is also identified from the start. The main outcome from the report highlights that a review is important to be able to develop a future vision for a coordinated industry approach. A video outlining the report has been produced featuring PwC Director Sarina Fisher and Presidents from both the State associations who reflect on the benefits of the State mergers for their associations at www.agedcareunited.com.au. n
national update
ACAA - WA Anne-Marie Archer, CEO ACAA-WA
EXTRA, EXTRA – hear all about Extra Service!
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nyone who has spoken to me in the last six months has probably heard my heralding about the ACAR Extra Service region percentages in WA and the impact that had upon our members with the will to build in this State. Granted, every other state experienced a similar situation and WA did get a comparatively large number of the Extra Service licences allocated last year, yet
interestingly much the same could be said for the community care package provisions. However, this did not extend to the bed licences allocated, with only 20 percent of the available beds taken up in the last round. Nevertheless, whilst our Members need Extra Service licences to complete construction or make them operational we will continue to raise this issue until there is some resolve that will no doubt be in the form of some regional ratio reviews and eventually the outcome of much needed reform. Unfortunately the industry found itself subject to a process that had providers willing to build and provide services that would accommodate both Extra Service and standard bed licences seriously considering their future developments.
It has been a truly challenging time in the West for those providers who were mid-flight or about to start development – which is ironic – given in the next breath you can say that you can hardly give a provisional licence away in WA. The “equity of access” argument seemed grossly out of step with reality in the West and equally elsewhere I presume... no extra service licences = no finance = no buildings = no supported access = greater competition from those who have the means to pay a bond in the existing facilities. All that aside, we remain respectful and appreciative that the Minister has made considerable time to talk to the West about this issue and we hope and trust that the provisions for extra service licences in this round will afford WA providers the opportunity to make some of their existing beds operational. n
congress
ACAA 30th Annual Congress
6 – 8 November 2011 | Gold Coast Convention & Exhibition Centre Awards – Now Open
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Building Awards There are four awards on offer this year. They include: New standard facility New extra service facility Renovated standard facility Renovated extra service facility
Employer of Choice Awards This award provides an opportunity for both employer and employees to showcase your aged care facility and to demonstrate to the broader industry what it is that makes your staff and colleagues want to work in aged care and for this aged care provider. The winning applicants will each receive a $5,000 contribution toward attending a SAGE Study tour of their choice. The tour must be taken within the following 2 years. Submissions close 31st August 2011. Details and submission guidelines available from the Congress website at http://www. acaacongress2011.com.au/awards.htm
Social Program The social program will provide delegates with plenty of time to network and have some fun. The first official social function will be the Welcome Reception in the trade exhibition on Sunday 6 November. There will be an Exhibitors’ Reception for all Congress attendees offsite on Monday 7 November, and then the Gala Dinner, the social highlight of the Congress, will be held on Tuesday 8 November – this year’s theme is The Magical Mystery Dinner.
Exhibitors Listing • • • • •
50 Plus Aged Care Association Australia Aged Care Channel Aged Care Online Aged Care INsite
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Aim Software AirLiquide Healthcare Aqualogic ArjoHuntleigh Australia Ageing Agenda Australian Medicines Handbook AutumnCare Systems Bond Select Bunzl Cater Care Australia Catering Industries CH2 Clinicall Colonial First State Creek Solutions DPS Publishing Ebos Group Electrolux Laundry Epicor E-Z-Go Cars Ezidebit Eziway Salary Packaging Grant Thornton Hahn Healthcare Recruitment Health Industry Plan Health Super HESTA Hynes Lawyers iCare IMB Ltd Independence Australia Inerva Innova Group Invacare Kimberly Clarke Kings International College Lappset Australia Laundry Solutions Australia Leecare Solutions Lille Healthcare LINAK Australia Materialised McNeil’s / Euron Medicare Australia Medirest Microchips Aust / Trovan Moving ON Audits National Australia Bank Nationwide Health & Aged Care Services NEC NEHTA Nestle Healthcare Nutrition
• • • • • • • • • • • • • • • • • • • • • •
Nextt Health Paul Hartmann Presidential Card Provider Assist QPS Benchmarking Questek Australia Richard Jay Sarah Aged Care Software SCA Hygiene Australasia / TENA Sebel Furniture Simavita Smith+Tracey Architects Sodexo ThomsonAdsett Tunstall Healthcare Unicharm Vision Food Solutions Vivir VM3 Purefier Webstercare Westpac Zenith Insurance
Trade Exhibition and Sponsorship Opportunities The trade exhibition will be a key feature of the Congress and is an opportunity for organisations to promote innovative products and services directly to decision makers within the industry. There are still a few sponsorship opportunities for organisations who wish to gain a higher level of exposure. A sponsorship and trade exhibition brochure is available on the Congress website at www.acaacongress2011.com.au n
General and Delegate Enquiries ACQ Conference + Events T: 07 – 3725 5555 F: 07 – 3715 8166 E: acaa2011@acqi.org.au
Trade and Sponsorship Enquiries Jane Murray, ACAA T: 08 – 9405 7171 F: 08 – 9405 6585 E: enquiries@acaacongress2011.com.au
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keynote speaker
Congress 2011 Speaker Profile:
Lessons from Past Experience “There is no need to re-invent the wheel because we can all learn from one another.” By Mike Swinson “When you read the Australian Productivity Commission’s draft report on Caring for Older Australians it is interesting to note the contributions and constructive comments, included in the document from both ‘for profit’ and ‘not-for-profit,’ providers. When I read similar documents in the UK, I would be surprised to find similar acknowledgments of the contribution the provider community makes to our aged care sector! It’s a reflection on the different tone of care sector discourse in the UK that a similar Government report would be unlikely to acknowledge so respectfully the contributions from a wide range of industry experts as the PC has done in Australia.”
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hat remarkable acknowledgment about the respect accorded to CEO’s and senior staff in the aged care sector, from the broader Australian business community, comes from the respected CEO of one of the biggest not-for-profit aged care providers in the UK, Andrew Larpent OBE, from the Somerset Care Group. “Most of the aged care services that are provided here in the UK are as good as any in the world, however providers continue to work within a generally negative context and are not afforded the respect they deserve for the quality of their contribution. Much of the progress that we have achieved in recent times has been despite the UK’s health and social care system rather than because of it. The discussion I hope to open up at the ACAA Congress this year will focus on lessons learned from developments in the UK in recent years, drawing also on experiences in the USA, Canada and New Zealand.” So who is Andrew Larpent? Scratch the surface, run a Google search and hey presto, it’s all there, well, not all. You need to use that search information and then ask questions,
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which is exactly what I did. So let me introduce Andrew Larpent, one of this year’s Congress Keynote speakers. Andrew comes from a military family. His grandfather served in the Boer War, then both WW1 and WW2. He won a VC, DSO and bar and MC. Andrew’s father served in WW2 in Burma and then Andrew himself joined the British Army serving in various roles, including a covert intelligence officer in Ireland and ended up commanding the family Regiment in Iraq in the first Gulf War. ”It’s my maternal grandfather, Major General Dudley Johnson, who inspired me the most as a youngster. He was wounded when fighting alongside ANZAC troops on the beaches at Gallipoli and went on to win his VC on the Sambre Canal in 1918 when commanding the Royal Sussex Regiment. His front line combat engineers were Australian Tunneller “diggers” from the 409th Field Company Royal Engineers who had come out of the tunnels to support the final offensive against the German Army. When we staged a big family gathering at the
battlefield to mark the 90th Anniversary of that battle on 4th November2008, we were joined by descendants of the Australian Tunnellers who had been involved in the action. I guess it is that association with Australia that has contributed to my growing admiration for this country and its people. As a schoolboy Andrew used to spend school holidays with his much decorated and much loved widowed Grandfather, in a big old house in Hampshire, as his own parents were living and working with the British Army in Germany. “My Grandfather was a very caring loving man, unassuming, dignified at all times and reserved in a way, but he was always warm and friendly towards me. My father was also from a military family, he was in the Royal Northumberland Fusiliers. He saw service with the Chindits in Burma in WW 2. His story has been written about by his boss at the time, the famous British author John Masters, in his book ‘The Road Past Mandalay.” When Andrew left the military, his first civilian job was working for a private German manufacturing company. He said it was all about making the owner a very rich man, a mission that did not turn him on at all. “It was a valuable experience but it didn’t enthuse me much so I moved on and worked as CEO of a British children’s cancer charity. This was a most enjoyable and satisfying challenge. I loved the job and particularly the sense of service to vulnerable people. I don’t think that, as a younger man, I gave the concept of service to others a great deal of thought, but I do now. There is a strong resonance between life in the armed services and my current service life working to improve the lot of older and disadvantaged people. The British not-for-profit sector is populated by a lot of people who share these values; people who want to work in ways that make a positive difference to the lives of others.” On his recent study tour visit to Australia and New Zealand, it was the difference in the atmosphere that exists in the business of health and social care when compared to the UK that struck Andrew most strongly. “At the moment in the UK we are going through a highly charged political process, redefining what the health and social
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We have to change if we are to survive and grow and offer better and different options, and there are lessons we can learn from Australia
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care architecture of society should be, with strong consequences for the public sector. The Health and Public Care sector in the UK has been dominated for the last 50 or 60 years by the public sector, and increasingly run by bureaucrats. The National Health Service delivers the health sector care segment, and local government has responsibility for commissioning the social care service sector. There is a yawning gap between the two elements of health and social care. There is widespread recognition that the present system has to change and there is an almighty row going on as the vested interest groups within public services and entrenched bureaucracy try to shore up their positions and stop any major changes. It is a challenging time and it will require exceptionally strong political leadership if we are to see the necessary changes driven through.” “We have to change if we are to survive and grow and offer better and different options, and there are lessons we can learn from Australia.” “I am very proud of much that I see about the UK Aged Care system. The majority of providers are working hard and delivering services that are of a high quality. However what I notice in Australia is that the care and health sectors are not dominated by the public sector to anywhere near the extent they are in the UK. The result of this, as I see it, is that in Australia, the independent provider, not-for-profit or for profit, enjoys a status and a degree of professional respect that is missing from the UK debate. There are clearly many issues to be resolved, and these are addressed in the Productivity Commission recommendations, but the spirit of partnership and mutual trust that I think I see in the public discourse in Australia is something that needs urgently to be improved in the UK. n
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keynote speaker
Congress 2011 Speaker Profile:
Dr. Nader Robert Shabahangi “Perhaps elders move slower, but they know where they are going. Perhaps elders take longer to decide, but their decisions feel wiser! Perhaps they think slower, but their thoughts are almost always more insightful! Perhaps their eyesight is not as sharp, but their vision is more profound. Perhaps their hearing has lessened but they know what is worth listening to and perhaps they struggle with modern technology, but they understand more about the mystery of life!” This, according to Dr Nader is a bit like acknowledging cultural differences. In Germany you do not talk about family problems, particularly mental health problems, you sweep them firmly under the carpet. In Italy everyone talks loud and long about everyone else’s problem and it doesn’t matter.
By Mike Swinson
and friends with a chance to discover a life that is different, not diseased.
The essence of Dr Nader’s research
“My life’s training is as a Psychotherapist, so it revolves around the whole field of mental illness or what we all regard as ‘not normal,’ whatever that means!”
into Dementia turns traditional attitudes on their head.
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he essence of my research and work would be that I have a choice as a human being, to look at what I am faced with in the people I meet; the differences that I notice, as either something I dislike, something that I do not want to make part of me, something that I think is bad, or; I have a choice to consider it as something I can be curious about, want to understand, want to learn from and want to grow with and be enriched by.” Now stop and ponder that message for a moment, in the context of meeting someone with dementia, living with a partner or family member who suffers from Dementia. There I go, see, I said ‘Suffers,’ as if Dementia is a disease. It isn’t according to Dr Nader, not by any imagination. It is simply a state of forgetfulness. It provides us all, carers, family
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“So the choice we all have as human beings is to not categorise others as ‘not normal’ as dysfunctional, as diseased and instead look at them as a wonderful opportunity to explore a new way of being. To become curious about how they live their life now, given the impact of being ‘forgetful.” Got your head around that one? I am fascinated, because as I talk further to Dr Nader, who I have just met for the first time on the phone call to San Francisco, I find myself warming to this man. I feel he has a different way of being with people with dementia, oops, sorry, I forgot, Forgetfulness! I, like many others, am looking forward to what he has to say as a keynote speaker at this year’s ACAA Congress. If you get a chance, get hold of a copy of one of his books, called ‘A Conversation with Ed.’ It’s an eye opener, also loved by many who have read it.
“We can all cope with different cultures, so why can’t we cope with ‘forgetfulness? What is our identity, if I can’t remember Mike’s name, does that mean I can’t remember anything about Mike? Is my inability to communicate anything in the written and spoken word the end of my ability to communicate at all? I think not, well not if you can learn or try communicating in a different way. That is what Agesong is all about” The goals at Agesong are to help professional care partners make ‘in the moment’ connections with the people they care for and watching for improvement in well-being as a result. Dr Nader has also been the co-author of another wonderful book, ‘Deeper into the Soul,’ which explores the concept of shifting from a ‘disease’ mentality into a ‘shifting experience or ‘forgetfulness.’ The book revolves around conversations with four characters who have been diagnosed with Alzheimer’s or other types of dementia. Don’t miss this unique opportunity to come to congress and listen, talk with one of the world’s explorers in different therapies for different conditions. Don’t forget now! n
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Claude Choules The Last Man Standing
By Mike Swinson, drawing on research and articles about Claude Choules from as far afield as The BBC, British News Media and outlets here in Australia.
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ntil his death on Wednesday 4th May this year, Claude Choules was regarded by historians across the globe as the ‘last man standing,’ the last surviving individual who had seen action during The Great War. “I’m lucky aren’t I, to be surviving all that time,” he once told the BBC. “If I had my time over again I wouldn’t change a bit of it” Claude Choules passed away quietly in his sleep at a nursing home in Perth, Western Australia. This article is a tribute to a man who regarded himself as ‘just an ordinary bloke
doing his job,’ and it comes from publishing houses, newspapers and broadcasting organisations from across the world. After the funeral, the family asked the media to respect their privacy; hence this story does not draw on family recollections, unless already published. Claude’s remarkable life journey began when he was born in March 1901, just a few weeks after the death of Queen Victoria. He grew up mucking about in boats on the river Avon, at Pershore in Worcestershire. His otherwise idyllic childhood was shattered by the departure of his mother when he was five. It seems to have given Claude a chance to become an independent young man, a bloke who would, as the years passed, develop his skills and combine them with a goodly dose of common sense, not to mention courage. He became an explosives expert and lived to tell his story.
Perth based publisher, Hesperian Press reveals details of Claude’s life on its website. “With his characteristic wry humor, Claude may credit cod liver oil as the secret of his longevity, or he may advise his questioner to “keep breathing”, but, at heart, he really believes that a loved and loving family kept him going. When Ethel died at the age of 98 in 2003, she and Claude had been married for more than 76 years. His book, ‘The Last of the Last,’ was written when he was in his early eighties (as a member of Elizabeth Jolley’s Creative Writing class), Claude’s memoirs were originally intended for his family. But time and circumstances have given this engaging and historically significant manuscript a unique status. In his one hundred and ninth year, Claude Choules became the world’s oldest first-time published author. Covering the first two-thirds of the twentieth
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At the outbreak of war in 1939 Claude was the Acting Torpedo Officer, Fremantle and also the Chief Demolition Officer on the western side of the Australian continent. He was tasked with destroying vital military installations should the threatened Japanese invasion of Australia come to pass. He remained in the Australian Navy until he transferred to the Naval Dockyard police, finally retiring in 1956 after 40 years in uniform.
century, Claude’s biography takes us from the peace of Edwardian rural England, through war, troubled peace, another war and finally the peace of living and working at the aptly named “Safety Bay”. For a man who spent a good part of his career handling dangerous explosives, nothing can be taken for granted. So the now idyll Claude depicts in the last chapter of his book — a happy, growing family enjoying the simple pleasures of creation in a world at peace — is meant to show us how ordinary men and women can, without fuss, live rewarding, useful lives. Such is the wisdom of this cheerful but shrewd man. His engaging, always readable account of his life and times is a work in the tradition of that other Western Australian classic, A Fortunate Life.” The BBC published a number of web based articles and ran television stories when Claude finally passed away, as did television and radio stations around the world, from France, Germany, the UK to Australia and the USA.
The reason for this remarkable coverage? In July 2009 Claude became – as one of three surviving veterans – the only remaining combatant of WW I. He was also the last man in the world who saw active military service in both World Wars. The BBC’s Robert Hall: “Claude Choules was the last link with a war that wiped out a generation. Now, like the conflict in which he fought, he has passed into history. He was the last known surviving combat veteran of the Great War, and served in both the world wars of the 20th Century. Born in Pershore, Worcestershire in 1901, he tried to sign up for the army at the beginning of World War I but he was too young. He was just 13! Two years later, at the age of 15, he joined the Royal Navy serving on board the training ship HMS Impregnable based at Devonport. His earliest memories in the service were of seeing the convoys of ships, returning to Britain, carrying the wounded from the Battle of the Somme. In 1917 he transferred to the battleship HMS Revenge, one of the newest and most powerful ships in the British fleet and the flagship of the First Battle Squadron. It was while on board the Revenge that Choules witnessed the surrender of the German High Seas Fleet in November 1918 in the Firth of Forth. In 1926, along with a number of senior sailors he was sent to Australia to work as an instructor at the Flinders Naval Depot near Adelaide. He was so taken by the Australian way of life that he applied for a transfer to the Royal Australian Navy where he became a specialist torpedo and explosives expert.
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Claude wasn’t the retiring sort, so when faced with a question of what to do with his time, he decided to continue to do what he knew best, mucking about in boats! For the next 10 years he operated a crayboat off the coast of Western Australia. As, one by one, his fellow veterans passed away he must have felt history was closing in on him. But, although his body was failing, his mind remained alert until the end. Meanwhile, back in his home town of Pershore in the UK, the locals have built an armed forces memorial garden to Claude and others who saw service during the great wars. Two wreaths were laid, including one by the Lord Lieutenant of Worcestershire, Michael Brinton. He said: “We should all remember the sacrifices of people who fought in the wars and Claude is the last of those from the First World War. “He’s always been well-known round here he served in both world wars, he told a lie to get into the first war about his age. He’s a part of Pershore,” they say. After his retirement from the navy in 1956, Claude and Ethel bought a block of land right on the beach at Safety Bay, south of Perth, and went fishing. Surrounded by their children and grandchildren, the still active couple taught new generations the pleasures of mucking about in boats, of rescuing oil-smeared penguin chicks, and of just observing the infinite variety of the natural world. The Australian Prime Minister, Julia Gillard said, “Mr Choules and his generation made a sacrifice for our freedom and liberty that we will never forget, we must now, more than ever, ensure that the contribution of those who fought in the First World War is never forgotten.” n
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David Wren – Riding 22,000km for
Dementia Foundation for Spark of Life David Wren, a Professional Golfer, has travelled extensively around the world with a personal passion for visiting third world countries. Having climbed throughout the Himalayas and completed bike crossings of Vietnam, Tibet, Nepal and South America, his new challenge is to ride ‘halfway round’ the world to raise money for Spark of Life.
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onsisting of over 22,000km by bike, David’s journey starts in Ireland and will see him travelling through Europe, the Middle East, and Asia, finally returning to Australia to ride the final leg across the Nullabor to Melbourne, Victoria. David often asks himself, do we find ‘true challenge’ in our day to day lives? He also believes if you are happy and challenged in your daily life, you are pretty much guaranteed a fulfilling life. To not judge and appreciate our differences is an integral part of David’s personal philosophy. He knows that 12 months on the bike will be mentally and physically challenging and at times he will feel a world away from his comfortable life with his beautiful wife Susan in Melbourne. Life on the bike will be the opposite and here lies his next ‘true challenge.’
David’s thoughts on Spark of Life “All of us have experienced the effects of illness to a loved one. My mum lived an active, challenging and fulfilling life until she developed dementia. She has spent the last
10 years of her life with no memory of loved ones sitting in a chair being spooned fed. The reasons are therefore obvious why I chose to dedicate my ride to my mother Althea Wren and raise much needed funds for the Spark of Life Foundation. Spark of Life does not search for a cure. Instead, the focus is to provide a positive change for people like my mum to experience some happiness in their lives. We would have loved to see a smile and a little more happiness in her day-to-day life. Althea’s ‘true challenge’. The Spark of Life Foundation supports the provision of specialised education to health care professionals and families on how the social and emotional wellbeing of people with dementia can be enriched. David’s ‘Halfway Round’ symbolises how as a society we are only ‘halfway’ to meeting needs of people with dementia. The physical, environmental, and at times occupational needs are met, however there is still a symbolic 22,000km to go before we meet the unmet social and emotional needs of people with dementia. Raising awareness of this issue is the driving force behind David’s ride. All funds raised from David’s 22,000 km epic ride will go to the Dementia Foundation for Spark of Life. The aim of this foundation is to facilitate the enrichment of lives of people living with dementia and their carers through Spark of Life Education, special projects, and educational resources. The foundation also works to promote inclusion for people with dementia as valued members of society. Education can be provided through grants to aged care organisations, in community care, and for family carer groups. In this way, the funds raised will have a direct and practical impact on the quality of lives of people living with dementia in Australia and across the world. For more information on this ride or to donate visit www.dementiacareaustralia.com
David’s Journey so far Setting Off Sitting in Qantas Club thinking about my life in Melbourne and how different my life on the road will be. That said I cannot wait to unpack the wheels and start pedaling. The Epic Journey Begins in Ireland!
Arrived Dublin Tuesday 19th April and headed straight out to County Meath and the ancestoral village of the Wren family. Nothing too exciting about the place apart from the pretty
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countryside! Did in a way feel connected to the place so it must be the Irish blood in me.
through Bologna then on to the coast. Hitting the Adriatic sea at a place called Rimini.
Spent the next 3 days riding southeast towards Rosslare harbour for my ferry to France. The riding was easy and the weather perfect. Covered the 300 kms in good time. Stayed with a lovely couple in the town of Gorey - Tony & Ann Breen, home-cooked meals and some red wine.
All going well; have settled in to life on the road.
Arriving France today at the Port of Cherbourg around midday and will hit the road after lunch. Looking forward to the french food and some nice weather.
Update: 6 May 2011 Have reached Lyon in Eastern France! It has been pretty tough over the last couple of days as the Alps approach. My next stop will be Grenoble about 105 kms away, uphill most of the way. As always the thought of it is actually harder than riding it.
decided I had reached my limits and decided to take a bus from Grenoble France to Torino Italy. A distance of about 120 kms! It was just too hard and the road was in my judgement unsafe as there was no shoulder to ride on and a couple of tunnels as well. Whilst I am a little bit disappointed I am spending the night in Torino then start pedalling across Northern Italy. The Italians seem a little noisier than the French. Update: 11 May 2011
Update: 29 April 2011 Have made it to Le Mans in France! Feels good as it was a ‘tick off’ point to get to. Will have a day off and listen to the AFL, Blues play Swans. Update: 2 May 2011
All is well and I had a day off and watched the (royal) wedding. Carlton were playing as well so I listened to the game on my iphone and watched most of the wedding on the BBC. Bike touring is a matter of slowing down all of your thinking. At times you feel great and at times you feel, what the hell am I doing here? It feels tough at the start of the day and fantastic at the end of the day. The luxuries of home cross your mind but that is all part of the challenge. Got a little lost and finished up on the Le Mans race track!
The problem with photos is that you sort of have to be there to experience it as well. My average day on the bike is 100 km. I start around 8.30am and ride until around midday stopping every 10km or so for a coffee or a rest. The bike is heavily loaded so it is not like riding on the road in Melbourne. I will stop for 30 minutes or so for lunch then arrive at my planned stop for the night 4 pm onwards depending on conditions. Often places on the map look big and interesting then when you arrive they are like ghost towns! This photo was lunchtime yesterday and the town was not even on the map. There was a local market on and plenty of people around. I had a ham roll and a coffee and could not have been happier.
Update: 5 May 2011
I have changed my route slightly and will enter Italy via Torino! Then head directly east
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Update: 9 May 2011 Have arrived in Torino Italy! I was unable to make it completely over the Alps and after 2 days of the hardest riding I have ever done I
Loving Italy! It is flat, food is tasty and people are friendly. Have arrived today in Modena after a full day on the road, it is a lovely city and it is also home of the Ferrari, probably equating as to why the hotel is expensive. I will hit the coast of Northern Italy in two days. Distances are funny over here in the sense that I will have ridden the equivalent of Melbourne to Albury and crossed the country! Your mind thinks of funny things when you are on the bike all day! I thought as I was riding today that each day I wake up and ride 100 kms which is the equivalent of Melbourne to Seymour or Portsea. To continue doing a task that is tough the mind becomes a powerful tool ! I read once of a mountaineer saying “you can always take one more step”. If your mind tells you you can you will. So sometimes when the going gets a little tough like a headwind or a large hill you need to use your most powerful tool! Your MIND. I often think of Althea, my Mum! I bought a proper map for Italy, which details the layout of the bigger cities so rather than getting lost I can navigate through them. Reggio is a non-descript city until you venture into the old part of town, not on the main road. It was a real buzz riding the bike down these streets. Lots of bike riders, older ladies and even men in business suits.
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Update: 16 May 2011
the Adriatic sea. Apart from a headwind and a couple of big climbs there are snakes on the road! I can handle the dead ones but the live ones are a little freaky. Update: 21 May 2011
Even though no one speaks English. Sometimes the coffee is disgusting but is a good excuse for a rest. The downside on the bike is not stopping at places that you really like, you might stop in the middle of the day at a great little village with a place to stay that looks really good. If I did stop it would take me 5 years to get home! I have not had any problems with my bike not even a puncture so someone is looking after me.
I have arrived in a place called Ancona on the Adriatic sea, Italy. Waiting for an overnight ferry to Split in Croatia. I have decided to explore a little more of the Dalmation coast, met a bike rider in France who suggested taking this route. I will see a lot more of Croatia as well! I’ll be little sad to leave Italy as I loved the place. The locals were friendly and happy and even though I spoke zero Italian they were helpful and tried to help me as much as they could. Update: 17 May 2011
I am tracking south towards the Greek border. Rode south from Skopje to a place called Negotino still in Macedonia. My border crossing will be at Gevgelija in a days’ time. The last 5 days has been the hardest so far ! Changing countries and currencies seems to break my rhythm. The Balkans is very harsh place and the mountains were punishing. It looks like the tough stuff might be over for a little bit as I am coming down a large valley towards the coast. I am planning on heading to Anzac Cove Gallipoli in Turkey. I will see what that involves as I get closer to the border. If it is not too far out of the way I will head down there. I have set a goal to be in Istanbul by the 30th or 31st of May. Setting targets is for some reason a priority for me on the bike. It seems to keep my mind on the job at hand.
Crossed the Adriatic sea from Ancona - Italy and arrived in Split - Croatia. Headed south east and arrived in Dubrovnik after 3 days of up and down riding. Spent the night in a place called Neum - Bosnia. For some reason there is a little part of Bosnia that reaches the coastline of
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The big plus on the bike is that you see so many interesting places and things every day. You see local people living their day to day life. I am a big coffee drinker so stopping at places to find a cup is fun and interactive with locals.
Have arrived in Skopje - Macedonia. Tough last 4 days. Hoping the biggest of hills are over and done with. I could not ride all the way as the border officials in Kosovo would only let me across if I took a bus, so it was a 150 km to Macedonia and the city of Skopje by bus. This part of the world certainly is a different place. Considering there was a war here everything seems to be back to normal. I feel a little ignorant to the complexities of what the war was all about. I will have to read up when I get home. I have not travelled to Russia but I feel like that is where I am at the moment. After getting some info from locals I have decided to head south to Greece and tackle border crossing into Turkey from there. Had a day off in Dubrovnik - Croatia. Weather was rainy so it did not feel like a wasted day. Felt really tired and slept most of the day.
Woke up and hit the road to a place called Kotor -Montenegro. A really long day up and over the border then down into Kotor a lovely little town. A little harder to find wi-fi now. continues next page >
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David Wren – Riding 22,000km for Dementia Foundation for Spark of Life
It feels strange crossing borders of countries I have only heard of. The map I have is of Europe and the borders are not clearly defined. It will take me another day to hopefuly get to a place called Podgorica. After Podgorica I head to Skopje 4 days hard riding and may change my route yet again and head south to the northern part of Greece and avoid the mountains of Bulgaria.
Update: 28 May 2011 Crossed Turkish border at a place called Ipsala from Alexandroupoli in Greece. As soon as I crossed border it was dry and barren compared to Greece. Stayed the night at a place called Kesan then headed south for 110 kms to Eceabat. This place is the closest town to Anzac cove. The weather is ordinary, really windy and a little rain.
Istanbul looks like 2 weeks of solid riding at around 1400 kms. Felt a little homesick on the day off and yesterday on the road. Spoke to Susan (my wife) who cheered me up. Her support is the most important thing to me on this journey! Update: 24 May 2011
Rode out to Anzac cove this morning and spent a couple of hours there. I left at 6am so there were no crowds. The Turks are very proud of this place and rightly so, they have defended their country for centuries from this area. The memorials are for the Turkish soldiers who fought and died here. That said the Australian cemetery at Lone Pine had an Australian feel to it. It was a great feeling to make it here and I am glad I came down.
Have left Macedonia and hit the coast of north east Greece. The last night in Macedonia was a town called Gevgelja then it was all downhill into Greece. Clocked up biggest day so far of 160 kms. Totally spent and slept like a baby. I am going to Anzac cove Turkey even if it means bypassing Istanbul as I am tracking south. Will cross border at a place called Kipoi.
It felt strange riding south west yesterday instead of east. So I have decided to bus it up to Istanbul then head east from there. My mind says keep going but my body is saying have a break! So I will spend 3 or 4 days in Istanbul. I need to sort out my visa for Iran. Update: 29 May 2011 Hi from Istanbul! Feeling rested after plenty of sleep yesterday so I will explore the place today. I was here 15 years ago but it has changed since then, it is a great city and the Turks are fantastic people.
The ultimate challenge ? A tortoise crossing a Greek highway! I waited to see if he made it and he did, and I feel like I am taking my chances out on the road at times. As they say there is always someone doing it a little tougher than yourself.
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Heading to Iranian consulate tomorrow and hoping the process doesn’t take too long. Plan to start moving again on Tuesday! n Go to www.dementiacareaustralia.com for David’s latest journey updates.
Francis W Cook Cook Care Group By Mike Swinson There have been two defining moments in the life of ACAA board member Francis Cook, well; two that he will admit to and says are worth sharing!
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he first occurred after he had spent seven years working for the federal public service, in the specialist area of aged care, whilst at the same time, completing a University Degree, part time. “I was approached by the then Executive Director of ACAA NSW, John Gillroy, who invited me to leave the public service and come and work for him, setting up an aged care management and consultancy company. Six long lunches later, I said ‘No thanks,’ with a young family I need the security of the public service.” Francis told me the response was ‘One day soon, I hope you will realise that you make your own security in this world, then you’ll leave the safety of the public service and come and work for us!’ With these words ringing in his ears, Francis went home and told his wife that he was going leave the public service and join ACAA (NSW) to set up the Nursing Home Management and Advisory service. “Bob O’Shea had already started the operation and it’s still running. We had to market ourselves and help owners deal with the vagaries of the department. That was right up my alley because I enjoyed working with; and aged care providers, whom I had found to be some of the most committed people I knew, and I knew the intricacies of the legislation backwards.”
In 1982 Francis became its GM and stayed ten years. The business grew and is still operating successfully as a cornerstone of ACAA (NSW).
Francis’s parents were good role models, his Mum worked three jobs, while Dad, a machinist first class, travelled by bus and train from Dundas to Arncliff and back every day.
Francis Cook and his second wife, Christine, both come from humble beginnings. They grew up in the Housing Commission suburb of Dundas in Sydney and have known one another since they were fourteen.
“I remember Dad used to leave home really early and get back late. We kids all went to local Catholic schools including Marist Brothers where discipline was hard. I can still remember what the strap looked and felt like!” said Francis, “not that I deserved it that much!”
“I was part of a very close family; we were taught the value of hard work, focus and not accepting your lot in life. We were told by Mum and Dad, that where you ended up in life depended on you, and taking advantage of opportunities that came your way,” said Francis. He added, “Mum and Dad could not afford to send me to University, so that’s when I joined the public service and began my degree part time. It meant a lot of hard work and long hours and took me six years to finish.”
On the weekends, his Dad played first grade soccer and then later coached and took up refereeing. “If we had an outing to the beach it was the bus to Eastwood, then a train to Redfern, change and go to Cronulla Beach. That was our only outing. During the week, once we had finished our homework it was off on our bikes with the dog but we had to be home by the time the street lights came on.
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how he was managing this consultancy company that was going really well. Then the American asked him a profound question! “Tell me my man, why do you do all this for other people? “ Francis said he was gobsmacked, he hadn’t really thought about it until that moment. On the flight home it was all he could think about.
Francis W Cook Cook Care Group
They were fun days, we made our own fun and we did it well,” said Francis.
“I got home, mortgaged the family home, borrowed a huge sum of money and bought into our first facility. Ever since then we have financed growth through debt including building five (5) new Extra Service facilities in the last seven (7) years, so we have a close relationship with our bank! We have always kept it that way because we have never taken in partners.”
The second defining moment in his career was while at an aged care conference in San Diego, California. Over breakfast, an American conference delegate asked him about his job, so he told him what he did,
His first marriage ended after 17 years and his second marriage to Christine has just passed 20 years including their raising four children, Belinda and Brett from his first marriage and Christine’s Nicholus and Carlan.
According to Francis “the expansion and development of our facilities has been done hand in hand with my wife Christine. She came up with our motto; ‘people are not only cared for, but are cared about’ and that’s how we operate.” I followed Mark Twain’s motto “Put all your eggs in one basket and manage the basket”. He says the business has a good name and reputation. He said their managers sift through a lot of staff to get the right people in every area of the business. “Many of our senior staff have succumbed to the stresses of the industry, taken a break, gone elsewhere and then come back to us. At Cook Care we pride ourselves on retention of our high quality staff and are strong advocates of internal and external education. “We use an administration and quality assurance IT system, but our Management team of James Saunders (GM) and Corrie Ploeg (OM) are carefully working through the cost benefit analyses of available Care Packages. Whichever package we choose it will have to mean better quality care and
bring substantial advantages. We are being cautious in our uptake, and will only install the IT system when we are ready.” Francis loves working in and around aged care policy formulation, hence his time as Federal President of ACAA for 4 years and twelve years (three by four year terms) as State President of ACAA. (NSW) He is currently both State and Federal Vice President. “I love being involved in policy formulation, thinking about and developing policy directions, analyzing and digesting it, always looking at issues from all perspectives, particularly small to medium providers who have personally invested their lives in the industry as they are the ones most impacted by change and are the best barometers of how the industry is travelling. Cook Care currently runs 10 facilities (731 beds), 4 in Queensland, 5 in Sydney and 1 on the far South Coast of NSW. “Chris and I are still personally involved and regularly visit our facilities and meet formally and informally with the management team.”
“We built our first extra service facility in 1999, Australia’s first Dementia Specific Extra Service wing. We are great advocates of people having an option, for those who can afford it to have this available. I do not understand why “Extra Service” is restricted to 15% of total bed numbers; it does not make any economic sense at all. It should be at least 30% or not limited at all,” says Francis. “It is the proprietor’s risk, not government’s.” He says this is an area that he is concerned the Productivity Commission has not thoroughly investigated and will overlook due to its simplicity. “As far as the PC is concerned I have always been an advocate of incremental change not radical change. Major improvements could be made by simply combining high and low care giving all access to Bonds and periodic payments, particularly as we have at least a 10% vacancy level at the moment. That’s my lot on that topic for now, I could say a lot more but I’ll save it for another day!” n
technology
Cloud gains traction in Aged Care
L
eading companies everywhere are rethinking what matters in the face of good, and improving broadband connectivity, web standardisation, upskilling in employees carrying over from their online private/social lives, staff expectations around “enter it once”, and viewing IT as an enabler not an end.
David Cooke
Head of NEC’s Health and Aged Care Solutions Group
New technology trends are driving down the cost of information technology (IT) and providing significant productivity gains for organisations across the country at a time of immense change in how IT works and gets delivered.
Australia is leading the adoption of Cloud computing (that is delivering IT services across a broadband network) in the Asia Pacific region. According to the latest Frost & Sullivan report State of Cloud Computing in Australia: 2011 43% of Australian enterprises are now using Cloud computing in some form and 41% of Australian IT decision makers indicate that Cloud computing will be a top priority for them in the current fiscal year.. The primary reasons that companies are turning to Cloud services include reductions to capital and operational expenditure, cost savings, increased business agility, and the ability to deliver IT on-demand. Tim Dillon from research firm IDC forecast this year that 80% of all new software will be delivered via the Cloud in 2014 and that Cloud based IT growth is forecast to outstrip traditional IT investment by four to five times. In an indication of just how corporates are looking at new models for IT, Suncorp announced in March it would not refresh its 20,000 PC fleet, but rather let employees opt to bring in the device that they felt was most productive for their role. Suncorp does not worry about the hardware and user interface layer but ensures a robust, secure interface for BYO devices. This ensures employees only have access to company-approved applications and information served over a Cloud. This is a game changing approach that may well become the norm as technology
end device costs plummet, but centralised management, acquisition and employee training/retraining costs rise. Suncorp indicated they considered intangible outcomes such as employee satisfaction and retention, as well as cost savings in this move. In this dynamic environment, the Aged Care Industry IT Council took the view that the emerging “Cloud” technology trend was maturing to the point where aged care operators could benefit from its lower cost and increased flexibility for Aged Care service providers. The “Cloud” takes on a number of different forms depending on whether the service provides application, operating system or hardware services. Generally, we think of: •
•
•
the Public Cloud where applications or IT resources such as servers or storage are made available via the web to authenticated users The Private Cloud where applications or IT resources are confined to a single entity, either on or off premise, possibly within a private network The Hybrid Cloud as a combination of the above.
The Council teamed with Cloud provider NEC Australia in 2010 to establish an Aged Care Cloud for the industry, leveraging NEC’s existing footprint including enterprise applications, voice, broadband connectivity and hosting environments. NEC is predominately focussed on providing open access to key aged care vendor clinical application providers such as Leecare, i.on mycare, Autumncare Goldcare, Health Metrics and Clintel amongst others. Key to the initiative was the creation of a suitable environment for the industry’s software developers to run their applications using NEC’s virtualised infrastructure at one of its Melbourne-based data centres.
aca Aged Care Australia | Winter 2011 | 37
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Cloud gains traction in Aged Care (continued)
The Aged Care industry is well positioned to take advantage of this trend to Cloud with its Peak Bodies and the ACIITC, seeking to qualify a suitable environment – the NEC Cloud – as a way to ensure the industry would be offered quality, resilient systems, and also mitigate technology/platform selection costs that would otherwise be borne individually by their members each time a facility went to assess Cloud options. The Aged Care Cloud initiative is a leading indicator of how other industry associations might consider taking their organisation forward. This move to the Cloud across all sectors of industry is based on improving corporate performance through productivity and efficiency gains, by reduction in operating expenditure (Opex) costs, capital expenditure, staff and recruitment, disaster recovery and support costs. Significantly, accessing the Cloud using monthly Opex as opposed to large upfront Capex fits naturally with the monthly funding / expenditure cycle of the aged care industry. Typical gains expected in Aged Care Cloud deployments through a Total Cost of Ownership approach are over 20% currently compared to equivalent on-premise implementations, with this figure expected to increase as economical higher bandwidth becomes a reality and as a result more bandwidth intensive applications deliver increased efficiencies. The primary reasons that aged care organisations, both residential and community, might consider turning to Cloud services include low entry point, scalability, reductions to capital and operational expenditure, cost savings, increased business agility, and the ability to deliver IT on-demand. Industry
acquisitions/consolidation are now much easier with less hardware, licenses, applications and data at the facility level. Such savings are repeated in much of the physical IT infrastructure, such as racks, air conditioning, supervision, staff recruitment, energy, room space, cabling frames etc. Additional savings accrue through virtualisation, whereby large, powerful servers are segmented into “virtual servers” to efficiently handle multiple organisations’ IT applications within strict and secure control of data and resource access. The Aged Care Industry is on a journey of efficiency and productivity gains. We know that demand will rocket, that care workers will become more difficult to recruit and retain, so one area of narrowing this gap is effective IT. More people are entering old age in good health, allowing continued independence of living arrangements, resulting in flatter demand for low care residential accommodation, however, many of these older Australians will eventually require higher level institutional care shifting the relative share of low vs. high care (see Figure 1 The Challenge). This is occurring at a time of lower fertility, smaller family sizes, later child bearing, increased family breakdown, increasing workforce participation of women, that children are more likely to live away from their parents has meant informal care, such as within families, may be reduced. Additionally, the diversity of Australia’s ageing means that it is likely that a wider set of care solutions/services may be required to address cultural/language requirements than the essentially mono-cultural aged care system as we know it today. It is the need for continued capacity to deliver that demands new thinking, and in some cases changes to investment patterns.
Fig. 1: The Challenge – the demand for high care looming down the road Age Group
Population 2010
Growth 2010 to 2020
Growth 2020 to 2050
0-64
19.2M
20%
26%
70+
2M
50%
106%
85+
0.4M
25%
260%
100+
0.004
75%
614%
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The Draft Productivity Commission Report recognises the aged care workforce will need to expand at a time of ‘age induced’ tightening of the overall labour market, an expected relative decline in family support and informal carers, and strong demand for health workers from other parts of the health system. It suggests “new, cost-effective, assistive and information technologies offer some opportunities for productivity gains and higher quality care.” There are three areas of gain where technology can produce an effective outcome: 1. Cohesive information management within and beyond individual facilities. The ability for carers to manage, correlate, predict, claim and audit their facilities is further enhanced by the ability to interchange high quality data with third parties such as acute, sub-acute and Government agencies. The advantages of e-health initiatives to the aged care sector are well known. 2. In-home enablement to reduce labour expenditure in non care contact. 3. Socialisation enablement through technology as an adjunct for real world contact. What is clear is that productivity gains are more achievable if current costs are visible – be they the costs of paper-based systems (such as invoicing, lack of records when and where required, inconsistent reporting, inability to detect and apply quality control techniques to data and compliance, and ACFI claiming errors), or electronic systems including software licensing, maintenance, hardware support, recruitment (and rerecruitment) costs, staff shortages, and funding claims effectiveness. For Aged Care organisations, including those not yet using IT systems, particularly clinical systems where there is big bang for the buck, and those using IT on-premise, the “Cloud” is now a real consideration, delivering all the advantages of a modern capable IT system with a monthly fee and a low or no Capex, on-premise server accommodation or specialist IT staff requirements. n
technology
eHealth in Aged Care and the National Privacy Principles Dr Caroline Lee
Aged Care IT Vendor Association President
R
ecently, following an extensive application process, the Department of Health and Ageing along with the National e-health Transition Authority released funds to support ‘Wave 2’ e-health projects implement the Health Identifier (HI) system and other Personally Controlled eHealth Record (PCEHR) activities. These projects traverse various Australian population cohorts and various health care settings including acute care, pharmacy services, GPs and diagnostic services. The Aged Care IT Vendor Association along with the Aged Care Industry IT Council sent a joint submission to be part of this process. However, the selected Wave 2 projects do not include or integrate the PCEHR into aged care organisations. Hence, the Aged Care IT Vendor Association (ACIVA) have asked the Hon Nicola Roxon MP, Minister for Health and Ageing and the Hon Mark Butler MP, Minister for Mental Health and Ageing to consider implementing a more intensive and true aged care project, so that aged care providers will be able to realise true quality care benefits through the adoption of HI accredited software programs.
Citizens will be required to provide their HI number to healthcare providers but before their e-health information is made available to healthcare providers, citizens will have to opt-into this system. Citizens will also have control regarding what information is held about them in what is commonly called “the cloud” and made available to healthcare providers in these information repositories. By July 2012, some medical, pharmaceutical, diagnostic and other health information stored about an individual citizen, by
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software programs used by GP’s, pharmacists, hospitals, Medicare, diagnostic laboratories and others, can be made available to other healthcare providers through the sending of the stored health information, to secure internet based repositories. The information sent by software programs to repositories will be stored against an individual’s HI number and will form the person’s personally controlled e-health record. Citizens will be required to provide their HI number to healthcare providers for billing purposes but before their e-health information is made available to healthcare providers, citizens will have to opt-into this system. Citizens will also have control regarding what information is held about them in what is commonly called ‘the cloud’ and made available to healthcare providers in these information repositories. If the health professional or organisation is provided a person’s HI number and given approval to access e-health information repositories, which store information regarding an individual citizen, the health professional will be able to access this internet based information via their health software program. Every aged care client/resident will have a history of health service usage, prescribed medicines and other diagnostic results, securely built in, the cloud ’, which can be made available to healthcare staff to review. Staff will be able to view this information via their aged care software program (but only if they use an accredited one). Also, every client/resident will have family members and staff who will potentially be able to see the benefits of healthcare staff accessing this wonderful repository of health information to improve the health knowledge about and therefore care of their loved one. This can only improve staff/client/family relationships. The Commonwealth Privacy Act significantly changed in 2001 to improve
the confidentiality of information held by healthcare (and aged care) organisations. They needed to ensure there were systems in place by 21st December 2001 that were compliant with the National Privacy Principles (NPP) related to accessing personal health information. Systems had to also be in place to address circumstances where client/ residents or their authorised representatives wished to limit the information made available ie. where no information is to be provided to certain individuals. This is a well established process undertaken during the admission of every aged care recipient and subsequent to admission should client / resident personal circumstances change. This puts aged care providers ahead of most healthcare organisations in terms of developing systems to manage individual client/residents’ preferences regarding access to their health information. For example, ‘NPP 1 – Collection’ required aged care organisations to explain fully to clients/ residents why information is collected ie. to develop appropriate care and activities plans, and to monitor and evaluate the effectiveness of care provided, so that changes to care are made as necessary. NPP 2 – Use and Disclosure and NPP 10 – Sensitive Information required aged care organisations to ensure only staff involved in care and Commonwealth or State Department officials could view health and other details. These systems can be easily enhanced to establish whether the aged care organisation healthcare staff and other professionals can access PCEHR internet based information stored about clients/residents. Two aged care software vendors participating in funded Wave 2 projects are involved in the electronic passing of pharmaceutical prescribing and dispensing information into and from medicines repositories. This will be via participating healthcare providers and pharmacies’ software for the
benefit of individuals in the community. Other infrastructure aged care vendors are participating in various projects also.
Medicare or NEHTA. And ACIVA members will variously develop components that will access the HI service over the coming year.
ACIVA members through their client base, understand the aged care industry, and it’s need to be involved in projects demonstrating valuable and positive outcomes before the industry can commit funds (and the commensurate change management activities) to implementing projects such as the PCEHR initiative.
To access this information, the aged care industry will have to use accredited software programs that can access these repositories and send the HI number into ‘the cloud’ and bring back this information onto the screen. The software accreditation process (CCA) is only just now being developed and trialled, and will be made available for software programs to utilise in the coming months.
ACIVA has communicated this understanding to both Ministers and the commitment that ACIVA members have made to the HI and PCEHR initiatives so far. ACIVA actively encourages its members to understand the various secure messaging Standards and Compliance, Conformance and Accreditation (CCA) processes which need to be undertaken before being involved in any e-health project involving the Department of Health and Ageing,
ACIVA has determined that aged care organisations can potentially lessen the number of hospitalisations and adverse medication events if they can access individual client/resident Personally Controlled eHealth Records upon admission and during their residence within the organisation. Access to healthcare knowledge built over years regarding individual clients/residents, can also assist
the industry utilise limited Pharmaceutical Benefit Schedule (PBS) and Medical Benefits Schedule (MBS) resources in a judicious manner. Access to knowledge can assist in making good healthcare management decisions. To truly test and demonstrate benefits, the aged care industry needs to be able to access quality health and medication information held electronically in the various internet based repositories. This information will have been sent to these repositories by the various software programs used by health professionals across the country who have serviced individual clients/residents and which are linked to an individual client/resident’s HI number. Some of the information the accredited software programs will be able to access is held by Medicare. ACIVA members want to continue to be involved in the various NEHTA and DOHA
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< committees that it currently participates in, regarding the implementation of the PCEHR and HI. But they need to be involved in trial projects to ensure any developments they make to access the HI service is accurately developed, implemented and funded. If members develop these features without support, the Compliance, Conformance and Accreditation (CCA) trial and testing costs etc. will have to be passed on to aged care providers. The industry cannot afford to adopt initiatives where there are no proven demonstrated benefits.
If the aged care industry is not involved in trialling and testing access to these health repositories, this could significantly reduce the uptake of any PCEHR related features across the sector. This will also reduce the significant ‘onsell-benefits’ which can be realised if families and staff see first hand, the great healthcare benefits that are achieved when healthcare providers have access to an individual citizen’s PCEHR. Aged care will be a major user of the PCEHR. Building confidence in the PCEHR process via the aged care industry, can assist the country to realise the benefits of the PCEHR system, which will in turn support the uptake of this initiative and citizens ‘opting into’ the process. ACIVA supports the initiative originally proposed with the Aged Care Industry IT Council and any other projects that truly involve aged care organisations across the nation. Who does ACIVA represent? Aged Care Quality Association e-health benchmarking Ascribe Autumn Care Campana Systems - Goldcare ComCare (Silverchain) Database Consultants Australia Eclipse computing e-health education Epicor Ethan Group icare Inerva isoft Leecare Management Advantage NEC Australia Nunatak Systems Peoplepoint Procura QPS benchmarking Questek Australia Riteq Sarah Simavita Telemedcare Thoughtware - Ionmycare Wecare Australia Webstercare
technology
eHealth In Aged Care Aged Care Peak Bodies, through the Aged Care Industry Information Technology
•
Delivered the fully developed solution to DoHA in July 2010
•
Submitted a tender for the delivery of a electronic medication chart to the PCEHR funding round
•
Entered into an agreement with NEC to provide a hosted data, telephony and technical support service (Cloud Computing) to the industry
Council (ACIITC), establishes the framework on how Aged Care will develop eHealth.
M
uch has been stated by the Government and its Agencies about eHealth over recent years. ACIITC has been involved and contributing to the eHealth Agenda for the nation over the last three years. This involvement includes contribution to electronic transfer of prescriptions, discharge summaries, digital signatures and Personally Controlled Electronic Health Records. This involvement involves Aged Care Providers participating in various committees. The ACIITC was formed by ACAA and ACSA three years ago for the express purpose of improving the quality outcomes for recipients of aged care services in residential and community care settings. Aciitc has during this period achieved a number of notable outcomes: •
Raised the profile of aged care and eHealth across the health system
•
Provided regular advice to the National eHealth Transition Authority (NeHTA) on aged specific service issues
•
Initiated the formation of Aciva the aged care it vendors association
•
Accepted a priority action to reform the medication management service within residential aged care
•
Proposed an electronic medication chart that would support remote access for general practitioners, pharmacists and aged care staff
•
Received funding from DoHA to produce a fully developed medication management solution for aged care
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This has involved considerable work by the Peak bodies and the members of the IT Council, all of whom give generously of their time on behalf of the industry. Guiding Principles for eHealth in Aged Care eHealth has the potential to transform Aged Care, improve efficiency, deliver improved health outcomes and to change the way we deliver community care by using assistive technologies to place the care recipient at the centre of the system and allow the care recipient to take much greater responsibility for their own care. Accordingly, we set the following principles to engage with eHealth: 1. Support National Health Reform Aged Care is part of the wider Health System. As such, eHealth is a lever in assisting in Health Reform for Australia. An aspect of Health Reform is to reallocate resources to where they are needed and to use current resources effectively. Any activity in eHealth must pursue demonstrable and measurable health reform outcomes. Aged Care is integral to this. 2. Address Aged Care Workforce challenge by increasing productivity Any eHealth activity must be focused in delivering materially increased productivity, or increasing current workforce capacity as a clear and core outcome. 3. Facilitate Improved Care Current workflow practices often cause bottlenecks for health and care
professionals in trying to deliver the best possible care. We must be able to demonstrate how eHealth will make an identifiable difference and demonstrate that improvement has been achieved. 4. It is Consumer Centric Consumers need to be enabled to make the ultimate choices about their care services and their service providers. eHealth must deliver consumer centric care outcomes that moves from the current paradigm.
There is a growing emphasis by Consumers for “ageing in place” services. Telehealth will be an enabler, amongst other activities. How will the national programs in eHealth, Telehealth and National Broadband network assist older Australians?
What is the difference that all these will make to the Care Provider and Care Recipient and wider stakeholders who are part of team-based care for the Older Australian?
5. Care cycle must involve authorized family and friends As we all know, volunteers, family and friends have an increasing role in completing the team based care of older Australians. eHealth will make a significant difference in the provision of better coordinated care. 6. Transform Aged Care With all of the above, we must realise a transformation, an evolution of Care delivery in Aged Care. Delivery Framework for eHealth To realise the benefits of eHealth, there must also be in place a delivery framework that protects and enhances the quality service provided by the Aged Care Sector. They are : A. Industry wide The program needs to be scalable and deliver to the Industry as a whole. No more trials.
B. Sector Driven Industry involvement has a history of delivering success. It also indicates a program is a serious one that is desirous of success. C. Enable what already exists and scale it Nationally This is fundamental to the National eHealth Strategy endorsed by the Australian Health Ministers Council in 2008. There are many electronic records in many sectors, in particular in Aged Care. The strategy is to take what is there, make it interoperable to overcome disparate islands of information with different Care Providers and then scale this capability nationally. Not to reinvent what already exists.
ever increasing and innovative Care. This could encourage new entrants. More importantly it will protect and encourage the current market. This is in the interest of the Aged Care Industry.
E. Open Standards We support Open Standards. What is an Open Standard? An open standard is publicly available, and developed, approved and maintained via a collaborative and consensus driven process.
D. Vendor Agnostic A National Program must support all current vendors, not just one or a few. Not only software and hardware vendors but also Providers of Technology Services.
We ensure a level playing field where all who want to risk their capital to provide goods and services to Aged Care are encouraged to do so in a playing field that is assured to be level so that success can be achieved, where choice reigns supreme, innovation can thrive to propel the Providers to deliver
Reduction of choice and increasing costs is not acceptable.
That is, interoperability between software (such as Aged Care Clinical and GP Desktop, for example) is seamless and open. That is, a public road that all software adopt and use as a norm. To put it another way, if Open Standards are adopted for interoperability, one does not have to invest in locked-in processes that require Providers to spend more money to facilitate interoperability. Open Standards deliver better and reducing costs to Aged Care Operators so they can re-invest in IT that delivers productivity. If eHealth or professed players in the field do not deliver this, then consider your choices carefully. We must evaluate very carefully whether
to invest in eHealth that fails to deliver Open Standards.
We must future proof our investments to ensure access to the wider market in the future.
F. Sustainable eHealth must be Sustainable, not a demonstration. It must be viable and must be able to be absorbed by the market and the customers who drive it. G. Equity of Access Equity of Access to Care is the foundation that our Industry and that of the wider Health System is built on. eHealth must be able to continue to enable this foundation and increase its reach in delivery of Care. After all, that is why we also support National Health Reform. n Aged Care Industry IT Council is an incorporated company with the two Peak Bodies of Aged Care Association Australia and Aged and Community Services Australia as its two shareholders.
technology
eHealth – Personally Controlled Electronic Health Record By Chris Gray Managing Director, iCare Solutions
In the 2010/11 Federal Budget, the Australian Government announced that they would spend $467 million over two years to develop and launch a personally controlled electronic health record (PCEHR) for every Australian who wants one. The aim of the PCEHR is that by July 2012 every Australian will be able to access his or her healthcare records electronically. Each individual will personally control who has access to the information contained within their record. The Benefits to Aged Care There is a constant flow of information about eHealth in Australia, but what does it mean and what is being done to ensure the aged care industry is part of Australia’s eHealth journey? Together with the Federal Government’s telehealth initiatives and the roll out of the National Broadband Network (NBN), the PCEHR aims to provide better health services and healthcare outcomes for all Australians by enabling better access to crucial health information. This will include persons in residential aged care facilities. In aged care, some of the potential benefits of the PCEHR include: • • •
the opportunity to access up-to-date health care information on an individual when they are first admitted to an aged care facility; continuity of care for aged care residents when transferring to, or discharging from, a hospital; and complex medication management.
PCEHR Initiatives The aged care sector is well positioned to play an integral role in PCEHR as many aged care providers already use IT systems to move clinical and medication information within their aged care facilities. The PCEHR system will be implemented based upon a combination of ‘top down’ national initiatives and ‘bottom up’ lead eHealth sites.1
National initiatives will focus on delivering the core infrastructure components of PCEHR System, such as Healthcare Identifier (HI) service, National Authentication Service for Health (NASH), call centre for PCEHR, consumer portal and health record index services. The bottom-up implementation program will concentrate on the provision of two waves of funding for twelve lead eHealth sites spanning different geographic and functional parts of the Australian health sector. The objectives of these sites are to deploy elements of eHealth infrastructure and standards in real world healthcare settings and to demonstrate tangible results and benefits by using eHeatlh. The Aged Care IT Vendor Association is working closely with the Department of Health and Ageing and NEHTA to ensure that all aged care consumers and aged care providers realise the full benefits of Australia’s eHealth system, no matter which vendor software they have implemented. To date, the Federal Government’s eHealth initiatives have been broken down into Wave 1 and Wave 2 sites. Wave 1 was announced in the second half of 2010 and involves three sites based around GP’s. The primary objective – provide a community of services for individuals using a range of community and health service providers. The Wave 2 sites expand on this approach and aim to allow key health information exchanges between healthcare providers and specific health groups. Nine eHealth sites were announced in Wave 2 on 29th March 2011, with one of those projects – MedView, led by FRED IT Group – involving iCare and the aged care industry. The MedView project will allow consumers and health professionals to access consented patient’s medication history via a PCEHR conformant repository. The Aged Care Model iCare will be responsible for the aged care segment of MedView. By providing integration to the MedView medicine repository, iCare will enable nursing staff to access prescribed and dispensed medications of an aged care resident with consent. All prescriptions
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eHealth â&#x20AC;&#x201C; Personally Controlled Electronic Health Record and dispensing records of the resident will be securely transmitted and stored in the MedView system. Clinicians will be able to see a combined list of prescribed and dispensed medications regardless of how many different doctors and pharmacies the patient has visited in the past. When a resident is discharged from hospital or returned from a visit to a specialist, the nursing staff in the aged care facility and pharmacist will be able to view medication prescribed by the doctor or specialist via MedView instantly. The Participants The aim of the project is to deploy MedView to all pharmacies and GPs in the Geelong region and to a further 10% of this target market nationally. The project will bring together a grouping of private sector eHealth organisations and vendors including GP division of Geelong, Pharmacy Guild of Australia, Pharmaceutical Society of Australia, Best Practice, Zedmed, FRED Health, Simple Retail, iCare, eRx Script Exchange, Microsoft, Simpl Group, Monash University Faculty of Pharmacy and Pharmaceutical Sciences and Barwon Health. The Aged Care IT Vendorâ&#x20AC;&#x2122;s Association is a strong supporter of eHealth in Australia and the use of standards to move electronic health information securely within the health system, particularly as it relates to aged care. We are committed to sharing the knowledge gained from the Wave 2 projects to ensure the aged care industry can take a leading role in the implementation of eHealth in Australia. n 1. National e-health Transition Authority, Draft Concept of Operations version 0.13.6, April 2011
workforce
Give Your Employees Hundreds of Extra Dollars Every Year For The Effective Cost Of One Extra Cent Per Hour !
T
here is a lot of discussion in the industry at the moment about pay equality with similar industries. As we all know, there is no money tree in the backyard… let’s face it…the pit is not bottomless. The ability to be able to give your employees more without a major ongoing financial outlay is definitely appealing. How about an option that effectively costs you the equivalent of a pay rise of only one cent per hour! The ACAA Employee Benefits Program is a cost-effective way of giving a valuable bonus to your employees for very little outlay…. only $24.90 per annum, per employee…and that includes GST! The Program is strongly branded, with your organisation’s logo on the Card & Website. We also provide full implementation support to reinforce the message that your organisation is a caring employer. So…how much can the average family of three save in a year by using the Program? Food & Fuel Insurance Entertainment
$ 910 $ 720 $ 300
Health Insurance Movie Tickets Clothing Holidays Household Items Car Servicing
$ $ $ $ $ $
280 270 200 140 100 77
$ 2,997
With over 11,000 retailers offering discounts and in excess of 30,000 household products online, there is something in the Program for everyone. To make it more valuable to your employees, and hence your organisation, we have also made the Card usable by family members. I often meet resistance from organisations to implement an organisational funded Program, with the perception that “We don’t think our employees would use the Card”. I don’t know any Aged Care employee that could afford to pass up hundreds of dollars in savings annually, let alone thousands. We also off a Hybrid Program, that allows you to fund the Program for full time and part time employees (for example), and offer the Program on an Opt-In basis for casual
employees, who contribute to the Program themselves. This option still allows us to offer full implementation support. From experience of this type of Program, we are finding that 85% of employees that attend information sessions do perceive the value and purchase a Card on the spot. At the equivalent cost of a 1 cent / hour pay rise, the ACAA Employee Benefits Program is a fantastic opportunity to offer a substantial benefit to your employees at a minimal cost. Whilst each website is co-branded with your organisation’s logo and welcome message, our generic website can be viewed using the following login details: www.presidentialcard.com.au/acaa LOGIN: ACAA00000 PASSWORD: ACAA For full details, please contact me personally. Brad King Manager Business Development Presidential Card 0413 839999 BKing@PresidentialCard.com.au
workforce
Industry Feedback Good News Stories ACAA’s exciting section allowing you, our readers, to share ‘Good News’ feedback letters from clients, happy staff emails, anything to do with the business of caring for frail and older Australians. Following are 2 more examples of the positive feedback received:
great experience and compassion in caring for a dying person shone through and they looked after me as well. I was blown away. I found their care very moving and am indebted to them all. Words are inadequate. It makes me think that there really is not enough praise and recognition given to those who care for our frail and elderly population and that we should acknowledge them more loudly and strongly. Thank you again to Annette and her fabulous team at WYNWARD HOUSE NURSING HOME.
My mother, Elaine Stuart, died 3 weeks ago in Wynward House Nursing Home in Hornsby, Sydney. She’d had a series of CVA’s which caused a worsening of her Dementia and rendered her unable to care for my father. He had become frail with Rheumatoid Arthritis and suddenly his carer, Mum, became unwell. Dad was actually in Hospital at the time of Mum’s big stroke and he had to go into Respite.
Dr.Anne Stuart (received 17th November 2010)
I recall well how very helpful and supportive Annette Davis was, the DON at Wynward, in clarifying the complex process. I was upset at the time with both parents in Hospitals --- both unwell and both unable to go home.
Just before we go home, in addition to the thanks and appreciation for all your care for Frank we have already expressed, we want to leave you with something a bit more formal to put in the file!!
Annette’s care and concern extended straight through to her staff, who have been a fabulous team. I got the bed at Wynward for Dad after meeting Annette.
On behalf of all Frank’s family and friends, thank you for all your efforts, individual and collective, this enabled Frank to enjoy so much of his time at Wattle Glen. The quality of professional care and personal relationships were responsible for Frank enjoying good health and maintaining a positive outlook at a time when life can be very challenging.
It was decided after Mum’s failed rehabilitation that she needed a nursing home bed too as she could not walk and was increasingly confused. She came over to Wynward House this year to be with Dad. Mum deteriorated with more strokes and finally died in October this year. I found her care by the staff WAY beyond the call of duty. Mum was never in any pain, and she was closely attended to as she lost her ability to swallow, and so eat or drink. The staff cared for my mum with love and understanding. Their
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Dear everyone at Wattle Glen, Look, I’m afraid it’s us again!
Frank frequently said that he was lucky to be at Wattle Glen and was always singing the praises of all of you the Wattle Glen ‘mob’ as he called you! Frank was very grateful for your combined efforts which make Wattle Glen such a positive, supportive and caring facility. Frank took an active interest in each of you and knew who was working (or not working/on holiday/sick) on any given day also!
As family members, we are very aware of just what this support meant not only to Frank but to us also. Supporting Frank through the transition from home to supported care was not easy and we very much appreciate your support over this time. From his first visit, Frank was very positive and this did not change! (You also managed to cater for his very individual ways – not always easy!) We had complete peace of mind knowing that Frank was receiving the best of care and was supported to be as independent as possible. We found all of you – whether your role was administrative, nursing or other support always ready to discuss matters serious and trivial. We will certainly miss the frequent and close contact we have had with everyone at Wattle Glen. As for us, we are about to return to our home in Lismore – where we have not been for some time! After a period to let the dust settle and life return to something resembling normal, we will make longer term plans. We will continue to be regular visitors to Melbourne and hope to keep in touch in the future. Our thanks and very best wishes to one and all. Dated: 15 May 2010
ACAA encourages anyone who works in the industry to submit their positive feedback received from clients and their relatives for publication in future editions of Aged Care Australia. Submissions can be emailed to editor@agedcareassociation.com.au
sponsors
Energy Contract Discount Offer (ACAA Preferred Supplier) EnergyAction is the largest energy brokerage in Australia and have been chosen as the Preferred Supplier to all the ACAA members and affiliates for Energy
and potential refunds including analysing the Network Tariffs for $ savings. The good news is that our fee of 1.5% is paid to EnergyAction by the successful retailer and your application and administration fee has now been reduced to only $450.00.
lthough your electricity contract maybe a period away from expiration, we secure more attractive rates NOW than you could at a later date.
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Energy Action began trading in 2000 and since 2005, we have conducted more than 4000 online energy auctions, with a combined value in excess of $5 billion whilst during 09/10 we conducted over 1200 online energy auctions and presently negotiate over $35,000,000 of contracts per month.
We are also confident that there will be a substantial rate increase over the next few months (see Futures Forecast below).
We are receiving in February 2011, Victorian rates of 5.0c kWh for Peak and 2.5c kWh for Off peak, through our auction platform.
Energy Action is an Auction House that trades contracts “on-line” through a reverse auction platform. We invite all energy retailers (AGL, Origin, TRUenergy, Energy Australia, etc) to bid against each other over a 10 minute transparent window, viewed by the client, to win the lowest price for your current or future electricity contracts.
Our starting point is to determine if you are a large enough energy consumer to qualify as a “contestable” contract (ie: to auction) or either fall under the category of “General Supply” whereby we obtain you up to 15% discount with the published Government regulated retailer rates.
Contract procurement.
Simply put, Energy Retailers compete on the auction platform to win your business and it purely comes down to which Energy Retailer can provide the best price. Furthermore, it is an open and transparent system with no hidden agendas, designed to save you time, effort and money. EnergyAction also monitors daily meterage demands, consumption, errors, anomalies
Initially, all we require is a copy of a recent electricity bill from all sites (front and rear sides of 1st page) and if you qualify as a “contestable” customer, then we require you to complete an LOA and RA forms (I will advise if these forms are required).
Peter Naylor EnergyAction Pty Ltd 17-33 Milton Parade Malvern Victoria 3144 Ph: 03 9832 0855 Fax: 03 8677 9633 Mbl: 0415 103707 Email: peternaylor@energyaction.com.au Web: www.energyaction.com.au
Futures Forecast It is very hard to forecast the future of electricity pricing as it is a volatile commodity. There is now a change of government and the imminent re scheduling of Carbon emissions trading. However I have copied a graph below with forecasted pricing until Q2 2014. In summary it shows pricing getting steadily dearer with a few peaks in periods of peak demand, historically this is in summer. At the moment pricing is very low due to the inclusion of new Queensland generation, the postponement of the Carbon Trading Scheme and the mild weather on the Eastern seaboard. Average pricing in Peak and Off peak rates at the present time is: NSW VIC QLD SA
7.3 6.1 5.1 7.8
3.1 2.4 2.0 3.3
Please realise that all pricing is site specific and these rates are the average. n
Required documentation is to be faxed through to (03) 8677 9633 addressed to Peter Naylor or contact direct for further information.
Figure 1 d-CyphaTrade regional quarterly base futures prices The side axis shows electricity wholesale pricing per MWH… this can be divided by 10 to show rates in cents. The price is also an average between peak and o/peak, therefore peak of 6c and o/peak of 2c equates to 4 cents per KWH or $40 $/MWH
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New online courses – Increase your CPD hours As part of ACAA and e3Learning’s strategic partnership, the following significantly updated titles are now available. Purchase direct on the ACAA online store. http://acaa.e3learning.com.au
C
ontact us at: info@e3learning.com.au to discuss organisation wide pricing and implementation.
Work Health and Safety Fundamentals (formally OHS Fundamentals) The Work Health and Safety Fundamentals course has been developed in collaboration with the National Safety Council of Australia to introduce learners to the underlying legislation, processes, roles and expectations associated with Work Health and Safety (OHS) in Australia. The course is the perfect introduction to OHS legislation and appropriate for all staff in Australian organisations. Learning Outcomes After completing the course, learners will have: • • •
An understanding of what to look for in the workplace to keep safe A practical understanding of how to follow workplace safety procedures An understanding of the roles and responsibilities of each level of workplace responsibility
Course Content • Employer responsibilities • Supervisor responsibilities • Employee responsibilities • Identify work health and safety responsibilities
• • • •
Risk management Hazards and controls Isocorp - Simulated Workplace Workplace expectations
Equal Employment Opportunity (EEO) The Equal Employment Opportunity (EEO) course was originally developed alongside EMA Consulting, a leading industrial relations consulting firm. The course has been recently re-written and reviewed by workplace relations industry experts, and is an excellent employee introduction to the requirements of EEO. Learning Outcomes This course has been designed to provide the learner with: • • •
• •
Complain resolution Making an EEO claim
Delivering these courses online is a great way to ensure your organisation or facility is upto-date with the fundamentals of workplace safety and equal employment opportunity. Record CPD hours as mandatory training and receive certificates of completion and full system tracking for compliance. To purchase, visit the ACAA online store and select ‘Buy Online Now’: http://acaa.e3learning.com.au For further information contact: Adam Dunkley Ph: 08 8221 6422 adam.dunkley@e3learning.com.au
An understanding of what equal employment opportunity (EEO) is Knowledge of what constitutes discrimination, and The processes for EEO complaints and claims
Course content • What is EEO? • EEO legislation • Discrimination • Internal complaints
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aca Aged Care Australia | Winter 2011 | 53
sponsors
Moving towards a National Framework for Advance Care Directives Samantha Tucker
Lawyer, Hynes Lawyers
Advance Care Directives (ACDs) provide for autonomy in health care decision making after a person has lost capacity. The laws relating to ACDs are complex and vary from state to state. Considerable support has been expressed for greater national consistency in those laws.
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n 2009, in recognition of the diversity of legislation and the challenges experienced in using ACDs, the Australian Government appointed a working group to prepare a draft ‘National Framework for Advance Care Directives’ (the Framework). The draft Framework offers a best practice guide for a consistent approach to the use of ACDs and is a valuable resource for aged care providers to improve their processes with respect to the use of ACDs. This article summarises the most significant proposals contained within the Framework and considers how they can be incorporated into an aged care provider’s policies and procedures.
The Framework The Framework does not replace, nor override the law in each state and territory which applies to the use of ACDs. The Framework acknowledges that developing a nationally consistent legislative approach to ACDs will be a slow process. The Framework has primarily been developed to inform policy-makers of the key ethical and practical issues associated with the use of ACDs and is a valuable resource for aged care providers to use to improve their internal systems. The Framework has two parts: • •
a code for ethical practice; and a set of best practice standards.
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Providers should consider adopting a policy about the use of ACDs which is consistent with the laws in the state in which they operate and which is also consistent with the ethical principles and the best practice standards contained within the Framework. The Code for Ethical Practice The Code consists of 15 principles which acknowledge the importance of maintaining personal autonomy and are intended to guide ethical practice where ACDs are applied in a health or aged care setting. The ethical principles contained in the Framework are not laws but set out some basic principles that should be applied to the use of ACDs across the board. When undertaking a review of their processes with respect to the use of ACDs, aged care providers should ensure that their policies and procedures are not inconsistent with ethical principles contained in the Framework. The following ethical principles are contained in the Code and policies and procedures should reflect these principles: •
• • • •
•
competent adults are autonomous individuals and are entitled to make their own decisions about personal and health matters; a substitute decision-maker carries the same authority as that of the person when competent; an ACD can be relied upon if it appears valid on its face; a refusal of a health-related intervention in an ACD is binding; a person or their legally recognised substitute decision-maker, can consent to treatment offered, refuse treatment offered, but cannot demand illegal treatment; and a valid ACD that expresses choices or preferences relevant and specific to the situation at hand must be followed.
An awareness of the Code (and consistency of internal systems with the Code) will assist aged care staff to appreciate the use of ACDs
in an aged care setting. It will also provide an ethical understanding for staff as to the role of aged care professionals in the use of ACDs in clinical practice. The Best Practice Standards The Best Practice Standards describe best practice in the use of ACDs and are intended to guide the development of laws and policy. They are also intended to provide a means to measure practice against a national standard and determine whether law or policy needs to be changed to meet those standards. A move in practice towards these Standards will assist with greater national consistency despite the current diversity of legislation. Aged care providers can incorporate the best practice standards into their policies and procedures with respect to the use of ACDs. In order to adopt the Best Practice Standards referred to in the Framework providers, as a start, would consider the following: • •
•
Staff should be educated about the provider’s policy and procedure on the use of ACDs. A provider’s admission policy should incorporate a requirement that prior to the admission of any new resident, staff will: ask prospective residents (and their families) whether they have an ACD; provide information to prospective residents and their family members about the use of ACDs - which could include providing a copy of the provider’s ACD policy and procedure; and inform prospective residents (and their families) that the resident does not have to complete an ACD. Providers should implement a system for storing and recording ACDs. The Best Practice Standards recommend designated ACD sleeves in the front of care recipients’ notes that are readily identifiable and ensure that the ACDs travel with the resident between health and aged care settings.
•
• •
Health and aged care practitioners are encouraged by the Best Practice Standards to propose a review of ACDs when a care recipient’s health circumstances change. The provider’s policy and procedure on the use of ACDs should inform staff of this expectation and provide for the circumstances in which the ACD should be reviewed. Policies should differentiate between ACDs and clinical care or treatment plans but ensure staff are aware that clinical care plans should nevertheless be consistent with the person’s ACD. The policy and procedure which is adopted about the use of ACDs should complement the aged care provider’s policy on end of life decision making.
The Best Practice Standards are not law and to the extent there is any inconsistency between the Framework and the laws in each respective state, the laws will prevail. However if implemented into internal systems appropriately, the Best Practice Standards will reduce the current barriers and challenges associated with the use of ACDs. Where to next? The Framework is the first step towards a nationally consistent system regulating ACDs. Once the Framework has been finalised, it will be submitted to Health Ministers for approval. Aged care providers should seek legal advice when drafting policies and procedures about the use of ACDs (and about end of life decision making) as the laws are complex and differ from state to state. n
editorial
We all Face the Same Dilemma By Angela Gifford and Mike Swinson
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n Australia the aged care industry waits with bated breath for the final recommendations of the Productivity Commission enquiry and the Government’s reaction.
Around the western world, almost without exception, governments are facing a similar quandary; a rapidly ageing population, a shrinking workforce and restricted tax revenue having to cope with the increasing demand for care that will come. Take the UK as an example. Angela Gifford, the proprietor of Able Community Care, a nationwide, UK domiciliary care company and a recognised UK Law Society Care Expert and international care consultant posed the question recently: “Why have things gone so wrong in the UKwhen they were going so well?” Angela writes; ‘The implementation of the NHS and Community Care Act 1990, in 1994 was greeted enthusiastically by older people, people with disabilities, their families and professionals who worked in the care sectors. People needing care were going to be given the choice of where and by whom they were cared for. There would be some financial assessment and those who would need to contribute for all or part of their care would and those who could not would receive their care paid for by the State. The State would no longer be the provider of care services, which to date they had been, but would be the purchaser and the independent care sector immediately began to grow with the majority of the new provider organisations being ‘for profit’. To protect the recipients of care, new regulatory legislation came in and in 2002 the Commission for Social Care Inspection became the legal body. The CSCI would inspect each individual care provider, agencies and aged care homes, against legislated Standards. Prior to the introduction of the CSCI, each local County Council since 1994, had brought in their own specifications that care organisations had to sign up and work with if they wished to contract with a particular Council. For providers like us who worked with several Councils or were nationwide providers, the task to become Accredited/Approved was onerous as each Council re-invented the wheel and would not accept their neighbouring Councils acceptance of a care provider. The national inspection process by the CSCI was to make this Council approach unnecessary and was widely welcomed. But, and it is a big but, the warning bells began to ring when Scotland decided they would not accept the CSCI decisions and produced a Scottish based inspection system.
Three years ago the demise of the CSCI and the birth of its replacement, the Care Quality Commission offered a reduced service to the providers of care and in effect, to the general public. The agency spot checks have been drastically reduced; the registration process for providers, previously a face to face practice has been replaced by an online form as is the inspection process. So, County Councils are bringing back their own Accreditation systems, we are back to the position of the 1990’s. The result; fewer specialised care staff on councils, unethical organisations on the increase and the British public becoming bewildered. The bewilderment for the public is twofold and growing as the subject of who is eligible for care, who has to pay (dependent on the postcode area you live in) and how to access either state funding or find ways to raise the funds on a personal basis is not common knowledge. The Government is fudging how future care is to be paid for and this avoidance looks set to continue. As an experienced UK national provider of over thirty years, I am asking the question “Why have things gone so wrong when they were going so well.” Interestingly, Angela Gifford and others in the UK aged care sector are keeping a close eye on the final recommendations of the Australian Productivity Commission, obviously hoping that what transpires here might catch the eye of UK decision makers. n
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SAGE International Study Tours SAGE industry study tours are an industry first, being a joint venture between the three peak industry organisations, Aged Care Association Australia (ACAA), Aged and Community Services Australia (ACSA), Retirement Village Association Australia (RVA) and commercial entity, ThomsonAdsett.
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China.
AGE tours have been running since 2006 with over 7 successful tours to USA, Europe, UK, Hong Kong and
The tour partners are delighted to announce 2 of the 3 tours to the USA in October 2011 are fully booked with only 2 places left on the Philadelphia tour.
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This year SAGE delegates, represented by senior industry leaders, will take part in study tours to Chicago and New York, Boston and Philadelphia including attendance at the International Association of Homes and Services for the Aged (IAHSA) bi-annual conference taking place in Washington. Tour Program leader Judy Martin said the success of the program is mainly due to the fact the tours are an industry collaboration. Over the years we have been able to develop a strong relationship with international Seniors Living organisations and colleagues, enabling ongoing collaboration across all boundaries, said Judy. Rod Young, ACAA CEO said the feedback he receives from members has reflected the professionalism of the tours and value add of travelling on a designated learning tour with colleagues. Pat Sparrow (ACSA) and Andrew Giles
(RVA) supported this sentiment saying members who had travelled on a SAGE tour had benefited greatly not only from the International experience but from how concepts could be bought back to industry at a number of levels. Chris Straw from ThomsonAdsett says his company has been proud to support such a wonderful industry first. Anyone wishing to take up a place on SAGE has a last minute opportunity to fill the remaining 2 places on the Philadelphia tour. Registration can be made via the SAGE website www.sagetours.com or by contacting Judy Martin on 0437 649 672. The SAGE 2012 and 2013 programs are currently being put together and will be open for Expressions of Interest later in the year. The 2012 /2013 programs will be launched at each of the three peak bodies National conferences. Please refer to the SAGE website for updates. n
Distinguishing the difference between Aged Care Facilities and Retirement Villages Rachel Lane
Executive Manager Aged Care Solutions Colonial First State
It can be difficult to distinguish between a retirement village and an aged care facility these days. There are many terms that are used across a range of different developments, each with their own financial and legal structures. Such terms include “Lifestyle Village”, “Supported Living Community”, “Assisted Living Neighbourhood” “Retirement Resort” and even “Aged Care”. However, the distinctions are important when considering which arrangement is the right one for you.
Retirement villages, aged care facilities and your care needs The ability to access care is becoming a key consideration as many people move into a village in their mid seventies, with around 60% entering as a couple. The level of care that can be provided to you in a retirement village will vary from one to another. Traditional retirement villages focus on the lifestyle and activities and want to attract residents who are sociable and physically active. These villages may require that you leave if your health deteriorates, as too many people sitting around in wheelchairs or hibernating in their units can have a detrimental effect on the experience of the other residents as well as the ability to sell units to new residents. In some circumstances the village operator will allow you to have care provided to you in your unit. If the retirement village cannot organise this for you will need to arrange for the services to be provided just as you would in your own home; through government funded community aged care packages or private services or a combination of the two.
A retirement village that can provide care services or has an aged care facility located on the same site is often a good solution where one member of a couple requires care but the other doesn’t. At the other end of the scale there are retirement villages that are purpose built to deliver aged care. It can be difficult to tell the difference between these and an aged care facility. The rooms are often single rooms or small apartments with an ensuite bathroom and they are often built to the same specifications as an aged care facility: wide doorways; bathrooms with handrails and showers without a recess to enable assistance with showering; call buttons to request assistance; as well as the provision of meals, domestic services and some nursing services. These services may be delivered to you as your care needs increase or it may be a condition of your entry that you already require some or all of these to be provided. Where it is a condition of your entry that you require care the retirement village operator will generally assess your needs prior to you
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Distinguishing the difference between Aged Care Facilities and Retirement Villages
(continued)
1. What are my care needs now? What are they likely to be over the next 5-10 years? At what point can the village no longer provide the care or services I require? 2. How do I feel about living with other people who have care needs that are likely to increase? 3. How will I fund the next move?
moving in to ensure that they can provide the services you need. They will generally co-ordinate the package of services for you and provide you with a price table to help you understand what the cost will be now and what you can expect to pay if your care needs increase. In many cases the care being provided will be through a government funded community care package with the retirement village delivering any â&#x20AC;&#x153;top upâ&#x20AC;? services themselves or through private contractors. The key questions you should think about if you are thinking about moving to one of these villages are:
Costs Financially, there are significant differences between retirement villages and aged care facilities that you need to consider in light of your own circumstances. The money that you pay for your unit or apartment in a retirement village is called an entry contribution, and the amount you pay determines whether you are considered a home-owner or a non-homeowner for pension purposes. In some circumstances, people who pay an entry contribution below the threshold can claim rent assistance in
addition to their pension. The amount of the entry contribution will be set by the village operator, whereas the maximum amount of accommodation bond you pay to an aged care facility is based on an assessment of your assets by the government Most retirement villages will refund the balance of the entry contribution when they sell the unit to the next resident. The most important thing to understand is the calculation of the deferred management fee (DMF). The deferred management fee, sometimes referred to as an exit fee is deducted from the proceeds from the sale of your unit with the balance being refunded to you. Historically it has been common for the DMF to be calculated at 3% per year for a maximum of 10 years and based on the sale price, for example if you bought a unit for $200,000 and sold the unit for $250,000 10 years later the DMF would be $75,000 and the remaining $175,000 would be refunded to you. However, there are a number of different ways in which the DMF
can be calculated, and in some cases the retirement village operator may give you a choice of models. In looking at the models it is important to understand whether the DMF will be calculated using the purchase price or the sale price and whether it will be before or after any capital gain sharing. Capital gain sharing means that you get some (often it is split 50/50 between yourself and the operator) or all of the capital gain, which can assist in offsetting the DMF. Some villages that don’t expect residents to stay for a long period shorten the DMF period; for example the DMF is calculated at 10% in the first year and 6% for the next 5 years, meaning that the DMF for those who stay for 6 years or more will be 40%. In some cases the entire entry contribution can be retained by the village operator; a DMF of 20% per year for a maximum of 5 years based on the purchase price would be mean that any resident who lived in the village for more than 5 years would not receive any of their entry contribution upon departure. The DMF can also have other costs added to it, such as refurbishment costs. Refurbishment costs can vary from a fresh coat of paint to a complete re-fit of the unit: new carpets, curtains, bathroom and kitchen. In contrast,if you pay a lump sum to enter an aged care facility this is called an accommodation bond. While the amount you pay may be similar to the entry contribution paid to a retirement village,
it is distinctly different. Firstly, the amount of accommodation bond you pay does not determine your homeowner status for pension purposes. If you sell your home to pay your accommodation bond you are considered a non-homeowner for pension purposes. When you move into an aged care facility and sign a residential care agreement you will be provided with a letter confirming that the accommodation bond is guaranteed. You will also be provided a statement of the balance each year. The amount of accommodation bond you pay (less any retention amount) is guaranteed by the government. The retention amount is a fee that is deducted from the accommodation bond by the aged care facility each month for a maximum of 5 years or for as long as you live there, whichever is the lesser. The maximum retention amount is set by the government and is currently $307.50 per month, which would mean a maximum of $18,450 after 5 years. In some cases you can also negotiate with an aged care facility to have some of your ongoing fees deducted from the bond instead of paid from your cash flow each month. This strategy is often used to make extra services more affordable to people living on a pension. Aged care facilities are legally obliged to refund the balance of your accommodation bond within 14 days of you leaving the facility or receiving a letter of administration
“
When looking at retirement villages and aged care facilities it is vital to ensure that you are going to be able to receive the care and services you need now and in the future.
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or probate if you pass away. In fact the aged care facility needs to pay interest on your accommodation bond from the day after you leave the service to the day the bond balance is refunded. If the bond is refunded within the legislated timeframe then a base rate of interest is applied, currently 5% pa. However if the facility does not refund the bond within the legislated timeframe then the maximum permissible interest rate at the time (currently 8.92%) is applied. Of course when looking at retirement villages and aged care facilities it is vital to ensure that you are going to be able to receive the care and services you need now and in the future. You should ask questions about what will happen if your care needs change or increase and what effect this would have on your fees and charges to ensure that it is affordable. Like anything, it is not about what is “right”, “wrong” or “best” it is about making an educated choice based on your own personal situation. n
editorial
National electronic Resident Agreement New Innovative National Service ✔ It’s fully compliant ✔ It’s easy to use ✔ It’s inexpensive ✔ Your support will support your Associations
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he National electronic Resident Agreement (NeRA) software is a joint ACAA/ACSA initiative supporting the first national approach to resident agreements. The uptake has been significant since its launch, with over 700 sites nationwide now using the software. It has been great to see so many Association members - and the industry in general - taking an interest in this initiative and supporting a positive national approach to resident agreements. Recognising the advantages of having a nationwide industry standard for resident agreements, rather than individually maintained documentation, the Associations
have taken on the responsibility of monitoring legislative changes and maintaining the agreements via NeRA. NeRA automatically updates government data and the latest legal templates in relation to resident admission. This reduces the burden on providers to maintain accurate agreements and minimises errors made in generating agreements. Furthermore, the national standard embodied in the NeRA program is constantly being reviewed and revised based on feedback from providers. As part of a dynamic approach to both the content of the agreements and the development of the program, aged care software developer e-Tools is pleased to support both Associations by taking on board provider feedback and working with the Associations to ensure a current national approach that reflects the industry’s interests. •
The ease of creating and managing agreements
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•
The security of knowing that the agreements are current and accurate The potential to save on your most precious resources - time, labour and money
These benefits explain the overwhelmingly positive response from the industry. For a very modest investment, you will have a reliable, effective, long term solution and you will recover the cost in less than a day of traditional work time, let alone legal costs! So, purchase, subscribe and rest easy….the NeRA application has been designed to take all the work out of generating agreements while ensuring that the agreements are legally up to date at all times. For further information about NeRA or to view the software in action for yourself, book an online demonstration by calling e-Tools on 03 9571 8611 or visit www.e-tools.com.au. n
editorial
Aged Care facilities
The gap between the rich and poor to grow? With the release of the Productivity Commission Draft Report (PCDR) on Aged Care in Australia in May, substantial changes within the aged care industry may result in traditional funding no longer being available in the same form with alternatives being introduced including more user pay style, which could see changes to how a facility is analysed and the valuation methodology that is applied. National Directors of Colliers International Healthcare & Retirement Living, Paul Moschione and Phil Smith, discuss how they saw this change coming about and what it means for our sector.
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ecent transactions in the aged care sector have been limited following the level of high activity between 2005 and early 2008. We believe there are three main reasons for this, the most notable reason being the global financial crisis, together with the investment market’s re-consideration of the value and risks of accommodation bonds, and finally, the uncertainty prior to the release of the PCDR. This lack of activity has made valuations extremely difficult, with comparisons thin on the ground. But now with the release of PCD Report, where do values go from here? The PCD Report is a comprehensive document which diagnoses and promotes the need for change within the industry. Many analysts have provided summaries of their interpretation of the PCD Report, but the ultimate message is clear; eventual reduced
regulation, with an increase in user choice, and an increase in user pay. With the proposal of the “capping” of accommodation bonds, periodic payments or monthly contributions from users (or their families) to subsidise the Commonwealth, entitlements may become more prevalent, and perhaps even preferable to accommodation bonds. If the average length of a resident’s stay in an aged facility continues to decrease, operators may increasingly prefer to take monthly cash flows rather than wait for the sale of the family property to obtain an accommodation bond (particularly if the bond is capped). Indeed residents and their families may be more willing to commit to a monthly payment rather than a large lump sum payment that often reflects substantial amount of their accumulated family wealth. There is a view that this is something that the retirement village sector needs to consider. To enter a retirement village, a substantial outlay is required for a loan/license securing of tenure. Rental arrangements are generally associated with lower standard of accommodation – innovative retirement village operators are now looking at offering a specific care service and rental options which may present real competition for traditional, certain aged care facilities. The result of this is that we may move towards a more balanced cash flow valuation model, rather than simply a model of new facilities driven by reducing capital costs and debt / equity funding by obtaining bond commitments. These cash flows will most likely reflect the costs of local communities – facilities in more affluent areas will derive higher cash flows than those in less affluent areas. With this model “core values” based on sustainable EBITDA will be more robust. However perhaps the biggest influence on values following the PCD Report will be that, with supply potentially opening up, increased user choice may dramatically affect occupancy. Common sense would suggest
that quality of facility will be of paramount importance with values going forward. Like it or not, the quality of accommodation is often the key focus of families, as, rightly or wrongly, quality of care is generally assumed to be adequate. The sector has typically referred to ‘value range per bed’, with little differential in relation to whether it be an older, multi bedded facility, or a new modern ‘single room plus ensuite’. We expect that the proposals in the PCD Report may end this sweeping, broad approach. In terms of accommodation quality, it is expected that the value gap between the rich and the poor may grow over the next 5 years. n
About Colliers International Colliers International is a global leader in real estate services with more than 15,000 professionals operating out of 480 offices in 61 countries. As a subsidiary of FirstService Corporation (NASDAQ: FSRV; TSX: FSV and FSV.PR.U), Colliers International offers the stability of a strong financial partner and significant local ownership providing clients with accountability and enterprising real estate solutions. Colliers International provides a full range of services to real estate users, owners and investors worldwide including global corporate solutions; sales and lease brokerage; property and asset management; project management; hotel investment sales and consulting; property valuation and appraisal services; mortgage banking and insightful research. Founded in Australia in 1976, Colliers International is the largest locally formed real estate services firm with professionals that service clients throughout the country. Find out more at www.colliers.com.au For all the latest international news from Colliers International visit www.colliersnews.com For further information please contact: Sarah Stewart, National Manager | PR & Communications Corporate Marketing & Communications, Colliers International Tel: +61 2 9257 0200 Email: Sarah.Stewart@colliers.com www.colliers.com.au
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editorial
Changes to the Accreditation Grant Principles The new Accreditation Grant Principles 2011 came into effect on 20 May 2011.
Changes at a glance Self-assessments
You need no longer provide self-assessment results with the application for re-accreditation, but must make your self-assessment available at the re-accreditation audit. You can choose the format that suits you best – however a template is available on the website.
Continuous improvement plans
You need to maintain a plan for continuous improvement (PCI). If you do not meet the Accreditation Standards, you need to submit a revised PCI.
Appeals against decisions
You can ask the Agency to reconsider a decision about the period of accreditation. If you are unhappy with the reconsidered decision, you can ask the Administrative Appeals Tribunal to review the reconsidered decision.
Some things haven’t changed, under the new Principles:
Fee structure
No change.
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Sanctions
We will no longer recommend sanctions to the Department of Health and Ageing. Sanctions are entirely a matter for the Department.
Residents’ input
We must interview at least 10 per cent of residents at review audits as well as reaccreditation audits.
Advising residents of planned visit
You must tell residents 21 days before a visit is to take place, using the wording provided by the Agency. You must display the poster provided by the Agency in a prominent place.
Assessment team members
You can no longer nominate team members.
Site audit
Follows an application for re-accreditation and involves an assessment of a home’s performance against the Accreditation Standards. The desk audit has been discontinued.
Review audit
Initiated by the Agency, or at the request of the Department of Health and Ageing, and involves an assessment of a home’s performance against the Accreditation Standards.
Assessment contact
Support contacts are now called assessment contacts.
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he new Principles use clearer and consistent language, simplify some processes and provide greater flexibility for providers. As of 20 May 2011, the Accreditation Grant Principles 1999 no longer apply, although applications for accreditation submitted prior to 20 May will continue to be dealt with under the old processes. The new accreditation arrangements include changed arrangements for notifying residents and their relatives of visits by assessment teams.
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You will still need to carry out selfassessment, although you can use whatever report format suits you and you don’t have to submit your selfassessment with your application for re-accreditation. There are no changes to the Accreditation Standards or the expected outcomes. Accreditation fees, and the fee structure have not changed.
More details on the changes to the Accreditation Grant Principles 2011 is available online at www.accreditation.org.au n
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Compulsory reporting –
A guide for facility managers from Hynes Lawyers Under the Aged Care Act Approved Providers must report “reportable assaults”. The purpose of this article is to help facility managers understand when an incident has to be reported and when an incident does not have to be reported. A reportable assault is unlawful sexual contact, unreasonable use of force, or any assault on a resident. An approved provider must report every allegation that a reportable assault has occurred and on every occasion they reasonably suspect a reportable assault has occurred. Since these reporting requirements were introduced there has been a lot of confusion and hype about what has to be reported and when the 24 hour deadline for reporting begins. In order to clarify these issues Aged Care Association Australia (ACAA) has sought legal advice from Hynes lawyers. The contents of this article is based on that legal advice.
Reporting An Approved Provider must report to the CIS (1800 550 552) and to the police: • Every allegation that a reportable assault has occurred – that is when a person claims to have witnessed a reportable assault, or asserts that one has occurred. The 24 hour reporting period commences immediately the allegation is made to Key Personnel or Key Personnel are advised of it. AND •
On each occasion that the Approved Provider starts to suspect on reasonable grounds that a reportable assault has occurred.
If the Approved Provider suspects there has been an assault (in contrast to where an assault has been actually alleged), the Approved Provider, or more specifically the Key Personnel on behalf of the Approved Provider, must conduct some level of inquiry or investigation in order to form a view that there is a reasonable basis for the suspicion. Immediately Key Personnel have conducted sufficient inquiries to satisfy themselves that there are reasonable grounds for the suspicion, the obligation to report arises and the 24 hour reporting period commences.
Examples of incidents that must be reported: •
A resident, with dementia or some other cognitive impairment, tells the facility manager (assuming she or he is Key Personnel) that they have been physically or sexually assaulted by a staff member.
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Sexual assault includes inappropriate touching or sexual contact.
This is a reportable assault and must be reported within 24 hours of the allegation being made to the facility manager. •
A staff member reports to the facility manager that they have seen a family member physically assault a resident by slapping the resident on the face.
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Physical assault includes any physical contact without consent.
This is a reportable assault and must be reported within 24 hours of the allegation being made to the facility manager. •
The facility manager sees a staff member restrain a resident and the facility manager thinks that the level of force used is more than what is necessary.
This is a reportable assault and must be reported within 24 hours. •
A family member tells the facility manager a resident has been sexually assaulted by a staff member.
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If the allegation was made to a staff member, the staff member must tell the facility manager. The 24 hour reporting period starts from when the facility manger (or other key personnel) has been informed.
This is a reportable assault and must be reported within 24 hours of the allegation being made to the facility manager.
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Compulsory reporting – A guide for facility managers from Hynes Lawyers (continued) •
A nurse notices some bruising on a resident and tells the facility manager that he/she is unsure how this happened and is concerned the resident might have been assaulted.
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The facility manager immediately commences inquiries to determine whether there are reasonable grounds to suspect that the resident has been physically or sexually assaulted. Within a matter of hours she has conducted sufficient inquiries to be able to say she believes there are reasonable grounds for her suspicion.
This is a reportable assault and must be reported within 24 hours of the facility manager having sufficient information to suspect (on reasonable grounds) that a reportable assault has occurred.
Examples of incidents that do not need to be reported •
A family member complains that a staff member made crude or vulgar comments of a sexual nature to a resident. This is inappropriate behaviour and should be dealt with as a disciplinary matter.
This is not a reportable assault and does not need to be reported. •
A family member tells the facility manager that they overhead a staff member threaten to withhold care from a resident unless the resident co-operates with the staff member. This is inappropriate behaviour and should be dealt with as a disciplinary matter.
This is not a reportable assault and does not need to be reported. •
A staff member tells the facility manager that he/she is concerned that a resident is withdrawn, refusing to eat and is acting differently to how the resident usually acts. The staff member reports to the facility manager that they are concerned about the resident and suspect the resident may have been abused.
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The facility manager immediately commences inquiries to determine whether there are reasonable grounds to suspect the resident has been physically or sexually assaulted. Within a very short time of commencing those inquiries, the facility manager forms the view that there are actually no grounds at all to indicate that the resident has been assaulted.
This is not a reportable assault and does not need to be reported. •
A resident is injured while she is being transferred to bed by a carer. The facility manager speaks to the carer and is satisfied that the carer did not intentionally harm the resident and that the level of force used to reposition the resident was reasonable.
This is not a reportable assault and does not need to be reported. • A staff member reports a medication incident. The resident had a serious reaction and was transferred to hospital. • A staff member reports a medication incident. The resident suffered no injury and there was no need to seek medical attention. These are not reportable assaults and do not need to be reported.
Exceptions to obligations to report If a resident physically or sexually assaults another resident an Approved Provider does not need to report the incident provided: • • •
the resident who committed the assault has a previously diagnosed cognitive or mental impairment; a behaviour management strategy is implemented within 24 hours of the assault; and the diagnosis and plan are noted in the resident’s care plan.
Note: Approved providers do not need to report an incident if a similar incident involving the same resident has already been reported.
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Victorian Floods: Goodwin Village Anthony Hogan Executive Officer Goodwin Village
Goodwin Village is located in the small Victorian country town of Donald, that has a population of 1700 people. The Village consists of a 33 bed residential aged care facility (hostel) with ageing in place, and 29 independent living units.
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he Village is home to 66 elderly people. Despite some great community efforts to sandbag the property, the biggest flood waters in the Richardson River since 1909 inundated the Village on 15th January 2011. 320mm of water went through the hostel. Nine independent living units had water levels varying from 240mm down to 80mm through them. Due to the considered insignificance of the river there was no official monitoring of river flood water levels by water authorities, and therefore no flood warnings given. Prior to the buildings being inundated, the Organisation activated its emergency management plan, and evacuated all residents from the hostel, initially to three nearby facilities, by community bus and motor vehicles. Some residents went to their families. All threatened unit residents went to stay with families. The neighbouring facilities and residents families have been very helpful to Goodwin Village, and have provided excellent ongoing support to the organisation, and it’s residents. Two of the facilities providing the majority of the accommodation for Goodwin Village residents - Dunmunkle Lodge (Minyip) and the Rupanyup Nursing Home, have been especially helpful and fortunately have required the majority of Goodwin Village care staff to travel to their facilities to provide sufficient staffing levels. The familiar faces also eases the trauma of relocation. Goodwin Village care staff have been fully employed. Since the initial evacuation other facilities have also offered to accommodate residents, including Kara Court, and Coates Hostel St Arnaud; Riverview Aged Care, and the Hospital in Donald; as well as Sunnyside Retirement Village Horsham. The residents feel fortunate to be able to remain in the neighbouring facilities, but are certainly ‘homesick’ for their friends in Donald. Goodwin Village has relocated its administration, including phones and computer network to a one-bedroom unit that was vacant just prior to the flood. The real disappointment of the floods was the fact that Goodwin Village had almost completed a $2.1 million upgrade of its residential
aged care building. Local builder’s were refurbishing all resident bedrooms, and providing all bedrooms with single ensuites. Dining areas, and fire warning systems throughout the hostel were also being upgraded. The building works were about a month off completion. Residents had already consented to compromising, around the renovations, being shuffled to temporary bedrooms, and suffering other inconveniences. Fortunately, Goodwin Village was well insured to cover this unfortunate event, including material damage, equipment losses and business interruption. The insurance claim will be close to $3.0 million in value. All buildings will be fully ‘refitted’ as new again. New plasterboard, floor and wall coverings, curtains, joinery, fittings, and equipment, and painting are required. After the flood, the ‘wet’ hostel and units were ‘stripped out’ by the builders. That process had been commenced enthusiastically by local volunteers, including resident families. Once buildings were ‘stripped out’ all wall cavities, and the concrete slab, were commercially dried out by contractors from Melbourne. The ‘refit’ commenced just before Easter, and is expected to take a total of 8 months. The hostel may be ready for occupancy in September, with the units being finished in November. Not far short of 12 months since the flood. The Management Board has many issues to resolve in the months ahead. Their number one concern is always the care and welfare of the residents, in their present accommodation, and ultimately in their return to Goodwin Village. The Board is investigating implications of constructing a levee bank on the property. Any proposed levee will be designed in consultation with the Catchment Management Authority and the Shire of Buloke and other authorities. n
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Victorian Floods:
East Wimmera Health Service By Kathy Huett Late on Thursday 13th January 2011 East Wimmera Health Service (EWHS) were advised that the river at Charlton was at risk of flooding on Friday 14th January. Early on the 14th January we were advised that the river was likely to rise more than a meter higher than it had done so in the September 2010 floods.
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WHS had made the decision during the September floods not to evacuate any patients/residents as we did not believe that the flood would affect us. We were lucky at that time that the flood water did not severely affect the campus but given this insight it was agreed that we would evacuate the campus on Friday 14th January 2011. Fortunately there were no acute patients in the hospital at the time but there were 15 aged care residents who required relocating. Of these 2 relocated with family to private houses and the remaining 13 were relocated to other EWHS campuses via private transport, community bus and Ambulance Victoria. In addition to residents from EWHS Charlton the EWHS Donald Campus welcomed six residents from a private aged care facility which was also affected by the flooding of the Richardson River in Donald. The Charlton campus of East Wimmera Health Service and the Charlton Medical Centre were inundated with flood waters ranging from 500mm to 1000mm across the site and throughout the buildings. This caused extensive damage resulting in the closure of the buildings. While evaluation is underway to ascertain the damage and requirements to ensure ongoing health services into the future, the building remains closed. As the Campus will be closed for some time all of the residents who were relocated have now opted to transfer to their new homes on a permanent basis with the assurance that they may transfer back to Charlton when the building is repaired or rebuilt. To ensure that the community had access to medical services the Department of Health (DoH) set up an interim emergency Medical unit managed by Ambulance Victoria. This was situated in the basketball stadium of the Charlton College and operated from Friday 21st January 2011 until the temporary Medical and Primary Care unit opened on 28th March 2011. This centre has been established in the grounds of the St Joseph Church at Charlton and comprises of 2 relocatable buildings which have been refurbished to specifications which ensure continuation of medical services in Charlton. The support from the communities and volunteers during this disaster has been overwhelming both for the townships affected by the floods and the Charlton Campus of EWHS. Words cannot express the gratitude felt towards these selfless individuals who have given their time, money and support and keep giving. n
Dr Adele van der Merwe and Kathy Huett, Chief Executive Officer, East Wimmera Health Service in front of the Emergency Medical Unit affectionately known as the â&#x20AC;&#x2DC;Mash Tentâ&#x20AC;&#x2122;
Some of the damage
Industry reflects on Queensland Floods Significant flooding occurred in many areas around Queensland during late December 2010 and early January 2011, with three quarters of the state declared a disaster zone. Across the broad spectrum of community care, residential care and retirement living, aged care staff and residents stepped up to the challenge presented by the floods and continued on with business as usual.
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ince then, ACQ has heard many positive examples of how the industry responded and assisted one another during and after the flood crisis. Management and staff who were personally affected by the floods in many cases placed the welfare of residents/ clients ahead of their own needs. ACQ received reports of staff working extended overtime, sleeping at facilities and undertaking other tasks outside their normal routines. In total 14 residential aged care facilities and four retirement villages were evacuated. While, most evacuated residents have been able to return home, some will not be able to return until their facility has been rebuilt. Residents from Churches of Christ Care’s Warrawee Aged Care facility in St George who were evacuated have finally been able to return home. When floodwaters inundated the St George region in early January residents from Warrawee were transferred
to Churches of Christ Care’s Moonah Park facility in Brisbane and the Moreton Bay Nursing Care Unit. After much discussion the organisation decided that it was safe to return the residents back to St George. Churches of Christ Care’s Director, David Swain, has commended the efforts of his staff throughout the flood crisis. “We are vey proud of the way all our staff have pulled together during this difficult time,” Mr Swain said. Residents from Pine Lodge who were evacuated during the floods had been informed that they will not be able to return for quite some time. Arcare and The Salvation Army have both generously accommodated Pine Lodge staff and residents at their own facilities. Pat McCarthy, Arcare’s Regional Operations Manager in Brisbane, has utilised Arcare Logan’s new Extra Service wing and has withheld the sale of these beds, which had been on the market for up to $400,000, in order to accommodate the evacuees. “It took about a week for everyone to settle in. It’s a very interesting situation for everybody – running two aged care facilities under one roof. There are two teams looking after two different groups of residents,” Pat said. The reach of community care services was also significantly impacted upon, with the widespread flooding resulting in many
providers assisting vulnerable clients to prepare or evacuate and only providing essential services on days where access was at risk. Meals on Wheels sustained stock losses as a result of lack of power but has since regained operations in all areas including Centenary. Debra Tape, CEO of Meals on Wheels Queensland commented on the service ethic prevailing in the industry. “Meals on Wheels as I am sure other services have been in the thick of the floods however in true volunteer spirit have managed to rise to the challenge,” she said. By far one of the biggest issues for all affected by the floods was staffing. Staff had difficulties both getting to and from workplaces and accessing roads to reach clients. Athena Ermides, General Manager of Berlasco Court Caring Centre, advised her staff that if they could not get into work they could help out at another facility and still receive payment of wages. There was also a reciprocal arrangement for staff from other facilities who could access Berlasco Court. Athena would like to see this approach adopted in the future. “It would be great if we could have an agreement or a memorandum of understanding within the industry which adopts a similar model to that implemented at Berlasco Court,” she said. The importance of forward planning and the execution of effective disaster management
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“We now know that if the river gets to 3.8 meters it’s fine but you need to have a pre determined level where you know you should be evacuating.” Carol said that whilst Ningana’s action plan still needs work appropriate procedures were now in place.
plans proved to be essential requirements in coping with the effects of the flood. Carol McDowell, Facility Manager at Ningana Retirement Village, said that during the floods they faced three different periods of possible evacuation and had since updated their emergency response plan. “It necessary during flooding to have a pre determined river peak,” Carol said.
“We know to have 40 overnight bags ready to go and a next of kin list with names and telephone numbers. Staff members have also been allocated roles in the event of a disaster, for example, one staff member is responsible for phoning the families of residents,” she said. Carol also emphasised the importance of establishing relationships with local hospitals and Disaster Management Planning committees. “As part of our preparation last February I saw the Director of Nursing at the hospital
and she became my point of communication during the floods,” said Carol. Overall, Carol believes that the floods had a positive impact on her team at Ningana. “The floods reaffirmed the dedication of my staff and their resilience during a very stressful time was inspiring to me. Residents have praised the way we all managed during the event together to make their lives and daily routines as normal as possible during a period where they were very anxious, tearful and often afraid as they were uncertain about what was going to happen.” The demonstrations of compassion, generosity and strength shown by the industry throughout the flood crisis is testament to the morale and commitment of staff who work effortlessly to provide a continuing high standard of care and services. ACQ commends all aged care staff, volunteers and residents for their efforts throughout the floods and the recovery process. n
editorial
In Her Own Words – Vicki’s story of residential aged care Vicki is a current relative and carer of Jamison Gardens – this is her story in her own words.
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t was up until May 2010 that my Mum, Noeline, and my Dad, Doug, had resided on the North Coast of NSW. Unfortunately Dad suffered a fall that put him in hospital. He was then ACAT assessed and we were told he needed to go into full time care and couldn’t return home. So I moved Mum in with us and began searching for an aged care centre for Dad. We started by calling and visiting the centres close to where we live. I also asked my local contacts and always received good feedback about SummitCare Jamison Gardens. Mum and I had visited other centres but when we walked into Jamison Gardens, we both knew this was the place for Dad. The staff at the centre immediately came across as warm, caring and extremely informative. I actually had an operation there many years ago when it was a hospital. I live and work locally to Jamison Gardens, so the positioning was ideal for me, however the care and atmosphere are what mattered so much for my Dad. It was not long after we placed Dad into care that Mum began to suffer with Sundowner Dementia. Unfortunately this worsened quickly – it also affects the sufferer more later in the day than earlier in the day. It soon got to the point where I couldn’t leave Mum at home or even alone for a minute. This put a lot of pressure on me and also began causing tension in my marriage. My Doctor recommended respite care for Mum a couple of days a week to help alleviate the pressure. Then one night Mum had a fall and hurt herself – and I’d only turned away for a moment. Mum was ACAT assessed and I was
advised she needed to be placed in full time care. I’d already spoken to Jamison Gardens about the respite care and luckily there was a full time room available for her. I now have peace of mind and my relationship with my husband has improved with the constant edginess and concern now gone. Initially I was hoping for a room Mum and Dad could share, but as Mum’s dementia worsened, my brother and I decided it was best for Mum to live in the secure section of the home. The staff at Jamison are wonderful and every morning they help Mum up, help shower and dress her then facilitate Dad to see Mum. They spend the morning and enjoy lunch together every day. If Mum wants to go and see Dad instead, the staff are more than happy to work that way too. Mum settled very quickly into her new home. When she was admitted I gave the staff her social profile that included her likes and dislikes. One of the things she likes doing is knitting, so imagine my surprise when I arrived to see Mum with a ball of wool and knitting needles happily knitting away. I’m always pleasantly surprised at the wonderful range of activities for residents
to try to help restore their memories. The fully supervised tea parties are always a highlight. Mum really enjoys these social activities that help enrich her life. All staff are caring, polite and informative – especially Pearl at reception, Suzanne the Operations Manager and every single one of the Nurses and Care staff. If I do have an issue or a request, Pearl or the Nurse on duty are always available and it’s actioned immediately – whatever it is. If I request the Doctor to visit one of my parents, it’s honoured in a timely manner. The staff accept each issue as an opportunity to improve service to the residents. I love knowing Mum and Dad enjoy lunch as their main meal together and a lighter meal in the evening. I feel like some of the staff are my extended family. I think the care my Parents receive at SummitCare Jamison Gardens is brilliant. The staff are informative and give time and patience to every resident. I applaud them for the work they do. The atmosphere is happy and pleasant and the building is always clean and well maintained. I cannot fault anything about the service my parents receive. n
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“Green” Clean Stock Take Sallyanne Bond | Henk La Dru
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Directors, Optimal Energy Solutions
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Most companies don’t realise that implementing some simple changes to how they use their power can reap dividends to saving energy costs.
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reen initiatives can be fiscally rewarding. Taking the ‘feel good factor” aside, it is about reducing energy overheads and improved competiveness. The Australian Bureau of Statistics reveals that only 5% of all businesses conducted an energy audit. A report by the Australian Industry Group (AIG), which represents the nation’s manufacturing sector, said around 66 per cent of companies had made no energy efficiency improvements over the past five years. (Source ABS, Catalogue 4660.0 released 30/07/2010)
There is enormous potential for Aged Care Facilities to become more energy efficient. Undertaking an Energy Audit can be highly effective. Introducing more efficient technologies, particularly in lighting, ventilation, airconditioning, insulation, sealing, solar usage including water, photovoltaic, thermal transfer, makes commercial sense. Think of it like a Green Stock Take. It provides an assessment identifying your current energy use amongst the various sections of an Aged Care facility. It offers the following benefits: • • •
Brings environmental considerations into each element of your core business Meet or exceed all environmental regulations throughout the workplaces Establishes a structured and consistent environmental management system
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Provides a total review of the consumption of energy to reduce power costs Confirms your commitment as a company taking steps to reduce their carbon footprint
The purpose of an energy audit is to reduce operating costs by reducing energy consumption. Why? It is about assessing and improving your economic and environmental performance. As the world transitions to a low carbon economy, it is a forward-looking strategic positioning for the future. With energy prices on an upward trajectory and as Australia imposes a price on carbon emissions, energy efficiency is even more important now. Conducting a detailed energy audit whether a Level 1, 2 or 3 as defined under AS/NZ ISO 14001.2004 essentially establishes an energy policy for an organisation which states the company’s commitment to achieving improved energy performance.
How the process works It involves a site induction and tour of the facility to identify the energy aspects arising from the operating activities which can identify areas where savings can be made which forms the basis of recommendations and solutions to provide better outcomes. Conducting Energy Audits at a Switchboard level can help isolate specific areas of energy usage and work flow processes. Looking objectively at where, when and why equipment is being used at specific times of the shift or day or process can improve energy demands significantly. It entails meeting with Management and all key parties to the whole process to establish priorities and set appropriate energy objectives and targets. This resulting information provides the basis for establishing an energy management programme, providing a package of measures and recommendations of selection of equipment, raw materials and services.
A level of reporting could include equipment recommendations and a financial analysis highlighting installed cost, projected savings, and any utility rebates or government subsidies available. Potential measures include but are not limited to: Track metered savings at premises, monitor usage and provide real time data to assist with maintenance and energy expenditure Lighting can be up to 20% of your operation’s power bill. Managing effective lighting control is critical for safety and productivity reasons and with correct management can provide substantial savings. Using metal halide, mercury vapour lights or sodium vapour lamps, although very effective lighting, can in many situations be substituted for high efficient LED or CFL technology. CFL or LED replacement lamps use less than a quarter of the power to that of a typical equivalent mercury vapour lamp and can be coupled with movement sensor switching with delay off or timer or even day light assisted monitoring. For example if skylights are fitted and the area has more than the required light level for the work environment due to the ambient day light, the lighting will not come on unless the programmed light sensor detects that there is insufficient light and will enable the lighting to be switched on. LED lighting also has dramatically reduced bug attraction due to the lighting spectrum and the small amount of heat produced. A level of reporting could include equipment recommendations and a financial review of Heating, Water Processes & Usage, Ventilation and Air Conditioning Equipment Utilising modern energy saving Air conditioning systems that are solar thermal assisted can reduce energy usage up to 50% on one of the highest power demanding requirements of modern industry and employee work place requirements. Building Envelope Existing Energy Management Systems Provides the guidelines for implementing an Environmental Management Programme.
partly evaluated on the basis of energy efficiency. Identify your organisation as one that takes its sustainability responsibilities seriously.
It is important to carry out regular audits or reviews to ensure development and continuous improvement of an effective Programme. Take into consideration, when purchasing energy consuming equipment, Management should inform suppliers that purchasing is
It is financially beneficial to produce a performance statement setting out how an organisation can improve its energy performance and how it intends to meet its stated policy and energy targets. The type of actions available to an Aged Care Facility will vary and in reality funds for environmental improvements may be limited by resources, productive time and
staff. However, there is a range of short and long term improvements to ensure you are on the path to making effective changes to your bottom line and also making a difference to the environment. The office can be an area where environmental performance should not be overlooked. Empower your staff to be part of this energy reduction awareness to ensure the best energy practice. Improvement in energy management goes along way to saving companies money. The result is a win win of reduced operating costs and improved environmental outcomes! n Sallyanne Bond or Henk La Dru of Optimal Energy Solutions can be contacted on 1300 710 059 or sab@optimalenergysolutions.com.au Optimal Energy Solutions will work with you to ensure your Aged Care Facility is on a path of improved energy efficiency.
events
2011 Calendar of Events 20 – 22 July
22 - 23 September
October
Nurses in Management Aged Care (NIMAC) Conference
5th Annual National Dementia Research Forum
SAGE - USA (Including IAHSA)
Jupiters, Gold Coast Contact: ACQ Conference + Event Management T: 07-3725 5588 E: events@acqi.org.au www.acqi.org.au
Wesley Conference Centre Sydney dementiacrc@unsw.edu.au www.dementia.unsw.edu.au
19 & 20 October
6 – 8 November
Breaking Through the Barriers
ACAA 30th Annual Congress
Brisbane Convention and Exhibition Centre Lisa Woodward Conference Coordinator Tel: 02 9270 6626 Email: lisa.woodward@cshisc.com.au www.cshisc.com.au/conference2011
Magical Mystery Tour - The Long and Winding Road
T: (02) 9689 2088 E: j.okeefe@thomsonadsett.com www.sagetours.com.au
Contact: ACQ Conference + Event Management T: 07-3725 5555 E: acaa2011@acqi.org.au or enquiry@acaacongress2011.com.au www.acaacongress2011.com.au
LETTERS TO THE EDITOR Aged Care Association Australia is interested to hear from you. Maybe you’d like to
respond to an article you’ve read or you have an article you’d like to submit. ACAA welcomes letters to the editor of no more than 300 words. All letters must have the writer’s name, address, telephone number and job title clearly written. ACAA reserve the right to edit for reasons of space and clarity. Send to: editor@acaa.com.au or PO Box 335 Curtin ACT 2605.
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A Bit of Humour
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f you are a senior you will understand this one, if you deal with seniors, this should help you understand them a little better, and if you are not a senior yet… God willing, someday you will be…
The 2.99 Special
We went to breakfast at a restaurant where the ‘seniors’ special’ was two eggs, bacon, hash browns and toast for $2.99. ‘Sounds good,’ my wife said. ‘But I don’t want the eggs..’ ‘Then, I’ll have to charge you $3.49 because you’re ordering a la carte,’ the waitress warned her. ‘You mean I’d have to pay for not taking the eggs?’ my wife asked incredulously. ‘YES!’ stated the waitress. ‘I’ll take the special then,’ my wife said. ‘How do you want your eggs?’ the waitress asked. ‘Raw and in the shell,’ my wife replied.
She took the two eggs home and baked a cake. DON’T MESS WITH SENIORS!!! WE’VE been around the block more than once! n
product news
Simavita helps people everywhere improve quality of life and reduce the cost of care
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imavita is creating solutions to the challenges of rising healthcare costs and an ageing population throughout the developed world. Simavita’s first product addresses urinary incontinence, which is common in older people living in residential aged care facilities worldwide. Incontinence has a significant impact on the psychology, social well-being and quality of life for many aged care residents. Despite the high prevalence of incontinence in
older people, it is poorly assessed and managed. A continence care plan is the most common strategy to manage a resident’s individual continence needs. This usually takes the form of a toileting-assistance program and use of continence aids. Identifying an appropriate continence care plan is a key part in developing person-centered care and funding requirements for aged care facilities. At present, most facilities conduct a manual continence assessment. This requires a carer to manually check each resident every 1 to 3 hours to determine the level of incontinence. It is labour intensive, inaccurate and disruptive. Simavita has developed a medical device called SIM® (Smart Incontinence Management) to address this issue and provide a solution. SIM® allows care givers to do away with costly
manual continence assessments. SIM® technology enables care givers to perform assessments with precision and reliability. SIM® is an instrumented assessment tool, which provides a person-centered continence care plan. SIM® enhances care, reduces costs and leads to improved quality of life. www.simavita.com
Next Gen Insulated Covers
TECO – The Comfortable Choice
.A. Diversified Products has just launched the first in its range of insulated products called Distinctive. The new insulated Dome and Base combines the latest in material technology and modern design to produce an innovative product that meets the ever changing demand of meal delivery.
ECO has been manufacturing Televisions for over 20 years and now has available the latest technology in LED/LCD flat screen models in sizes from 15 inch to 42 inch. Some models in the range also come with an inbuilt DVD player. All models have inputs allowing them to be used as computer monitors and some models also have USB play back and record functions allowing residents to enjoy personal photo or video memories. The size range covers usage suitable for personal areas as well as larger common areas. The latest LED technology ensures these models consume far less energy than older style CRT models.
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The efficient modern design provides excellent temperature stability, food clearance and the contours placed on the Dome allows for a superior handle giving greater finger room and comfortable grip as well as better drying when stacked. Distinctive Dome and Base unique design not only provides a great visual look to the presentation, its modern technology also provides efficient food delivery. S.A. Diversified Products has developed and manufactured the insulated Dome and Base in Australia which allows them the flexibility to work with organisations on corporate colours. For more information call Warren on 0419 990 200 or see www.sadiversified.com.au
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TECO has also supplied a range of Wall Split system and Window Wall Air conditioning units in Australia for over 25 years. The current ranges feature either Fixed Speed compressors or Inverter controlled compressors, all with fully featured wireless remote controls. The smaller capacity systems can be used in individual rooms with capacities also available for larger common areas. TECO Australia has distributors in all states and our staff will assist you with product details and can put you in contact with your closest TECO supplier, who will be able to assist with any enquiries. Both Air conditioning and LCD/LED television are major technologies providing the comfort conditions residents in Retirement and Aged Care facilities should expect.
TECO is “The Comfortable Choice” for Retirement and Aged Care Residents.
www.teco.com.au aca Aged Care Australia | Winter 2011 | 81
product news
Ekotek Wireless Positional Duress System
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kotek’s wireless positional duress product is a unique state of the art 2 way communications and duress system. Its flexible design can help to improve safety and response times in a multitude of industries and applications. Operating on a 2.4 GHz platform via Zigbee wireless protocol. A completely wireless system allows Ekotek to have both flexibility and versatility in many areas. It is a cost effective solution for both new and existing facilities. Minimal disruption to business during installation means business as usual whilst the mesh network goes together. Self configuring and self healing the system is intelligent enough to be able to notify you of any abnormalities on the network. Duress alarms, man down and dead man alerts, location based services, acknowledged paging, integration with other devices such as DECT cordless, Nurse call systems, Security and Fire panels are just some of the benefits of the Ekotek system. Unlike a number of other systems currently in the market place Ekotek’s radio mesh network provides accurate positional location of all alarms raised on the network. Two way messaging allows acknowledgement of received messages. The system is made up of the following components: The Hub: Is the device that creates the network. All communications on the system pass to and from the hub. The Hub can be located anywhere within the network. Alarm messages are displayed on the hub and can be responded to and cancelled from the Hub or a Paging device. Repeater: There are 3 types of repeaters which go together to form the backbone of the mesh network.
HEAD GUY OF AGED DESIGN
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ice Daubney, a leading Australian architectural practice, has appointed Guy Luscombe to head up its new Aged Design sector. The sector has been specifically established in response to the growing demand for buildings that meet the needs and expectations of Australia’s growing ageing population and to address the challenges this poses for both the built environment and the aged care industry. Guy Luscombe has over 25 years of architectural experience with over eight years focusing exclusively on seniors and aged care projects. Some of his recent projects include a new 86 villa, 100 bed multi-level care community at Gordon in Canberra, a 74 bed multistorey residential care building in Nambucca Heads and a 128 villa staged seniors living development in Lithgow. Luscombe also co edited the book “Beyond Beige: improving architecture for older people and people with disabilities” and is currently involved in the
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Internal repeaters (ceiling mountable), call point repeaters (wall mountable) and solar repeaters (externally mountable) mean that you are not restricted to building your network within the normal internal boundaries of a building. Pager: Gives the user the ability to see a duress message and also respond to it. Audible alert, Vibrate and Visual are 3 ways to receive a message. The Pager also has a snatch cord and man down / dead man facility built in. Pendant: Allows for assistance calls to be raised using the location signal from repeaters to give accurate positional location. Audible, vibrate and illumination are all available methods for receiving a message. Man down / dead man feature are also available on the pendant.
See ad on page 13 of this issue. For more information contact Multitone Australasia on 03 9888 1244 n
www.multitone.com.au
peer review of the NSW Government Ageing and Disability Accommodation Design Guidelines. “The ageing population is changing rapidly, at Rice Daubney we believe there is a need to focus on the design of the buildings and communities to address this change,” said Guy Luscombe, Head of Aged Design. “We believe the physical environment does affect our well being and that the most important thing we can do is provide the right space for a healthy and positive living experience for the older person,” he said. With Luscombe’s understanding of the existing ageing landscape, Rice Daubney will pioneer innovative designs for new communities for aged residents where the physical environment not only acts like a ‘silent carer’ but is also a stimulating and life enhancing place for the whole person. The new Aged Design sector will draw on Rice Daubney’s expertise, extensive knowledge base and proven track record in masterplanning and health projects to underpin their approach to the delivery of aged projects. With the
Guy Luscombe, Associate Director and Head of Aged Design at Rice Daubney completion of numerous health care facilities, Rice Daubney understands the key drivers in creating a successful healing environment.
Agewell Physiotherapy
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gewell Physiotherapy provides experienced physiotherapists to Aged Care facilities in Australia to implement a variety of falls prevention strategies. Agewell’s assessment will highlight risk factors that can be managed. These risk factors include reduced balance and muscle strength, poor exercise tolerance, unsafe mobility aids and declining confidence to move. Agewell’s staff will use the latest research to implement effective falls prevention programs such as: individual exercise programs, prescribe safe walking aids and hip protectors, reducing pain, improving continence and provide falls prevention education programs to staff and residents. One of the most effective falls prevention strategies are group exercise programs. Agewell has been able to deliver to over 100 Aged Care facilities its modified No Falls Exercise Program. No Falls Exercise Program was designed by Professor Stephen Lord in conjunction with Monash University’s Accident and Research Centre in 2003. This program uses a combination of seated and standing strengthening, stretching and balance exercises with some visual exercises. Agewell can train physiotherapy assistants and recreational officers to conduct classes x2/3 times per week of 30 minutes duration. This class alone has been able to reduce falls rates by 40%. Agewell recommends that each facility develops a falls prevention team. Successful falls prevention programs are one where the high risk residents are assessed and continually evaluated by different health professionals including physiotherapy. Agewell provides prompt assessment, treatment and education that limits the functional decline of residents and reduces their falls risk.
Massage benefits the elderly
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assage therapy is widely known to improve circulation, posture and sleep. It boosts the immune system, reduces stress, tension and muscular pain and is a gentle way to promote positive well being. Massage seems to be the perfect therapy for older people living at home or in residential aged care settings. Sandra Allars, a massage therapist with more than a decade of experience, has established a business catering to the needs of the people at home or in care – Soothe Mobile Massage.
Eliminate Monthly Oxygen Rental Costs An AirSep Visionaire Oxygen Concentrator pays for itself in less than a year! Yes that’s right, call WyMedical and we can show you how. Lighter, Quieter and more Power-Efficient” – AirSep Visionaire 5 litre oxygen concentrator
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ook to the future of In-Home Oxygen with the new generation AirSep Visionaire compact 5 litre oxygen concentrator. No filters to clean, quieter and more efficient than the others, this third generation model weighs only 13kg, glides easily on its castors from room to room or it can be lifted in and out of a vehicle for relocation or travel. Covered by a full 5 year warranty the Visionaire is maintenance-free for five years and there is no external filter to clean saving you time and money. WyMedical is proudly an Australian company providing a range of oxygen, asthma, nebuliser and respiratory products for aged care facilities, hospitals and home patients.
NEW TENA Duo Protection Layer™ –
Faecal care made easier
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ENA Duo Protection Layer™ has been specifically developed to support faecal incontinence care. Designed to be inserted into a base pad from the TENA range, TENA Duo™ has a bowl-shape for containment and a body shape fit for comfort and optimal security. TENA Duo™ protects the base pad from faecal contamination while allowing the base pad to work to its optimal urinary capacity, therefore making faecal incontinence management more time and cost effective. TENA Duo™ is now available for purchase. To receive more information or a FREE sample, please contact TENA Customer Service on 1800 623 347 or visit TENA.com.au.
We have a comprehensive range of oxygen equipment available for purchase together with asthma nebuliser pumps and other respiratory products. (see our website www.wymedical.com.au for details) We hire oxygen concentrators, regulators, cylinders and trolleys. We offer a 24-hour service for all oxygen patients. Call Wymedical today on 1800 812097 or email peter@wymedical.com.au and request an obligation free evaluation of an AirSep Visionaire on your site.
Sandra explains; “our dedicated team of professional therapists provide quality massages. They genuinely love their jobs. The positive results of the massage therapy for clients has an exceptional impact on their well-being, mobility and general health.” The effect of massage as a therapy is best described by Michael’s story, who has Multiple Sclerosis and is wheelchair bound. Michael started having massages from Sandra in 2006 and calls the weekly sessions, “the highlight of his week”. The therapy treats his muscle stiffness and general aches, assisting in overall mobility but as important is the social aspect of the visits which together ensures that the massage therapy has a positive outcome on Michael’s overall well being. Soothe Mobile Massage can also tailor a corporate booking for your staff or a social workshop for your family and friends. These popular group
occasions provide an ideal environment where people can gather to enjoy the Soothe experience and come away feeling better. Soothe Mobile Massage has been partnering with several aged care providers and assists many of their clients and carers through EACH and CACP packages. Sandra has developed Soothe Mobile Massage through great service, brilliant work ethic and extensive word of mouth based on many great outcomes and invites any aged or community care provider or individual consumer to contact her to discuss their needs. For more information Phone: Sandra on (03) 5943 2156 Email: info@soothemobilemassage.com.au Visit: www.soothemobilemassage.com.au
aca Aged Care Australia | Winter 2011 | 83
product news
Abena “Premium” Incontinence Range
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bena has launched its new range of “Premium” Incontinence Product into Australia. This range stands for the very best comfort and security including new, innovative product solutions.
Genuinely breathable material ensures that the skin is protected to the highest possible standard. The “Premium” incontinence range includes Abri-San (Shaped pads), Abri-Form (All-in-ones) and Abri-Flex (Pull-ups). Abri-San Premium (Shaped pads) and Abri-Form Premium (All-inone) is the first adult incontinence range to carry the Nordic Swan Eco-Label. The benchmark levels for environmental requirements are constantly increasing, and we are at the cutting edge of market developments. Abena’s traditional product features, such as optimum leakage security, quick absorption, odour system, top dry surface, discreet
Popular Australian Nurse Education Site Provides Low-Cost Education for Aged Care
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ith the rapid flow of new treatments to benefit our ageing population, it is difficult for healthcare professionals to stay up-to-date with current developments. However, nurses have the opportunity to learn in their own time, at their own pace by utilising the resources now available at AusmedOnline. com. The goal of the website, developed by Australian publishing company Ausmed Publications, is to provide easy access to the most up-to-date information for nurses. “Education is an ongoing part of being a nurse. But it is difficult for nurses, who work round-the clock-shifts, to fit seminars and classes into their demanding schedules,” said Cynthea Wellings, RN, and Ausmed Publisher. “We designed AusmedOnline.
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wetness indicator, graduation scale and breathable backsheet are included in the new Premium incontinence products. In addition, the Abri-Form Premium products now feature flexible tapes for extra comfort and security. Quality Makes Savings After evaluating the total costs with Continence Management, our “Premium” product saves money. With breathable superior backsheet it reduces skin problems and eliminates treatment expenses. Studies show that the total costs for incontinence products and fitting pants can be reduced by 12-15 % by using Continence Management Strategies. (Ref: “Assessment of citizens with newly identified incontinence by means of Minimal Care, based on competency development, prevention and health promotion” By Ingrid Mortensen, Continence nurse at Bornholm’s regional municipality) This can be achieved by using the graduation scale on our Premium products. For more information about our entire incontinence range and other Nordic Swan Eco-Label products, please call 1800 655 152 or visit our website www.bunzl.com.au
com with a ‘School of One’ education model in mind. Nurses can create a personalized study plan, and work at their own pace.” The website offers hundreds of lectures on topics, such as infection control, law, documentation and management – all delivered by highly regarded healthcare experts. A new video lecture series on “How Medicines Work” focuses on the special needs of older persons when selecting and administering medicines. New programs are continually being developed. All lectures on the site have been peer reviewed. AusmedOnline.com operates as a membership program. With one annual fee, nurses have unlimited access to all resources: audio and video programs, books, articles, and power point presentations. It is also an excellent resource for nurse educators as it offers tools and useful teaching resources.
Membership feedback is considered when identifying new content or revising existing material. This is just one of the reasons Ausmedonline.com is already so popular among Australian nurses. Every resource on AusmedOnline.com counts towards a nurse’s annual continuing professional development (CPD) requirement if related to their context of practice. In addition, there is an online CPD calculator and free CPD Organiser to help nurses keep track of their continuing education. There are already 1000s of members using the site and since July 2010, nurses have downloaded more than 29,000 items of content. To find out more visit AusmedOnline.com.
AusmedOnline.com