Aged Care Australia 5_1

INFORMATION TECHNOLOGY IN AGED CARE

19 & 20 aPril 2012 melBourne Park Function centre melBourne

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smart technology For modern aged care: delivering change

Autumn 2012

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Aged Care Australia Voice of the Aged Care Industry

Special ITAC Edition features...

ITAC 2012 | Come along and see Matilda the robot Telehealth | The true value of video Let’s Face It | Residential Aged Care needs Technology

Aged Care Australia Voice of the aged care industry

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Autumn2011 2012 Winter

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National Update 5 CEO’s Report 7 President’s Report 10 State Reports

38 Smart technology for aged care 40 Technology for Aged Care admin doesn’t need to be complicated 42 Head for higher ground

Profiles 20 Keith Dickinson

Workforce 48 The new Workplace Health and Safety laws 51 Presidential Card 52 Living & Coping with Chronic Pain 55 Registered nurses, aged care and unsatisfactory professional conduct

General 60 Planning for an inclusive diversity approach in aged care 65 A new choice for older Australians 66 Age Well Campaign 69 “Using Our Clinical Expertise” 71 Sage and Sodexo Strengthening a Global Alliance 72 Aged Care – your place or mine 74 It Pays to Plan as the The Flood Survival Stories Continue 78 Laughter has always been the Best Medicine 80 Making the Most out of Life 83 Disability Access Implications

contents

Technology 25 ITAC Awards 26 ACIVA 28 Connecting Aged Care through Information Technology 33 Let’s Face It: Residential Aged Care needs Technology 34 The Great Technology Debate 36 Telehealth: The true value of video as part of a broader communications platform approach

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

Sponsor Articles 56 Energy Contract Discount Offer 58 Launching ACAA’s brand new Aged Care elearning portal

86 Calendar of Events 87 Funnies 88 Product News

ACAA – NSW 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

ACAA OFFICES

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

FEDERAL PO Box 335, Curtin ACT 2605 T: (02) 6285 2615 F: (02) 6281 5277 E: office@agedcareassociation.com.au W: www.agedcareassociation.com.au

ACAA – TAS PO Box 208, Claremont TAS 7011 T: (03 6249 7090 F: (03) 6249 7092 E: smithgardens@bigpond.com Contact: Tony Smith

ACAA – WA 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 AGED & COMMUNITY CARE VICTORIA 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 QUEENSLAND 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

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 Emily Wallis (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

national update

CEO’s Report Rod Young CEO, ACAA

Is Aged care reform possible without IT integration and deployment?

I

n December 2011 the, National eHealth Transition Authority (NEHTA) advertised an EOI for aged care IT vendors to apply for participation in an aged care vendor IT Panel.

The successful applicants would be assisted to achieve compliance with components of the PCeHR being developed by NEHTA. At the time of writing it is not possible to announce the successful applicants for this process as nehta is still in negotiations with applicants.

However, at the same time that this has been happening the Aged Care Industry IT Council (ACIITC) through its partner organization ACAA has been negotiating a contract with DoHA which will have as its core objective bringing the lessons learned from the vendor experience and those of selected aged care providers to better inform the industry about the benefits of the PCeHR.

understanding by providers of the processes for deployment and the benefits that can be obtained through adequate planning and investment in the systems changes that an integrated IT system can help deliver. n

For the Latest Aged Care News go to www.acaa.com.au

“Enhance the space around you with innovative design that works”

Indeed the purpose of this second contract is to assist aged care providers to understand what business process changes aged care providers may need to take if they are to take advantage of the PCeHR. What systems may need to be put in place to achieve this outcome? What work would need to be undertaken with a provider’s IT vendor/s to make the necessary changes?

The project will look at both community care and residential care.

The objective will be to look at the different requirements of the two service domains. More particularly to consider what are the differences between the two service domains? Are their different business drivers and potentially different business outcomes dependent upon where the service offering takes place?

The analysis of this learning will support the development of a roadmap for the development and deployment of Information and communication technology services across the broader aged care industry.

This learning will also assist in the development of a range of aged care training and information products that can be widely disseminated for the purpose of driving a more in-depth

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aca Aged Care Australia | Autumn 2012 | 5

national update

President’s Report Bryan Dorman, President, ACAA

This is the seventh year that I have been honoured with the position of President of ACAA.

S

ince my first involvement in the industry twenty five years ago, it has been an exciting and memorable journey, during which I have held various official positions within the Victorian state association and subsequently with the Board of the National Association.

More importantly are the positive improvements that I have seen in our industry, particularly in the move to better business practices and a stronger focus on quality care, support and service for our care recipients.

There is a tendency when people are reviewing history to look back nostalgically, and see the attractive things of the past. However, whilst I am not inclined to exercise a coloured view of history, in reviewing our past quarter century as an industry, I can positively reflect on where we were then, the journey, and where we are today.

I am also sure that those of us who have been involved in the industry over that quarter century, fully appreciate the significant changes that have occurred during that time.

We sometimes get so bound up in our day to day problems and issues that we often fail to appreciate the improvements that have occurred so far and the level of commitment and investment that has occurred in getting to our current position.

It may therefore be fitting to take a moment, and consider what has been achieved as an industry and to applaud the enormous effort that has gone into achieving this change.

An early experience always comes to mind, when visiting an old style Nursing Home with 8 and 12 bed “wards” and residents being fed in their bed or beside it, with little or no community space within the building and a communal toilet and bathroom. In effect they were waiting rooms, and were the standard conditions for many residents at the time.

Compare this to most cases today, where, if not receiving full care in their own home through a variety of care and support programs, the elderly reside in single rooms with their own bathroom en suites, amidst a substantial living environment.

With the introduction of the Aged Care Act in 1997 we saw the start of the industry’s maturing phase which has continued to today. It provided the momentum and direction to develop good

business and management processes, applying much more vigorous disciplines to how we operated and more importantly put us on the path to our quality systems and practices that are now delivering outstanding outcomes for our residents.

Amongst a series of industry “reviews”, in 2005, we saw the results of the Hogan Review and a significant injection of additional funds from government, recognising the funding shortfall of the preceding years. It was an early recognition that the existing system, whilst improving industry skills, practices and processes, was failing to recognise and address the true costs of care.

The Government of the time was applauded for accepting those recommendations from Professor Warren Hogan’s report but was widely criticized for not adopting the balance of those that came in his packaged report. Had this not been the case we may not be at the watershed stage the industry is at now.

During the course of these many reviews and related events, this Association had a central role in representing the industry and highlighting to Government the need for further reform and change.

I doubt that many of these reforms would have occurred without the ongoing lobbying pressure and influence that this Association, amongst others, brought to bear to achieve changes to the system of the day.

The work of an industry body such as ACAA is crucial. Without fear or favour, it must robustly prosecute the industry’s interests in the community and through the political process. This work requires a constant review and reform agenda which brings about the best possible outcomes for residents and a strong, robust and viable industry.

Each of these reforms have required pursuit of various strategies by the Association, and a policy review process that reflects the political circumstances of the time, as well as stakeholder partnering and subsequent resourcing.

In recent times and particularly during this current Governments life, we have seen an extraordinary coming together of every primary stakeholder organisation to affect a common goal and a unified position across the industry. ACAA has willingly participated in this broad engagement and advocated strongly, across the Federal political spectrum.

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national update

This unity of voice has promoted a broadly and strongly held policy position, which is in support of essential industry reforms to meet future customer requirements, with expanded consumer choice and market forces enabled.

Every stakeholder group agrees that reform to the current system is required. So, it is never more likely than at present that an aged care reform agenda, such as contained in last year’s Productivity Commission report, can be achieved. The planets are effectively aligned!

Your support to drive a message home to Federal political Representatives and Senators, that reform of the industry is crucial for the 2012 budget and their failure to deliver on a structural renewal of the industry at this time, will be a totally unsatisfactory outcome for the industry and our many supporters. n

We all want an industry that ensures service quality with accessibility and choice for consumers, but to achieve this, industry sustainability is essential. A reform package based on the objectives contained in the PC recommendations will ensure reforms that promote confidence to undertake the necessary investment in the services and infrastructure that our rapidly ageing population will require, now, and in the future.

I therefore seek the assistance of all the readers of this magazine.

Go to the Age Well website and register your interest as a supporter, and convey the website to friends and family to register as well.

For the Latest Aged Care News go to www.acaa.com.au To view the latest Aged Care magazine online visit Adbourne Publishing www.adbourne.com.au/ aged-care-latest.html

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national update

ACAA – SA Paul Carberry, CEO ACAA – SA

U

nder normal circumstances, an aged care association would be unlikely to get involved in a campaign about retail trading on public holidays.

There’s no obvious connection and most other states resolved the issue long ago. They allow retail shops to trade on most public holidays whereas, for many years South Australia hasn’t, except by exemption on particular holidays.

The main reason for this is that the retail employees’ union, which has an influential relationship with our State Government has refused over the years to allow shops to open on public holidays.

Last November, however, the Government announced it had reached agreement with the union on a Bill which would allow shops to trade in the Adelaide CBD on most public holidays.

What does all this have to do with aged care? Well, in addition to the shop trading provisions, the Bill would create two new part holidays, from 5 pm to midnight on Christmas and New Years Eve. Consequently, every business or organization which operates between those hours on those days will pay holiday loadings which, in most cases including aged care, are 250% of normal rates.

This was the condition which the retail union placed on the Government, in return for securing its agreement to the trading hours’ arrangements. Sadly, and to its shame, Business SA, which is supposed to represent businesses in this state, was also a party to the “deal”.

So, on a matter which theoretically has nothing to do with aged care, shop trading hours, we have found ourselves in a fight with the Government, because they have tied this issue to the establishment of two new holidays.

We estimate that the extra wages cost to residential aged care in this state, as a result of the two seven-hour blocks, which will now attract holiday rates, will be around $475,000.

As we have advised the Government, this is already an industry already under financial pressure, and operating in the highest-cost

state for aged care, with workers compensation levies two to three times those paid by providers in other states.

The campaign has brought together an eclectic group of associations whose members will be affected if this goes through – hotels, restaurants, clubs, service stations, tourism operators, bakers, aged care.

Many have said they will close, because they won’t be able to recover the higher costs. Of course, that’s not an option for our members, and I have adopted the phrase “can’t afford, can’t avoid, can’t recover” to summarise the predicament aged care providers will face.

The campaign has had its lighter side. Our group has run ads with the line “it’s a pig of a deal”, with a picture of a pig wearing lipstick.

We have held two press conferences, with an actor dressed in a pig suit standing in the background with a placard.

I’ve also done several radio interviews and had some press articles published which include aged care’s position on this.

How will it all turn out? We don’t know, but, without doubt, the campaign is having an effect.

The Premier has been forced to defend this proposal and has found it to be a difficult task. He has not satisfactorily explained why two new part holidays are needed in order to allow trading on public holidays.

Everyone knows why, but the Premier can hardly say that the union made him do it.

Business SA has been forced to explain how an organization which is supposed to represent business has agreed to a deal which will cost businesses a lot of money. They can’t.

The campaign is also having an effect on our politicians.

The crucial arena will be our Upper House, where neither major party has a majority. It will be necessary for four of the independents to vote against the Bill in order to defeat it. We know that three will vote against it, and there are two others whom we are hoping to persuade.

If the Bill is defeated in the Council, the Government will have to decide whether to drop the whole idea, or go ahead with the trading hours without the extra holidays.

Dropping the whole idea would be a very embarrassing and unpopular thing for the Premier to do, so we are hopeful that SA will finish up with holiday trading, which is a good idea, but without the extra holidays, which is a bad idea. n

For the Latest Aged Care News go to www.acaa.com.au To view the latest Aged Care magazine online visit Adbourne Publishing www.adbourne.com.au/aged-care-latest.html

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national update

ACAA – NSW Charles Wurf, CEO ACAA – NSW

New website

T

he breadth of responsibilities in aged care means that each day at ACAANSW we encounter a range of issues and challenges not facing many other industries.

Our working day might involve negotiating enterprise agreements, the ongoing review of building standards, policy discussions with different levels of government, and working to improve the skill and capacity of a dedicated workforce. All of these being in support of our industry’s primary responsibility: to care for thousands of our frail-aged fellow Australians.

So in a climate of dealing with pressing issues, it might seem odd that there was a reluctance

to undertake an upgrade of our Association’s website. In part, this was through not knowing the full impact any upgrade would have on our time and resources, and in part it was a concern that a new website would not adequately address the needs of our membership.

In late 2011 the Association commenced the website upgrade and our new site went live in early February. Looking back to last December, the process has not been as difficult as we feared, and has in fact delivered unexpected benefits to the Association.

Firstly, the planning and development of the website brought together staff from different sections of the Association. There was much positive feedback and discussion to how we continue to service our Members’ needs.

The website upgrade also saw a re-examination of our approach to many aspects of our work, ranging from the structure of our Associate Membership, to the frequency and layout of our electronic communication to Members.

To consider what we think worked best for the website upgrade would best be described as the three “c’s”: clean layout, capacity for upgrade, and core-function.

We aimed for a clean layout with no clutter, without too much information on each page, and the use of colour that was not ‘overthe-top’. The capacity for upgrade is largely self explanatory. The website is a dynamic communications tool and is meant to change and be upgraded over time. While the corefunction was to build a website with a public face, but also having a dedicated place for the membership. For the new ACAA-NSW website this includes a Members-only portal providing information, assistance, and archived material.

Undertaking the upgrade of the Association’s website did at first seem daunting. But as we learned at ACAA-NSW, it was rewarding beyond its initial aim, as it brought our staff together, and unexpectedly, allowed us to reexamination many areas of the organisation. n

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national update

Aged & Community Care Victoria Gerard Mansour, CEO Aged & Community Care Victoria

ACCV launches Graduate Nurse Program

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positive workforce initiative announced by the Commonwealth Department of Health and Ageing in 2011 was the funding of fourteen organisations to assist aged care providers improve the quality of clinical placement experience for graduate nurses in aged care.

A total of 350 clinical placements were funded in this important national initiative, which will make a vital contribution in strengthening the aged care workforce.

Aged and Community Care Victoria (ACCV) was successful in applying for funds from the Department of Health and Ageing to establish a

program in Victoria. ACCV has since partnered with Monash University to develop and deliver a funded 12 month graduate program in aged care for registered nurses. This innovative program is aimed at supporting and mentoring nurses through their transition from student to graduate nurse.

There has been strong backing for the program from our members who are collectively seeking to increase the capability of their workforce.

ACCV has been funded to coordinate a total of 70 graduate placements over two years, with targets of 30 graduates in 2012 and 40 in 2013.

Central to the roll out of this program was the establishment of an Industry Reference Group where host employers and other key stakeholders share their intelligence on everything from recruitment to guidelines for graduate employment. The Group benefited from the active participation of Monash University, as well as BUPA who have generously shared their experiences of running a similar program.

In mid-February, an exciting milestone was achieved when graduate nurses selected for the 2012 Program completed week one of a seven week specialist curriculum program at Monash University. The following week, the graduates started work across sixteen host organisations, where they will spend the next twelve months combining on the job learning with the specialist aged care curriculum – which will also provide them with twelve credit points towards a Masters in Aged Care.

Each graduate will have access to preceptors employed at their workplace, the ACCV specialist placement supervisors and the support of Monash University. This support network will ensure graduates receive the best education and support available while completing a high quality aged care graduate nurse program.

Over the 12 months each student will undertake study days, accreditation and leadership courses and gain a range of quality clinical practice skills that are paramount to working effectively in aged care.

Monash University has also provided training for preceptors in host employer facilities, and ACCV has employed two clinical supervisors who will work with preceptors to support the graduates.

It is very exciting for ACCV to collaborate with our members in this important workforce initiative. This Graduate Program is well positioned to contribute most positively to the creation of specialist skills needed by nurses wishing to enter the aged care industry.

While it is early days, the ACCV Graduate Nurse Program is clearly positioned to make a major contribution to the aged care workforce in Victoria, and we look forward to sharing our experiences more widely as this program progresses. n

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aca Aged Care Australia | Autumn 2012 | 15

national update

Aged Care Queensland Nick Ryan, CEO Aged Care Queensland

Queensland State Election

W

ith a State election scheduled for 24 March and Local Government elections set down for 28 April, the political scene in Queensland is currently very much in caretaker mode. On behalf of the industry, ACQ has actively been working with both sides of politics and also encouraging members to take up the key issues identified as part of ACQ’s State Election Platform 2012 with their State members and political candidates.

The five key issues that we are calling on all political parties and candidates to adopt and promote include:i) Workers’ compensation self insurance To align with the majority of Australian states and remove the requirements that an employer or industry group have a minimum 2,000 employees (FTEs) in order to operate a workers’ compensation self insurance scheme. ii) P lanning & Development Responsive to an Ageing Population To adopt a streamlined approach to the approval and release of land for the development of seniors housing and the use of current ‘brownfield’ sites in existing suburbs. This will ensure appropriate housing options for older Queenslanders to continue to reside in their existing neighbourhoods and ensuring new land releases will cater for the needs of a larger older population.

iii) Full Funding for Community Care

Sustainability Project

To continue to invest in the early intervention and prevention services currently available through the Home and Community Care (HACC) program. This investment needs to ensure that the cost impacts of wage increases for the social and community services sector are fully funded.

In the face of a new carbon tax, sustainability is becoming an important issue for members. ACQ is pleased to announce that it has recently been successful in obtaining grant funding from the Department of Environment and Resource Management to conduct a Sustainability Project across the aged care industry over a two year period.

iv) Sustainable Ageing Communities To address the impact that inconsistent pensioner concessions and utility charges such as waste levies have had on residents and operators of Retirement Villages and operators of Residential Aged Care Facilities. v) Supporting Community Safety To support the aged care industry in the implementation of coordinated Disaster Management practices and compliance with mandatory Fire Safety regulations.

This requires investing one-off funding and ongoing engagement with the aged care industry.

Fire Safety in Residential Aged Care The majority of facility inspections were completed by the 1 March deadline and we understand from Building Codes Queensland (BCQ) that significant noncompliance is evident. ACQ members have been informed about alternative approaches to gain compliance via submitting new paperwork or engaging a certifier to approve alternative methods. However, older multi-storey facilities will no doubt require sprinkler installation by 1 September 2014.

Part of our State Election Platform covers financial assistance in hardship cases to help with the funding compliance work.

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The funding is targeted at industry associations to support individual businesses and for the industry to adopt more sustainable practices. Some of the key deliverables include an Environmental Sustainability Innovation Call with awards to be presented at the ACQ 2012 State Conference, an Eco-Efficiency Trial across 20 sites incorporating residential aged care, community care and retirement living, and the development of a Best Practice Guide for Ageing Communities.

State Conference At the time of writing, the 20th anniversary State Conference is being held at Jupiters Hotel on the Gold Coast and has attracted a large number of Aged Care Queensland members. The conference theme, ‘Mission Possible: Should you choose to accept it”, will look at the challenges that our industry is facing and help us to work our way through the ‘missions’ and tasks that we must complete to stay one step ahead.

The first day’s session was brilliant and included a panel facilitated by Dr Norman Swan on the Big Picture facing aged care.

The key points were that the demands on public purse are so large that we need to mobilise to make aged care THE issue for the Government in the lead up to the next Federal Budget. Chris Richardson spoke

on economics and Sarina Fisher spoke on effective industry peak bodies.

It looks like being another successful event.

Some of the key speakers include Chris Richardson – Director of Deloitte Access Economics, and Noel Whittaker as well as many other prominent industry professionals.

Retirement Living Symposium

Central Queensland, Sunshine Coast, Gold Coast and Darling Downs regions. These locally based trainers will be able to increase the frequency of contact for our students.

Marketing & Events The new Education Institute website was launched on the 15th March www.acq.qld.edu.au

A great display has been put together for State Conference and we look forward to promoting a major Skills Queensland program for the community care casual workforce. The Institute Manager will also be providing up to date workforce projections from the 2012 Environmental Scan during her Workforce presentation delivered in concurrent sessions on the Thursday. n

As a lead in to the State Conference, ACQ conducted a Retirement Living Symposium. The Symposium featured key operators, legal and other experts who presented a provocative and informative program for us – particularly as the 1 March 2012 Amendment to the Retirement Villages Act poses a number of key issues for scheme operators.

We were delighted to have Peter Inge of the Zig Inge Group to present the keynote address and to be actively involved in the Symposium.

Member Survey We are currently finalising the second Annual Survey of members with the assistance of independent market researchers Alliance Strategic Research. The results will help us to continue to expand our member engagement processes and develop ACQ’s service offering as part of our continuous improvement process.

Education Advisory Committee The Education Advisory Committee identified two areas for focus in 2012; Career pathway models for workers in aged care not just focussed on nursing; and models of co-delivery to utilise content specialisation of our member employees. A presentation on the Vocational Placement Framework was made by the Institute Manager for new members to showcase the work previously done by the committee; it was agreed that this was a great start in assisting to lift the expectations of industry with the RTO’s approaching them for placements.

The Institute has appointed several regionally based trainers in North and

aca Aged Care Australia | Autumn 2012 | 17

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national update

ACAA – WA Anne-Marie Archer, CEO ACAA – WA

W

estern Australians sweltered this summer in an unprecedented number of heatwave days, as well as some regions experiencing the devastation of bushfires.

It seems a far cry from the weather conditions endured by our eastern cousins with storms and flooding conditions that threatened so many communities and those who live within them.

Meanwhile our Members were working hard to ensure their residents and clients remained safe, cool and comfortable over the summer months.

Providers in the West are always striving to improve residential and community care services by developing better care services for the State’s frail aged.

One outstanding example of this is Embleton Care, which recently received accolades from the Aged Care Standards and Accreditation Agency’s National Better Practice Award for the production of an emergency procedures training video.

The Embleton management and staff teamed up to develop the training material that included script writing, acting, filming and the pre-production process.

The experience gave staff the opportunity to participate and take ownership of the final product.

Embleton Care has since conducted audits to gauge their staff knowledge of emergency procedures and the level of enjoyment and participation during training sessions.

The results were as hoped, indicating that the new training material has resulted in major improvements in staff retention and knowledge of the procedures.

Embleton Care Managing Director, David Cox was extremely pleased with the high levels of staff involvement to complete the project and was delighted to see his well-deserving colleagues recognised for their hard work that resulted in winning the Award.

Western Australian providers continue to push the boundaries of innovation and creative thinking to make our facilities safer and more enjoyable for both residents and staff.

We congratulate Embleton Care on winning the Better Practice Award and look forward to more WA facilities being recognised for their outstanding contributions to the aged care industry. n

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profile

103 Not Out! He has hands the size of a batsman’s cricket gloves and his cricket club statistician told him many years ago when he was still playing; ‘Keith, you never dropped a catch!’ I can tell you, it’s no wonder, with hands that big and an eagle eye to boot!

A

s they say in the classics, Keith Dickinson is a legend in his own lifetime. He has an OAM after his name, he is still a JP and a life member of Rotary. These days Keith is the oldest resident at the Glenview Residential aged care facility in Glenorchy, Tasmania.

Yesterday (February 23rd) I took him to Bellerive Oval to watch the Sri Lankin team limber up for today’s game against Australia, hence the photo’s. As we drove up to the main gate, everyone knew him; ‘G’Day Mr Dickinson, how are you? Are you coming back for the game tomorrow?’ Too right he is, he wouldn’t miss it for quids!

Today Keith and his son in law are in their usual reserved seats in the

members stand watching the game. Keith is the oldest member of the Bellerive Cricket Club by a country mile!

I first met Keith in the sunroom at Glenview, I had an appointment there with the CEO and was patiently biding my time in the sun.

Next to me was an older gentleman reading the paper. As you do sometimes, we started to yarn, first about the cricket. It was the match when Tasmania beat WA that had his attention and he was rolling off opinions and comments on players, scores and performances. He is a walking encyclopaedia when to comes to cricket and the AFL. I left the sunroom to go to my meeting with Lucy O’Flaherty, the CEO and talked about the bloke I had just met.

‘How old do you think he is?’ said Lucy. ‘I think he’s about 83 or 84,’

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For more information call 1300 FRONTIER or email sales@frontiersoftware.com.au www.frontiersoftware.com 3/15/2012 12:33:51 PM

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Perth Convention and Exhibition Centre Sunday 28 – Wednesday 31st October 2012

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Aged Care Australia | Autumn 2012 |

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profile

said I. ‘He’s 103’ said Lucy and I had to lean down and pick my jaw up off the ground.

In the introduction to his autobiography, ‘To take a chance’ it says: “This is the story of a Tasmanian who was born just seven years after Federation, and four years after the first manned flights by the Wright brothers. He has lived through a period that is dominated by the most extraordinary developments and change in every field of human endeavour.”

Keith was born in 1908 in a small unimposing farm cottage in Black Snake Lane, Granton on the outskirts of Hobart. He had 3 brothers (including one set of twins) and at one stage his mother was coping with four kids under the age of 3!

Keith has happy memories of growing up, lot’s of hard work but also lots of time for cricket, football, fishing and shooting. As we were

driving to the cricket ground he told me a story of how a local doctor told the kids he wanted a supply of green parakeets for his dinner table. ‘They were good eating according this bloke’ said Keith.

‘So my brothers and I took an old muzzle loading gun out to the orchard when the fruit was ripening and the birds were there in flocks and proceeded to shoot about half a sugar bag full every day.

It wasn’t long till the doctor said ‘I have enough thanks, getting a bit sick of eating those birds!’ ‘But we made a few bob pocket money out of it!’ said Keith Keith excelled at school and in sport and earned himself a bursary to the University of Tasmania to do Engineering. But in those days family finances were not good, so at the end of his first year he had to give up a promising career, which could easily have included a Rhodes Scholarship to return to the family farm to help out.

Keith told me he didn’t mind doing this at all as he loved farming life and particularly working draught horses.

Keith also remembers that one day he and his brothers put some dairy cows into a paddock of lush green feed, including left over poppy heads. ‘The cows soon got ‘high’ on the poppies and were charging around the paddock chasing one another and anything else they thought they saw!’ (Tasmania is the world’s biggest producer of morphine poppies for the health industry.)

How do you fit in the details of a life that is still progressing into this brief memoir. Keith married, had one daughter, has grandchildren, great grandchildren and more. He is the sole survivor of his original family, having been told by one of his brothers who knew he was about to die; ‘It’s up to you mate, you are the only one now that can make it to 100.’

Keith’s mum lived to 103 and he told me he has a few months to go to beat his Mum’s record.

I can tell you that all the signs are that his innings are not over yet, not by a long shot! n

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SMArt technology For Modern Aged cAre: delivering chAnge

INFORMATION TECHNOLOGY IN AGED CARE

19 & 20 April 2012 Melbourne pArk Function centre Melbourne exhibition And SponSorShip opportunitieS

now open

Nomination for Implementation and Innovation are now open for submissions ITAC 2012 is brought to you by the Aged Care Industry Information Technology Council (ACIITC ) supported by the Aged Care Association Australia and Aged and Community Services Australia

Aged cAre ASSociAtion AuStrAliA

Go to itac2012.com.au for details For further details contact Jane Murray J’S corporAte & event ServiceS T: 08-9405 7171 F: 08-9405 6585 E: itac2012@jayscorpevents.com.au aca Aged Care Australia | Autumn 2012 | 23

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With Panasonic Toughbooks like the CF-C1 and the MCA CF-H2 (Mobile Clinical Assistant), you can care for your patients with greater efficiency and safety. Their comfortable, singlehanded operation with hand strap, and carrying handle make your work easier. The Intel® Core i5-520M vPro™ Processor support an extremely long battery life of up to 12 hours (CF-C1) and accelerate everyday, time-consuming hospital processes. And with easy-to-clean surfaces and robust, fanless design, the CF-H2 meets even the strictest medical safety standards.

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INFORMATION TECHNOLOGY IN AGED CARE

ITAC 2012 –

The National Conference you do not want to miss!

ItaC 2012 awarDS nomInatIon for

ImplementatIon anD InnovatIon There are five critical subjects you need to be across in 2012:

Health Records – business impacts and process changes

Telehealth – compliant solutions, government rebates and system integration

Care Quality – InnovatIon how technology can improve outcomes for staff and clients (aged Care provider Category) (vendor and Service provider Category)

National Broadband Network – The awards are open to Aged and Community Care Providers and The ‘ICT Company of the Year Award’ is open to ICT companies what opportunities emerge with better bandwidth?

ImplementatIon

their implementation partners (vendors or service providers) that

that have designed outstanding and innovative products that

in the will enhance Commission Report –the Australian Aged and Community Care ICT have effectively used ICT to improve business outcomes Productivity how technology plays a role in these areas: Australian Aged and Community Care environment. There will be marketplace four (4) awards in the Implementation category:

• to Hardware There is just one place do this – 1 Best Implementation of theInformation Year award Technology – in Aged Care•2012, Melbourne April 19-20.

Software Hear your peers talk about projects, outcomes and the future of Smart Aged Care!

Under 150 places/clients

• ICT Support Services (eg. Consulting service)

– facilities with less than 150 places/clients owned by the one organisation 2 Best Implementation of the Year award – 150 to 650 places/clients Who should attend?

• Directors of Nursing

Carewith Advocates – • Aged facilities greater than 150 places/clients owned by the • Government Policy Makers one organisation • Care Managers

• Healthcare Administrators

3 Best Implementation of the Year award –

• Carers

• Hostel Supervisors

• Chief Executive Officers

• Industry Partners

• Chief Information Officers one organisation

• Operational Staff

Greater than 650 places/clients

– facilities with greater than 650 places/clients owned by the 4 Best Implementation of the Year award for Infrastructure – hardware and / or software that enables the implementation of business applications

KeY InformatIon Why should I go?

• Network with industry

All submissions will be reviewed bymembers the Awards Judges.

• Learn about the latest

Finalists will be selected from each Category. innovations • Listen to some of Australia’s

leading technologists The company logo (jpg format) and 3 digital high resolution • Identify new ways to achieve

photos required better are outcomes forwith care the nomination • See the submission. latest in gadgets and

and compliance aged care robotics Finalists may be required to submit a multimedia presentation for the Awards Gala Cocktail Recpetion.

• Explore technologies • View lots of IT specific

of the future exhibitors Finalists are required to attend the Awards Gala Cocktail Reception to beothers held Thursday 19 April 2012.

• Connect with and

share experiences

SUBmISSIonS CloSe: 31St DeCemBer 2011 Registration and full program at www.itac2012.com.au For further information contact: Finalists notified: 15th February 2012 Jane Murray, ITAC 2012 Conference NominationManager forms available from the ITAC 2012 website at J’s Corporate & Event Services www.itac2012.com.au T: 08 9405 7171 F: 08 9405 6585 itac2012@jayscorpevents.com.au

technology

ACIVA Report Caroline Lee, President

F

ollowing much encouragement, lobbying and explanation regarding the importance of including residential and community aged care in e-health demonstration projects, NEHTA (the National e-health Transition Authority) and the Department of Health and Ageing have selected a number of aged care specific software programs to be involved in an Aged Care Vendor Panel.

An announcement regarding the programs who will be part of the Vendor Panel, and therefore those who will participate in this next very extensive development phase, in order to achieve connectivity with the Health Identifier Service and access the Personally Controlled Electronic Health Record, will be made late March, early April. Developments will need to be completed and connectivity achieved by 30 June 2012.

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The aged care software industry through ACIVA (Aged Care IT Vendor Association) have committed to sharing their development knowledge with the wider group of software programs, so that following this next phase, other programs who weren’t included in the vendor Panel developments shall be supported/enabled to develop their connectivity soon after 30 June.

Much staff workflow consideration needs to occur between now and the end of the development phase, as aged care organisations will need to modify some integral admission and clinical practice systems to embrace this new access and capability. Access to the PCEHR and HI Service will only be through software programs at this stage.

Some in the industry have been asking, why do they need to license/ purchase a software program to access PCEHR related documents such as Event Summaries, Discharge Summaries or e-health Shared Health Summaries. Organisations will need to use a software program to access these details and documents, as these details will only be present in the national repository because essentially, healthcare software programs will have uploaded that information so that it can be made available from the national repository. And it is only software programs who have passed the relevant Conformance/ Compliance and Accredited Tests who will be able to access this detail and import those reports/documents into a format that is readable and available in a resident/client’s e-profile. There are no plans currently for NEHTA or DOHA to develop separate access programs that don’t relate to currently available software. Without compliant and sophisticated software to access the information, aged care staff and health professionals will not be able to obtain these reports and data.

More information and workflow consultations will be conducted over the coming months with Providers and software vendors to ensure any developments support the procedures that care and nursing staff currently follow. Vendors will be required to consult and use test sites throughout the process so that the aged care industry benefits in real terms. Watch this space for more details regarding the software programs who will initially be involved and those who will follow soon after. n

For the Latest Aged Care News go to www.acaa.com.au To view the latest Aged Care magazine online visit Adbourne Publishing www.adbourne.com.au/aged-care-latest.html

aca Aged Care Australia | Autumn 2012 | 27

technology

Connecting Aged Care through Information Technology Rod Young, CEO ACAA

Demographics 2.8 million Australians are over 65 today.

By 2040, in thirty year’s time, that number will rise to 7.2 million. Today 400,000 Australians are over 85 years of age by 2040 there will be 1.8 million people over 85 years of age.

Today there are five taxpayers for every person over 65 years of age. In 2040 there will be 2.7 taxpayers for every Australian over 65 years.

The Desire for Independence Australians clearly wish to remain independent and in their own home environment for all of their lives.

Quite simply, if Australia is to maintain a quality aged care system, and to satisfy the wishes of an ageing population, to have choice about the type and range of services they can secure; and the location in which those services will be provided then the aged care system must become much smarter at how it delivers its services and how it maximizes the capacity of a rapidly diminishing workforce.

Care System Design In essence the Australian Aged Care system must use every technological solution that will assist care recipients. More importantly these solutions need to focus on making the care recipient the centrepiece of the care continuum. The care recipient must be enabled, as far as practical to manage their own health status to become the expert of first resort in the management of their care and health needs.

This is not diminishing the role and responsibility of carers and health professionals. It is simply recognising the

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reality of our future world. We simply will not have sufficient human resources to do what we do today, in the future. Unless we engage the consumer of care more actively in managing their health and care status then the whole health and care system is in jeopardy and could fail.

So what does all this mean?

Quite simply we need to plan for the exciting technologies that are already available and which will be developed over coming years and ensure we can maximize the benefit that these technologies can provide to our future care service provision.

Technology Options for the Future

2. Twenty four hour service support Home based services are considerably enhanced by the deployment of 24/7 call centre support. To ensure these benefits are realised Australia needs to invest in the development or engagement of existing call centre service providers to ensure all community care providers can have access to a comprehensive call centre/back of office support system that will underpin a range of home based technology deployments.

This capacity to assist all community care providers to access a comprehensive back of office call centre support is crucial in the long term deployment of home based technologies.

1. Home based monitoring

A small number of providers have already made the considerable investment in the development of an in-house service and several commercial call centre operators are acting as a back-up service.

Community Care Providers service 670,000 older Australians in their homes. Services can range from simple garden maintenance to daily nursing support for wound management or medication administration.

Small community care providers need contracting and service development support in extending their service offering to their clients to maximise the benefits of deployed technology solutions.

These service providers are uniquely placed to deploy a range of home based monitoring devices for frail, older care recipients.

3. Digitised diagnostics

Some of the opportunities that immediately spring to mind are:

These devices can be alert systems, falls monitors, movement monitors, bed exit monitors and a range of other devices all of which are currently available.

The services need to have access to a 24/7 call centre service so that the client has faith that a response will be initiated no matter the time of day when a trigger or alert is activated.

There are a range of technologies already capable of being deployed in a care recipient’s home that can provide enhanced care and support for care recipients in two ways:

(a) t he care recipient becomes fully engaged, where possible, in the management of their care therefore ensuring greater efficiency of resources and more direct engagement by the care recipient and their voluntary carers in care

status and being better informed therefore able to seek interventions much earlier and hence avoid more expensive service needs such as a hospital admission; (b) care service providers have a much clearer understanding of service need and can target their workforce to more acutely service the needs of the individual client Several aged care providers are already deploying digitised devices, so far in a limited context. They are:

(1) Silverchain, a WA based major community care provider with approximately 200 home based deployments (2) RDNS Vic, the largest home care provider in that state (3) Feros Care, a medium sized residential/community care provider in NSW/Qld

(4) Communications integration When discussing home based care technologies it is often assumed that deployments must begin from scratch and that new communication systems will be required.

In fact one of the largest pieces of infrastructure in the Australian telecommunications space is the home based television set with over 99% of all households having one or more units.

With the conversion of the Australian television network to digital the opportunities for convergence emerge very rapidly.

Digital TV connectivity to the internet is rapidly occurring. With this conversion comes the capability to deliver a range of care related services not able to be delivered through existing channels.

The next development will be the capability to interface with the digital television through voice recognition technology. This capability already exists, however broad deployment over coming years will break down a barrier many older people feel when trying to access the internet and that is their keyboard skills.

Integrating the internet, television with voice command capability will enable the average home based care recipient to deploy a range of digitised devices to support monitoring devices they use on a daily basis.

It also immediately supports the linking of that digitised source to health and care related databases which are providing the data management and data analysis capability that will fully support the care recipient to understand their health/care status as well as provide the health/care recipient with enhanced care and service knowledge to better target services to the individual.

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aca Aged Care Australia | Autumn 2012 | 29

technology

4. Telehealth Telehealth is a critical component of future home based care delivery. The three aged care providers mentioned above are all keen to utilize the NBN to deliver improved telehealth capability.

Telehealth can include several different formats:

(1) V ideo Conference Using business grade broadband to deliver remote consultation capability between various health professionals in a variety of locations (2) R emote Monitoring Using community care providers to deploy and monitor a range of home based devices targeted at more accurately managing a person’s health and care needs (3) H ospital Avoidance Strategies Empowering GPs and Community Care Providers to operate virtual nurses stations underpinned by business grade broadband to enable quality service delivery in a person’s home (4) E arly Discharge A robust home based monitoring service care also underpins early hospital discharge with short term home based maintenance and support. To safely do this requires 24/7 monitoring and call centre support integrated with a service provider who can provide emergency home based services when required.

5. Care integration One of the substantial holes in the current care regime is the lack of communication between home based nursing and care services and local GP medical services.

The profile of the usual person in receipt of home care or home nursing is usually someone suffering a chronic disease or frail aged requiring an escalating suite of services.

These factors if not monitored effectively and managed appropriately are likely to lead to poor health outcomes or an unnecessary hospital admission.

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It is essential therefore that community care providers who are often in a person’s home on a daily basis, if not more frequently, are supported to collect a range of data about the client. The essential components of this data collection should be shared with the treating GP so there is a much better understanding of the home based care plan as well as the medical care plan.

If this interaction and exchange of care/ health information is not present then it is likely that the care and medical decision making will be sub-optimum and just as importantly inefficient workforce utilisation would be the result.

Reform of Australian health and care systems must include the empowerment of care professionals operating in a person’s home to collect a range of health and care data which will be highly reliable and which can then be shared with health professionals especially treating GPs.

6. Hospital avoidance As stated above one of the opportunities flowing from an integrated care and health data collection from a person’s home is the ability to avoid unnecessary hospital admissions.

If the care and health professionals are able to support a person through remote monitoring, virtual consultations, virtual nurses station and to better link this information to the GP and thus achieve better clinical decision making; it is a given that a high level of existing presentations at hospital emergency departments can be avoided.

This would be a considerable benefit to the broader health system and to the individual, their families and carers.

7. eHealth record solution The decision by the Australian Government to move to a Personally Controlled electronic Health Record (PCeHR) was timely and recognised the capability of a range of support technologies that will be needed to make such a plan capable of being delivered.

To take full advantage of the PCeHR concept however, will require recognition; that much of the work of the care system occurs outside of the mainstream health professional’s framework.

Yes, all health professionals are key to ensuring that an individual receives quality care and services in the health system, however community carers and community nurses usually spend much more time with the chronic disease, frail aged and long term care recipients than the mainstream health system other than in high activity events such as hospital admissions or medical service visits.

The care of this group rests far more with voluntary carers and community based professional nurses and paid carers. Yet this group of care recipients consumes a disproportionately large portion of the overall health budget.

It is therefore essential that the health and care data available to home based carers of all types is collected in such a fashion that it is capable of being shared with other health professionals and care service providers alike.

8. Voluntary Carers The contribution of voluntary carers in the Australian health and care system is crucial for long term sustainability. Maintaining a person in their home environment is often not possible unless there is a voluntary carer able to support the care regimen.

In the health service world this person is often forgotten or ignored, especially the impact on aspects of the voluntary carers own life; as they modify their lifestyle to suit the needs of the care recipient.

In addition, often family and friends are keen to help or need to be assured of the safety and wellbeing of their loved one. With the introduction of business grade broadband capability this group even though they live separately from the care recipient can have a much greater input to the management of the care and support of the home based care recipient through remote monitoring and video conferencing capability. 

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Contact us for a demonstration! t. +61 3 9339 6888 aca www.leecare.com.au Aged Care Australia | Autumn 2012 | 31

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technology

Let’s Face It: Residential Aged Care Needs Technology Dr Stephen Weeding and Jeremy Baird, NEC

R

esidential aged care is undergoing a technical revolution driven by the move to patient centred care and the demands of an ageing population.

Technology is emerging as a competitive advantage adopted by residential aged care providers to attract clients looking for more home-like environment in new facilities.

with individual passive radio frequency identification (RFID) tags; the fork lift moves the pallet to the delivery dock for unpacking onto a conveyor belt. Each package and its RFID tag are scanned while making its way into the large warehouse where a computer records the date, time and each package’s storage location.

The increase in competition is being driven

by The Productivity Commission 2011, Caring for Older Australians, Final Inquiry Report and has set the scene where, if the key recommendations are adopted by the Commonwealth Government, residential aged care providers can look ahead to accommodating more and more clients with particular expectations and needs in what is to become a consumer lead market in the provision of residential aged care services.

Australia, like many other countries around the world, has adopted wireless, technology to address the needs of a mobile population and workforce.

The technology revolution has taken hold in the development of new residential aged care facilities on Greenfield and redeveloped sites. Forward looking residential aged care providers acknowledge that technology is essential to and is playing a major role in addressing productivity issues such as the shortage of qualified carers and nurses, and the duty of care and safety issues, for example, when caring for wandering dementia patients.

Residential aged care needs to look outside its own industry to examine the technologies that are driving change, especially in labour intensive industries. For a long time, the logistics industry has been utilising RealTime Location System (RTLS) technology to reliably improve its point A to point B capability.

For example, a delivery truck arrives with a pallet full of packages each fitted

For example, many hospitals around Melbourne have installed wireless networks to compliment the static wired network.

The wireless network allows nursing staff to ‘untether’ themselves from the wired network and computer behind the Nurses station to have immediate access to a patient’s electronic record, such as medication information and pathology reports, at the point-of-care (POC) using a wireless laptop on a trolley. Properly designed, this ever-increasingly powerful wireless technology can support RTLS, voice over Internet protocol (VoIP) and provides Internet access, for example, nurses looking up MIMS for medication advice.

As Australians we have an uncanny knack of accepting technology in areas of our lives where there is overwhelming benefit and convenience. We only have to look at the adoption of smart-phones and smart-tablets that have fast become essential commodity items helping us to communicate with our friends and family, supporting our everyday living, recreational and business activities, such as using a smart-phone for surfing the Internet, paying bills, ordering stationary supplies and grocery shopping.

A significant advance in Unified Communication (UC) platforms is how seamlessly Internet protocol (IP)-based telecommunications has converged with wireless/3G/Long Term Evolution (LTE) or 3GPP/4G technologies. The result is a consumer-based smart-device that can operate as an internal telephone extension, utilising a wireless network when inside a building but automatically switches to, say a 3G network, when outside a building ensure constant access to the UC platform.

These single device smart-phones and smart-tablets allow access to the Internet for research, search corporate Intranets for important information, and serve up business email in a heartbeat; these devices can truly change the way residential aged care facility workforces operate.

RTLS technology can not only help staff to easily locate vital and important equipment utilised within, both single and/or multiple storey residential aged care facilities, but can be integrated with other technologies, such as UC telephony providing care staff with important information more quickly in order to improve the quality of life for dementia and other residents. Smart-phones and other devices are changing the way we receive and pay for Government and other services, such as telehealth consultations with Medical Specialists.

In order to prepare themselves to meet the growing needs of a more informed clientele, of an increasing ageing population, where there is an inverse-growth in their professional workforce, scarce funding, residential aged care providers will need to adopt technology as one of the key fundamental drivers designed to keep their businesses relevant to meet client and workforce expectations. n

aca Aged Care Australia | Autumn 2012 | 33

technology

The Great Technology Debate This article is almost entirely drawn from a Blog on the ABC website, written by the organisations Technology and Games specialist reporter, Nick Ross.

“

I’ve had enough and something has got to be done. I’m pretty much certain now that, outside of the tech sector, the majority of Australians hate the NBN. Many people hate it because of its ties with Labor. Some hate the idea of the (perceived) massive amounts of tax money being spent on an infrastructure for geeks which is irrelevant to them. Some are hating it because the Coalition is telling them to. And I no longer blame them.”

In a nutshell, Labor and NBN Co’s failure to explain the NBN’s benefits is undermining the entire project.

“Viewing the NBN simply as a business which delivers fast web access is utterly wrong.”

The cost savings to health and power industries will pay for the entire build. Healthcare, education, business innovation and, in many quarters, society in general will be revolutionised for all Australians – particularly for those in rural areas plus the elderly.

A total lack of core information on a very complex topic leads to trouble “When the government sprang its Satellite NBN announcement on the country, even the techies struggled to analyse this niche area.

The 7.30 report did a good piece but ‘balanced’ it by showing Malcolm Turnbull saying it was too expensive. The Financial Review’s top tech journalists (who are very good) couldn’t drum up much more analysis before deadline than the same Turnbull soundbite plus a quote from a company with an axe to grind. There was no holding to account and readers once again got to choose who they wanted to believe.

I do not intend to be harsh to colleagues, these were the two best reports that I saw and it took some of Australia’s other top tech journalists almost a fortnight to analyse everything and establish what was really happening.

But far far far fewer people would have seen these articles than saw the immediate news reports which have much shorter deadlines.

In short, even the best news journalists in the country can struggle to get a hold on the NBN and even reports with positive elements are unlikely to change the mind of cynics.

The lack of information in the public or media domains means there’s virtually no positive coverage of the NBN at all. It’s also resulted in the deployment being politicized and people choosing who they want to believe rather than basing their opinions on all the facts.

If the public knew the truth about the NBN, and believed that the Coalition wanted to destroy it, then Labor would have an unassailable lead in the polls right now and the National party would

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have ditched any association with the Liberals. I’m deadly serious.

However, if the public and the Coalition knew all the facts, then the Coalition could not, in good conscience, oppose it.

Marketing It’s against my instincts to heavily criticise anyone for their marketing prowess. After all, NBN Co is head down, bum up concentrating on building the NBN. Stephen Conroy, who’s in charge for Labor, has simply said that it’s the media’s job to inform the public about it.

I can’t think of a worthwhile, positive NBN message that’s relevant to the greater public that’s come out of Labor, or NBN Co in the mainstream media, well... ever.

What the public think the NBN is “If you know little about technology, this is what I’d expect you to think about the NBN based upon what’s been reported: • That it costs $50 billion • That its business case is deeply flawed • That we don’t need these speeds • That new wireless technologies undermine the need for fibre • That we don’t need to build in redundancy for the future.

None of this is true.”

What is actually going on “People who have been reading my articles will note that, for a very long time, I’ve been threatening to write a Cost Benefit Analysis of the NBN. The reason I haven’t published anything yet is because locking down numbers is a nightmare. Furthermore, this is something that a multi-million, government endorsed study should be doing, not an ABC journo when he’s got a moment. But I can’t hold off anymore.

What follows is my work in progress. All that’s missing are the final figures. Right now I just know (and will illustrate) that they are enormous. There’s no point preaching to the choir here, I need to be convincing people who downright hate the NBN, so future refinements will appear. What’s important is to get people thinking differently about the NBN right now.”

Business Proposition “Paul Fletcher, one of the Coalition’s top anti-NBN spokesmen, is about to engage on a speaking tour, telling us how the returns on the

NBN’s internet subscriptions make a poor business case.

I don’t doubt they do. But that’s because the NBN is an infrastructure which provides a platform for business, services and innovation. Did anyone query the direct profitability and “business case” when building Australia’s sewer infrastructure?

The lack of preciseness here is exactly why Stephen Conroy has said he won’t do a Cost Benefit Analysis - there are too many variables and inscrutables. But all he needs to do is come up with figures to justify the overall expenditure.

This is what the public now absolutely needs, this is what Coalition wants and I completely agree with them. Even using the Coalition’s ridiculous $50bn figure (which continually appears unchallenged in the media) it’s still doable.”

Let’s just look at the cost SAVINGS to the health service Healthcare will be revolutionized for ALL Australians, particularly the elderly and those living in rural areas at the same time.

“Savings, efficiency boosts and improvements in real care actually mean it’s worth the health service building the NBN on its own.

Savings from remote diagnosis, monitoring people at home, remote visits to GP’s and specialists, remote delivery of specialist services such as Cochlear do now.

I could go on, but those are some of the main benefits to having the NBN. Critics, like Abbott and Piers Ackerman don’t understand that the reliable and high-bandwidth speeds required for these services aren’t available to most people now and that wireless isn’t and will never (at least in the foreseeable future) be nearly reliable enough.”

Telepresence and video conferencing “A few months ago the government announced the results of its telepresence trial. By creating special meeting rooms which had half a normal boardroom facing a wall of massive high-definition televisions government employees could participate in proper meetings with participants from all over the country. Everyone was looking at high-definition, life size counterparts and there was no lag or signal drop outs. The system cost $24m to set up and, in two years had recouped $12m in travel cost saving alone.

Rolled out to the public, many people simply wouldn’t need to commute to an office ever again.

• How much time will that save?

• How much money will that save in company office space rental?

• W hat would it do to the roads and traffic in metropolitan centres?

• W hat would it do to affordable property prices if people didn’t have to live in the city anymore?

• W here would you like to live?

• W hat would all the diminished commuting time and reduction in traffic in the city mean to the economy?

• W hat would we spend our time and money doing with all the extra hours in our lives?

Schools and Rural benefits All schools will benefit from NBN access - being able to tour remote museums and being taught by some of the world’s best teachers and lecturers is already being implemented by companies like Google and Panasonic.

Conclusion Ultimately, I hope that if I’ve illustrated one thing to members of the public, mainstream media and the Coalition who read this, it’s that the NBN represents far more than a fast internet business and that a Cost Benefit Analysis absolutely MUST be done before any decisions are taken to destroy the NBN and rob Australia of this socially and economically transformative infrastructure.

Let’s be more constructive. Labor and NBN Co have the power (and the funds) to stop all of the poisonous bickering and misinformation dissemination by focussing on the proper, universal benefits of the NBN and advertising them to the nation.

Ignoring petty arguments and giving the country proper information will solve a world of ills and guarantee survival of one of the most exciting and important things to happen to Australia ever. n Read the full story and some of the over 500 responses on this Link: http://www.abc.net.au/technology/articles/2012/02/21/3435975.htm

Life Changing, Life Saving.

The WSD telehealthcare trial on 6,000 UK patients revealed that telehealth delivered: 45% reduction in mortality rates 20% reduction in emergency admissions 14% reduction in bed days Dave Tyas, Project Manager of the WSD telehealth trial will explain the implementation of the program in depth at ITAC 20 April 2012 2:40pm-3:30pm Visit Stand 30 to see how Tunstall Healthcare’s telehealth products impact on today’s society For more information contact 1800 611 528

www.tunstallhealthcare.com.au

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technology

Telehealth: The true value of video as part of a broader communications platform approach Ron Emerson, RN BSN, Polycom Global Director, Healthcare Markets

Defining ‘Telehealth’ Telehealth as a concept has permeated the healthcare industry for some time, however the way in which it is defined varies greatly depending on its use – diagnostics, on-going patient care, medical training. In fact, it would not be inaccurate to say there is no one true universal definition for the term.

It is important however, to acknowledge that telehealth has been available in one guise or another for more than two decades and contrary to popular belief; it goes beyond traditional ‘videoconferencing’. While video collaboration technology plays a critical role in telehealth practices, most importantly by enabling patients to ‘see’ a medical specialist or consultant, without the time and expense of physically travelling to another location, it also encompasses more than this.

Telehealth should refer more broadly to the provision of clinical advisory services to patients, using technology remotely.

Broader Technology Adoption The proliferation of technology in every aspect of our lives is constantly advancing and evolving. Having entered an era of communication where voice and video technology solutions can now be custom built to fit the specific needs of any industry sector; there is an enormous opportunity to embrace the full range of capabilities this affords us. The aged care industry is no exception. With investment in Government initiatives including the National Broadband Network (NBN) and more specifically, the Telehealth Rebate Initiative launched

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by the Federal Government in July 2011, we are seeing greater adoption and investment in new technology applications in the area of video collaboration and unified communications (UC) by the Australian aged care industry specifically.

Australia’s Ageing Population As we are all acutely aware, Australia’s population is ageing at a significant rate.

Between now and 2050 the number of people aged 65-84 is expected to more than double with those aged 85+ expected to quadruple to 1.8 million in 2050. These statistics are not new, however they do represent both enormous challenges and opportunities for the Australian health system. A country as vast as Australia, presents its own set of unique challenges when it comes to offering world-class aged care services. An example might include the growing trend towards citizens of retirement age (and over) being based outside urban centres, away from specialist medical treatment. Aged care facilities are increasingly under pressure to deliver the best patient care possible, as well as, increase services and reduce costs in an increasingly competitive and regulated market. As the Baby Boomer generation continues to move toward retirement, these organisations are increasingly looking at new and innovative technology solutions to help them achieve industry excellence and best practice.

Telehealth Rebate Initiative Previously in Australia, there was not a viable business model in place to support telehealth initiatives on a broad scale, however since the government’s commitment to invest AU$620 million into this area, with a further AU$20.6 million announced in January 2012, the industry has been provided - in the first instance at least - with an incentivised program to drive telehealth adoption; helping it to mature into a viable channel for patient care. More and more aged care facilities are seeing the true potential of video collaboration and UC solutions to not only help them overcome challenges such as: large travel distances between healthcare facilities, stringent privacy and security requirements to protect patient health information, a shortage of healthcare providers especially in rural areas, and the ever-increasing costs of delivering resident and patient care; they are also being used to offer a different model of care to aged care residents driving social inclusion of family and friends, that also helps to coordinate administration across aged care facilities. In fact, it is likely that ‘telehealth suites’ will become commonplace in the aged care industry as facilities seek to extend their unique selling propositions throughout Australia to retain and attract new residents.

While the Telehealth Rebate Initiative has succeeded so far in encouraging the broader healthcare industry, including the aged care sector, to explore e-health strategies such as telehealth programs, it is also important to understand the full range of technologies available and how they

can be utilised effectively. There is a vast number of ‘telehealth solutions’ available in the market today, however many sit on different technology platforms and do not interoperate with one another.

Choosing the right technology Video collaboration technology – both hardware and software-based solutions – provides a unique opportunity to overcome many of the challenges facing the broader healthcare industry today. The best quality telehealth consultations are supported by business grade, high definition, standardsbased video collaboration systems, that easily interoperate with other IT. By implementing video collaboration systems of this calibre, aged care providers can expect the following benefits from their investment: • Ensure less disruption to the connection, making video consultation sessions much more productive • Provide the most life-like interaction with the patient regardless of clinician or patient location • Guarantee security and privacy of data transfer for protection of patient information • Be interoperable – so that your video technology is compatible with other video technology with minimal firewall or technical issues

Investing in a ‘communications platform’ Extended network availability and new devices such as personal desktop video, tablets, and healthcare phones means video technology is already being incorporated into best medical practice, however it is also important for aged care providers to consider broader UC communications solutions that can be leveraged to extend their capabilities beyond video alone. While the ability to make a successful video-call is the threshold for a telehealth consultation, a communications platform approach is necessary to deliver an efficient, sustainable telehealth service. Important applications to be considered beyond video include:

Telehealth is used across a broad range of medical applications – from neurologists saving critical time assessing and recommending treatment for stroke victims in remote areas, through to the areas of tele-psychiatry, endocrinology, and dermatology. Benefits even extend as far as helping overcome staff shortages, especially in rural areas and in specialist fields where skills are in high demand.

- Calendaring and appointment systems for consultation coordination - Email for non real-time correspondence and document exchange - Secure online workspaces for caregiver collaboration - Analytics for reporting and call auditing - Referral management systems Without smart investment in your broader communication platform, companies may not generate the ROI they originally envisaged. Stand-alone video solutions can be extremely effective, however without a platform approach companies will not offer the same level of sustainability in their telehealth offerings as other aged care facilities.

Aged Care Industry – Early Adopter The aged care sector in Australia has embraced the benefits of telehealth. One aged care provider in Victoria is already reporting significant cost and resource efficiencies from the reduction of resident visits to specialists located either in the community or hospital setting. An appointment that could take anywhere

from 6-8 hours for a resident and their primary care-giver, has now been reduced to approximately 30 minutes by carrying out a consultation from the aged care facility via video. The associated administrative processes have also been reduced drastically.

By levering applications available through an integrated communications platform, companies can schedule follow up appointments with specialists and share critical resident information in real-time in a secure and time efficient way, ensuring less disruption for residents and more time dedicated to providing care. Increased access to care to aged care facility residents will also reduce the number of unnecessary emergency room visits and provide a significant cost savings due to not having to transfer patient’s large distances to see a clinician in a timely manner.

Given that the one-off ‘on board’ incentives and telehealth item rebates will be cut by 20% from 1 July 2012 and progressively reduced further over the following five years, now is the time for aged providers to really explore telehealth as a viable channel for providing the highest level of patient care.

The Telehealth Rebate Initiative offers aged care facilities an opportunity to supplement their existing UC strategies and improve their bottom line, (see table below). n

2011-12

2012-13

2013-14

2014-15

Telehealth On-Board (one-off)

$6,000

$4,800

$3,900

$3,300

Telehealth Service (specialist)

$60

$48

$39

$33

Telehealth Service (patient-end)

$40

$32

$26

$22

Telehealth Bulk Billing

$20

$16

$13

$11

RACF On-Board Incentive (one-off)

$6,000

$4,800

$3,900

$3,300

Telehealth Hosting Service Incentive

$60

$48

$39

$33

http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/content/connectinghealthservices-specialists

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Smart technology for aged care

W

ith an ageing population putting strain on the nation’s aged care providers, two leading Australian software companies, TechnologyOne and Health Metrics, have joined forces to deliver a preconfigured enterprise solution that will make day-to-day processes simpler, more compliant and more profitable.

TechnologyOne has been providing world class, deeply integrated enterprise business software solutions for 25 years, which it develops, markets, sells, implements and supports locally from its Brisbane-based head office. In February this year, the company unveiled its first cloud products, known as TechnologyOne Cloud.

Customers can now access TechnologyOne solutions in the cloud and reap the rewards of reduced operating costs and scalability.

PEPA

Program of Experience in the Palliative Approach

Ensure your organisation’s future

• A subsidised workforce placement of up to five days within a palliative care specialist service; and/or • A palliative approach workshop.

Aged care providers have long been subject to complex funding requirements and are under substantial pressure to remain financially viable.

There is no fee for placement attendance. PEPA is funded by the Australian Government Department of Health and Ageing. Financial assistance for travel and accommodation may be provided.

Reimbursement towards backfill is available for your employer if you attend a placement.

Maximum funding amounts and eligibility requirements apply.

Apply for PEPA PEPA is available for generalist health professionals across Australia.

PEPA promotional DVD available on YouTube: http://www.youtube.com/watch?v=lS3mGeNXk8I (search terms = pepa pall care).

For further details visit: www.pepaeducation.com

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“There is a constant need for aged care organisations to be responsive and meet new challenges, such as changing economic conditions, increased competition and ongoing regulatory requirements.

PEPA provides an opportunity for health professionals to update their skills in the palliative approach through undertaking:

Financial support

– NURSE

“We have taken aspects from TechnologyOne’s solution suite and Health Metrics’ enterprise suite to deliver software specific to the diverse needs of the aged care sector,” says TechnologyOne Executive Chairman, Adrian Di Marco.

How can PEPA enhance your practice?

Placement participants are supported to integrate learning into practice and build networks of support with other specialist services.

I am more confident now to discuss with my peers, talk with family and ensure the resident has the best care.

The integrated software solution, TechnologyOne OneCare, provides a unique offering for the sector and will allow aged care organisations to manage their entire business from clinical care, funding, payments, budgeting and compliance to human resource management and beyond. TechnologyOne and Health Metrics will have the architecture to support a cloud computing model, future proofing the investment of aged care providers.

“We have built strong relationships with a number of customers in the industry to ensure our technology responds to the different requirements and pressing issues in the aged care industry.

Funded by the Australian Government Department of Health and Ageing

Do you or your staff care for patients who are at end-of-life?

Health Metrics is a privately held technology business that specialises in the aged care industry. A key differentiator for Health Metrics is its marriage of technology and clinical skills, with technology experts and health professionals in its team.

aca Aged Care Australia

The TechnologyOne OneCare solution helps organisations maximise the funding they receive. Facility revenue can be efficiently managed and optimised. The enterprise wide solution empowers users with all the reactive and proactive fundamentals for managing the revenue stream, removing the intricate, convoluted and timeconsuming activities that burden care and other support staff involved with service delivery.

Cater to individuals’ needs Each aged care resident requires different attention, but the industry staffing crisis is offering little respite. TechnologyOne and Health Metrics recognise aged care systems need to efficiently store, transfer and access residents’ history, and that this information is required quickly. The TechnologyOne OneCare solution offers an architecture it calls Single Client Record or “SCR”. This means resident data is carried with the resident, irrespective of their individual care journey. That is, from community care to respite,

Compliance and effective monitoring… to an independent living unit, or into residential care, the resident’s care history travels with them as a secure, robust and accessible data set.

…two essential components for optimising oral anticoagulation therapy enables quality of care.*

Organisations can hold all resident’s data for billing and rebates, waiting lists, the level of care required and details of dependents, relatives and co-residents in one system.

“The software also improves the quality of service, providing organisations with relevant, up-to-date information so residents’ specific needs can immediately be met. The Clinical Care capability encompasses progress notes, charting, assessments and care plans that can be quickly accessed at the push of a button,” says TechnologyOne Health and Community Services Solution Manager, Paul Curtis.

Manage high demand for services The growing demand for services makes the maintenance and management of assets such as buildings, vehicles and other infrastructure a key priority for the aged care sector.

TechnologyOne OneCare’s asset management function will put more time in the hands of organisations, by eliminating data duplication, streamlining workflows and reducing the complexity of maintenance requests, allowing them to focus on provision of services. The software also helps users oversee occupational health and safety reporting, preventative maintenance and capital projects management.

Overcome reporting pains Both companies recognise the increase in government reporting requirements has stretched the already strained resources of aged care organisations. TechnologyOne OneCare enables aged care providers to meet the onerous statutory reporting requirements, which the likes of Medicare and the Department of Health and Ageing require, including an integrated and seamless approach to Medicare Online claiming.

TechnologyOne OneCare converges all organisational information into a central system and generates reports that can be automated at the click of a button, decreasing manual error and saving a considerable amount of time.

Compliance and monitoring - inter-related factors in oral anticoagulation * Aged Care Standards and Accreditation Agency Ltd, Accreditation Standard 2, 2.7 Medication management.

The importance of compliance • •

ompliance rate with long-term medication in general has been estimated C at between 50% and 60%1 Evidence shows that INR monitoring improves the quality of oral anticoagulation between 50% and 85%2

Warfarin – a particular case in point • • •

T his is increasingly prescribed as lifelong therapy for patients with mechanical heart valves, atrial fibrillation or thrombophilic disorders, effectively preventing arterial embolism in a wide range of conditions3 Maintaining INR within its therapeutic range is effectively achieved through monitoring Patients on warfarin who have had a heart valve replacement there was a 32% difference in survival at 15 years between patients with low and high variability in anticoagulation control4

The obvious choice is partnering VKA and CoaguChek® XS Plus for improved compliance

The TechnologyOne OneCare solution is continually relevant and has the ability to evolve with changing customer requirements, s technology and legislation, thanks to ongoing collaboration withsystem R S ® X st I N o aged care customers. k e t e h o t C y de s wofathe n ma nt oaguedge,astate t e r e b “TechnologyOne OneCare is based onCleading art m tme ever he s andidevelopment has n apy adjus technology and is backed by a substantial g - tresearch n r r nito te the asecurity,” program to ensure customers are providedNwith molong-term I R r immedi says Mr Curtis. n fo easy TechnologyOne and Health Metrics will be unveiling TechnologyOne OneCare at the Information Technology in Aged Care 2012 conference in April.

E LIF E TIM Y T N A R WAR

CoaguChek® XS Plus References: 1. DiMatteo MR. Formulary 1995; 30: 596–8, 601–2, 605.

2. Heneghan C, Alonso-Coello P, Garcia-Alamino JM, Perera R, Meats E, Glasziou P. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis.

Lancet 2006;367:404-411.

3. Ansell J et al. Int J Cardiol 2005; 99: 37–45.

4. Butchart EG et al. J Thorac Cardiovasc Surg 2002; 123: 715-23.

Roche Diagnostics Australia Pty Limited., 31 Victoria Ave Castle Hill NSW 2154, Phone: 02 9860 2222 ABN 29 003 001 205

COAGUCHEK, BECAUSE IT’S MY LIFE are trademarks of Roche.

Stay ahead of the game

aca Aged Care tAustralia h | Autumn 2012 | 39

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technology

Technology for Aged Care admin doesn’t need to be complicated It also doesn’t need to be expensive.

It just needs to work for you

I

f you’ve ever worked in or with administration, you would know how much time is needed to enter data. And that data may need duplicating into other programs or lists – fees or charges might need checking and personal information added for records.

Altona Meadows agreed: “Everything is so simple and logical to use...

The updates are seamless and all the visual aspects of the program remain the same regardless of how often the software is updated.

Knowing all the legal issues are taken care of is also piece of mind.”

But although it may seem at times to increase our workload, technology can also be our saving grace*. Some forms help us get through our tasks just that little bit better and a little bit quicker... a faster computer; a better server; a newer version of software.

NeRA automatically updates government data (and the latest legal templates), which in turn reduces the burden on providers to maintain accurate agreements with minimal errors – saving time and money. Marketed at a low cost and with an easy to use interface, NeRA is example of the positive impact smart technology can make in the workplace.

Every advancement is designed to reduce the time we spend doing our daily tasks – and – without these continual steps forward in technology we couldn’t perform at the levels that are now expected in a competitive, accountable business environment.

Aged Care, like any business, needs technology. An example of this is the software developed by software company e-Tools (and endorsed

by ACAA and ACSA) for processing resident agreements – NeRA. (National electronic Resident Agreements) The idea behind this joint initiative was simply to create software so industry specific and compliant that the hard work would be done for you. And it has worked.

Over 700 sites nationwide are currently using NeRA for processing resident agreements and feedback from users confirms that it is making this task much easier.

Since switching to NeRA for generating resident agreements Jeff Kramer, CEO of

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Take a look at NeRA at www.e-tools.com.au and call e-Tools for a free demonstration on 03 9571 8611. You can only make things easier! n *We should all hug the person who invented spell check.

FRONT & CENTRE

Placing Resident Care First

Harmonise communication between care providers

Vocera® Voice Communication enables caregivers to directly connect

• Hands-free mobile communication • Find care staff immediately • Increase time with residents as a result of efficient communication

The Vocera Communication Platform

to each other and residents from anywhere, in real-time. Staff can spend more time with residents when they can communicate at the point of care with the one-touch Vocera Badge, eliminating the need to search the facility for help. Staff can now easily and securely call any resident’s room or any staff member from any location, while continuing to perform other tasks.

Harmonising healthcare communications.

Learn more at vocera.com/badge

aca Aged Care Australia | Autumn 2012 | 41

technology

Head for higher ground John Sheridan, CEO, Digital Business insights

In 2001, John Sheridan co-founded Digital Business insights (DBi) www.db-insights.com, to help organisations leverage the benefits of the digital economy.

F

rom more than 40,000 surveys, DBi has mapped the way businesses use ICT across all industry sectors, tracking adoption of emerging technologies, identifying best of breed solutions and creating more than 550 case studies illustrating the benefits.

All the symptoms are there to see. Fear, Uncertainty, Doubt, Global Financial Crisis, higher prices and customers with locked wallets and purses.

Inside organisations of all kinds, CEOs and senior managers are being asked to do more with less. Decision makers are only making the easy decisions, the ones they are forced to, the ones that impact the next quarter bottom line. The hard decisions are being shelved. And everyone is planning to cut staff if they have to.

On top of this, the currents of change from the convergence of IT, telecommunications and content are confusing all parties – the telcos, the IT vendors, the media industry and all their customers.

Nobody quite knows where it is all heading.

Tip in mobile devices, social media, the “cloud” and integration and it gets even more confusing.

Convergence is the merging of telecommunications, information technology and content, which is happening as a result of all information being digitised – converted to “1”s and “0”s.

The result. People, organisations and information networks are being connected across a host of channels, platforms and devices. This is ongoing. It won’t stop.

And that changes things forever.

When things are connected, really connected, where does your organisation start and stop?

That is a serious question because with traditional boundaries blurring or even

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disappearing, organisations can now extend their reach into territory once considered somebody else’s, not core business, or even places that were remote and inaccessible.

The border now starts and stops wherever we decide it does. Defining the new boundary to our organisation’s reach is a strategic, executive decision but to make it requires clear vision and understanding of what is going on.

We can choose to open up channels to the flow of information and knowledge or we can try to block and control the channels.

But whatever we decide must be considered.

At a physical level, nothing much changes.

We might simply add a few wires, boxes and software applications to the organisation.

It all seems much as it was before. But at the information level the genie is out of the bottle.

On balance, that can be a good thing.

Properly managed and understood, we can do a lot more with less.

For all organisations in every industry sector there are two main things to consider – the benefits and threats of convergence, and the new informed customer.

The ever-promoted benefits of the digital revolution – efficiency, productivity, collaboration, connection and communication are now readily available at an affordable price.

Every organisation can do more with less.

Every organisation can improve its systems to become more effective – “fitter and healthier” and by becoming so, feel better about itself – improving the internal culture and increasing job satisfaction and pride in performance.

The effects of getting it right (and that is the key) are wide ranging and resonate far beyond the budget, annual report and performance review. The results are multi-level and holistic.

In Aged Care that means complete systems integration within the facility – communications, financials, administration, care management, medication and mobility.

It means external integration with pharmacists, GPs, other specialist suppliers and even hospitals.

It means connection, information sharing and collaboration between residents, their families, friends, the community and the world.

It means connection and collaboration with other aged care facilities and industry associations. And all this in a planned, integrated and automated networked solution.

All this can be done today and more.

For a real world example of what I have just described, read the case study of Star Gardens, a residential aged care facility in Beaudesert, Queensland on page 123 of the Non-Profit report available at www.db-insights.com.

The digital revolution hasn’t just changed the way we use technology, it has changed what we all now expect.

Star gardens – integrated management system Star Gardens is a residential aged care facility located in Beaudesert, Queensland. Star Gardens employs more than a hundred staff and has been in operation for fifty years in Australia.

Who are your clients and customers?

Star Gardens is currently a residential aged care facility, but we are planning to move into other aged care services in the near future. Our residents are older people that can’t be cared for elsewhere.

What changes are taking place in your category?

Customers are more demanding than they used to be. This includes both residents and their families who want to be more involved

and take a greater interest in day-to-day activities, events and future plans.

We are seeing the results of more drug and alcohol use in the community influencing the ageing process. We have a lot more clients with early dementia than we used to.

The sophistication of all stakeholders in aged care is increasing – GPs, pharmacists and materials suppliers and this offers an opportunity to move towards more connection and automation through the use of technology.

This allows us to improve the assessment process, with less intervention and better care. So that is an underlying trend that we are taking advantage of.

The aged care sector is less profitable, primarily due to under funding from Federal Government. Probably 50% of the sector would be making a loss. There are very tight margins in the sector. The Productivity Commission has released a report warning of the looming crisis and we are hopeful that the Government will heed the report recommendations and reform the industry.

How have you been successful?

We deliver a very high level of care to our residents. To remain successful into the future we are planning to increase our beds and expand into retirement villages and in home care with better margins. We are planning to be ready for any changes in the industry and because we are small we can change and adapt quickly.

What prompted your most recent IT project?

Five years ago I moved to Star Gardens from Bluecare. We knew and our board knew that we had to make significant changes.

So we worked on a strategic plan reviewing everything. One of the key issues identified was to improve governance.

That is where we started. Next we looked at management and our systems and this is where technology can deliver enormous benefits if it is implemented properly.

When I first arrived the only technology in place was the financial system. I knew this had to change and I knew the culture had to change with it.

Did you write a project plan before you started?

I spent a couple of years looking at all the issues. I had to get it right. Because we are a relatively small facility we couldn’t afford to make the wrong choices with our technology investment.

So I looked into IT use in Aged Care, looking for innovators. I networked and visited Aged Care facilities across Australia.

I looked at the care systems and what the software applications were behind the care system.

About four years ago I went to the first Aged Care IT conference. The following year there was a grant from the government to improve IT systems. I used the grant to upgrade the Datacare financial system first. Then I looked at the rest.

The first thing I looked at was the Vocera voice communicator system, which allows staff to contact each other for assistance anywhere in the facility.

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I visited an Aged Care facility using the system to see how it helped the organisation.

A consultant analysed the tasks before the system went in and then reviewed it afterwards. There were huge benefits.

I next looked at clinical systems. Once again I visited facilities and looked at their clinical systems to see how they worked in situ. During that period we built additional residential space and added more beds. We also had new staff join us and other staff leave.

I knew that I had to view any new clinical system and the Vocera system as an overall integrated and connected system that had longevity and would give us the productivity and improved service delivery we were looking for long term.

Any decision had to involve all the key stakeholders, so when I visited the Aged Care facilities to look at the IT they were using, I took the board with me so they could see it for themselves. I started taking my Care Manager along with me as well. I wanted the whole management team convinced before moving.

I wrote a complete strategic plan.

The technology was the foundation.

How did you decide which technology to use?

I didn’t know exactly which systems would be the best, but I knew that it all had to happen over the next three years. We had to grow to stay here long term. But we had to get the system decision right. I knew I couldn’t wait three years to put the system in place.

So I discussed it with my Care Manager. We needed to make the right choice to put the system in. We went to look at places using the systems I thought would be most useful. The first key decision was the clinical care program.

There were fifteen or so systems available but probably only three or four to seriously consider.

We wanted to look at the system operating in a similar sized Aged Care facility. After looking carefully we decided on iCare. I then went to visit their headquarters and met their people. They had a good team and a high level of commitment to ongoing development.

They gave us a presentation on the software and I asked them about the best way to implement.

I was impressed with their implementation process and training proposals.

How much time did it take to get up and running?

I went to look at places where iCare was operating and discussed the training and implementation process. I knew we had to have the full training and support to be successful.

Before we put the iCare system in place I looked at the rest of the overall system I would need. I discussed this requirement with IT Integrity, our IT consultant and systems integrator.

I wanted the system to be live with staff connected by tablet computers, so I needed wireless throughout the facility.

Because we needed wireless for the tablets and Vocera, I had to look at our overall communication system.

We began with the documentation and management system for iCare. This contains the resident details and allows staff to keep care notes up to date as well as recording any incidents. We then added the medication module, which manages medication information and links to the local dispensing pharmacy.

The system is accessible through tablets, so staff can walk around with a trolley and check medication as they go. The care manager has access to the system and can keep an overall eye on everything as it happens. The system is transparent and reduces any chance of mistakes.

My key people are the carers and nurses who interact with residents every day for medication, incontinence and personal care.

If I can make it easier for them, it makes both staff and residents happier.

Did you use outside contractors?

The project was project managed by DataCare (now IT Integrity). They coordinated with the various vendors involved with the project, as well as supplying the desktop computers, notebooks and servers.

IT Integrity also provides ongoing managed service support that allows staff to call one number regardless of the issue. They will then determine what the problem is and work with the vendors to resolve it.

How much did it cost you?

It has cost about $400,000 for everything including the new IT and infrastructure.

What mistakes did you make that you wish you hadn’t?

None really. I knew that every system we implemented, I had seen in operation. I knew the system would do what I wanted it to. We also had the right training for staff and the right support.

What were the main risks you took?

The biggest risk was doing it all in one hit. My board thinks I’ve done enough IT implementation for now. It’s a risk putting in new technology systems, but there is a much bigger risk if you don’t. And any risk can be mitigated by research and planning.

People forget the three years of planning to make it all happen. In each case we started with the wish list – “what would we like?” – and then we priced it and made changes to that list if necessary. One thing I cut out was putting the GPS system in.

What advice would you give someone else?

Be open to opportunity. When we looked at the Cisco infrastructure for the wireless system, I heard about a product called Simavita.

This is an electronic incontinence management system. It uses microchips in the incontinence pads that let staff know wirelessly that attention is required. The system monitors and assesses any incontinence episodes providing an indication of the level of care required.

I wanted to know whether we could link the Simavita system into our overall system as well.

At the moment Simavita sends information to the mobile phone network. I want to link it directly to iCare so that it will put information into the system automatically. So I am talking to iCare and to Simavita about linking the two products seamlessly for the sake of the whole Aged Care industry. It is looking hopeful.

For the first time ever, we have been able to reduce our incontinence budget by a significant amount. There are some unexpected benefits as well. Because we are able to respond so quickly it builds confidence with residents and with care staff. It has had some really good care outcomes.

One benefit leads to another. As a result of integrating everything, we needed to have a better integrated financial system. I wanted a roster system as well. So we put in Corporate Information Management, which is an Aged

technology

Care financial system with HR and rostering.

We are also moving to palm readers for staff management scanning.

What I am looking for is to get rid of paper.

That will streamline the system.

The final bit of technology was from the Alfred Hospital. They have developed some software called ChiSL that uses smart cards to allow staff to securely logon from any computer and it returns them to the window of the last open session. So you can be working on something, get a call to another part of the facility and continue working from any other desktop.

Our telephone system also needs upgrading.

This will allow us to get rid of the speakers and do everything through the personal communication system.

What were the barriers to the project?

There was a lot of change in a relatively short time period. We needed to manage the change properly. We needed to get all staff used to using computers and not being frightened of the technology. All of our staff were used to the manual systems we had in place and many were not used to computers at work.

So we surveyed the staff to get feedback and we found that three or four were quite worried. Then we initiated a “train the trainers” program to ensure that our key staff were confident with the technology. We chose a project leader for iCare.

We then selected our training team, which included some staff who were worried about technology. We deliberately chose people with different levels of computer skills, knowledge and age range.

That meant that all our IT infrastructure had to be upgraded with new PCs, Windows 7 operating system, three new servers, plus a new database serer and terminal server. Vocera also interfaces with the PABX system, so phone calls can go direct to staff from any extension.

We targeted the staff who were most threatened to help them with extra training and attention. I set a decent budget for training. It was an investment in our future.

In due course, we will put a Vocera icon onto smart phones so that we can use iPhones to link into the system as well. We can then provide the same connectivity to the local GPs as well.

We didn’t only have to bring our staff along with the project, we also had to bring the pharmacy and local GPs along as well.

What are the business benefits you are hoping for?

The business benefits are wide ranging. We don’t have any infrastructure duplication.

So information goes into the system once.

Reports come out how we want them.

Information is available throughout the whole site and it is correct.

iCare and the medication module talk online to the local pharmacy. I had to get them on board.

We also have Medical Director in the facility to connect to the local GPs. It also talks to iCare.

We put an iCare icon on the doctors desktop system, so they can look at our residents from their surgeries. We would like to get the

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Being this connected and automated has helped with our funding.

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Staff motivation and leadership has improved, partly from training, and staff are learning new skills.

We save time with resident care and there is a new level of confidence in the information and residents details. Staff can find the information they need easily. Staff can find the people they need easily. So residents see a more confident staff.

We have made some productivity gains. I have made some changes to the night shift as a result of being able to analyse what is required clearly. We have also improved communication dramatically because of the great communication system.

We will have a 3.5 year payback on the investment. It is a difficult business with tight margins, but we wouldn’t have survived without the changes.

Are any of these benefits quantifiable?

We are about to bring iCare back to do an audit, so we can see what is being used and what isn’t. I did this after three months. The results showed that we are using more of the iCare system than any other Aged Care facility.

We are about to do an audit on the Vocera system. I would expect to be able to quantify this in the next couple of months. We are now getting calls from other Aged Care facilities to have a look at what we have done.

Are customers happy with what you have done?

Yes they are. Before we started we told families what we were planning. They love it. We are now helping residents and their families use computers and connect with each other through Skype and other communication tools.

Are staff happy with what you have done?

Universally, they are really happy. We don’t have any unhappy staff. People pick things up at different speeds, but now they are all up to speed.

It was a lot for the staff and the management team. So I am delaying the next upgrade until March next year, until things have settled down a bit. We spent about $110,000 on the training budget. We normally spend half that. But it worked.

In another year things will really be looking good. I think we can get a lot more out of the system.

What is the most important thing you’ve learned in the last year?

Never underestimate what the right planning and training can do for you. Don’t underestimate your people. You can move a mountain.

What are you planning to do next?

We are going to move from 78 beds to 102 beds. We are changing the layout and landscaping of the facility.

We are going to put in a new model of care including a gym and personal trainer. We have plans to build a retirement village and we are planning in-home community care. We also have developed considerable experience and expertise in high end care for dementia.

We want to share our learnings and experience in education and training in a more formal way, probably through a relationship with a university or other research organisation. So we have a lot to look forwards to. n

workforce

The new Workplace Health and Safety laws – What do aged care providers need to know?

Julie McStay, Hynes Lawyers

N

ew Workplace Health and Safety legislation (The Act) has now been introduced in all states and territories except Victoria and Western Australia. The legislation which has been adopted is uniform and is intended to ensure that all workers in Australia have the same standard of health and safety protection regardless of the work they do or where they work.

The laws are intended to provide greater certainty for employers particularly those operating across state borders and over time reduce compliance cost for business.

The Act applies to employees, contractors, sub-contractors, apprentices and trainees, work experience students, volunteers and employers who perform work. The Acts also provides protection for the general public so their health and safety is not placed at risk by work activities.

substantial part of the business or who has the capacity to significantly affect the entity’s financial standing or whose instructions or wishes are likely to be acted on by the directors.

Key Personnel are likely to be regarded as “officers”.

The Act imposes onerous obligations on PCBUs and on officers and provides several categories of offences for breach of those duties by PCBUs and officers. The penalties for a breach of those offences are very serious and include significant fines (up to $3M) and in the case of extreme breaches resulting in the death or serious injury of a person, even jail sentences.

While officers who are volunteers (which would include a volunteer board member) still owe obligations under the Act, they are exempt from prosecution.

The new legislation introduces some significant changes and additional obligations that aged care providers must understand.

Prudent aged care providers will consider the legislation very carefully and take immediate action to ensure they have systems in place to meet the obligations imposed.

What’s new?

PCBUs

The Act introduces some new terms and definitions.

A worker is now replaced by the term employee and an employer is replaced by the term “a person conducting a business or undertaking” (PCBU).

The Act imposes very serious obligations on PCBUs and on “officers” of PCBUs. All aged care providers will be regarded as a PBCU. An “officer” includes a director and any person who makes, or participates in making decisions that affect the whole, or a

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The Act imposes general health and safety duties on PCBUs, workers and any person who is entering the workplace. The primary duty of care owed by a PCBU is to ensure the health and safety of workers so far as reasonably practicable. Workers include volunteers, contractors and contractor’s workers.

The primary duties owed by a PCBU include, so far as is reasonably practicable: (a) providing and maintaining a work environment and work equipment that is

safe and without risk to people entering the workplace; and (b) p roviding workers with appropriate information and training for them to work safely and without risk to their health.

Duties of officers The new legislation imposes serious obligations on the officers of PCBUs to exercise due diligence to ensure that the PCBU complies with its workplace health safety obligations. An officer may be charged with an offence under the Act independently of any breach of duty by the PCBU. In practice, due diligence means that officers must proactively ensure they are taking reasonable steps to acquire information on workplace health and safety matters, understand the risks in their facilities and ensure that appropriate resources and processes are implemented to eliminate or reduce those risks. Ignorance of the law will be no defence to a failure to comply.

If you are a paid officer hefty penalties can be imposed for a breach of these obligations.

Volunteers are also subject to duties under the Act. A prudent board (including a board consisting only of volunteers) will take immediate steps to ensure their obligations are being met.

Duty to consult A PCBU also has a duty to consult with workers and health safety representatives about matters that directly affect them.

This extends to an obligation to consult with contractors and their workers, employees of labour hire companies,

students on work experience as well as the PCBUs own employees and volunteers.

In an aged care context, this has a number of implications. For example, it would certainly impose an obligation on an aged care provider to ensure that they consult with any agency who provides staff to a facility to ensure that the workplace health and safety of those agency workers has been considered and to develop a plan to ensure that obligations with respect to those workers are being met. The same obligation applies with respect to volunteer workers and work experience students.

Notification of incidents Workplace health and safety legislation has always imposed obligations on employers to notify the local Division of Workplace Health and Safety as soon as they become aware of a workplace incident which has caused a death or a serious injury. These obligations turn not on whether the death or serious injury was of a worker, but rather whether the incident occurred in a workplace.

This of course can create confusion in an aged care context where, by the very nature of its business, death and serious illness can occur on a daily basis.

Under the new legislation, the incident reporting obligations are somewhat clearer.

A PCBU must notify Workplace Health and Safety immediately after becoming aware of a death or serious illness or injury arising out of the conduct of the business that results in immediate hospital treatment as an in-patient, immediate medical treatment or medical treatment within 48 hours of exposure to a chemical substance.

A notification to Workplace Health and Safety in an aged care context should be made: (c) for every incident which caused the death or serious injury or illness of an employee, contractor, sub-contractor, apprentice, trainee, work experience student or volunteer; and (d) when the incident relates to the death or serious illness or injury of a resident – only when the incident arose out of the conduct of the business i.e. the incident was caused or contributed by some action or inaction of the employer or of an employee, contractor/subcontractor etc.

Some examples: (a) W here a resident falls and is admitted to hospital – A notification should be made if the cause of the fall was some action or inaction of a worker or some failure by the employer to have a safe system in place. (b) If a resident is seriously injured during a transfer in a sling – A notification should be given if the cause of the incident was some action or inaction of a worker or some failure of the equipment. (c) If a resident passes away as a result of the natural progression of their age and condition – A notification to the Division of Workplace Health and Safety is not required.

The Division of Workplace Health and Safety may or may not decide to take any action in respect of reports made but by adopting the above approach providers should be safe from any criticism about a failure to report.

The Act does also impose additional notification requirements in relation to incidents. For example, workplace health and safety must be notified in relation to any asbestos removal work or work involving hazardous chemicals.

What should you do?

It is important to take immediate steps to deal with the obligations imposed under the legislation. Ignorance of the law is definitely not an excuse for failing to comply with workplace and safety obligations.

As a minimum aged care providers should take the following steps: 1. Review your organisational structure and allocate responsibility for workplace and safety obligations including notification obligations.

2. Identify what policies need to be implemented to ensure that workplace and safety obligations are met including ensuring that you can demonstrate that the due diligence obligations of officers have been met.

3. Ensure that you have undertaken an appropriate assessment of your facilities to identify workplace health and safety risks and to ensure that the PCBU and its

officers have appropriate resources and processes to eliminate and reduce risks.

This should include preparing a workplace health and safety plan for your facilities. It is important to remember that when you are assessing workplace health and safety risk, the assessment must be site specific.

4. That you have appropriate employment arrangements in place to assign responsibility for WHS requirements.

5. Review contracts with suppliers to clarify obligations.

6. Ensure that the PCBU and the officers have appropriate processes in place to receive and consider information about hazards, risks and incidents and to respond to those incidents in a timely manner.

7. Ensuring that the PCBU and the officers (including key personnel) have processes that enable them to demonstrate they have complied with their duties and obligations. For example, reporting incidents, consulting with workers and contractors, providing training and instruction.

8. Review arrangements with third party contractors to ensure that workplace and safety obligations are met and to manage any additional risk created by those arrangements.

The ultimate intention is for the new legislation to reduce regulatory burden and improve workplace health and safety across Australia. The new Act will involve some additional compliance work for approved providers but the obligations imposed (and the penalties for breach) are serious and cannot be disregarded.

Hynes Lawyers are specialists in aged care and in workplace health and safety. We can review your systems and documents to ensure they comply with the changes we have outlined above.

Contact julie.mcstay@hyneslawyers.com.au – aged care and retirement living or kristen.duff@hyneslawyers.com.au – workplace health and safety and industrial relations. n

aca Aged Care Australia | Autumn 2012 | 49

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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 back yard... 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.

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$2,997 With over 8,000 retailers offering discounts and in excess of 20,000 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.

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workforce

Living & Coping with Chronic Pain Mike Swinson, with Elizabeth Lenton from Hall & Prior

J

ust a few days ago I was chatting to Keith Dickinson (who is heading towards his 104th birthday, see the story ‘103 and Not Out’) and he was telling me how he wanted his life to end when he was 98 after he had fallen and injured his back. He was in severe pain and for many months there was little anyone could do.

Keith is better now and his outlook on life is wonderful, but he was adamant when telling me that living with chronic and severe pain made his life a living hell.

Keith is still mentally alert and can chat to you for hours about cricket, football and politics, however many others particularly those suffering from dementia cannot communicate with carer’s or family that they are in pain, sometimes severe pain.

Research tells us that chronic pain can lead to hopelessness, depression, anger and anxiety disorders. Chronic pain sufferers often end up inactive because they fear exacerbating their pain through activity, some becoming socially withdrawn and losing contact with friends, others overweight due to inactivity and/or overeating. It’s worse for those suffering from dementia because for most they cannot communicate with others to share this critical information.

Dr Refshauge presenting Caroline Chisholm’s Director of Nursing Jane Hammon, with their Better Practice Award.

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So for those of you dealing with residents or family with dementia, the award winning work on pain management at both Hall & Prior’s Sirius Cove home in Mosman and Caroline Chisholm in Lane Cove will be of great interest. The program, which includes pain management treatments such as Japanese Tapping Touch and massage, began at both Hall & Prior homes in March 2010.

relief. I started to realise there was more to pain relief than just medication.”

The results have been remarkable, as pain ratings have improved for more than half the residents after six months of treatments under the program.

Elizabeth found research that suggested there were a large percentage of aged care residents who suffered from pain, many more than most carer’s realised, especially residents with dementia.

The story begins with Hall &Prior’s NSW Coordinator for Quality, Safety and Staff Development, Elizabeth Lenton.

“When I started work at Hall & Prior it was evident that the NSW Senior Management Team were interested in implementing a program to help residents, particularly those with dementia who were suffering from chronic pain.”

“I have had an interest in pain for a long time. It started when I became a surgical nurse and was looking after patients who had been through major surgery. When I moved into nursing in aged care and was appointed as the Director of Nursing, I became aware that many people in our care were suffering in silence. They just put up with pain and didn’t grumble about it.”

There is the added challenge of a resident with dementia as they will almost certainly have trouble telling you they are in pain.

As a nurse or carer you see signs, some will get agitated, some become withdrawn and you might think they are depressed, but it could be that they are experiencing high pain levels and that this is what is upsetting them. Hall & Prior’s Pain Management Program is about learning to recognise signs and symptoms, then trying a variety of traditional and non traditional therapies.

“For while I worked with a physiotherapist who taught me about different exercises and pain relief, and we looked at how the neurological pathways worked and how exercise to release serotonin helps with pain

Elizabeth says “so what we do now is to train staff to recognise the signs and symptoms of pain. Once they know what to look for they can quickly determine the best therapy for the resident. We use nontraditional

From left to right: Jennifer O’Connell - NSW Quality, Safety and Staff Development Coordinator; Graeme Prior - CEO Hall & Prior; Kris Healy - NSW Director of Care; Elizabeth Lenton, Dr Refshauge, The Mayor of Lane Cove, Jane Hammon, Senator Concetta Fierravanti-Wel.

Dr Refshauge with Cathy Orie Director of Nursing, Sirius Cove Aged Care Home

treatment for pain, alongside traditional means of controlling pain, so it’s about teaching staff to work outside the square.”

These case studies are revealing.

“Tapping Touch doesn’t exist much here in Australia and most of the research is written in Japanese but in simple terms it is a combination of light tapping combined with music. We also use massage and hot packs with great effect.”

“One of our residents used to get very agitated, his knee got sore whenever he walked and his wife (who we know just adores him!) used to try and comfort him, but because of his dementia he used to be quite rude to her. After a period of Tapping Touch he would be calmer, happier, quieter and could walk easily. So every time his wife would visit the nurses would do a session of Tapping Touch beforehand and this has helped restore their close relationship.”

A female resident with aches and pains in her legs, took up massages and hot packs and after a short period of treatment said to one of her nurses ‘I’m feeling so good now, you are not going to kick me out of here are you?’

It lifted her well being and she felt much better about herself.

Another story involves a resident who when she first came to Hall & Prior was vibrant, very outgoing and social. Then the nurses noticed she wasn’t interacting with others as much and was becoming withdrawn.

It finally got to the point where she refused to leave her room apart from having a shower or going to the toilet. She even refused to see her visitors.

“She was on pain relief medication but noone associated her change of personality with chronic pain. It took a while but once we started her on the natural therapy pain relief program, in close consultation with her GP we could adjust her pain relief medication, and soon she began to improve.

She started with massage and hot packs.

The result was a series of improvements, wanting to read the paper again and see her visitors once more, and now she is back to her old vibrant self. It’s just wonderful and so rewarding to see these sorts of things happen.”

Great people celebrating great care The staff and residents from two of Hall & Prior’s Aged Care homes recently joined relatives and key stakeholders for a Celebration of Care as they were presented with a Better Practice Award from the Aged Care Standards and Accreditation Agency. One of the 41 Better Practice Award recipients, Hall & Prior received the award for their Pain Management Program.

Improvements in pain management were attained at two of Hall & Prior’s New South Wales homes, Caroline Chisholm in Lane Cove and Sirius Cove in Mosman.

These improvements were the result of the introduction of a comprehensive program solely focused on the management of pain.

Elizabeth Lenton, Hall & Prior’s NSW Coordinator of Quality, Safety and Staff Development said that she believed the program was successful as it thinks outside the box. It gives staff a deeper understanding about pain management and different techniques to use to meet the needs of residents.

Jane Hammon and Cathy Orie with their trophy and certificate.

Both events were attended by over 100 stakeholders including; Federal Government representatives, local mayors, councillors, staff, residents, relatives, social workers, general practitioners and industry representatives.

While discussing the success of the events, Ms Lenton added that “anything that promotes quality of life and can be done affordably is important. It’s also very important to share what you have learnt so other people can benefit.”

If you would like more information on the Pain Management Program please contact our NSW office on (02) 9427 8978 or info@hallprior.com.au

The program results have been rewarding.

Within one year of introducing the program, 100 per cent of residents in both homes became participants. Six months after entering the program, more than half of the residents experienced improved pain ratings and 30 per cent had unchanged pain levels, despite 46 per cent of these residents experiencing significant natural progression of a diagnosed disease.

It is because of these positive outcomes that Hall & Prior were presented with the Better Practice Award. An award presentation took place at both aged care homes in early February. Dr Refshauge, a member of the Aged Care Standards and Accreditation Agency board, presented both the Directors of Nursing, “Receiving the Aged Care Standards and Accreditation Agency Better Practice Award has been a wonderful achievement.

It recognises our staff and rewards them for their continued hard work and the quality care they provide to our residents.”

Elizabeth says Hall & Prior have implemented this program in all of its six homes in NSW and are looking to expand the pain management program into its 13 Western Australian homes. n

aca Aged Care Australia | Autumn 2012 | 53

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workforce

Registered nurses, aged care and unsatisfactory professional conduct – Getting back to basics Julie McStay, Hynes Lawyers

A

recent decision by the Nursing and Midwifery Professional Standards Committee of New South Wales (the Committee) provides a timely reminder to aged care providers to ensure that their nursing staff follow good clinical practice.

As the registered nurses (RNs) in this particular decision found, slipping into practices regarded as falling below the standards expected of a reasonable nurse can result in adverse findings being made by a disciplinary tribunal.

In the decision of HCCC v Banks, Boyce, Gossip, Hinchcliffe and Sharp (which was delivered in October 2011) the Committee were called upon to consider whether or not the actions of five RNs had fallen below the standard of care reasonably expected of a nurse of equivalent training and experience.

The conduct of the five nurses was scrutinised by the Committee, which focused on the care that they provided (or failed to provide) to a resident at an aged care facility in a period following an adverse neurological event.

Without exception, each of the five RNs were found to have engaged in unsatisfactory professional conduct. The Committee expressly stated that it was no defence for the nurses to say that they had failed to meet these basic competencies because they were “quite stretched” on the day in question.

The areas in which the nurses’ conduct was scrutinised were areas that you would expect would fall within basic clinical competencies such as:

• c ontacting a medical practitioner after the incident to arrange a review of the resident; • u ndertaking appropriate neurological observations; • e nsuring the resident was provided with adequate pain relief; • k eeping adequate documentation of observations; and • u pdating the care plan as the resident’s condition changed.

All of the nurses were either cautioned or reprimanded and conditions were placed on their registration requiring them to undertake further education. Orders were also made in respect of two of the nurses that they be restricted to supervised practice for a minimum period of one year.

Although the decision does not make any adverse comments about the operation of the facility as a whole, the decision does provide a timely reminder for approved providers to ensure that their nursing staff are following good clinical practices and that the facility has systems in place to ensure that they monitor the practices adopted by nursing staff and address any deficiencies that are identified.

It has been our experience that the areas in which clinical practice in nursing homes seems to most frequently fall are as follows: • f ailing to follow good documentation practices; • f ailing to follow appropriate manual handling techniques;

• failing to ensure that residents in a palliative stage receive appropriate nutrition and hydration; • failing to recognise and manage residents who are having difficulties with their bowels; • failing to make an appropriate call to transfer residents to hospital; • failing to arrange for a timely review by a medical practitioner; and • failing to appropriately record and implement appropriate changes to care plans.

It is incumbent on an approved provider to ensure that they have good systems in place to monitor the clinical competence of their nursing staff and to the extent that any deficiencies are identified, that they implement appropriate training and mentoring for those staff. Approved providers should also ensure that they have appropriate working instructions in all relevant areas of clinical practice and implement appropriate protocols for the management of various conditions particularly for high risk areas.

Hynes Lawyers is able to assist you in developing appropriate processes and systems for your facility. n

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Who is Energy Action?

Energy Action is Australia’s leading independent energy management company offering comprehensive buying and management services for both gas and electricity, aimed at reducing energy usage and saving your aged care facility money.

The coming carbon tax is expected to drive energy costs up by at least 10 per cent for most businesses and aged care facilities are likely to experience the full impact of this. This is because aged care facilities deliver around the clock services, having high energy requirements as a result.

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Independent energy brokers = no agendas An important consideration when dealing with an energy broker is that they are independent and deal with as many retailers as possible.

The more retailers looking to secure your business, the more chance you have of driving down costs. Energy Action have a list of retailers displayed on their website and are frequently in discussions with new entrants to the market.

Energy Action – a full service offering Energy Action is also experienced in providing energy management services including: • Energy monitoring • Power factor correction • Site energy audits • Bill validation • Carbon tax calculator • Tariff analysis • Carbon pricing and impact reports • Sustainability and energy efficiency team

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Wholesale Electricity Price Index (last 12 months)

now rather than later. This is part of the benefits of dealings with an experience and independent energy management company who monitors the energy marketplace on a daily basis – both retail and wholesale.

The Wholesale Electricity Market The wholesale electricity market can be highly volatile and it is difficult to forecast future prices of energy with certainty. The Wholesale Energy Price Index (WEPI) however provides a good indication and insight into market trends and movements.

The main driver of wholesale prices is caused by demand peaks which are generally driven by extreme weather events. Compared to previous years, the past 12 months of wholesale market activity has been relatively stable across all states. The second half of 2010 saw steadily decreasing contract prices driving the WEPI down to record lows. The wholesale market reacted early in 2011 with the WEPI rising high as cyclones, floods and heatwaves hit Australia.

Electricity prices over February eased as most of the Eastern states experienced a cool and wet summer compared to recent years. It is also important to note, the carbon price that was introduced in October 2011 and January 2012 caused a spike in prices across the states. The sudden surge indicates it is a beneficial time for customers to consider securing their future electricity contracts now.

How do I receive my free energy health bill check?

ACAA members and affiliates are eligible to receive a free energy bill health check.

The first step is to contact Energy Action on (03) 9822 5244 or email acaa@energyaction.com.au. Energy Action will require you to send a copy of all pages of your most recent electricity or gas bill. n

Wholesale Electricity Price Index (last 6 years)

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sponsors

Launching ACAA’s brand new Aged Care elearning portal CAA and e3Learning have launched a brand new online training portal and, as part of the launch, have made the nationally recognised Hand Hygiene Australia course available for no charge!

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The new portal provides a central location for low cost, high quality online training relevant to your staff. Create accounts, assign courses and run reports - it’s simple to use and maintains an audit trail for compliance.

“With our brand new online training portal, we are re-confirming our commitment to delivering the highest quality elearning solutions to our members. Having relevant, engaging and affordable training available 24/7 is one way to meet the challenging training requirements of our busy industry”

The portal makes available a range of compliance training, both in the area of aged care and health and in broader compliance areas, such as industrial relations and workplace health and safety. Recent new titles available with immediate application for all aged care facilities include:

Rod Young, CEO, ACAA

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• Work Health and Safety Harmonisation – A quick and easy way to introduce your managers and supervisors to the new OHS/WHS legislation • Basic Life Support – Critical training for all health care workers To provide an introduction to the benefits of online training, right now all ACAA members can setup accounts for their staff and receive access to online hand hygiene training at no cost. To create an account for yourself and your team, and to find out about the other available courses, visit http://acaa.e3learning.com.au If you’re interested at delivering these courses from a portal branded with your company’s branding, or developing a custom online solution, contact e3Learning on (08) 8221 6422 or at info@e3learning.com.au n

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Planning for an inclusive diversity approach in aged care – Developing an understanding of older Lesbian, Gay, Bisexual, Transgender and Intersex people Craig Gear & Corey Irlam

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est practice community and residential aged care service models are based on the principles of holistic care which is planned to meet the individual client or resident’s needs. The principles of access and equity are enshrined within the Community Care Common Standards and the Residential Aged Care Accreditation Standards. Aged Care Providers have long recognised the need to tailor services to the individual needs of clients, particularly those from different diversity groups.

Diversity brings with it personal individuality that is shaped by our experiences, the way that we live our lives, language, family structures, culture and beliefs.

Historically, the diversity focus and diversity training has predominately been around the needs of clients from linguistically and culturally diverse backgrounds, that is people from different ethnographic, language or faith based groups. This has included the identification of the individual needs and life experiences of aboriginal and Torres Strait Islander peoples. Diversity issues and training has focused on the personal and diverse experiences of these potential and actual service users and residents to allow aged care health professionals to support the individual, their social values and their sense of community belonging.

To date, there has been limited recognition within the aged care sector of Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) people as a diversity cohort. The need to recognise the person centred care needs, along with aged care access and equity issues, for LGBTI people has been identified by the Productivity Commission Caring for Older Australians report. The report stated: “Many older gay, lesbian, bisexual, transgender and intersex people have experienced considerable discrimination over the course of their lives and this may continue in aged care where their sexuality and/or gender identity are not recognised or supported in the delivery of aged care services.”

The Productivity Commission recognised the need for greater training to enable more inclusive practices within the aged care sector. They stated, “Initiatives that increase the awareness of LGBTI issues within the aged care industry, such as training for aged care

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workers, are important in creating an environment in which sexual diversity is respected and catered for.”1 An understanding and recognition of LGBTI issues is important in the provision of holistic care for older LGBTI people. This is more than just acknowledgement that older people retain active, healthy and intimate sexual relationships as has been demonstrated by local and overseas studies2, 3, 4. Being LGBTI is not just about a person’s sexual relationships. It is about who they love and who has loved them. It’s about the holistic and passion-filled life they have lived, where they may consider their LGBTI status as only one of the many things that makes them who they are, or may not self-identify as LGBTI at all.

An understanding of sexual orientation, sex and gender diversity in Australia It is important to differentiate the terms and concepts of sexual orientation, gender identity and biological sex. An understanding of

these three terms is important in appreciating people’s life journeys and in facilitating inclusive practice for people who may identify as gay, lesbian, bisexual, transgender or intersex. The term “sexual orientation” is as a generic term describe who a person is attracted to.

It may include people who have had same-sex behaviour, attraction or who self-identify as gay, lesbian and bisexual.

The phrase “gender identity” is used in referring to a person who may identify as being of the opposite gender assigned to them at birth.

This term refers to transgender people who may identify as either male-to-female transgender or female-to-male.

The term “sex” refers to a person’s anatomical or biological attributes.

Intersex refers to human beings whose biological sex cannot be classified as clearly male or female. An intersex person may have the biological attributes of both sexes or lack some of the biological attributes considered necessary to be defined as one or the other sex.

These three groups of people may share similar life experiences of social exclusion but have individual and distinct histories that should not be confused as belonging to the other.

Distinguishing the LGBTI elder population from the Australian population is difficult and debates around this often include the differing terminology and definitions used to describe the diversity

within the LGBTI population itself. Most national statistics do not include appropriate identifiers to distinguish LGBTI people.

In the 1996 Census, 0.2% of Australian adults said they were living with a same-sex partner. By 2006, this had increased to 0.4% (approximately 50,000 people). However, statisticians believe LGBTI people do not report their status for various reasons including that of privacy and personal safety. In addition, these figures only identified one population within the LGBTI community (those living with a same sex partner). To further complicate identifying LGBTI older people, many have lived a lifetime of not identifying their sexual orientation, gender identity or sex identity due to social norms of the era they grew up in and the discrimination faced by them during their formative years.

The Australian Medical Association estimates that approximately 8% of Australians have either had a same-sex experience, had been attracted to someone of the same-sex or identify as LGB. This equates to approximately 1.75 million people6. Based on this study, approximately 1 in 12 Australians are from the LGBTI community.

However, it is important to note that LGBTI population figures are often contested, particularly in relation to older people, for this reason much of the Australian LGBTI population remains hidden.

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In the Australian Study of Health and Relationships 1.6% of men identified as gay and 0.8% of women identified as lesbian, which is 1.2% of all respondents. 0.9% of men and 1.4% of women identified as bisexual, which is 1.1% of all respondents. This equates to a total of 2.3% of respondents who identify as LGB. Nevertheless, 8.6% of men and 15.1% of women reported either same sex attraction or some sexual experience with the same sex. Moreover, half the men and two-thirds of the women who had same sex sexual experience identified as heterosexual. As Smith et al. (2003) point out, these results underline the complexity of human sexuality, and the frequent lack of congruence between behaviours and selfacknowledged identity labels 7.

Despite the challenges with identifying the current and future populations of LGBTI older people a large increase in the demand for aged care services is anticipated consistent with the ageing of the overall population10. Tailored LGBTI aged care awareness training is required to facilitate inclusive and person centred care. For many years most LGBTI people in aged care have remained invisible from the system. On the odd occasion they have popped their heads above the fold, their LGBTI status has often been dismissed with rationales such as “it doesn’t matter who they sleep with, we treat everyone with respect”.

There are no reliable estimates at this time for the numbers of transgender or intersex people in Australia. In relation to transgenderism internationally, Olyslager and Conway (2007) review recent reports from Thailand, the UK and the US and estimate the prevalence of male-to-female transgenderism as at least 1:100 (i.e. 1% of the total population)8.

Whether it is residential aged care, care in the community or services delivered in the person’s own home, for many LGBTI people, a safe and inclusive aged care environment is essential. Understanding that the current generation of LGBTI seniors were coming of age at a time when their sexual orientation and/or sex or gender identity could result in enforced medical/psychiatric ‘cures’, imprisonment, loss of family and friends, rejection by community of faith, loss of employment or loss of housing; is an essential part to understanding the culture and history of LGBTI clients.

A recent unpublished examination of Intersex variations listed in the New South Wales, Victorian and West Australian birth defects registers range between 13 in 1000 and 18.3 in 1000 live births; i.e.

1.3-1.8% of live births9.

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Why LGBTI inclusive practice is important

Essential social change has been occurring within Australia over the last 20 years. This has recognised and removed a number of the previous discriminations in law and practice. However, a recent study

by the Queensland Association of Healthy Communities identified that between 42 – 53% of LGBTI Queenslanders were concerned that aged care services would not recognise same sex partners, nor be inclusive of LGBTI issues or people, Those surveyed held the perception that the aged care providers would hold prejudices or discriminatory attitudes 11.

The survey demonstrated, LGBTI older people continue to have major concerns in relation to institutional discrimination on the basis of their sexual orientation or gender identity. This actual or perceived discrimination impacts on the willingness of older LGBTI to engage with the aged care sector and access to quality aged care12.

An awareness of a clients’ LGBTI cultural heritage and histories is important in providing an inclusive environment. As the industry continues towards a person-centred model of care, practical strategies are required for aged care providers to enable inclusive LGBTI practices in order to better recognise, understand and meet the specific needs of LGBTI people.

There is likely to be an increased visibility of LGBTI clients within the sector. In part, this has been brought about by the financial incentive to declare your same-sex relationship. Changes to the Commonwealth Aged Care Act now mean that clients no longer have to sell their family home, when a same-sex partner remains in the home after our LGBTI client moves into aged care.

In addition, LGBTI baby boomers are increasingly accessing aged care. This group of LGBTI elders are more likely than the generation before them to declare their LGBTI identity and may want it known by service providers. By understanding the lifetime of discrimination that many LGBTI people have overcome, a deeper understanding of the culture that makes up the LGBTI community will be understood and greater social inclusion of the individual client provided.

References 1. Productivity Commission (2011). Caring for Older Australians Report, p266.

2. Lindau, S.T., Schumm, P, et al (2007). A Study of Sexuality and Health among Older Adults in the United States, New England Journal of Medicine, 357:762-774.

3. Ginseberg, T., Pomerantz, S., et al (2005). Sexuality in older adults: behaviours and preferences, Age and Ageing, 34 (5): 475-80.

4. Horden, A.J. & Currow, D.C. (2003), A patient-centred approach to sexuality in the face of a lide limiting illness.

5. OII Australia (2012). Accessed online at www.oiiaustralia.com; accessed 20th Feb. 2012.

6. Australian Medical Association(2002). Sexual Diversity and Gender Identity. Retrieved from http://ama.com.au/node/552.

7. Smith, A.M., Riessel, C.E., Richters, J. et al. (2003). Sex in Australia: sexual identity, sexual attraction and sexual experience among a representative cohort of adults. Australian and New Zealand Journal of Public Health, 27 (2): 155-63.

8. Oyslager, F. & Conway, L. (2007). Paper presented at the WPATH 20th International Symposium, Chicago, Illinois, September 5-8, 2007.

9. Wilson, G., 2011 cited by the National LGBTI Health Alliance, 2011.

10. GRAI and Curtin Health Innovation Research Institute 2010; Harrison, J. and Irlam, CB. 2010 11. Queensland Association of Healthy Communities (2008). The Young, The Ageing and the Restless Survey.

12. McNair, R. & Harrison J. (2002) Life Stages within the GLBTI Communities” in What’s the Difference?,. Gay and Lesbian Issues and Psychology Review. The Australian Psychological Society Ltd: Melbourne, Victoria.

A number of aged care providers have educated themselves and their staff on inclusive practices. This has included the language used within and about the LGBTI community, revisions of policies, inclusive language within forms and updated intake processes. A number of guidelines and frameworks exist to guide providers on LGBTI inclusive practice and a recent pilot project by the Australian Government Department of Health and Ageing has demonstrated the effectiveness of LGBTI aged care awareness training for aged care direct care staff.

The next issue will explore some of elements and strategies available to aged care providers to further enhance their person-centred care approaches and the ability to provide an LGBTI inclusive aged care service.

Craig Gear and Corey Irlam were involved in the LGBTI Aged Care Cultural Awareness Project run by ACON (Australia’s largest LGBTI and HIV health organisation) in partnership with ACS NSW/ACT, thanks to funding from the Department of Health and Ageing. The project piloted an education training program on raising awareness of LGBTI people in aged care. If you would like more information about providing appropriate services for LGBTI people in aged care you can contact ACON on 02-9206-2000 or via email ageing@acon.org.au n

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A new choice for older Australians Rod Young, CEO ACAA

This month I had the privilege of meeting with someone who looks at Aged Care from a completely different perspective.

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amar Krebs, Managing Director of Group Homes Australia, has taken the initiative to look for what she sees as a “A new choice for older Australians”,

Is there benefit in bigger facilities compared to smaller facilities besides the economies of scale for the business?

For Tamar, the journey began after commissioning and managing Dementia units at a state of the art Aged Care facility in the Eastern Suburb of Sydney for 5 years.

What do we do with people that are isolated in their homes?

Tamar says, “I believe people should age in their own community surrounded by their families, social networks and familiar environments.

People spend their entire life establishing themselves in their communities as valued members and soon after they become frail and when they are in need of support we send them off to an Aged Care facility often out of their local area.

Rod Young: What do you see as the alternative?

Tamar Krebs: I began looking at models overseas- UK, Netherlands, Scandinavia, the USA and Japan. It seems that the trend is that people want to stay in their communities and stay involved in their communities living in smaller scale homes. The majority of older people do not wish to age in an Aged Care facility if they have an alternative. This landscape is similar for the up and coming ageing baby boomer generation.

I looked at the current models that exist in Australia; I began to question the Aged care industry.

Is there an opportunity to capture and celebrate cultural diversity in the ageing population?

Can we create a new choice for older Australians?

I wanted a model that empowers people to stay active and participate in their communities regardless of declining cognition or physical frailty. I wanted a model that focuses on people’s abilities to engage and participate in life as much as they choose to, not have it dictated to them. I wanted a model that focused on meaningful relationships with family friends and pets. I wanted a model that celebrates peoples differences.

Rod Young: How can you amalgamate all of that into a Model of Care?

How do Australians wish to age?

Tamar Krebs: I believe with a purpose built environment, a program that empowers and enables choice with a strong emphasis on the “GHA WAY” our education program for the guiding Staff, our Residents will flourish.

Why do we look at and treat ageing like a disease?

The ‘Group Homes Australia’ home is a self–contained residence, designed as a private

What do people want?

freestanding house, with all of the “Ageing in Place” amenities It accommodates between 7 and 10 ageing people, each with his or her own bedroom and full bathroom.

The physical space is not meant to be “homelike,” but to be a home.

This model will provide a whole new dimension when it comes to choosing accommodation for Ageing Australians. n

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Age Well Campaign ACAA are seeking industry participation and support in registering your interest on the Age Well website and circulating the site to friends and relatives who are also asked to consider supporting the Age Well Campaign.

Age Well Campaign Media Release Blueprint shows the way to avert aged care crisis Australia’s looming aged care crisis can only be averted if the Federal Government commits to aged care reform in 2012, leading aged care sector groups have said.

Releasing the Australians Deserve to Age Well Blueprint for Reform, the 28 members of the National Aged Care Alliance outlined the list of priorities for critical aged care reform over the next 12 months.

COTA Chief Executive Ian Yates said that by 2041 almost one quarter of the Australian population would be aged 65 or older.

“Without reform, this big increase will leave future generations to foot the bill and we’ll see a shortfall in the quality and availability of services,” Mr Yates said.

“Older people are calling for more support, workers are leaving aged care because they feel undervalued, and providers are frustrated because the current system doesn’t support them to meet the needs of the communities in which they work.

“The Australians Deserve to Age Well Blueprint for Reform outlines a way for Government to responsibly prepare for our future starting in 2012 - before the situation gets any worse.”

Priorities include: • a timetable for reform; • a simple entitlement-based system; • a one stop shop for aged care information and assessment; • greater choice and consistency for people to fund the care they need; • the Aged Care Commission to guarantee service quality; • an independent cost of care study;

• dementia risk reduction and research; and • a high-level Aged Care Reform Council to drive the reform process.

Rod Young, CEO, Aged Care Association Australia urged the Gillard Government to uphold its commitment to reform in this term.

“It has now been seven months since the Productivity Commission findings were delivered. In the meantime older people struggle to get in-home care and respite services, we’re not building enough facilities to keep up with future demand and anyone trying to navigate the system is left frustrated and fed up.

“It’s time we saw bipartisan support on this issue and a long term plan for the future,” Mr Young said.

Louise Tarrant, National Secretary, United Voice, said the quality of aged care was in serious jeopardy unless reform addressed the wages and conditions of aged care workers.

“Staff turnover now runs from 25 per cent to 45 per cent annually,” Ms Tarrant said.

“How will we possibly attract the predicted 500,000 more workers we’ll need by 2050 if we can’t even keep the ones we have now?

“It is time our aged care workers got the recognition they deserve and were made a priority in aged care reform.”

Glenn Rees, CEO Alzheimers Australia, said there needed to be greater recognition of the need to plan for the dementia epidemic.

“Right now there are 280,000 Australians with dementia. By 2050 this is expected to be close to one million,” Mr Rees said.

“Over 50 per cent of those in residential care have dementia, a number that far exceeds the resources available to provide specialist care.

“We must invest in dementia risk reduction and research now to reduce the numbers of people with dementia in the future.” n

The National Aged Care Alliance is a representative body of peak organisations in aged care, including consumer groups, providers, unions and health professionals, working together to determine a more positive future for aged care in Australia. www.agewellcampaign.com.au

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We’re here to help protect your healthcare facility With delicate medical equipment, large facilities and many less mobile residents, the healthcare sector requires highly specialised fire protection solutions.

With Wormald, you have an organisation that is always right behind you when you need us most. We’ve helped prevent and protect against fires for over 120 years.

From emergency evacuations plans, fire detection and suppression solutions, to staff training and tailored system design, Wormald’s specialist teams can design, install and maintain fire systems to match your needs and budget.

So, you can get on with providing care, confident that your staff, patients and facilities are supported by one of the world’s fire safety leaders. That’s peace of mind.

Trust the healthcare fire safety experts.

Call 1300 556 015, email wormald.ads@tycoint.com or visit wormald.com.au/healthcare

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From July 2012, Australians can choose to register for a personally controlled electronic health record

The national eHealth record system will provide access to key health information drawn from local clinical information systems. With your patient’s consent, this information can be quickly and securely shared with other healthcare professionals involved in their care.

An eHealth record is expected to particularly benefit Australians aged over 65, and those living with complex and chronic conditions. People will have their own section in their eHealth record to enter demographic and basic healthcare information, including the location of their advanced care directive.

Over time the record will provide access to a patient’s current health summary, updated medications, test results and treatment plans. This will provide additional value for people within the community and residential care settings.

July 2012 is just the starting point for the eHealth record system. The more healthcare organisations that participate, the better connected the network will become, and the better it will serve you and your patients.

If patients wish they can share their health information with family members, carers or other trusted people.

People who travel will be able to access their record wherever they go within Australia as their healthcare information will travel with them.

For more information or to sign up to receive regular updates visit www.yourhealth.gov.au or call the Helpline 1300 901 001

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“Using Our Clinical Expertise�

The Nursing and Management Professional Advisory Committee (NAMPAC) is the clinical advisory group that supports the work of ACAA by giving considered professional nurse/clinician/professional advice to the Association and to its governance activities.

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here is no doubt that aged care has as its major component of service delivery the provision of quality nursing and care services.

ACAA has for many years, recognised that there is a pressing and ongoing need for the organisation to recognise the expertise that exists amongst members and to ensure that expertise is garnered and used efficiently in assisting in making appropriate decisions regarding the future of the organisation and the industry more broadly. All members are state representatives of the clinicians working within the age care sector and hence are reliant that the views expressed are representative of the people within our states and as such are only as relevant and effective as the feedback we receive.

NAMPAC is made up of the chairs or representatives of like organisations from each state jurisdiction.

The members of the federal NAMPAC committee are:

Mary Anne Edwards (Chair)

Pam Bridges (Qld)

Deborah Key (NSW)

Kate Hough (Vic)

Florence Padman (SA)

David Cox (WA)

Rod Young (Federal and Secretariat) Mary Anne Edwards is an aged care provider from Mackay in Northern Qld and a director of Aged Care Qld and ACAA Federal.

Mary Anne would describe the work of NAMPAC as critical in ensuring that the decision making of the organisation and the industry recognises its core values and core services in providing informed decision making about issues that are central to how the industry functions and central to the role of an association representing the interests of its members.

Mary Anne also strongly suggests that senior clinicians across the industry consider greater engagement in their respective nursing and professional advisory groups at state level to ensure that there is ongoing and high standard discussion and debate amongst colleagues about the issues impacting the industry and that

appropriate forums are utilised to ensure that nurses exchange their views regarding clinical practice, clinical governance and best practice service provision from which we can all learn and improve the way in which we provide care and services to our older Australians.

Pam Bridges who will be known to many across the industry, is in her fourteenth year as President/Chair of the Nursing Issues Management Advisory Committee (NIMAC) in Qld and has an ongoing desire and passion for supporting clinical practice within the industry.

Kate Hough is the clinical advisor at Aged and Community Care Victoria and has come with a strong background in facility management and clinical practice from across the industry.

Florence Padman is an owner/operator of fourteen facilities in SA and Qld and is a passionate advocate for excellence within the industry.

David Cox is the managing director of Embleton Care in Western Australia and is on the board of ACAA WA. Deborah Key is the Director of Nursing at St Luke’s Care in NSW and is responsible for the clinical governance of the hospital, aged care facility and community home care and has over 20 years experience in health management.

The national NAMPAC Committee is formed by the coming together of the chairs of the various state organisations plus a federal director and federal CEO. As you can see from this representation, the clinical expertise and capability of NAMPAC in influencing the decision making of the organisation, particularly issues regarding clinical practice is crucial to the long term benefit of the industry and for the Association.

ACAA would like to recognise and strongly applaud the contribution that the various clinical committees throughout the federation and to suggest that any clinicians who would like to get involved at state level, please make contact with your respective state organisation and arrange to join the committee and benefit from the exchanges of information and the opportunity to discuss broad ranging policy issues across this industry of which we are all fond and proud. n

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2012 Study Tour Program STUDYING & ADVANCING GLOBAL ELDERCARE

China

Registrations Now Open

With an ageing Chinese population, a rising middle class,

2nd - 13th June 2012

improving regulatory frameworks and increased interest from international investors in the sector, interest in aged care development in China has never been stronger.

An intensive ten day tour exploring seniors living operations and business opportunities in Shanghai, Tianjin and Beijing

Experience an intensive program of networking, study sessions, workshops, discussions and facilities tours around Beijing, Shanghai and visit Tianjin Mall the first and

Early Bird Price available until 14 April 2012 – save $350

largest Trade centre for the elderly and disabled in China.

Visit sagetours.com.au for full details.

available to Australian operators.

Europe

20th - 26th September 2012 study tour to Belgium, Luxembourg & Germany with optional tour extension to EAHSA conference in Malta

Delegates will gain essential insights into the current status of the Chinese seniors housing market and the opportunities

Delegates will gain access to the CEOs and facilities managers of leading seniors living organisations,

visit

innovative

facilities and gain an understanding of the business models and organisational structures that support them. Delegates will visit facilities and participate in round-table discussions, building valuable networks with continental counterparts.

Site

visits

are

selected

to

showcase

organisations

demonstrating outstanding approaches to service delivery,

Special Release Price available until 30 March 2012. Save $750.

use of new technology or that incorporate advanced

Visit sagetours.com.au for full details.

offering the full continuum of seniors living.

design features. Facilities will include a mix of commercial developments, institutional and community based settings

for more information or to register to attend visit www.sagetours.com.au or contact Judy Martin jmartin@agedcare.org.au SAGE study tours are a partnership between: Supported by:

a specialist design practice.

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China tour

China tour

Europe tour

general

Sage and Sodexo Strengthening a Global Alliance Sodexo was the proud and exclusive sponsor of a cocktail evening during the 2011 IAHSA/Leading Age conference in Washington DC, October 2011

S

odexo designed the evening to provide the 90 delegates who attended a space to network, share experience and knowledge within a relaxed and social environment.

In his opening remarks, Pat Connolly, Seniors Market Champion, SAGE noted; “Sodexo is committed to the Seniors sector and to improving the quality of daily life of the residents that we serve. We provide on-site service solutions for Seniors in over 2,900 sites across 24 countries.

This experience has allowed us to gain a robust understanding of the challenges and opportunities faced by our clients. It is through initiatives like this that we are able to leverage that global expertise to deliver tailored solutions that improve both client and resident outcomes.”

Yvonne Webley, National Business Development Executive ~ Seniors & Healthcare, Sodexo Australia commented on the overall experience;

Key Facts about Sodexo: Credibility & Commitment Sodexo understand that credibility is key for providers of [Aged Care] services.

As the largest provider of services to the [Aged Care] market globally, Sodexo has earned its credibility in the industry but providing consistently high service levels.

Resident Satisfaction

Sodexo understands that resident satisfaction play an important part of the ongoing success of any [Aged Care] providers. As a business partner, Sodexo guarantees to ensure it only adds to the positive experience of all residents, staff and guests.

Best practice - Globally

As part of a global provider of [Aged Care], Sodexo Australia has to access to best practices from around the world.

“Sodexo appreciated the opportunity to sponsor and host the cocktail evening and all feedback indicated that it was a highly successful event. From my perspective it gave me the opportunity to;

Current initiatives: ‘Sodexo Cares’ is a Sodexo initiative in the USA which has developed a culture of service specifically for Sodexo’s [Aged Care] service providers. Sodexo Australia is excited to be taking steps to access this program and bring it to Australian market.

• Meet industry professionals from around the world on a face to face basis and build a platform for the continuous exchange of ideas, innovations, business models, etc; and • Collaborate with my global Sodexo colleagues and gain a deeper understanding of their challenges, experiences and elder care programs.

The opportunity to build global alliances and collaborate globally was second to none. As a direct result of the conference and cocktail evening, Yvonne identified several initiatives that will be rolled out at Sodexo Australia during 2012. This will only serve to add to Sodexo’s rich global experience and well deserved brand it has built as the [largest] provider of services in the [Aged Care] global market.

Partnership Approach

The Sodexo approach, put simply is partnership. Sodexo seeks synergy with clients and ultimately the opportunity to add clearly defined value.

Sodexo will then draw from its substantial resources of people – subject matter experts across multiple fields, to design, manage and deliver personalised solutions.

The Leading Age Conference offered some interesting and thought provoking concepts, but again it was the SAGE TOUR which presented us with ideas, concepts and innovations we will be able to incorporate into our services here in Australia. n

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Aged Care – your place or mine For many people the move to residential aged care is not the first move they make to seek assistance with their care needs. And when we look at the statistics we can see that the majority of people who receive aged care services are not receiving these in permanent residential aged care. There are over 1 million people in Australia who receive aged care services and support, of which, around 215,000 receive care in permanent residential aged care. The role of informal carers is vital, in fact, Access Economics estimated in 2010 that if informal care (including to the frail aged) were to be replaced with formal paid care, the cost would exceed $40bn per annum.

T

his article is the first in a 4 part series that will examine the different legal and financial arrangements that people enter into – sometimes without realising – in meeting their need for care.

in exchange for a right of occupancy in a residential property.

“Mum’s very happy in her own little granny flat.” Sounds like the perfect arrangement for many families, with Mum – or Dad or both parents – enjoying their own private space but within the property occupied by an adult child who is close at hand should they need help. But such an arrangement embodies significant legal and financial implications for social security and can impact on the cost of residential aged care if required down the track.

1. Th e parents sell their home and pay for a self-contained unit to be built on the children’s property or cover the cost of modifications to the existing home.

Many people think of a granny flat as a small flat built in the backyard or semi-detached to the main home but a granny flat – and with it what is known as a granny flat right or granny flat life interest – can be established within an existing home. Often these arrangements are established when parent’s move in with their children and the children modify the home to enable them to receive assistance and move around safely.

A granny flat right is typically an arrangement made within a family where accommodation is provided in exchange for a payment or transfer of assets. Under social security provisions individuals are allowed to transfer assets in excess of the gifting limits

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There are three ways in which a granny flat right or life interest can be established:

2. The parents remain living in their home and have the children move in to provide companionship and care and transfer the title of the home to the children.

3. B oth the parents and the children sell their existing homes and purchase a new home in the children’s names.

Note: If the parents retain or have ownership of the property a granny flat right or life interest has NOT been established.

Payment for a granny flat right is essentially the purchase of a new Principal Place of Residence (PPR). The amount paid is an exempt asset and the determination of homeowner or non-homeowner status is based on the amount paid and whether or not it exceeds the entry contribution allowed amount under Centrelink’s assets test provisions.

If the former home is sold and exchanged for the granny flat right, then pension entitlement would remain unchanged as the asset position would remain the same. If the proceeds from the sale of the home and assets outside the home are used to purchase the granny flat, then pension entitlement would likely increase. However there are limits around this and once the limits are exceeded the amount above the limit will be treated as a gift.

So, how much is too much?

Generally speaking the amount paid for a granny flat right or life interest is considered to be the market price. This is because they are family arrangements and it can be difficult

to place a value on them. However, a reasonableness test will be applied if: • Someone transfers the title to their home (or purchases property in another person’s name) and transfers additional assets • Someone pays for the cost of construction and transfers additional assets • It is considered that the person is establishing a granny flat right to gain a social security advantage.

The reasonableness test amount is calculated by multiplying the combined annual couple rate of pension (on the date the right was established) by the relevant conversion factor.

The relevant conversion factor is available from Centrelink and will depend on the age of the person (or the youngest member of the couple) next birthday. For example, the relevant conversion factor for someone who is 79 next birthday is 10.25 (10.25 x $29,354 = $300,878.50).

While the idea of the family looking after their ageing members is certainly not a new concept, the complexities of such arrangements are often overlooked. What will happen if the children wish to go on holidays? What will happen if the parent’s care needs change and they cannot be safely looked after in the home? Who should pay for the cost of care? Will the parent make a contribution to household expenses such as food, utilities and insurance? Of course if the living arrangement continues for many years it may be necessary to consider what the consequences would be if the adult children divorce or if one of those caring for the parent became ill or passed away. While the obvious answers to increasing care needs may be to seek assistance through care packages, respite stays or even permanent residential aged care often these options have never been discussed and contradict the parent’s expectations.

RACHEL LANE is the CEO of Aged Care Specialists P/L Having worked in financial services for 12 years and as a specialist in aged care for the past seven years, she is well known and respected within these industries, particularly for providing advice on the structuring of assets and income for aged care residents. Prior to joining Aged Care Specialists, Rachel held the position of Executive Manager, Aged Care Solutions for Colonial First State.

She regularly facilitates workshops for Aged Care Association Australia (ACAA ), and is highly sought after as a presenter at aged care conferences and seminars around the country.

Rachel has a Masters degree in Financial Planning and has co-authored a book titled “Aged Care, Who Cares; Where, How and How Much” with Noel Whittaker. established and the reason that they need to leave would have been anticipated at the time the granny flat right was established, the value of the granny flat right will be considered a deprived asset. This means that the asset value can be assessed for determining the maximum amount of accommodation bond

or charge payable, and because it is deemed to earn interest an Income Tested Fee may be applicable.

You can read more about Granny Flat Right and Life Interests in the book “Aged Care, Who Cares; Where, How and How Much”

by Rachel Lane and Noel Whittaker. n

Because in many cases the purchase of the granny flat right is coming from the sale of the family home (or the transfer of the home) disputes often erupt amongst siblings who, although happy to concede that they are unable or unwilling to look after their ageing parents, have a vested interest in the family home as the largest asset in the future estate.

For people who think that residential aged care will be required in the future it is important to be aware: if someone needs to vacate a granny flat within 5 years of it being

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It Pays to Plan as the The Flood Survival Stories Continue Mike Swinson

‘This is a time when you need people who know what to do, who get on and do it and don’t complain, and that’s the sort of people we had!’

Words of praise for the staff of the Pine Lodge Aged Care facility at Rocklea in Brisbane from its CEO, Serge Voloschenko.

T

he staff at Pine Lodge had planned for the worst and when the floods in Brisbane hit, the worst happened, as almost a metre of water surged through the buildings. Very little was saved, just

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the essentials as staff did not have time or facilities to get beds and furniture to safety.

Many facility CEO’s say that the most important lesson to be learnt from these disasters is that you must have a clear, concise and easy to follow emergency plan for all

events. Serge Voloschenko says his team followed their emergency evacuation plan, then pulled together to achieve a fast rebuild with the help and support of their insurance company, residents families and others. It was only four months after the event that the first resident returned to what looked like a brand new facility.

News Flash: The Eden Magnet: Today, March 1st, 2012. Several parts of the Princes Highway and other main roads have been closed and some aged care residents were evacuated

because of flooding in the Eden area on Thursday evening.

were inundated last year, some for the third time

A number of aged care residents at Eden Community Aged Care were evacuated to Nullica Lodge and the homes of their relatives at around 4 pm today when water rose into the building through the drainage system.

‘We are used to the wet now, I’ve got webbed feet!’ laughs a local from St George. Not a word of complaint, just a typical Australian attitude of ‘she’ll be right mate, we will get on and fix it up.’

Warrawee Aged Care Services in the small Queensland town of St George faces a tough task ahead. It also has been flooded but this time the damage is serious and it will be a long time before residents are back home.

For me, as someone living in Tasmania, far removed from cyclones, fires and floods, it was the images of aged care residents being evacuated any way possible that has stayed with me most. I seem to remember one image of a front end loader being used to shift one wheelchair bound resident into the back of a waiting truck to get her to safety. Thankfully ingenuity is alive and well!

The past few years have provided us with many graphic images of unfolding tragedy, as fires swept through Victoria after years of drought. Then followed cyclones in North Queensland with Innisfail copping a double whammy. Just when people thought that was an end to the bad news, floods inundated areas of Queensland and Victoria to be followed by more floods and now St George has been inundated for the third time in two years. The floods are now re-visiting areas that

‘Getting our residents back here was our first priority,’ said Serge Voloschenko. ‘We had a great team of people to do that and we succeeded. We have spent well over a million dollars but the facility looks great, almost brand new, with new beds and furniture.’

News Flash: March 1st,2012. “Flood waters from Southern Queensland and North Western NSW are extending along on the Barwon River System. As a result of major flooding …… community members of North Brewarrina (The Billabong) should prepare to evacuate if instructed to do so.” SES Incident Controller Graeme Craig.

The Bourke Shire President, Geoff Wise said Bourke, its residents and its one aged care facility are all safe.

“The Darling river is expected to peak at 13.9 metres and our levee banks are 15 metres high, the only threat is if we get heavy local rain and inside the levee’s fills with water, that will test our pumps!” The water won’t stop at Bourke, it’s on its way further South, down the Darling River system then into the Murray.

At Warrawee in St George, when the water came again recently it was the third time in two years. That means residents whose ages ranged from the late sixties to mid nineties had to be moved, transported away again, in a

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Hercules in the last case, and are now all but one being cared for around the Gold Coast in other Churches of Christ facilities.

It was the army that threw many a shoulder to the wheel as over 70 members of the Australian Defence Force helped clean up the flood damaged facility. In little over one day, they had totally cleaned it out and removed the ruined furniture to the tip. Luckily most resident’s personal possessions were saved.

Warrawee is a part of Churches of Christ Aged Care Queensland, its CEO Dean Phelan said recently ‘the 34 people who call Warrawee home will be separated from their families, local community and support networks for an extended period.’

Damage to Warrawee is significant and even though it is fully insured, bathrooms will have to be replaced, some walls and support structures, electrical cables as the list grows ever longer. The damage was made worse by water inundation that was contaminated by sewage from the flooded treatment plant.

Churches of Christ Aged Care has a close working relationship with a Brisbane based builder, NCM and they will take on the task of re-building Warrawee. Will it be higher off

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the ground do I hear you ask? The answer is no, because that would mean demolishing the old facility down to ground level and starting again, a very, very expensive option.

As I write this story 75% of NSW is on flood watch, with decisions about evacuations for towns like Cooma, Goulburn and Cowra likely in the next 24 hours. That means more aged care facilities emergency evacuation procedures will surely be tested.

News Flash: March 2nd, 2012. Bureau of Meteorology, NSW. Severe Weather Warning for flash flooding for people in the Upper Western, Riverina, Lower Western, Central West Slopes & Plains, South West Slopes, Hunter and Central Tablelands forecast districts. Locations that may be impacted include Parkes, Mudgee, Bathurst, Dubbo, Cobar and Bourke.

Let’s hope that rain falls outside the levee’s in the town of Bourke! n

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Laughter has always been the Best Medicine Mike Swinson

“Every Wednesday when we ran the theatre workshops in a room next to my office, I will never forget the laughter that used to fill the corridor. It’s not the sort of thing you usually expect from a group of people with dementia.”

T

hat’s the defining memory of Tarnya Daniels, the Community Services Manager for the BCS Community Services Care Centre in the Northern Rivers area of NSW.

herself teaching stand up comedy to people with dementia.

“The laughter was coming from 20 dementia clients and was a part of our program of improvised performance, role playing and theatre sports,” she said.

Mandy had been asked to work with a bunch of ‘older’ people during Seniors week, that was it, nothing else. So Mandy turned up at the BCS run local Community Care Centre to find a bunch of people, all with dementia who had been delivered to the day care centre to participate in ‘activities.’

This is a remarkable story and not to be confused with the equally successful project ‘The Smile Within,’ being used extensively through the Whiddon Group of facilities.

She had been teaching comedy for about 15 years and already had a set routine, so she thought, “I’m very good at pretending I know what’s going on, so here goes!”

The background to this story is wonderful, of how the world works in the most mysterious ways.

“I started by asking questions, as you do with ordinary folk, that didn’t work at all, blank stares was all I got. Finally, after a few weeks of trying and feeling really inadequate, I had a little epiphany, and I realised I had to work

It’s set in Alstoneville, near Ballina where one day four years ago Mandy Nolan; a stand up comedian of many years experience, found

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‘in the moment’ and I did and it’s worked,” she said.

Mandy said “I realised what to do when I showed one older bloke a picture of another man and said, Fred, this bloke borrowed fifty bucks from you once and he’s never paid you back, what do you want to say to him?

And Fred went right off, he was right in the moment, knew what he wanted to say and everyone else did too, laughter filled the room, then I got it!”

She would teach at the weekly seminar then come home and talk to her partner John, who, as it turned out, works in the aged care space and dementia research at Southern Cross University.

John said ‘I watched this project develop over the eight weeks and was astounded at how the participants were benefitting from it, socially and with therapeutic benefits as well.

Not only that but it is fun and engaging for all concerned. I have seen people doing things that their carer’s thought they couldn’t do anymore!’

According to Tarnya Daniels, the benefits of this drama therapy are endless, “let me tell

you about ‘Mary,’ she says. Mary suffers from dementia; she is looked after by her husband.

After participating in these workshops her husband told me that ‘Mary was laughing when at home and she hasn’t done that for years!’ It’s enough to bring tears to your eyes.”

Tarnya says she has been told that clients have uplifted moods, are happier, more content, show fewer signs of agitated behaviour and less stress.

According to John and Mandy it is all about the power of laughter, of dementia sufferers being happy in the moment, because that’s where most of them live their lives, in the moment.

“We are getting tremendous feedback from family members and others about the program’s benefits, our staff love it, it’s the benefit of laughter in the moment and it lasts for days,” says Tarnya.

The program has also attracted the attention of filmmaker and media identity George Negus, who teamed up with local film teachers Russell Burton and Anne Chesher from the Byron Bay School of Audio Engineering. That project is still in the making.

The end result of eight weeks of workshops was this group of ‘oldies with dementia’ staging a comedy event at the Lismore to an audience of over 1000!

That’s right, do a double take, sit and think about this, the performers were the oldies with dementia! All doing comedy routines!

Associate Professor John Stevens said the performance was outstanding; the audience loved it, they cheered and clapped and the hall was filled with laughter.

The moment he will never forget was when one old dear, in her nineties delivered her lines. Her plot was a comedy routine was about how two men were romantically interested in her. Some lark in the audience yelled out a question; ‘How will you choose between them?’

Quick as a flash answer: ‘The one who takes the longest with me, is the one I will choose!’

The house roared and she did too.

After the performance one family carer told John she was amazed, she said after watching her mother deliver this almost operatic routine, ‘My Mum hasn’t spoken for two years so how did you get her to do this?’ Tears filled her eyes.

The thing that amazes John is that these people all have dementia, “how did they learn their lines, how did they manage to interpret humour, to ‘get’ the many jokes in the various comedy routines. I think we need some serious neurological research into the impact of comedy on brain function of those having to live with dementia.”

So the journey has begun.

The history of the program as described by the local newspaper, the Northern Star said:

“Byron Bay comedian Mandy Nolan started doing stand-up gigs for people suffering dementia to entertain, but instead she accidentally created a new form of therapy.

Four years after she started working with dementia sufferers, Ms Nolan developed a program of improvised performance, role playing and theatre sports that has been so successful veteran journalist George Negus is helping put together a documentary on it.

‘It is really surprising because it was something I was making up as I went along,’ Ms Nolan said.

Mandy has been funded to train care staff, 20 so far, stretching from Darwin to SA and Canberra to deliver this comedy routine to those they care for. She says the type of person suited to this work has to have the drive to perform, to understand drama and comedy and how to teach it, so it’s not suited to everyone.

Meanwhile John has been funded to research the effectiveness of the program. Already he knows that there have been improvements in sociability, in short term memory, in confidence and communication. His detailed findings are due soon. Watch this space!

Contacts Tarnya Daniels at BCS Community Care Centre in Alstonville, 02 6698 5700.

Associate Professor John Stevens and Mandy Nolan at Southern Cross University Lismore campus, 02 6620 3306. n

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Making the Most out of Life Or

UTAS study highlights the benefits of utilising respite care Mike Swinson

Loneliness and social isolation can be a debilitating and soul destroying part of growing old in our community. So any program or activity that puts people in touch with other people, that reduces loneliness and isolation, is a real positive.

F

or carers searching for facilities that provide respite care, social interaction and meaningful activities, the problem is, how do you assess the performance of each respite care provider?

Glenorchy based Glenview Community Services wanted to find out how effective their respite care service (Bisdee House) was, for carers and those who attend.

The study was conducted by The University of Tasmania’s Dr Christine Stirling, Senior Lecturer, School of Nursing and Midwifery and Dr Sharon Andrews, Research Fellow of the UTAS Wicking Dementia Research and Education Centre.

‘The findings of this study are revealing and fascinating, from both a carer’s perspective and the person who they look after and who goes to the Bisdee respite centre,’ said Dr Stirling.

‘For me, some of the most important findings are that carer’s say it is really important that the person they look after has a good time at Bisdee, that they are safe, that they are involved in meaningful activities and that the staff are trusted and respected.’

Meet Arthur, a typical larrikin Australian with a twinkle in his eye, even at the tender age of 75. Arthur is married to Pam and both have health issues. Arthur had a mild stroke that

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leaves him ‘muddle headed!’ as he describes it. Pam had a fall recently and seriously injured her shoulder. Each needs the other to stay living at home. Pam is the only one still driving and they survive on the pension.

One of the few outings Arthur enjoys is when Pam takes him to the Men’s Shed at Bisdee House, operated by Glenview Community Services. Pam leaves Arthur there for 4 hours and takes the chance to go and visit her parents who are in a nearby aged care facility.

Pam says these visits are a life saver for Arthur, who she says was a workaholic before the stroke.

‘He would stay outside working and not come in to eat till 11.00 pm at night! After the stroke he lost everything, as he already suffered from Obsessive Compulsive Disorder and Depression.’

Arthur says he can’t go walking anymore because his mate down the road died and if he walks on his own ‘I think too much and without someone to talk to my head gets muddled and I get depressed! That’s why my visits to the Men’s Shed are so important to me.’

The UTAS study findings showed that caregivers trust and respect the staff at Bisdee, describing them as dedicated, friendly and patient. It also shows that guests are more positive about life, are happier and feel useful after their visits.

For Arthur the visits to the Men’s Shed are a lifeline. ‘I can do stuff there! First I will say good day to my mates, we sit and chat, then I might get up and go and do something, use the bandsaw or the lathe. I have used woodworking equipment all my life and I love my time there.’

Pam says since Arthur started his visits to the shed, ‘he is more interested in doing all sorts of things, like gardening. I have seen a real improvement in his speech and attitude to life!’

Rhea Ahlanu, a Bisdee Support worker says the men’s shed has been one of Bisdee’s most successful programs, ‘We see men coming in and forming a really tight network of friends, in an environment that is or seems to be naturally male and they are really supportive of one another in that exclusively male way!’

Rhea says the findings of the UTAS research project support what she sees on a daily basis.

‘We see men going back to doing things that they either hadn’t done before or had done a long time ago, we watch as self esteem and confidence levels rise, it’s great!’

‘I see people whose lives blossom, they come in and are so excited to be here, it is the highlight of their week. It seems to make their lives much more worthwhile,’ she says. n

‘I think for me,’ said Dr Stirling, ‘the study revealed that social interaction is a key ingredient in successful respite services. We all know it’s supposed to be good for you, but I don’t think a lot of people understand it’s critical importance in adding value to older people’s lives, particularly when they might otherwise be living at home alone or be at home most of the time.’

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Disability Access Implications For Aged Care Facility Owners and Providers Mark Lewis

O

ne of the major changes to impact on the Built Environment in recent times has been the improvements to the commonality of the disability access provisions for buildings in the Building Code of Australia (BCA) and the Disability (Access to Premises – Buildings) Standards 2010. These enhancements have substantially harmonised the BCA with the Disability Discrimination Act, and as a result, the integration of the disability access code with the BCA carries significant implications for building owners and tenants generally.

While Aged Care facilities tend to be better designed for mobility needs and access due to their design intent and the needs of their occupants, Aged Care facility owners and providers may also find that additional Disability Access requirements need to be met if new buildings or alterations to existing buildings are planned.

The Premises Standards contain detailed disability access information specifying the circumstances and types of building where the Standards apply, and they apply to a new building, a new part of an existing building, and the affected part of an existing building.

Disability Access Terminology For disability access, the affected part of a building means: • t he principal pedestrian entrance of an existing building that contains a new part and • a ny part of an existing building that contains a new part, that is necessary to provide a continuous accessible path of travel from the entrance to the new part.

Generally speaking, the affected part of a building must comply with the new access requirements where alterations and/or additions are proposed to an existing building, and the proposed work is subject to a building permit/complying development certificate or a construction certificate.

The affected part of the building, relative to disability access, does not apply to: • e xisting parts of buildings outside the area of the new work and the affected part upgrade • a n accessway from the allotment boundary, from any accessible car parking space on the allotment or between other buildings on the allotment.

Upgrading works for an affected part may include the following disability access works: • accessibility of upper floors to new work • p roviding lift access features such as Braille or tactile buttons • signage • removing a step at a building entrance • upgrading handrails on a ramp •m inimum width requirements of doorways or passageways, including passing and turning spaces.

When Disability Access Provisions Apply Lessees submitting an application for approval for the building work to their leased area only, do not need to ensure that the affected part of the building complies with the Premises Standards for disability access.

However, this disability access concession does not apply if the new part is within a building with only one lessee. Note that for building owners

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who make alterations or upgrades to their buildings, the Premises Standards provisions will apply regardless of whether the building is multi-tenanted or not.

The Premises Standards makes some limited disability access concessions to these circumstances. For example, a lift is not required in a building of not more than three storeys, with a floor area of each storey, of not more than 200m².

There are also disability access concessions for existing lifts and disabled persons toilets under certain circumstances, and there is also a general exemption for areas where providing access would be inappropriate because of the purpose for which the area is used, such as a fire lookout tower for example, or to areas that would pose a health or safety risk for people with a disability.

Existing buildings that are not undergoing any alterations or change of use are not required to be upgraded to comply with the BCA disability access provisions. However the existing building could still be the subject of a compliant under the Disability Discrimination Act, and the case made that the building does not meet the general requirements for disability access in accordance with the Premises Standard.

While an application can be made on the grounds of unjustifiable disability access hardship, the extent of documentation that must be submitted with the application, (including financial position and so forth) is likely to make the process a difficult one that will receive serious scrutiny by the applicable State or Territory Appeals authority, and ultimately, unjustifiable hardship may only be conclusively determined by a Federal Court or the Federal Magistrates Court.

Implications of Disability Access for Aged Care Buildings Owners and Providers The circumstances under which these provisions will prevail will in all likelihood be tested going forward, but there is no doubt that the provisions for Disability Access code compliance have been significantly strengthened, and the scope for dispensations significantly curtailed.

These new disability access provisions will ultimately impact on most building owners and tenants, and while full compliance at this point in time may not be the objective, disability access appraisals can be conducted to establish the Aged Care facility’s current Disability Access position, and assistance can be given in formulating the strategy and the costings necessary to move progressively toward an acceptable future compliance outcome.

For further information on disability access you can link to our Hendry Group Disability Access Blog site www.disabilityaccess.com.au n

About the author Mark Lewis Mark Lewis is the Victorian State Building Surveying Manager of the Hendry Group.

Mark’s extensive experience includes Aged Care Audits, Disability Access Audits, BCA Audits and the issuing of building permits for a wide variety of projects. Mark can be contacted at the Hendry Group on tel. 03 8417 6500.

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The Caroma Care range offers practicality without compromising on style.

Caroma leads the way in bathroom innovation, offering specialised solutions designed to make life easier regardless of age, illness or disability.

OPAL 510 BASIN

McK31643/12

• Smooth rounded contours, clean lines • Ideal for smaller bathrooms where space is limited

OPAL II EASY HEIGHT WALL FACED TOILET SUITE • Elevated pan for those with restricted movement • Smartflush® suite with a WELS 4 star rating

Suitable for installation to comply to Australian Standard AS 1428.1 Design for access and mobility

For more information call 13 or visit caroma.com.au

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events & news

2012 Calendar of Events 19-20 April

17-18 May

21-22 May

28-29 June

ITAC 2012 – Information Technology in Aged Care – Smart Technology for Modern Aged Care: delivering change

Aged Care Association Australia – NSW Congress 2012

The 4th ACSA National Community Care Conference

Risky Business 2012 International Dementia Partnership

Sheraton on the Park, Sydney T: 02 9212 6922 E: admin@acaansw.com.au W: www.acaansw.com.au

Adelaide Convention Centre, Adelaide W: www.agedcare.org.au

Sydney Convention and Exhibition Centre W: www.dementiaconference.com

Melbourne Park Function Centre E: itac2012@jayscorpevents.com.au W: www.itac2012.com.au

11-13 July

3-5 September

28-30 October

Nurses in Management Aged Care (NIMAC)

2012 ACSA National Conference

ACAA 31st Annual Congress – Consec - Conference Management

Jupiters Hotel, Gold Coast W: www.nimac.com.au

maintain the

Gold Coast Convention Centre, Broadbeach T: 07 3725 5588 E: khart@acqi.org.au W: www.agedcare.org.au/news/2011-news/ acsa-national-conference-2012

T: 02 6251 0675 F: 02 6251 0672 E: acaa@consec.com.au W: www.acaacongress2012.com.au

2012 ACS State Conference 10 - 11 May, 2012

OCCUPY AGED CARE

rAGE

82,000 BEDS NEEDED

Australian Technology Park, Sydney

Consumer N Choice! RefoFP Agen rm da

LIFY SIMP E TH EM SYST

Support for Diversity

NEW STANDAR DS

Viability of smaller orgs?

WORKFORCE

Housing The nextwave

Design & ConstruCtion ConferenCe

Recovery, Renewal & Reinvestment 25 & 26th July, Novotel Sydney Brighton Beach

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Funnies...

A distraught senior citizen phoned her doctor's office.

The older we get, the fewer things seem worth waiting in line for.

“Is it true,” she wanted to know, to be taken “that the medication you prescribed has life?” my of for the rest

********

“Yes, I'm afraid so,” the doctor told her. the senior There was a moment of silence before lady replied,

thing You know you are getting old when every either dries up or leaks. ********

is my condition “I'm wondering, then, just how serious REPEATS.” NO ed mark is on ripti because this presc

like to go When you are dissatisfied and would ra.

Algeb of think h, yout to back

********

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table awaiting An older gentleman was on the operating a renowned surgeon, surgery and he insisted that his son, perform the operation. sia, he asked to As he was about to get the anaesthe speak to his son.

about One of the many things no one tells you from ge ageing is that it is such a nice chan being young.

“Yes, Dad, what is it?” and just remember, “Don't be nervous, son; do your best, ens to me, your if it doesn't go well, if something happ and your wife...” you mother is going to come and live with ******** eters.

Some people try to turn back their odom this way.

Not me! I want people to know why I look the roads I've travelled a long way and some of weren't paved. ********

******** old Ah, being young is beautiful, but being ble. orta is comf ******** et faces.

First you forget names, then you forg it's worse Then you forget to pull up your zipper... when you forget to pull it down. ******** (And this final one) and Your hand “Lord, keep Your arm around my shoulder over my mouth!”

Aging: you stop lying Eventually you will reach a point when t it. about your age and start bragging abou “you don't look This is so true. I love to hear them say that old.”

aca Aged Care Australia | Autumn 2012 | 87

product news

Independent Monitoring Consultants Independent Monitoring Consultants, a leading microbiology test laboratory and consultancy with its head office in Sydney and a network of people around Australia, has long been associated with services to Hospitals and Aged Care Facilities to help them in monitoring their water systems and the Indoor Air Quality of their premises to test for harmful bacteria and parasites.

In all hospital and Aged Care Facilities it is critical to ensure that the Air and Water that is supplied to these establishments is good quality for patients, residents and staff, and that a sound routine scheduled sampling and testing programme is in place to demonstrate that this is occurring.

If the presence of bacteria in Water and Air is found then corrective action has to be taken to eliminate such risk and the only way to

determine if these bacteria are present is to test for them.

This services offered by IMC, such as sampling and testing, are all carried out by highly professional technicians to ensure accurate and prompt reporting of results are given on time every time.

Independent Monitoring Consultants is the largest specialist NATA accredited and independent sampling and testing company for industrial waters in Australia, and with almost 20 years of offering our clients an outstanding service across Australia we have cemented our name as the one to trust when it comes to accuracy and professionalism within not only the Hospital and Aged Care fraternity but to Hotels and Resorts, Shopping Centre’s and Commercial buildings.

When choosing a Laboratory several things need to be taken into consideration and once you are satisfied that they meet these criteria only then should you engage their services: Is the Laboratory accredited with NATA, Australia’s national laboratory accreditation authority?

Does the Company hold the necessary Insurances?

Are the staff Professionally Trained?

Do they offer sampling, testing, consulting and training?

Are samples refrigerated after sampling and during transportation, and, are these procedures in-line with National Standards?

Speak directly to Ian Hartup National Corporate Manager on 0411 109 353

INDEPENDENT MONITORING CONSULTANTS PTY LTD Head Office: 23-25 Daking Street North Parramatta, NSW 2151 Australia Telephone: 131 131 405 or (02)9890 5067 Fax: 02 9630 1256 Email: ian@imc1.net webpage: imclive.com

Crystal Healthcare

Get the most from your cash reserves

Crystal Healthcare is 100% Australian owned with the majority of products proudly manufactured in Australia.

It is common for aged care facilities to have cash reserves. Exactly how much and where the funds are invested depends on several factors, such as the investor’s objectives over the short, medium and long term and how much risk they’re prepared to be exposed to.

Being a relatively simple asset class, cash is often overlooked in terms of strategic asset allocation. A financial adviser can recommend an investment strategy for your cash reserves suited to your organisation’s needs and mission.

You can hold your cash in a cash account which you can access anytime and earn an average interest rate. Alternatively, you can invest in fixed interest, like a term deposit, which typically is held for a fixed term and at a set interest rate, usually higher than a bank account offers.

Macquarie Private Wealth helps Aged Care facilities to manage their surplus funds, we understand the challenges and the opportunities that you face every day.

Based on this specialist knowledge, we have developed tailored investment solutions to suit your needs.

If you’re investing cash reserves for a longer period, investing in shares may also be a suitable option.

For more information call Matthew Boase on 1800 810 718 or email at matthew.boase@macquarie.com

Managing Director, Frances Ceddia has 35 year’s experience in the textiles industry. While having the responsibility of caring for an elderly family member, Frances found the market only offered disposable continence options. This began the design of her re-usable continence products.

Crystal Healthcare has over the years earned a strong reputation for producing the highest quality textile products for Health, Disabilities, Defence, Accommodation and Home markets.

Today Frances and her team continue researching new technologies, maintaining a strong focus on delivering competitive prices to match imported products.

For more information please visit our website www.crystalhealthcare.com.au

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Macquarie Private Wealth’s services are provided by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”) participant of Australian Securities Exchange Group, Australian financial services licence No. 237504, 1 Shelley St, Sydney NSW 2000. MEL is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth), and MEL’s obligations do not represent deposits or other liabilities of Macquarie Bank Limited ABN 46 008 583 542. Macquarie Bank Limited does not guarantee or otherwise provide assurance in respect of the obligations of MEL. This information may contain general advice and does not take into account your objectives, financial situation or needs. Before acting on this information you should consider whether it is appropriate to your situation.

product news

Fire safety training in aged healthcare facilities When identifying the best fire protection solutions for the aged healthcare sector, the evacuation of mobility restricted residents and the protection of vital medical equipment are just two key considerations.

Although it is not always possible to prevent a fire, healthcare facilities must be adequately prepared by having the correct fire protection systems and equipment in place. Furthermore, owners and managers must recognise the importance of investing in staff fire safety training.

When a fire breaks out, the highest priority is to move residents and staff out of harm’s way. Having trained staff should provide the best possibility for this to happen in a methodical and efficient manner. Facility managers must ensure that fire safety education is provided to all employees to build an understanding of what systems are installed on the premises, how to use the fire protection equipment and what evacuation procedures are in place.

Wormald recently launched a unique emergency management training course in NSW which is specifically targeted to hospitals and healthcare facilities. The RTO-accredited course enables participants to hone their skills and knowledge in developing risk management strategies and advising on the emergency planning process.

Other training courses available include; emergency control organisation, warden training, general staff emergency awareness training, fire safety officer training (NSW only), fire extinguisher training, fire safety advisor training (QLD only) and emergency response exercise.

For further details or to speak to a Wormald representative call 133 166 or visit www.wormald.com.au.

Media – for further information please contact:

Leading fire protection specialist Wormald offers a range of essential fire training courses which are suitable for all staff and can be tailored to the needs of individual healthcare facilities.

Skymed Aeromedical Skymed Aeromedical is a patient transport company providing a solution for any transport need. Our philosophy is to provide smooth, comfortable and stress free transport for our patient and their family, while being cost effective.

Air ambulance service: Where the patient can travel in a private plane on a stretcher with all medical equipment required.

Medical Air Escort on a commercial airline: This is a great alternative if the patient is in a stable enough condition to sit during take-off and landing. The patient flies comfortably on a major commercial airline and is under constant care of at least one member of the Skymed Aeromedical medical team.

Claire Smith, Write Away Communication + Events Ph: 02 9978 1400 Email: claire@writeaway.com.au, corrina@writeaway.com.au Claire Hartley, Wormald Ph 02 9638 8577, Email: clhartley@tycoint.com

Odacon – Incontinent Spray Instantly neutralises urine & faecal odour at source • Water based and non-irritant to skin • Free of solvents • Non-flammable •N eutralises odours at the source A health problem such as incontinence is a common occurrence amongst older people. Whiteley Medical has developed Odacon – Incontinence spray, to clean and neutralise odours on surfaces and in the air.

Odacon is best described as a highly efficient deodoriser for incontinence and human excrement. It is designed for safe use in circumstances where regular contact with normal skin may become part of the management of incontinent patients. The product has been in regular use in normal medical, geriatric and psychiatric institutions in the USA for many years where its’ unique properties have proved invaluable in improving environmental conditions by greatly reducing offensive odours associated with Aged Care patients.

Odacon is non-flammable, water-based and non-irritant to the eyes and skin. It eliminates a common cause of urine smell by neutralising urine and faecal odours at source. The ammonia producing mechanism in fresh urine is inhibited by the product, which has a bacteriostatic action in addition to its ability to destroy urine and faecal odours.

For more information please call our Product Support Hotline on 1800 833 566 or visit: www.whiteley.com.au

International and Domestic Commercial Stretcher: This option is a safe and effective method of medical transport. If the patient qualifies for transport by commercial stretcher, this method can save the family tens of thousands of dollars. Skymed can arrange a Commercial Stretcher trip that may well be a practical and cost-saving option for the patient.

Long Distance Ground Medical Escort Service: If the patient is not in a critical condition and cannot or will not fly, Long Distance Ground is a cost-saving alternative to air ambulance travel. It is also an ideal way to move a patient from one facility to another, within a distance that would not be practical for air travel.

Air Travel Companion: Skymed’s Air Travel Companion has the solution for people, especially the elderly and young , who avoid travelling alone domestically or internationally as they find it frightening or just too difficult, and where it is not practical for a family member or a close friend to travel with them.

One of Skymed Aeromedical’s jobs was relocating Mrs Judith Brewer from Melbourne to be closer to her family in QLD. Her son wrote: “The level of service and professionalism afforded to my mother, Judith, by Skymed was second to none and when you expect only the best for your mother the standards were never compromised.

Should anyone at anytime require a reference I would be only too happy to endorse your services”.

Mike Brewer Our staff is available to answer any questions or concerns about transportation for you or a loved one 7 days a week 24 hours a day.

Please do not hesitate to call, our team will be happy to help!

For further information visit our website www.skymed.com.au

SkyMed

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product news

McNally Architects in profile Architect James McNally talks about McNally Architects philosophical approach to enhancing the spaces around you through innovative design. This approach is used in their Seniors Living projects with great success.

During the past 30 years, McNally Architects, an award winning practice and industry specialist in aged care architecture have been involved in new builds and upgrades of many facilities throughout NSW. James says, “Facilities cannot be seen as just ‘a building’, instead they need to be seen as a ‘Urban Community Space’. This is how these facilities function on a daily basis – people live, sleep, eat and also work in these spaces. It is their home; their living environment, their work place, their community and it is a large part of who they are. “ This is one method McNally Architects instil when designing new facilities or when renovating and upgrading existing facilities.

James tells us how this is incorporated into McNally Architects works: “A current project we are working on is a new 130 bed Nursing Home located in Sydney. The building is made up of 3 to 4 separate but linked buildings; each has its own distinct identity.

These smaller buildings create an urban scale

Aged Care Metrics Mirus Australia, an aged care advisory group, has developed a new intuitive reporting tool to address the frustrations voiced by many Aged Care providers who lack appropriate management reporting and the ability to analyse Medicare data.

Aged Care Metrics (ACM) is a “Cloudbased” reporting tool meaning there are no systems to install and a new facility can be up and running in just a couple of minutes.

Mirus designed the application to run on the latest standard consumer devices such as the iPad to maxmise Executive and Nurse usability as well providing a low cost platform for future application development.

In creating ACM, Mirus’ objective is to empower management to be able to support long-term financial sustainability and to drive effective decision making. “Through our Advisory work with over 150 aged care facilities, we have observed very few with reporting that is easy to use and can help them improve their operations” said Simon Wilson, Director Mirus Australia.

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facility that makes it feel more homely to the residence. This is done by the way each building ‘looks’ but more importantly by its function. One building maybe for sleeping which will be the residents’ rooms. Its location is in a more private, quiet part of the site. While another maybe predominantly for living, socialising and dining.

This is in a more centralised location on the site so it is accessible to all other buildings on the site.

Another building is more public -made up of community spaces, being cafés, administration and areas that the surrounding community can use as well as, of course, the facilities residents.

This building will have a good connection to the street and its surrounds.

This brings ‘outside life’ into the facility it creates - a connection with the community – a belonging, familiarity. These are all positives for the residents’ wellbeing. We call this ‘successful aging’. If these simple human needs can be achieved then the owner/operator can feel comfortable that they are on the right path to running a successful and profitable facility.”

To find out more about this project or other Aged Care Projects by McNally Architects, please refer to the website www.mcnallyarchitects.com.au or contact our office on 02 9929 5144

“Furthermore, due to cost and resource limitations, many smaller providers struggle with implementing technology solutions.

ACM’s simplicity and ease of use was evident in the feedback received from our pilot users”.

Aged Care Metrics is now available and the standard subscription includes: • Executive Management reporting of key financial and operational metrics to enable site to site comparison and monitoring of leading key performance indicators (KPIs) • Facility level reporting that presents raw Medicare data into easy to understand information allowing a targeted improvement plan • Resident Dashboard showing key medical diagnosis and existing ACFI assessment scores

For further information and a video demonstration visit www.mirusaustralia.com or call Simon Wilson on 02 8823 3146

Fire Safety Compliance Reviews Do you need to review the fire safety protection of your aged care facilities?

Eagle Consulting Group is well placed to conduct fire safety reviews: •E agle has compliance expertise with aged care and other healthcare facilities including:

o Various [confidential] aged care facilities operators in NSW, and

o Various NSW public hospitals, such as Prince of Wales Hospital, Royal Prince Alfred Hospital and Royal North Shore Hospital.

•E agle has experience in ACHS compliance auditing of multiple metro and regional sites.

•E agle compliance reporting of aged care facilities can be measured against 2 standards:

o the relevant performance standards when the facility was originally constructed, or later upgraded, and

o the current BCA and referenced Australian Standards.

Eagle has been trading for over 20 years and our people are drawn from the fields of mechanical and fire safety engineering, building surveying, fire services contracting & compliance certification, resulting in: ombined fire safety engineering/ •C design, BCA, disabled access & property compliance experience exceeding 100 years, and •A unique blend of theoretical & practical experience, ranging from developing alternate fire solutions, to designing and project managing fire sprinkler retrofits and other fire upgrade works.

For Fire Safety piece of mind with your aged care facilities, please contact below.

Eagle Consulting Group Pty Limited PO Box 406, St Leonards, NSW, 1590 Telephone: (02) 9460 6366 Fax: (02) 9460 6466 Email: consulting@eaglecon.com.au Web: http://www.eagle.net.au