Nursing home checklist:
https://www.afr.com/by/bina-brown-1mnru0
Yet another fee layer makes aged care more complex
Watch out for facilities that could charge $25 a day for “additional” services that you’d expect to be part of the room price. Apr 7, 2021
MARCH and FEBRUARY 2021 Aged care
What aged care could look like
Private operators and member-led mutual organisations are leading the way in delivering better quality care. Feb 11, 2021
Allied health to assist with the ageing experience
Last Updated at October 25th 2021
There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
INFO - There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
Read the article here
What is the COVID-19 Aged Care Support Program?
The COVID-19 Aged Care Support Program is a grant program that will reimburse eligible aged care providers for eligible expenditure incurred for managing direct impacts of COVID-19. The program will run over two years from 2019-20 to 2020-21.
Who is eligible?
The following Commonwealth funded approved aged care providers with one or more services directly impacted by COVID-19 are eligible:
• Residential aged care
• National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP)
• Home Care Package providers.
Directly impacted means services with one or more COVID-19 infected, quarantined or isolated residents/clients/staff between 24 February 2020 and 31 May 2021.
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DO NOT GO INTO A NURSING HOME ALONE. YOU 'NEED' A FRIEND.
Choosing a nursing home can seem like an overwhelming task. If the need for care has become too much for you to continue to safely provide and you find yourself trying to make difficult decisions in an emotional whirlwind, this section will provide you with some invaluable tips if followed.
Steps to enter an Aged Care Home: https://www.myagedcare.gov.au/sites/default/files/2019-12/steps-to-enter-an-aged-care-home.pdf
As with any major decision-making process, finding the right nursing home is a staged (step-by-step) process. But making these emotionally charged decisions can make it awfully hard to understand and navigate through the process.
You can go to the Quality Agency to see the most current publicly available report for each aged care home.
Apply for an assessment online in 3 easy steps
https://www.myagedcare.gov.au/assessment/apply-online
Before you can access government-subsidised aged care services for the first time, you need to apply for an assessment. Using the online application is quick and easy and will only take 15 to 20 minutes to complete.
It’s the same form to apply for all types of care and support – including help at home, short-term care, and care in an aged care home. You can complete the application yourself or on behalf of a family member or friend. If you’d like to set up an ongoing representative, you can also do that here.
There are three parts. The first checks you are eligible, the second captures your details, and the third confirms who the assessor should call to arrange the assessment. You will need your Medicare card and enough time to complete it.
Start now
All Guides to Aged Care - just click on what YOU want to know NOW:-
https://www.agedcareguide.com.au/information/all
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Find a Provider - Aged Care Homes EASY! :-)
https://www.myagedcare.gov.au/aged-care-homes
Just click "Aged Care Homes" and put in the Suburb of interest and include (optional) surrounding suburbs. Is an easy to use and intuitive layout.
Newsletter
The Aged Care Quality Bulletin is the Commission's monthly newsletter for Australian aged care providers, sharing the latest information to support our vision of a world-class aged care service.
Subscribe to the newsletter for monthly updates on the Commission.
We value feedback. If you have comments or ideas on the content our newsletter, please send your ideas to [email protected].
Analysis of Consumer Experience Report data
The Commission has just released a new report detailing and analysing what consumers are saying about the quality of care in residential aged care services.
07 March 2019
Click here to find the latest Residential Care vacancies - like NOW.
Costs: The Australian Government subsidises many aged care services to keep costs reasonable and affordable. Costs vary for different types of care and different service providers. There are no standard costs for aged care services. If you are eligible, you are expected to contribute to the cost of your care if you can afford to.
https://www.myagedcare.gov.au/understanding-costs
New Aged care means assessment forms
The Department of Human Services (DHS) has released the new Aged Care Calculation of your cost of care (SA486) digital form. Your clients can fill it in online, print and sign it and send it to DHS with their supporting documents. The digital form uses dynamic questions tailored to the customers’ individual circumstances.
For clients who would prefer to use our simplified paper forms, they are as follows:
These forms are all available on the DHS website. Tips on how to download the digital form can be found here.
Aged care means tests: https://www.servicesaustralia.gov.au/individuals/services/aged-care-means-tests
We assess your financial details to work out how much you need to pay towards aged care.
Customers commencing a Home Care Package don’t need to fill in a form if they get a means tested income support payment from Centrelink or DVA.
Customers entering Residential Care don’t need to fill in a form if they:
It is important to make sure their income and assets are up to date when they enter into care to ensure their assessment can be completed automatically. They can do this by accessing their Centrelink online account or by calling Centrelink on 132 300or DVA on 1800 555 254.
Department of Health
13 August 2019
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Food quality and nutrition in aged care will be well and truly in the spotlight in the coming months as the Royal Commission into Aged Care Quality and Safety examines incidents of poor quality, sub-standard food served to residents.
Add to that the new Aged Care Quality Standards, which highlight nutrition as a key determinant of wellbeing, and it’s no surprise that food will play a big role in delivering dignity and choice to residents.
Reduced government funding and rising food costs are issues all providers face. But with increased choice, the ability to accurately track and cost food procurement will create even more hurdles.
Aged care chefs carry much of the burden of producing food that is not only nutritious and appealing, but manages the delicate and complex dietary needs of ageing residents, especially those with dysphagia who require special texture modified diets. Add in a layer of personal, cultural and dietary preferences and you can quickly see how tough it is to satisfy everyone’s needs.
06 February 2019
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https://hellocare.com.au/im-not-your-good-girl-why-older-people-dont-like-being-spoken-to-like-a-baby/
Calling older people names like ‘sweetie’ or ‘dear’ is quite common in aged care homes. But researchers have found that when aged care workers speak to older people as though they are children, it creates the perception of incompetence, and that can lead to a downward spiral.
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Allied health to assist with the ageing experience
Last Updated at October 25th 2021
There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
Allied health professionals can provide vital health and wellbeing services that are very beneficial to older people. [Source: Shutterstock]
Allied health encompasses a variety of different health services that can build and support the capabilities of older people.
Professionals in allied health will already have involvement with older people in the community at their practices but these services can also be provided within aged care facilities or in the home.
The Government is recognising allied health services as more vital for the health and wellbeing of older people in aged care. In this article, we give an overview of some of the key allied health professionals supporting older people in aged care.
Find an Aged Care Home:
https://www.myagedcare.gov.au/connect-aged-care-homes
The transition to long-term care or a nursing home is one of the most difficult any of us will face. "What's it Really Like?".
Lessons From My Parents, The Candid Truth Of The Aged Care Home
By Rosemary Iloste. Apr 9, 2018
Writes about her own experiences with her parents in care. Well worth the read.
and
https://www.cbc.ca/radio/whitecoat/just-ask-seniors-tell-us-what-it-s-really-like-to-live-in-long-term-care-1.4450594
Unannounced audits have begun rolling out across Australia’s aged care homes. July 1 marked the start date for the new system, under which aged care homes will no longer receive notices for the dates of re-accreditation audits. The move was recommended in Kate Carnell and Professor Ron Paterson’s Review of National Aged Care Quality Regulatory Processes.
On 18 April 2018, Minister Wyatt announced:
You can go to the Quality Agency to see the most current publicly available report for each aged care home.
Do have a look at https://www.agedcareinsite.com.au/ and explore their articles. In making your final decision, YOU need all the help you can get. Of course, if you or your loved one are unhappy, you can look around again and Change Accommodations. It is YOUR choice.
https://www.health.gov.au/health-topics/aged-care/providing-aged-care-services/delivering-quality-aged-care-services
How do I get help to talk to My Aged Care?
If you are an older person who would like a family member, carer or someone else you trust, to help you find government subsidised aged care, setting them up as a representative with My Aged Care might be a good option for you.
https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/06_2017/fact_sheet_rep_for_consumer_170627_v0.7.pdf
There can be another way... Look at having your loved one take 'Respite' in a Nursing Home, just for a few weeks to give them a feel for the place...
Respite Supplement in an Aged Care home:
The maximum daily fee for a respite resident is set by the Government at 85 percent of the single basic Age Pension. Because the stay is temporary, you don't have to pay an accommodation charge or bond the maximum daily fee for a respite resident is set by the Government at 85 percent of the single basic Age Pension. Because the stay is temporary, you don't have to pay an accommodation charge or bond.
The beauty of this is, that your loved one can 'try out' any number of nursing homes - just for Respite. You never know, they may make the choice for you!
SO, just give a few of the nursing homes a call and ASK :-) "Do you have any vacancies for respite?"
To immediately find a list of possible vacancies in Your Area, click here. Tip - Do click the markers on the map too... for that Extra Info...
Remember, you can apply to as many nursing homes as you like. When/if you decide, you can then ring around the others and ask them to take you off the list as you have chosen a home.
Check out the Reports: just click on the Aged Care name.
Following the first round of hearings, the Royal Commission released its first background paper on Australia’s current aged care system.
Background Papers 1-19 called Navigating the maze: an overview of Australia’s current aged care system. It outlines different aspects of the aged care system, the services currently being delivered in Australia and the areas in need of substantial reform.
Research Paper 19 – Does the quality of residential aged care vary with residents’ financial means?
09 February 2021
The Royal Commission will be accepting submissions until mid 2019 from members of the public interested in providing evidence. Submissions can be lodged online, via mail or telephone.
Top Tips for care recipients: Making a complaint about an aged care service factsheet.
Inform yourself and your loved one. Your nursing home Checklist.
and
Is what you see, what you get?
In hospitals and aged care facilities, especially nursing homes, there is a staffing crisis and this crisis is not resolved by simply increasing the nurse to patient ratios. Solutions that focus on supporting staff retention, including targeted training regimes specifically designed for geriatric care skills, are better for quality patient care. So do ask those awkward questions about nursing home staffing issues.
Residential Care Fee Estimator - click on Aged Care Homes
https://www.myagedcare.gov.au/fee-estimator
Schedule of Fees and Charges for Residential and Home Care: From 20 March 2022
This page provides the latest updates to aged care fees and charges.
[i] Residents in designated remote areas may be asked to pay an additional $1.06 per day.
[ii] This rate applies to residents who enter residential care within this time period but not to those who were already in care prior to this time period. The Maximum Permissible Interest Rate applicable for the calculation of a resident’s daily payments is fixed either at their date of entry to care (for a low means resident) or the date they agree to a room price (for a resident who is not eligible for government assistance with their accommodation costs).
and do remember that the daily care fee IS negiotable.
New aged care means assessment forms
The Department of Human Services (DHS) has released the new Aged Care Calculation of your cost of care (SA486) digital form. Your clients can fill it in online, print and sign it and send it to DHS with their supporting documents. The digital form uses dynamic questions tailored to the customers’ individual circumstances.
For clients who would prefer to use our simplified paper forms, they are as follows:
11 July 2019
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YOUR first look at Aged Care Homes:-
These notes you may keep for Years. Unless there is a rapid deterioration, hospitalization, advice from the medical staff at the hospital, YOUR health deteriorates, or simply that YOU cannot do it anymore. For now, you just visit, look and write down notes. Take along a trusted friend who will drive you around. Do not do this yourself. You will leave the nursing home distraught, in tears, and barely able to stand, let alone think in any coherent fashion. You need your friend's hug and understanding. It is these notes that when, in years to come, you take out and look at. In my case it was 2 1/2 years on due to rapid deterioration in Don's health and his physical total inability to help me even with the most simple of tasks eg. Don's whole body was leaning very much to the left, nearly off the pillow. I placed my hand across his chest and tried to move him back on to the pillow as I had always been able to. It did not work!!! and Don, with all the will in the world, could not help me help him. Also during this time at the hospital, I was being told by the Doctors, Specialists, Nurses, Speech Therapist, Physiotherapist, Dietitian... that I could not manage if I took Don home. I tried, twice and failed. I just could not do it. I rang the Ambulance and Don was returned to hospital and their care.
It was only then that I took out the pile of notes that had been gathering dust at the very back of the cupboard and actually Looked. I am SO glad I had done all of this year's before as I simply could not have faced it at that highly emotional time. As it happened, the nursing home I had placed on the top of the list as the one with the Best Nursing Care, had a vacancy. Don had to be placed straight from the hospital.
This is not an exhaustive list, and Aged Care Crisis may update this information on a regular basis, in line with reader feedback and changing industry standards.
Good Choice Indicators:
1: First Impressions
· Do you like the facility's location and outward appearance?
· Is the facility convenient for frequent visits by family and friends?
· Are you welcomed with a warm greeting from the staff?
· What's the home's attitude to regular visitors? (our research shows that in some facilities, constant visitors are regarded as hostile and are regarded with suspicion)
· Does the staff address residents by their names and interact courteously with them during your tour?
· Are the residents socialising with each other and do they appear well cared for?
· Are you able to talk freely with residents about how they like living there and about the staff?
· Are staff members appropriately dressed, friendly and outgoing?
· Do staff members treat each other in a professional manner?
· Are visits with the residents encouraged and welcome at any time?
· What percentage of the rooms/beds is available?
· Is there a waiting list? If so, how long do they estimate it will take to be admitted?
2: Staffing Levels and Experience
Reforms to aged care as exemplified in the Aged Care Act of 1997 have failed to provide for the safe delivery of quality care for aged persons in residential care facilities.
In Victoria, the previous Kennett Government removed nurse-to-patient ratio requirements. The ratios were one registered nurse per 10 patients on day and evening shifts, and a one-to-15 ratio on the night shift. It also required the appointment of a Director Of Nursing (DON) in each nursing home.
It is essential to ask about staff/resident ratios and the facility's staff turnover rate -- eg, a low staff turnover might indicate that the staff are generally happy, and suggests that what is good for staff is ultimately good for resident care. However, the turnover rate is only one indicator - what about the staff absentee rates - especially on weekends.
In hospitals and aged care facilities, especially nursing homes, there is a staffing crisis and this crisis is not resolved by simply increasing the nurse to patient ratios. Solutions that focus on supporting staff retention, including targeted training regimes specifically designed for geriatric care skills, are better for quality patient care. So do ask those awkward questions about nursing home staffing issues.
It is also important to speak to the Director of Nursing her/himself. The Director sets the tone for the facility. Are the values he/she espouses similar to yours?
Some important considerations include:
· Do nursing staff respond in a timely manner to residents requests for assistance such as help getting in and out of bed, dressing and going to the bathroom?
· Which nursing staff members are involved in planning the resident's individual care? Are they the same ones who provide the care to residents?
· How many trained nurses are there, as opposed to Personal Care Assistants/Attendants (PCA's) or Personal Care Workers (PCW's)?
· What is the Director of Nursing like? (the Director wields a lot of influence over the quality of care given)
· Ask questions about staff turnover. Is there frequent turnover among certified nursing assistants (CNAs)? What about turnover for nurses and supervisors, including the Director of Nursing and the Administrator?
· What is the nursing staff to resident ratio?
· How many registered nurses (RNs) are on staff?
· How many per shift? What is their training/education?
· Does this vary at different times, particularly at weekends?
· What is the history of compliance with staffing ratios and staff development and training?
· Is staff on duty qualified to handle the behaviour challenges of some residents?
· How does the nursing home ensure that all staff maintains licensure/certification, receives continuing education, and keeps their knowledge and skills up-to-date?
· How many staff are permanent? (A high turnover in temporary and/or agency staff means that there could be no-one on duty who is familiar with your loved one and their medical needs)
· Will any special needs of your family member be taken into consideration?
3: Prevalence of Bedsores
Check the resident bedsore rate as a general indicator of staffing problems (Bedsores are a skin condition that if left untreated, can lead to blood poisoning and death. They result when a body’s weight is left for long periods in a single position. The skin area, prevented from receiving proper blood flow, eventually degrades and disintegrates, exposing bone below.)
*Bedsores can sometimes result from other disease conditions, but it is most often a result of staff not turning bedridden residents often enough to avoid the sores. Therefore, good staffing levels are essential.
· Do they specialise in treating bedsores?
· What procedures and specialised equipment (water beds; sheepskins; etc.) do they have in place to limit the prevalence of bedsores?
. Pressure areas are the most fearsome issue confronting rehab and seating occupational therapists. “I will do anything to avoid it,” occupational therapist Sybbi Georgiou, from Megalong Positioning Service told F2L. “Even if a person does not have a pressure injury there is a lot of importance placed around prevention. “Once a person has a pressure injury they always have it. As the patient slowly deteriorates, whatever their condition, the pressure area can quickly become a stage III pressure ulcer that can develop into more serious medical conditions. What happens is that the ulcer can heal over but because it is the weakest spot it can break open again.” Prevention is critical in people who don’t move or can barely move, for example if a person is in a wheelchair, is older, has always had a disability or sleeps for long periods and have bony protuberances close to the skin that make them more susceptible, she said. “Pressure ulcers can be prevented by using support devices including cushions, mattresses and overlays.”
. Do be aware of Pressure Injury. This is MOST SERIOUS
https://www.freedom2live.com.au/feature-pressure-injury-prevention-is-the-word/
. The New Age Bedding System (NABS) is currently being used in nursing homes and community housing Australia wide. It is innovative in design and has enormous impact on overall costs. It will enhance new aged care building developments taking place at the moment and will bring already established facilities up to date. The New Age Healthcare waterproof doona is made from a polyester base fabric which has been coated with polyurethane, providing a total barrier to dust mites and their allergens. It has an anti-bacterial and anti-fungal finish and is breathable. The inside of the doona is a polyester fill and has been treated with silver (Ag) to facilitate infection control.
4: Health, Medication, and Personal Care
· The resident right-of-physician choice has been limited by some parts of the nursing home sector. For example, you may be provided with a list of physician's names from which to choose. If possible, obtain this list before your relative enters the Nursing Home, so that you have an opportunity to research each physician’s background and experience.
· It would be preferable if you actually had your right of physician choice and could choose the quality of care you prefer - you may need to stand your ground on this, although, it may be difficult if your physician is geographically located far away from the Nursing Home too.
· By the Nursing Home controlling the list of physicians, they can also control how medical care is dispensed and the services a resident will receive. To give yourself an edge (and if such a physician is available), choose your own physician.
Why Nursing Home care can be sub-optimal?
. Nursing home medical care is not a highly regarded practice area for physicians. Physicians are already unhappy with dropping Medicare and reimbursement rates for services. Therefore, to minimise their time spent with residents, physicians may opt to provide maintenance-only care, sometimes using polypharmia (overmedicating with multiple drugs) to treat residents. Physicians may or may not examine a resident, or may only provide a cursory exam, may even opt to simply record notes in the resident’s medical records, barely seeing the patient. It is the reason why polypharmia is so prevalent in Nursing Homes - the prescribing of medication gives the appearance of care.
. Your relative will be depending on you to evaluate the care he/she is receiving - making sure that his/her health stays on a path to wellness, rather than mere maintenance and continued, needless suffering. As you observe your relative’s condition and receive the medical advice given, you will quickly find that your research has prepared you to make the best decisions in preservation of your relative’s health, safety and overall well being.
. And finally -- always follow your gut instincts. In a worst case scenario, if the nursing home physician is not cooperating, if your relative is getting worse, if you are confused about what "is," have your relative taken to the nearest hospital for outside medical evaluation under closer care conditions -- today. Don’t second-guess yourself, don’t worry what the Nursing Home will think - take the lead.
. Remember, residents have the right to accept or reject healthcare. We employ the medical profession to borrow their expertise, not dictate what we will do. Consequently, if necessary, don’t think twice about rejecting the nursing home physician and proceed to find the emergent care you believe your relative needs.
What type of healthcare and personal care services are available?
· Does the facility have both short and long-term services, such as routine physical and dental/vision examinations as well as skilled nursing?
· How do staff safely administer, monitor, and assist a resident in taking medicine?
· Does the facility's pharmacy provide delivery, consultation and review of medicines?
· Does a staff physician visit the resident regularly for medical checkups or can the resident his/her have own personal physician?
· Can the facility provide a list of available services and are residents and families involved in developing the care plan/service agreement? Who provides these services/what are their qualifications?
· Are physical, occupational, or speech therapy services available onsite? Who coordinates these services and how are they billed? (Medicare, Private cover, etc.)
· Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? Activities of daily living include dressing eating, mobility, hygiene, grooming (bathing, toileting, incontinence)
· Does the residence have Alzheimer's programs, or other dementias and other specialized areas? How does staff safely manage residents who might wander?
· Are staff available to assist residents who experience memory, orientation, of judgment losses?
· How are medical emergencies handled? Does the residence have a clearly stated procedure for responding to medical emergencies? Is there an arrangement with a nearby hospital?
· What's the facility's attitude to medical visits outside? (homes are only required to 'facilitate' these -- sometimes this can amount to no more than dumping your relative in a taxi -- whether they are competent to manage on their own at the other end is something you may need to address)
· Are housekeeping, linen service and personal laundry included in the fees, or extra charges?
· Does the facility provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents and can it be arranged on short notice?
· Are pharmacy, barber/beautician and/or physical therapy services offered on-site?
5: Food, Liquids, and Nutrition
· Does the facility provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary from meal to meal?
· Observe meal times:
- Do all residents who need assistance with eating get help?
- Do staff give each resident enough time to chew food thoroughly and complete the meal?
· What about special diets; does a dietician plan or approve menus? Are resident's weight routinely/regularly monitored?
· Are residents involved in menu planning? Can they request special foods? Are snacks available?
· Does the dining room environment encourage residents to relax, socialize, and enjoy their food
6: Social and Recreational Activities
Social and recreational activities are important for the elderly: Some facilities attitude of 'activities' may simply be limited to placing your loved one in a wheelchair, dumped in a room facing a television, or lined up in a hallway.
You may want to ask the following questions:
· What kinds of group/individual recreational activities are offered and who schedules them?
· Is there a full-time Diversional therapist? (These should have a certificate and be trained for the job - cost-cutting measures can lead to untrained recreation officers fulfilling this role)
· Is there an organised activities program with a posted daily schedule of events?
· Do volunteers and family members come into the facility to participate/conduct programs?
· Does the facility schedule trips or go to other events off premises?
· Do residents participate in activities outside of the facility in the neighbouring community?
· Are the resident activity (social) areas appropriate and desirable to the prospective resident?
· Are there supplies for social activities/hobbies (games, cards, crafts, computers, gardening)?
· Are religious services held on the premises or arrangements made for nearby services?
· Are there fitness facilities, as well as regularly scheduled exercise classes? Can you use them at any time?
· Does the nursing home create a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole?
· Does the facility have a garden and allow residents who can participate in gardening activities? Are there raised flower beds for ease of use?
· Does the facility have pets? Who is responsible for their care?
· Does the facility encourage "Pet Therapy" visitations?
7: Living Conditions, Safety, and Environment
This section details impacts on the living conditions and environment a resident has whilst in the facility. The facility needs to be open for friends and family to visit. Studies show that the most effective way to prevent elder abuse is to have routine visitors (in some people's experience, constant visitors are regarded as witnesses and some homes don't like them)
· Is the floor plan well designed and easy to follow?
· Are windows easily dislodged for emergency needs?
· Are doorways, hallways and rooms accommodating to wheelchairs and walkers?
· Are elevators available for those unable to use stairways and handrails to aid in walking?
· Are floors of a non-skid material and carpets conducive for safe walking?
· Does the facility have good lighting, sprinklers and clearly marked exits? (is a sprinkler system and fire extinguishers installed; is there a fire escape?)
· Is the facility clean, free of odors and appropriately heated/cooled? (ie, if your geographical area subjects the Nursing Home to extreme weather conditions, you also want to be sure that proper heating and cooling systems are in use. If your relative’s bed is nearest a window, is the window well insulated, does it keep the area warm?)
· What is the facility's means of security if a resident wanders? (ie. the monitoring of wandering Alzheimer’s residents)
· What safety procedures are followed by the Home (door locking, security checks, etc.)
· Are the common areas in general attractive, comfortable and clean?
· Is there an outside courtyard or patio for residents and visitors, and assistance getting there?
· Does the facility provide ample security and is there an emergency evacuation plan?
· How are residents escorted to safety?
· Are private rooms available and/or double occupancy units for sharing with another person?
· Is there a place where you can talk in private with your loved one?
· Does the residence have furnished/unfurnished rooms? What is provided or what can they bring? (The furniture that is provided should be comfortable)
· Are residents permitted to decorate their own rooms? Is there adequate storage space? (The rooms should have space for personal articles and furniture)
· Is a 24-hour emergency response system accessible from the facility?
· Are bathrooms private with appropriate accommodations for wheelchairs and walkers?
· Do all rooms have a telephone and cable TV and how is billing handled?
8: Patient Choice and Input
The first area to investigate is whether residents are allowed to make choices about their daily routine (for example: some homes make a practice of bedding down residents at an early hour to ensure minimum staff is required for resident care during the night)
Residents should however, still be allowed to make some decisions such as when to go to bed, get up, bathe, or eat (some restrictions concerning the routine can be expected)
If the resident has special needs, it is important to see how the nursing home accommodates such needs
· Is there a resident's committee and/or a family member's group?
· Do they have regular meetings?
· Do residents and their families feel comfortable speaking up at these meetings?
· Can anonymous suggestions be made? (Consumer input is a requirement under the government's standards.)
· Is the home's documentation available in the language you need? (ie, the Agreement you sign on entry to the nursing home; complaint forms; etc.)
· Are you permitted to have your own family physician visit your loved one? (sometimes, nursing homes insist on using their own doctor, as well as their own pharmacy). Note: if you/your loved one don't like/think a particular visiting Doctor is not giving as much care as you believe your loved one needs, you CAN 'fire' them LOL and ask what other Doctor's come into the home and choose one of them. You CAN do this. There is no rule against changing Doctors.
· Are the residents and their families encouraged to have input into the quality of care? Vital!
9: Accreditation, Sanctions, and Reports
Through process of elimination, you will narrow your Nursing Homes list down to five or six. Next, you must learn more about each facility and evaluate each thoroughly.
After ascertaining which questions to ask and learning about the facility's track record, make sure you visit the facility to get answers to your questions and to see first-hand the appearance and operation of the Nursing Home.
· Is this a high care nursing facility and is a high care bed available?
· Is the facility accepting new patients? Is there a waiting period for admission?
· Is the facility sponsored by a non-profit organisation and managed under contract with a commercial firm? If so, what are the conditions of that contract?
· Is there a Resident Support Group through which resident/family have a means of voicing their views on the management of the nursing home and/or it's delivery of services?
· Each nursing home requires the residence to be "accredited" by the Aged Care Standards and Accreditation Agency. Does the facility have a current license/certification and is it displayed?
Where can I find accreditation reports for a home?
Accreditation Reports Search - type in the name of the nursing home
https://www.agedcarequality.gov.au/reports
Every accreditation audit and review audit report on each residential aged care home, along with the Quality Agency's accreditation decision is published on the Aged Care Quality and Safety Commission website. This helps ensure that information about aged care services is available to residents and prospective residents to enable them to make informed decisions about their care.
· What reputation does the nursing home have in the community? How long has it been in business? Is it in good financial health? Does the nursing home follow generally accepted accounting procedures?
· Check the history of the nursing home, ie, has it corrected any Quality of Care deficiencies in their past or present Accreditation audits or any other reports?
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In our opinion the best decisions will be those you have made yourself on the basis of your own assessments after face to face inquiries of the kind mentioned above. However, if you feel the need for an intermediary then we suggest the following questions should be considered and put.
In all cases however, we strongly recommend you make notes about the responses to all the questions you may ask, of the Providers, the staff and the consultant. It may be weeks, months or years – perhaps never, but notes of that kind can be extremely useful.
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Do have a look at http://www.agedcareinsite.com.au/ and explore their articles. In making your final decision, YOU need all the help you can get. Of course, if you or your loved one are unhappy, you can look around again and Change Accommodations. It is YOUR choice.
The Australian Aged Care Quality Agency is committed to supporting consumer choice, and promoting continuous improvement in quality in aged care service provision.
We interview more than 50,000 residents of aged care homes each year as part of our assessment against standards for the quality of care and services in aged care.
For more information, please browse the links below and see About Us.
12 April 2019
https://www.agedcarequality.gov.au/consumers
03 January 2020
What if I am having trouble Coping?
If you need to talk to someone immediately, contact Lifeline (24 hours a day) on 13 11 14.
14 April 2022
https://www.afr.com/by/bina-brown-1mnru0
Yet another fee layer makes aged care more complex
Watch out for facilities that could charge $25 a day for “additional” services that you’d expect to be part of the room price. Apr 7, 2021
MARCH and FEBRUARY 2021 Aged care
What aged care could look like
Private operators and member-led mutual organisations are leading the way in delivering better quality care. Feb 11, 2021
Allied health to assist with the ageing experience
Last Updated at October 25th 2021
There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
INFO - There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
Read the article here
What is the COVID-19 Aged Care Support Program?
The COVID-19 Aged Care Support Program is a grant program that will reimburse eligible aged care providers for eligible expenditure incurred for managing direct impacts of COVID-19. The program will run over two years from 2019-20 to 2020-21.
Who is eligible?
The following Commonwealth funded approved aged care providers with one or more services directly impacted by COVID-19 are eligible:
• Residential aged care
• National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP)
• Home Care Package providers.
Directly impacted means services with one or more COVID-19 infected, quarantined or isolated residents/clients/staff between 24 February 2020 and 31 May 2021.
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DO NOT GO INTO A NURSING HOME ALONE. YOU 'NEED' A FRIEND.
Choosing a nursing home can seem like an overwhelming task. If the need for care has become too much for you to continue to safely provide and you find yourself trying to make difficult decisions in an emotional whirlwind, this section will provide you with some invaluable tips if followed.
Steps to enter an Aged Care Home: https://www.myagedcare.gov.au/sites/default/files/2019-12/steps-to-enter-an-aged-care-home.pdf
As with any major decision-making process, finding the right nursing home is a staged (step-by-step) process. But making these emotionally charged decisions can make it awfully hard to understand and navigate through the process.
You can go to the Quality Agency to see the most current publicly available report for each aged care home.
Apply for an assessment online in 3 easy steps
https://www.myagedcare.gov.au/assessment/apply-online
Before you can access government-subsidised aged care services for the first time, you need to apply for an assessment. Using the online application is quick and easy and will only take 15 to 20 minutes to complete.
It’s the same form to apply for all types of care and support – including help at home, short-term care, and care in an aged care home. You can complete the application yourself or on behalf of a family member or friend. If you’d like to set up an ongoing representative, you can also do that here.
There are three parts. The first checks you are eligible, the second captures your details, and the third confirms who the assessor should call to arrange the assessment. You will need your Medicare card and enough time to complete it.
Start now
All Guides to Aged Care - just click on what YOU want to know NOW:-
https://www.agedcareguide.com.au/information/all
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Find a Provider - Aged Care Homes EASY! :-)
https://www.myagedcare.gov.au/aged-care-homes
Just click "Aged Care Homes" and put in the Suburb of interest and include (optional) surrounding suburbs. Is an easy to use and intuitive layout.
Newsletter
The Aged Care Quality Bulletin is the Commission's monthly newsletter for Australian aged care providers, sharing the latest information to support our vision of a world-class aged care service.
Subscribe to the newsletter for monthly updates on the Commission.
We value feedback. If you have comments or ideas on the content our newsletter, please send your ideas to [email protected].
Analysis of Consumer Experience Report data
The Commission has just released a new report detailing and analysing what consumers are saying about the quality of care in residential aged care services.
07 March 2019
Click here to find the latest Residential Care vacancies - like NOW.
Costs: The Australian Government subsidises many aged care services to keep costs reasonable and affordable. Costs vary for different types of care and different service providers. There are no standard costs for aged care services. If you are eligible, you are expected to contribute to the cost of your care if you can afford to.
https://www.myagedcare.gov.au/understanding-costs
New Aged care means assessment forms
The Department of Human Services (DHS) has released the new Aged Care Calculation of your cost of care (SA486) digital form. Your clients can fill it in online, print and sign it and send it to DHS with their supporting documents. The digital form uses dynamic questions tailored to the customers’ individual circumstances.
For clients who would prefer to use our simplified paper forms, they are as follows:
- Home Care Package Calculation of your cost of care (SA456)
- Residential Aged Care Calculation of your cost of care (SA457)
- Residential Aged Care Property details for Centrelink and DVA customers (SA485)
These forms are all available on the DHS website. Tips on how to download the digital form can be found here.
Aged care means tests: https://www.servicesaustralia.gov.au/individuals/services/aged-care-means-tests
We assess your financial details to work out how much you need to pay towards aged care.
Customers commencing a Home Care Package don’t need to fill in a form if they get a means tested income support payment from Centrelink or DVA.
Customers entering Residential Care don’t need to fill in a form if they:
- get a means tested income support payment, and
- don’t own their own home.
It is important to make sure their income and assets are up to date when they enter into care to ensure their assessment can be completed automatically. They can do this by accessing their Centrelink online account or by calling Centrelink on 132 300or DVA on 1800 555 254.
Department of Health
13 August 2019
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Food quality and nutrition in aged care will be well and truly in the spotlight in the coming months as the Royal Commission into Aged Care Quality and Safety examines incidents of poor quality, sub-standard food served to residents.
Add to that the new Aged Care Quality Standards, which highlight nutrition as a key determinant of wellbeing, and it’s no surprise that food will play a big role in delivering dignity and choice to residents.
Reduced government funding and rising food costs are issues all providers face. But with increased choice, the ability to accurately track and cost food procurement will create even more hurdles.
Aged care chefs carry much of the burden of producing food that is not only nutritious and appealing, but manages the delicate and complex dietary needs of ageing residents, especially those with dysphagia who require special texture modified diets. Add in a layer of personal, cultural and dietary preferences and you can quickly see how tough it is to satisfy everyone’s needs.
06 February 2019
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https://hellocare.com.au/im-not-your-good-girl-why-older-people-dont-like-being-spoken-to-like-a-baby/
Calling older people names like ‘sweetie’ or ‘dear’ is quite common in aged care homes. But researchers have found that when aged care workers speak to older people as though they are children, it creates the perception of incompetence, and that can lead to a downward spiral.
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Allied health to assist with the ageing experience
Last Updated at October 25th 2021
There are many allied health services that work within the aged care sector which are vital to improving or maintaining the health and wellbeing of older people receiving aged care services or in the community.
- Allied health is a vital part of aged care that works in both the community and in residential aged care settings
- Older people can receive great health benefits from accessing allied health services
- While allied health services a broad range of people and groups, some professionals focus specifically on the aged care sector
Allied health professionals can provide vital health and wellbeing services that are very beneficial to older people. [Source: Shutterstock]
Allied health encompasses a variety of different health services that can build and support the capabilities of older people.
Professionals in allied health will already have involvement with older people in the community at their practices but these services can also be provided within aged care facilities or in the home.
The Government is recognising allied health services as more vital for the health and wellbeing of older people in aged care. In this article, we give an overview of some of the key allied health professionals supporting older people in aged care.
Find an Aged Care Home:
https://www.myagedcare.gov.au/connect-aged-care-homes
The transition to long-term care or a nursing home is one of the most difficult any of us will face. "What's it Really Like?".
Lessons From My Parents, The Candid Truth Of The Aged Care Home
By Rosemary Iloste. Apr 9, 2018
Writes about her own experiences with her parents in care. Well worth the read.
and
https://www.cbc.ca/radio/whitecoat/just-ask-seniors-tell-us-what-it-s-really-like-to-live-in-long-term-care-1.4450594
Unannounced audits have begun rolling out across Australia’s aged care homes. July 1 marked the start date for the new system, under which aged care homes will no longer receive notices for the dates of re-accreditation audits. The move was recommended in Kate Carnell and Professor Ron Paterson’s Review of National Aged Care Quality Regulatory Processes.
On 18 April 2018, Minister Wyatt announced:
- the establishment of a new independent Aged Care Quality and Safety Commission from 1 January 2019
- enhanced risk profiling of aged care providers, to inform the frequency and rigour of visits and to ensure failures are quickly identified and rectified by providers
- the development of options, in consultation with the sector, for a Serious Incident Response Scheme to ensure the right systems are in place to identify an incident and prevent it from occurring again;
- the introduction of a performance rating against the new quality standards
- the development of a user-friendly provider comparison tool on the My Aged Care Website.
You can go to the Quality Agency to see the most current publicly available report for each aged care home.
Do have a look at https://www.agedcareinsite.com.au/ and explore their articles. In making your final decision, YOU need all the help you can get. Of course, if you or your loved one are unhappy, you can look around again and Change Accommodations. It is YOUR choice.
https://www.health.gov.au/health-topics/aged-care/providing-aged-care-services/delivering-quality-aged-care-services
How do I get help to talk to My Aged Care?
If you are an older person who would like a family member, carer or someone else you trust, to help you find government subsidised aged care, setting them up as a representative with My Aged Care might be a good option for you.
https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/06_2017/fact_sheet_rep_for_consumer_170627_v0.7.pdf
There can be another way... Look at having your loved one take 'Respite' in a Nursing Home, just for a few weeks to give them a feel for the place...
Respite Supplement in an Aged Care home:
The maximum daily fee for a respite resident is set by the Government at 85 percent of the single basic Age Pension. Because the stay is temporary, you don't have to pay an accommodation charge or bond the maximum daily fee for a respite resident is set by the Government at 85 percent of the single basic Age Pension. Because the stay is temporary, you don't have to pay an accommodation charge or bond.
The beauty of this is, that your loved one can 'try out' any number of nursing homes - just for Respite. You never know, they may make the choice for you!
SO, just give a few of the nursing homes a call and ASK :-) "Do you have any vacancies for respite?"
To immediately find a list of possible vacancies in Your Area, click here. Tip - Do click the markers on the map too... for that Extra Info...
Remember, you can apply to as many nursing homes as you like. When/if you decide, you can then ring around the others and ask them to take you off the list as you have chosen a home.
Check out the Reports: just click on the Aged Care name.
Following the first round of hearings, the Royal Commission released its first background paper on Australia’s current aged care system.
Background Papers 1-19 called Navigating the maze: an overview of Australia’s current aged care system. It outlines different aspects of the aged care system, the services currently being delivered in Australia and the areas in need of substantial reform.
Research Paper 19 – Does the quality of residential aged care vary with residents’ financial means?
09 February 2021
The Royal Commission will be accepting submissions until mid 2019 from members of the public interested in providing evidence. Submissions can be lodged online, via mail or telephone.
- Online submission
- Mail to: Royal Commission into Aged Care Quality and Safety, GPO Box 1151, Adelaide SA 5001
- Information helpline: 1800 960 711
Top Tips for care recipients: Making a complaint about an aged care service factsheet.
Inform yourself and your loved one. Your nursing home Checklist.
and
Is what you see, what you get?
In hospitals and aged care facilities, especially nursing homes, there is a staffing crisis and this crisis is not resolved by simply increasing the nurse to patient ratios. Solutions that focus on supporting staff retention, including targeted training regimes specifically designed for geriatric care skills, are better for quality patient care. So do ask those awkward questions about nursing home staffing issues.
Residential Care Fee Estimator - click on Aged Care Homes
https://www.myagedcare.gov.au/fee-estimator
Schedule of Fees and Charges for Residential and Home Care: From 20 March 2022
This page provides the latest updates to aged care fees and charges.
[i] Residents in designated remote areas may be asked to pay an additional $1.06 per day.
[ii] This rate applies to residents who enter residential care within this time period but not to those who were already in care prior to this time period. The Maximum Permissible Interest Rate applicable for the calculation of a resident’s daily payments is fixed either at their date of entry to care (for a low means resident) or the date they agree to a room price (for a resident who is not eligible for government assistance with their accommodation costs).
and do remember that the daily care fee IS negiotable.
New aged care means assessment forms
The Department of Human Services (DHS) has released the new Aged Care Calculation of your cost of care (SA486) digital form. Your clients can fill it in online, print and sign it and send it to DHS with their supporting documents. The digital form uses dynamic questions tailored to the customers’ individual circumstances.
For clients who would prefer to use our simplified paper forms, they are as follows:
- Home Care Package Calculation of your cost of care (SA456)
- Residential Aged Care Calculation of your cost of care (SA457)
- Residential Aged Care Property details for Centrelink and DVA customers (SA485)
11 July 2019
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YOUR first look at Aged Care Homes:-
These notes you may keep for Years. Unless there is a rapid deterioration, hospitalization, advice from the medical staff at the hospital, YOUR health deteriorates, or simply that YOU cannot do it anymore. For now, you just visit, look and write down notes. Take along a trusted friend who will drive you around. Do not do this yourself. You will leave the nursing home distraught, in tears, and barely able to stand, let alone think in any coherent fashion. You need your friend's hug and understanding. It is these notes that when, in years to come, you take out and look at. In my case it was 2 1/2 years on due to rapid deterioration in Don's health and his physical total inability to help me even with the most simple of tasks eg. Don's whole body was leaning very much to the left, nearly off the pillow. I placed my hand across his chest and tried to move him back on to the pillow as I had always been able to. It did not work!!! and Don, with all the will in the world, could not help me help him. Also during this time at the hospital, I was being told by the Doctors, Specialists, Nurses, Speech Therapist, Physiotherapist, Dietitian... that I could not manage if I took Don home. I tried, twice and failed. I just could not do it. I rang the Ambulance and Don was returned to hospital and their care.
It was only then that I took out the pile of notes that had been gathering dust at the very back of the cupboard and actually Looked. I am SO glad I had done all of this year's before as I simply could not have faced it at that highly emotional time. As it happened, the nursing home I had placed on the top of the list as the one with the Best Nursing Care, had a vacancy. Don had to be placed straight from the hospital.
This is not an exhaustive list, and Aged Care Crisis may update this information on a regular basis, in line with reader feedback and changing industry standards.
Good Choice Indicators:
1: First Impressions
· Do you like the facility's location and outward appearance?
· Is the facility convenient for frequent visits by family and friends?
· Are you welcomed with a warm greeting from the staff?
· What's the home's attitude to regular visitors? (our research shows that in some facilities, constant visitors are regarded as hostile and are regarded with suspicion)
· Does the staff address residents by their names and interact courteously with them during your tour?
· Are the residents socialising with each other and do they appear well cared for?
· Are you able to talk freely with residents about how they like living there and about the staff?
· Are staff members appropriately dressed, friendly and outgoing?
· Do staff members treat each other in a professional manner?
· Are visits with the residents encouraged and welcome at any time?
· What percentage of the rooms/beds is available?
· Is there a waiting list? If so, how long do they estimate it will take to be admitted?
2: Staffing Levels and Experience
Reforms to aged care as exemplified in the Aged Care Act of 1997 have failed to provide for the safe delivery of quality care for aged persons in residential care facilities.
In Victoria, the previous Kennett Government removed nurse-to-patient ratio requirements. The ratios were one registered nurse per 10 patients on day and evening shifts, and a one-to-15 ratio on the night shift. It also required the appointment of a Director Of Nursing (DON) in each nursing home.
It is essential to ask about staff/resident ratios and the facility's staff turnover rate -- eg, a low staff turnover might indicate that the staff are generally happy, and suggests that what is good for staff is ultimately good for resident care. However, the turnover rate is only one indicator - what about the staff absentee rates - especially on weekends.
In hospitals and aged care facilities, especially nursing homes, there is a staffing crisis and this crisis is not resolved by simply increasing the nurse to patient ratios. Solutions that focus on supporting staff retention, including targeted training regimes specifically designed for geriatric care skills, are better for quality patient care. So do ask those awkward questions about nursing home staffing issues.
It is also important to speak to the Director of Nursing her/himself. The Director sets the tone for the facility. Are the values he/she espouses similar to yours?
Some important considerations include:
· Do nursing staff respond in a timely manner to residents requests for assistance such as help getting in and out of bed, dressing and going to the bathroom?
· Which nursing staff members are involved in planning the resident's individual care? Are they the same ones who provide the care to residents?
· How many trained nurses are there, as opposed to Personal Care Assistants/Attendants (PCA's) or Personal Care Workers (PCW's)?
· What is the Director of Nursing like? (the Director wields a lot of influence over the quality of care given)
· Ask questions about staff turnover. Is there frequent turnover among certified nursing assistants (CNAs)? What about turnover for nurses and supervisors, including the Director of Nursing and the Administrator?
· What is the nursing staff to resident ratio?
· How many registered nurses (RNs) are on staff?
· How many per shift? What is their training/education?
· Does this vary at different times, particularly at weekends?
· What is the history of compliance with staffing ratios and staff development and training?
· Is staff on duty qualified to handle the behaviour challenges of some residents?
· How does the nursing home ensure that all staff maintains licensure/certification, receives continuing education, and keeps their knowledge and skills up-to-date?
· How many staff are permanent? (A high turnover in temporary and/or agency staff means that there could be no-one on duty who is familiar with your loved one and their medical needs)
· Will any special needs of your family member be taken into consideration?
3: Prevalence of Bedsores
Check the resident bedsore rate as a general indicator of staffing problems (Bedsores are a skin condition that if left untreated, can lead to blood poisoning and death. They result when a body’s weight is left for long periods in a single position. The skin area, prevented from receiving proper blood flow, eventually degrades and disintegrates, exposing bone below.)
*Bedsores can sometimes result from other disease conditions, but it is most often a result of staff not turning bedridden residents often enough to avoid the sores. Therefore, good staffing levels are essential.
· Do they specialise in treating bedsores?
· What procedures and specialised equipment (water beds; sheepskins; etc.) do they have in place to limit the prevalence of bedsores?
. Pressure areas are the most fearsome issue confronting rehab and seating occupational therapists. “I will do anything to avoid it,” occupational therapist Sybbi Georgiou, from Megalong Positioning Service told F2L. “Even if a person does not have a pressure injury there is a lot of importance placed around prevention. “Once a person has a pressure injury they always have it. As the patient slowly deteriorates, whatever their condition, the pressure area can quickly become a stage III pressure ulcer that can develop into more serious medical conditions. What happens is that the ulcer can heal over but because it is the weakest spot it can break open again.” Prevention is critical in people who don’t move or can barely move, for example if a person is in a wheelchair, is older, has always had a disability or sleeps for long periods and have bony protuberances close to the skin that make them more susceptible, she said. “Pressure ulcers can be prevented by using support devices including cushions, mattresses and overlays.”
. Do be aware of Pressure Injury. This is MOST SERIOUS
https://www.freedom2live.com.au/feature-pressure-injury-prevention-is-the-word/
. The New Age Bedding System (NABS) is currently being used in nursing homes and community housing Australia wide. It is innovative in design and has enormous impact on overall costs. It will enhance new aged care building developments taking place at the moment and will bring already established facilities up to date. The New Age Healthcare waterproof doona is made from a polyester base fabric which has been coated with polyurethane, providing a total barrier to dust mites and their allergens. It has an anti-bacterial and anti-fungal finish and is breathable. The inside of the doona is a polyester fill and has been treated with silver (Ag) to facilitate infection control.
4: Health, Medication, and Personal Care
· The resident right-of-physician choice has been limited by some parts of the nursing home sector. For example, you may be provided with a list of physician's names from which to choose. If possible, obtain this list before your relative enters the Nursing Home, so that you have an opportunity to research each physician’s background and experience.
· It would be preferable if you actually had your right of physician choice and could choose the quality of care you prefer - you may need to stand your ground on this, although, it may be difficult if your physician is geographically located far away from the Nursing Home too.
· By the Nursing Home controlling the list of physicians, they can also control how medical care is dispensed and the services a resident will receive. To give yourself an edge (and if such a physician is available), choose your own physician.
Why Nursing Home care can be sub-optimal?
. Nursing home medical care is not a highly regarded practice area for physicians. Physicians are already unhappy with dropping Medicare and reimbursement rates for services. Therefore, to minimise their time spent with residents, physicians may opt to provide maintenance-only care, sometimes using polypharmia (overmedicating with multiple drugs) to treat residents. Physicians may or may not examine a resident, or may only provide a cursory exam, may even opt to simply record notes in the resident’s medical records, barely seeing the patient. It is the reason why polypharmia is so prevalent in Nursing Homes - the prescribing of medication gives the appearance of care.
. Your relative will be depending on you to evaluate the care he/she is receiving - making sure that his/her health stays on a path to wellness, rather than mere maintenance and continued, needless suffering. As you observe your relative’s condition and receive the medical advice given, you will quickly find that your research has prepared you to make the best decisions in preservation of your relative’s health, safety and overall well being.
. And finally -- always follow your gut instincts. In a worst case scenario, if the nursing home physician is not cooperating, if your relative is getting worse, if you are confused about what "is," have your relative taken to the nearest hospital for outside medical evaluation under closer care conditions -- today. Don’t second-guess yourself, don’t worry what the Nursing Home will think - take the lead.
. Remember, residents have the right to accept or reject healthcare. We employ the medical profession to borrow their expertise, not dictate what we will do. Consequently, if necessary, don’t think twice about rejecting the nursing home physician and proceed to find the emergent care you believe your relative needs.
What type of healthcare and personal care services are available?
· Does the facility have both short and long-term services, such as routine physical and dental/vision examinations as well as skilled nursing?
· How do staff safely administer, monitor, and assist a resident in taking medicine?
· Does the facility's pharmacy provide delivery, consultation and review of medicines?
· Does a staff physician visit the resident regularly for medical checkups or can the resident his/her have own personal physician?
· Can the facility provide a list of available services and are residents and families involved in developing the care plan/service agreement? Who provides these services/what are their qualifications?
· Are physical, occupational, or speech therapy services available onsite? Who coordinates these services and how are they billed? (Medicare, Private cover, etc.)
· Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? Activities of daily living include dressing eating, mobility, hygiene, grooming (bathing, toileting, incontinence)
· Does the residence have Alzheimer's programs, or other dementias and other specialized areas? How does staff safely manage residents who might wander?
· Are staff available to assist residents who experience memory, orientation, of judgment losses?
· How are medical emergencies handled? Does the residence have a clearly stated procedure for responding to medical emergencies? Is there an arrangement with a nearby hospital?
· What's the facility's attitude to medical visits outside? (homes are only required to 'facilitate' these -- sometimes this can amount to no more than dumping your relative in a taxi -- whether they are competent to manage on their own at the other end is something you may need to address)
· Are housekeeping, linen service and personal laundry included in the fees, or extra charges?
· Does the facility provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents and can it be arranged on short notice?
· Are pharmacy, barber/beautician and/or physical therapy services offered on-site?
5: Food, Liquids, and Nutrition
· Does the facility provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary from meal to meal?
· Observe meal times:
- Do all residents who need assistance with eating get help?
- Do staff give each resident enough time to chew food thoroughly and complete the meal?
· What about special diets; does a dietician plan or approve menus? Are resident's weight routinely/regularly monitored?
· Are residents involved in menu planning? Can they request special foods? Are snacks available?
· Does the dining room environment encourage residents to relax, socialize, and enjoy their food
- Are the meals varied and of good quality?
- Are the meals cooked on the premises? Or are they just reheated, with Lovely but 'artificial smells' coming through the room?
- Are the helpings sufficient for your loved one?
- Are water pitchers/glasses accessible in rooms and does staff assist with drinking as needed? AND can your loved one REACH the glass?
- Are common dining areas available? Is tray service available when ill and are there staff to assist?
- Can meals be provided at a time a resident would like or are there set times for meals?
- Can residents have guests for meals in the dining room for an additional fee? Is there a private dining room for special events and occasions?
6: Social and Recreational Activities
Social and recreational activities are important for the elderly: Some facilities attitude of 'activities' may simply be limited to placing your loved one in a wheelchair, dumped in a room facing a television, or lined up in a hallway.
You may want to ask the following questions:
· What kinds of group/individual recreational activities are offered and who schedules them?
· Is there a full-time Diversional therapist? (These should have a certificate and be trained for the job - cost-cutting measures can lead to untrained recreation officers fulfilling this role)
· Is there an organised activities program with a posted daily schedule of events?
· Do volunteers and family members come into the facility to participate/conduct programs?
· Does the facility schedule trips or go to other events off premises?
· Do residents participate in activities outside of the facility in the neighbouring community?
· Are the resident activity (social) areas appropriate and desirable to the prospective resident?
· Are there supplies for social activities/hobbies (games, cards, crafts, computers, gardening)?
· Are religious services held on the premises or arrangements made for nearby services?
· Are there fitness facilities, as well as regularly scheduled exercise classes? Can you use them at any time?
· Does the nursing home create a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole?
· Does the facility have a garden and allow residents who can participate in gardening activities? Are there raised flower beds for ease of use?
· Does the facility have pets? Who is responsible for their care?
· Does the facility encourage "Pet Therapy" visitations?
7: Living Conditions, Safety, and Environment
This section details impacts on the living conditions and environment a resident has whilst in the facility. The facility needs to be open for friends and family to visit. Studies show that the most effective way to prevent elder abuse is to have routine visitors (in some people's experience, constant visitors are regarded as witnesses and some homes don't like them)
· Is the floor plan well designed and easy to follow?
· Are windows easily dislodged for emergency needs?
· Are doorways, hallways and rooms accommodating to wheelchairs and walkers?
· Are elevators available for those unable to use stairways and handrails to aid in walking?
· Are floors of a non-skid material and carpets conducive for safe walking?
· Does the facility have good lighting, sprinklers and clearly marked exits? (is a sprinkler system and fire extinguishers installed; is there a fire escape?)
· Is the facility clean, free of odors and appropriately heated/cooled? (ie, if your geographical area subjects the Nursing Home to extreme weather conditions, you also want to be sure that proper heating and cooling systems are in use. If your relative’s bed is nearest a window, is the window well insulated, does it keep the area warm?)
· What is the facility's means of security if a resident wanders? (ie. the monitoring of wandering Alzheimer’s residents)
· What safety procedures are followed by the Home (door locking, security checks, etc.)
· Are the common areas in general attractive, comfortable and clean?
· Is there an outside courtyard or patio for residents and visitors, and assistance getting there?
· Does the facility provide ample security and is there an emergency evacuation plan?
· How are residents escorted to safety?
· Are private rooms available and/or double occupancy units for sharing with another person?
· Is there a place where you can talk in private with your loved one?
· Does the residence have furnished/unfurnished rooms? What is provided or what can they bring? (The furniture that is provided should be comfortable)
· Are residents permitted to decorate their own rooms? Is there adequate storage space? (The rooms should have space for personal articles and furniture)
· Is a 24-hour emergency response system accessible from the facility?
· Are bathrooms private with appropriate accommodations for wheelchairs and walkers?
· Do all rooms have a telephone and cable TV and how is billing handled?
8: Patient Choice and Input
The first area to investigate is whether residents are allowed to make choices about their daily routine (for example: some homes make a practice of bedding down residents at an early hour to ensure minimum staff is required for resident care during the night)
Residents should however, still be allowed to make some decisions such as when to go to bed, get up, bathe, or eat (some restrictions concerning the routine can be expected)
If the resident has special needs, it is important to see how the nursing home accommodates such needs
· Is there a resident's committee and/or a family member's group?
· Do they have regular meetings?
· Do residents and their families feel comfortable speaking up at these meetings?
· Can anonymous suggestions be made? (Consumer input is a requirement under the government's standards.)
· Is the home's documentation available in the language you need? (ie, the Agreement you sign on entry to the nursing home; complaint forms; etc.)
· Are you permitted to have your own family physician visit your loved one? (sometimes, nursing homes insist on using their own doctor, as well as their own pharmacy). Note: if you/your loved one don't like/think a particular visiting Doctor is not giving as much care as you believe your loved one needs, you CAN 'fire' them LOL and ask what other Doctor's come into the home and choose one of them. You CAN do this. There is no rule against changing Doctors.
· Are the residents and their families encouraged to have input into the quality of care? Vital!
9: Accreditation, Sanctions, and Reports
Through process of elimination, you will narrow your Nursing Homes list down to five or six. Next, you must learn more about each facility and evaluate each thoroughly.
After ascertaining which questions to ask and learning about the facility's track record, make sure you visit the facility to get answers to your questions and to see first-hand the appearance and operation of the Nursing Home.
· Is this a high care nursing facility and is a high care bed available?
· Is the facility accepting new patients? Is there a waiting period for admission?
· Is the facility sponsored by a non-profit organisation and managed under contract with a commercial firm? If so, what are the conditions of that contract?
· Is there a Resident Support Group through which resident/family have a means of voicing their views on the management of the nursing home and/or it's delivery of services?
· Each nursing home requires the residence to be "accredited" by the Aged Care Standards and Accreditation Agency. Does the facility have a current license/certification and is it displayed?
Where can I find accreditation reports for a home?
Accreditation Reports Search - type in the name of the nursing home
https://www.agedcarequality.gov.au/reports
Every accreditation audit and review audit report on each residential aged care home, along with the Quality Agency's accreditation decision is published on the Aged Care Quality and Safety Commission website. This helps ensure that information about aged care services is available to residents and prospective residents to enable them to make informed decisions about their care.
· What reputation does the nursing home have in the community? How long has it been in business? Is it in good financial health? Does the nursing home follow generally accepted accounting procedures?
· Check the history of the nursing home, ie, has it corrected any Quality of Care deficiencies in their past or present Accreditation audits or any other reports?
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In our opinion the best decisions will be those you have made yourself on the basis of your own assessments after face to face inquiries of the kind mentioned above. However, if you feel the need for an intermediary then we suggest the following questions should be considered and put.
In all cases however, we strongly recommend you make notes about the responses to all the questions you may ask, of the Providers, the staff and the consultant. It may be weeks, months or years – perhaps never, but notes of that kind can be extremely useful.
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Do have a look at http://www.agedcareinsite.com.au/ and explore their articles. In making your final decision, YOU need all the help you can get. Of course, if you or your loved one are unhappy, you can look around again and Change Accommodations. It is YOUR choice.
The Australian Aged Care Quality Agency is committed to supporting consumer choice, and promoting continuous improvement in quality in aged care service provision.
We interview more than 50,000 residents of aged care homes each year as part of our assessment against standards for the quality of care and services in aged care.
For more information, please browse the links below and see About Us.
12 April 2019
https://www.agedcarequality.gov.au/consumers
03 January 2020
What if I am having trouble Coping?
If you need to talk to someone immediately, contact Lifeline (24 hours a day) on 13 11 14.
14 April 2022