The " Aged Care " Enigma !

The big worry for those tasked with finding aged care for their parents as their ability to live at home slips away is care quality and that varies widely across the aged care spectrum.   The media regularly deliver shocking stories of neglect and the government is quick to close down offending institutions that fail to meet its monitoring standards.

Aged care is a mix of " for profit " homes and those provided by charitable organizations and churches.  They range from lifestyle villages to nursing home accommodation and both staff ratios and the food standards have a lot to do with resident appeal.   The rate charged is very much in government hands but the standard of care depends on the outlook of the provider.

One of the problems is that the needs of residents vary as continuing age decreases their abilities and most aged care providers need to cater for individual requirements.  Some residents need more attentive care than others and eventually some need to be hand fed to achieve an adequate nutrient intake.  Often, this need changes dramatically the longer the resident is in care.

Of concern is the decision by a " for profit " aged care provider with forty-four homes nationally to make a change to its " overnight care " policy.   It is the policy of most aged care homes to look in on residents during the night to ensure that they are breathing and have not fallen out of bed.  Usually the check ratio is once on every four hour cycle.

It is simple, but effective.  A nurse with a torch opens the door and checks the patient without turning on the main light or disturbing their sleep.  If they find a patient awake they see if there is a problem keeping them awake.  In some cases they may turn the patient to avoid bed sores or elevate the bed to aid breathing.

This aged care group is deciding to cease this practice.   It claims that checking that a resident is still breathing and has not fallen out of bed is based on hospital culture and  is not a home environment routine.  It also directs staff not to wake residents unnecessarily and prioritise residents physical, emotional and personal comfort care needs over other tasks.

This will create concern in nursing circles.  The Australian Nursing and Midwifery Association said the document was obviously just a mechanism to cope with a reduction in staff.  It warned that nurses who followed this guideline would expose themselves  to actions for professional negligence if someone fell or if dangerous bed sores developed because a patient was not turned.

All this is of concern for those seeking aged accommodation for a family member.  The aged care industry is waging a constant battle to contain costs and very often this impinges on the standard of meals or the staff numbers employed to provide services.  That is something that is not apparent from glossy brochures and the wise will make personal checks and evaluate by their observations.

Most aged care homes have a call system beside each bed to summon a nurse if needed and the state of the patient can be monitored electronically if motion sensors or impression mats are provided but a regular call by a trained person is the best safety standard.

Ensuring care is adequate is best maintained by regular family visits with a wide spread of timing so that meals are checked.   When standards slip a call to the regulatory authority can usually bring results.  Unfortunately, checking if night care is still practised can not be ascertained by observation.