In recognition of widespread concern about the over-prescription of anti-psychotic drugs, and as part of the priority being given to improving care for people with dementia, Professor Sube Banerjee was asked to undertake an independent clinical review of the use of anti-psychotic drugs. 

Relatives and healthcare staff find it hard to diagnose pain levels in nursing home residents accurately, especially if they are cognitively impaired with illnesses such as dementia or unable to speak, according to a study in September issue of the Journal of Clinical Nursing.

Careless staff may explain why medication errors are more likely to occur in nursing homes than for patients self-administering their medicines at home, research by the Victorian Poisons Information Centre suggests.  

A major new statistical review of 82 individual research studies has revealed that nonprofit nursing homes deliver, on average, higher quality care than for-profit nursing homes. The findings could have a bearing on the present debate about the role of for-profit firms in U.S. health reform.

The Media: Aged Care Report Card 2007 – 2008

Related: Aged Care Report Card; The Data

The media were also interested in the way in which the Ageing Minister had reported the number of non-compliant nursing homes as 46 vs. 199:

Australia must learn the lessons resulting from the collapse of the private-for-profit ABC Learning centres.

It is obvious to Aged Care Crisis that the farming out of human care services as a profit-making activity, whether it is of the very young or the very old, is simply asking for trouble. And we have just seen that trouble with the collapse of the ABC Learning Centres.

Related and main article: Aged care report card

The Minister announced in her media release of 26 November 2008, and also states in the Report on the Operation of the Aged Care Act 1997 - 1 July 2007 to 30 June 2008:

"...This is about transparency and openness in aged care..."

Aged Care in Australia 2007 – 2008

The Minister for Ageing, Justine Elliot, commented in her media release on 25 November, 2008:

The Minister made further comment in her media release on 26 November, 2008:

Release of annual report – Operation of Aged Care Act 2007-2008

PDF printable version of Release of annual report – Operation of Aged Care Act 2007-2008 (PDF 54 KB)

25 November 2008

The Minister for Ageing, Mrs Justine Elliot today released the annual report into the Report into the Operation of the Aged Care Act 2007-2008.

It showed 300,000 Australians received care through the record support for the aged and community care sector provided by the Rudd Labor Government.

Currently, there are some 2.8 million Australians – about 13 per cent of the population – aged 65 and over. This number is expected to triple in 40 years.

“Australia has the world’s second longest life expectancy and the Australian Government is responding to the challenge of an ageing population,” Mrs Elliot said.

“Over the next four years, the Australian Government will invest more than $41.6 billion into aged and community care. We will provide on average $41,500 a year a resident in subsidies. No Government has invested more into this area than the Rudd Government.

“We want to ensure the long-term viability of the aged sector, but also ensure that there are quality and accreditation standards to protect vulnerable members of our society,” Mrs Elliot said.

In 2007-2008, more than 300,000 people received a form of aged and community and the Federal Government provided $8.3 billion for ageing and aged care in Australia.

As of June 30, there were 2,830 nursing homes and hostels in Australia; 174,669 residential places; 46,475 community care places and 1,963 transition care places.

The report covers July 1, 2007 to June 30, 2008, including the final four months of the previous Government.

Section 63-2 of the Aged Care Act requires the Minister for Ageing to present a report on the operation of the Act for 2007-2008 before November 30.

Key facts: Report on the Operation of the Aged Care Act

Aged and Community Care – 2007-2008

• 208,079 people received permanent residential aged care;
• 39,443 people received short-term respite care in aged care homes; of whom 18,415 were later admitted to permanent care;
• 61,739 received care at home through a community care or flexible care package;
• 10,351 received transition care following a hospital stay;
• 53,074 admissions to residential respite care, and care recipients used an estimated 1.18 million resident days;
• A total of 10,874 new aged care places were allocated nationally during 2007-2008;
• About 831,500 individuals received a form of Home and Community Care (HACC) service – with some receiving more than one service; and
• A total of 188,967 Aged Care Assessments were completed in 2006-2007, compared with 179,354 for 2005-2006.

Aged and community care providers

• As of June 30, there were 2,830 nursing homes and hostels in Australia;
• In 2007-2008, the nursing home and hostel comprised – religious, charity and community based (59.7 per cent); for-profit/commercial (33.3 per cent) and State and local governments (7 per cent);
• In 2007-2008, the community care sector comprised – religious, charity and community based (83.6 per cent); State and local governments (11.7 per cent) and for-profit (4.7 per cent).

Expenditure – 2007-2008

• Overall Federal government expenditure for ageing and aged care during 2007-2008 totalled $8.3 billion compared with $7.7 billion in 2006-2007 – an increase of 7.8 per cent in 2006-2007;
• $6 billion was spent on residential aged care;
• $448 million for Community Care Packages – an increase of 10.6 per cent over 2006-2007;
• $335 million for flexible care programs, including Extended Aged Care at Home (EACH) and EACH – Dementia packages, Multi-purpose Services and Transition Care;
• Average accommodation bond charged to a new resident by providers was $188,798 in 2007-2008;
• the average holding per approved provider was $6.5 million and the 10 largest bond holders held about 19 per cent ($1.2 billion) of all accommodation bond monies; and
• Thirty-five per cent (6,098) of the 17,132 Resident Classification Scale reviews resulted in re-classifications – meaning the funding claims made by providers accurately matched the level of care for people living in nursing homes.

Expenditure – 2008-2009

• Over the next four years to 2011-2012, funding for aged and community care will reach record levels of $41.6 billion.
• Funding in 2008-2009 for community care services will total $2.2 billion – an increase of $260 million over 2007-2008;
• For 2008-2009 alone, there will be an increase of 10.4 per cent in funding for aged and community care;
• The new Aged Care Funding Instrument (ACFI) that commenced on March 20 with bipartisan support will see more than $1.13 billion in additional funding to the residential care sector over the first four years of its use;
• An increase in the Conditional Adjustment Payment (CAP) in the 2008 budget will see an increase of more than $407 million over the four years to 2011-12 flow to the sector – bringing the total CAP funding for aged care to $2 billion;
• Allocation of $150 million in Zero Real Interest Loans to create 1,455 nursing home beds and community care packages for older Australians in areas of high need – with 375 and 154 places in Western Australia and Tasmania, respectively; and
• Allocation of 228 new transition care places under its $293.2 million plan – to help older Australians recover from a hospital stay and return to their own homes. The 228 places are expected to benefit up to 1,710 older Australians – in a full year. Each funded place will be used by up to eight different older Australians a year.

Construction/upgrading work

• $1.45 billion worth of new building, refurbishment and upgrading work was completed to nursing homes during 2007-2008 – involving about 13.4 per cent of all homes;
• $1.93 billion of construction work was in progress as at June 30, 2008 – involving 9.8 per cent of all homes; and
• At June 2008, an estimated 11.6 per cent of nursing homes were planning building work.

Quality, complaints and compliance

• During 2007-08 the Aged Care Standards and Accreditation Agency conducted 5,244 visits to homes, with 3,105 visits being unannounced. In this same period the Department undertook 3,127 visits to homes, of which 1,145 were unannounced.
• The Accreditation Agency identified 46 homes (1.6 per cent) that had some non-compliance in relation to the 44 accreditation standard outcomes.
• The Aged Care Complaints Investigation Scheme (CIS) referred 1,770 matters to the Accreditation Agency, 62 to Nurses’ Registration Boards, 53 to the police; 33 to the Coroner; 27 to the Health Care Complaints Commission and 13 to the Medical Practitioners Board.
• Twenty-two percent of the referrals to the Accreditation Agency requested a support contact or a review audit of a nursing home.
• During 2007-2008, the Department of Health and Ageing applied sanctions against 14 providers, issuing 15 Notices of Decision to Impose Sanctions and issued 75 Notices of Non-Compliance.
• The CIS received 11,323 contacts between July 1, 2007 and June 30, 2008 of which 66 per cent were able to be investigated as these related to approved providers’ responsibilities under the Aged Care Act 1997 (the Act).
• The most common issues reported to the CIS in order were: Health and Personal care (3,106 cases), physical environment (1,598 cases), consultation and communication (1,496 cases), personnel (1,255 cases) and 1,117 cases relating to alleged abuse.

Breaches under the Aged Care Act

• The CIS identified 930 breaches of an approved provider’s responsibility.
• There were 214 Notices of Required Action issued by the CIS requiring providers to address a breach.

Of the remaining number of breaches, the matters were resolved through a negotiated outcome or through referral to another agency.

Of the 930 breaches identified:

• 36 per cent (333) were in Victoria;
• 25 per cent (231) were in NSW;
• 17 per cent (162) were in Queensland;
• 9 per cent (84) were in WA;
• 6 per cent (53) were in SA;
• 4 per cent (39) were in Tasmania;
• 2 per cent (17) were in ACT; and
• 1 per cent (11) was in NT.

214 Notice of Required Actions were issued where approved providers were found to be in breach of the Act and had not taken action to rectify the breach:

• 40 per cent (86) of all NRAs were in Queensland;
• 22 per cent (47) were in NSW;
• 15 per cent (32) were in South Australia;
• 9 per cent (20) were in Victoria;
• 4 per cent (8) were in both Western Australia and Tasmania;
• 3 per cent (7) were in the Northern Territory; and
• 3 per cent (6) were in the Australian Capital Territory.

There were 925 notifications of alleged reportable assaults.

• Of those 725 were recorded as alleged unreasonable use of force and 200 were alleged unlawful sexual contact:
  
  NSW had 323 alleged reportable assaults,
  275 were alleged serious physical assault,
  48 were alleged sexual assault;
  
  Queensland had 225 alleged reportable assaults
  174 were alleged serious physical assault,
  51 were alleged sexual assault;
  
  Victoria had 224 alleged reportable assaults
  152 were alleged serious physical assault,
  72 were alleged sexual assault;
  
  SA had 86 alleged reportable assaults
  69 were alleged serious physical assault,
  17 were alleged sexual assault;
  
  WA had 33 alleged reportable assaults
  27 were alleged serious physical assault,
  6 were alleged sexual assault;
  
  Tasmania had 28 alleged reportable assaults
  23 were alleged serious physical assault,
  5 were alleged sexual assault;
  
  Australian Capital Territory had 5 alleged reportable assaults
  4 were alleged serious physical assault,
  1 was an alleged sexual assault; and
  
  Northern Territory had 1 reportable assault, which was an alleged serious physical assault.

Police are responsible for determining whether charges should be laid. As this is a police matter, within the jurisdiction of each State and Territory, the CIS is unable to track if and when charges are laid.

For more information, contact Mrs Elliot's office on (02) 6277 7280

Source:   News-Medical.Net [Disease/Infection News]

Methicillin-resistant Staphylococcus aureu (MRSA) is making news as a dangerous, sometimes fatal disease for hospital patients, and in recent cases, students.

Source:   News-Medical.Net - Medical Studies/Trials

Researchers at Yale School of Medicine have found that a low concentration of vitamin E in the blood is linked with physical decline in older persons.

Source:   News-Medical.net - Medical Studies/Trials

An elderly person's risk of falling is too often overlooked when trying to prevent them from getting serious fractures, for instance of the hip or wrist, according to an article published in this week's BMJ [British Medical Journal].

AAP: Linda A. Johnson, Associated Press Writer

Widely prescribed anti-psychotic drugs do not help most Alzheimer‘s patients with delusions and aggression and are not worth the risk of sudden death and other side effects, the first major study on sufferers outside nursing homes concludes.

Geelong Advertiser:

A GEELONG-based study has found a link between annual doses of vitamin D reducing the number of falls suffered by elderly women.

More than 2300 women, aged 71-95, are involved in the five-year research project which tests the effects of vitamin D by giving doses of it to some of the participants while others are administered a placebo.

A new study has found nursing home staff feel they do not get enough training and are overworked.

The Age: Annabel Stafford

MORE than a fifth of elderly people admitted to hospital are malnourished and 41 per cent are at risk of malnutrition, according to a study by Western Health Service in Victoria. It calls for screening for people at risk.

ELEANOR HALL: An Adelaide survey has provided a damning snapshot into the dental health of nursing home residents. The report by the University of Adelaide shows that people in nursing homes suffer oral diseases at a rate many times higher than older people living in the general community, and bad dental health is problem that can lead to further health complications such as pneumonia, as Nance Haxton reports from Adelaide.