Understanding National Advance Care Planning Week: A Vital Step Towards Informed Healthcare Decision-Making

We’re celebrating National Advance Care Planning Week (18-24 March), a time dedicated to fostering informed healthcare decision-making and advocating for proactive health planning.

What is Advance Care Planning?

Advance Care Planning (ACP) is a collaborative process aimed at preparing individuals for their future healthcare needs. It is a voluntary and ongoing dialogue that ensures one’s healthcare preferences and values are documented and respected. Through ACP, individuals can articulate their treatment preferences, end-of-life care wishes, and medical directives.

The Benefits of Advance Care Planning

The advantages of engaging in Advance Care Planning are multifaceted:

  • Consistent Care Delivery: ACP helps guarantee that individuals receive care that aligns with their wishes and values, even if they are unable to communicate their preferences in the future.
  • Enhanced End-of-Life Care: By outlining preferences in advance, individuals can receive more personalised and satisfactory end-of-life care.
  • Improved Communication: Advance Care Planning encourages open and honest communication between individuals, their families, and healthcare professionals, fostering mutual understanding and respect.
  • Reduced Moral Distress: Families and caregivers experience less moral distress when they are aware of their loved one’s healthcare preferences, making difficult decisions more manageable.
  • Prevention of Unwanted Treatments: ACP may help prevent unnecessary or unwanted medical interventions and treatments, ensuring that care remains focused on the individual’s goals and quality of life.

Empowering Individuals Through Information

At Reliant, we recognise the importance of Advance Care Planning in promoting individual autonomy and quality healthcare. We are committed to providing resources, guidance, and support to help individuals and families navigate the ACP process.

For more information on Advance Care Planning and how you can get started, please reach out to our compassionate team of healthcare professionals, and find information and conversation starters on the Advance Care Planning Australia website.

Let’s use National Advance Care Planning Week as an opportunity to prioritise our health and wellbeing, and to take proactive steps towards shaping our healthcare futures.

Final Report – Aged Care Quality & Safety Royal Commission

Yesterday, the Royal Commission into Aged Care Quality and Safety handed its report to the Australian Government (a summary is available here). While many of the criticisms and recommendations of the report (the report has 148 recommendations in total) are focused on residential care, we have received with great interest those parts of the report specifically focused on home care. Interestingly, both Commissioners found that the Aged Care Quality and Safety Commission had not demonstrated strong and effective regulation. At Reliant we hold ourselves to the highest standards, and as such we have voluntarily submitted ourselves to assessment by the Australian Council on Healthcare Standards. This body has fully accredited us until 2024 in recognition of our desire to meet and exceed best practice.

Below please find an article excerpt from Stephen Duckett, Director, Health Program, Grattan Institute and Anika Stobart, Associate, Grattan Institute published on The Conversation which succinctly outlines 4 key takeaways from the report.

4 key takeaways from the aged care royal commission’s final report

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Stephen Duckett, Grattan Institute and Anika Stobart, Grattan Institute

The Royal Commission into Aged Care Quality and Safety’s final report into aged care has laid out an extensive plan to overhaul Australia’s aged-care system.

Among the 148 recommendations, the report calls for a new system underpinned by a rights-based Act, funding based on need, and much stronger regulation and transparency.

Over two years, through more than 10,500 submissions and 600 witnesses, the two commissioners heard extensive evidence of a system in crisis. Australians might have expected the commissioners to provide one streamlined blueprint for reform.

But the commissioners diverged on a number of large and some smaller recommendations. This makes the already complex path to reform even more confusing. It reduces the power of the final report. More disappointingly, it gives the government room to pick and choose recommendations as the cabinet likes.

Nonetheless, if the major recommendations are adopted, Australia will get a transformed aged care system over the next five years.

Here are our top four takeaways from this landmark report.

1. Australia needs a rights-based aged-care system

In its recommendations, the final report highlights Australia needs a new Aged Care Act to underpin reform. The new Act should set out the rights of older people, including their entitlement to care and support based on their needs and preferences.

This would be a significant shift away from the current ration-based system, and would bring aged care more in line with the principles of Medicare.

Practically, this would mean the number of people in the system would no longer be capped — the long waiting lists for care would disappear over time. The current aged-care programs, such as home-care packages and residential care, would be replaced by a single program.

Under this new program, all older Australians in need of support would be independently assessed, and allocated care according to their personal needs and preferences — whether at home or in residential care.

This is a huge step forward, and, with the right support, would enable older Australians more choice and control over their care.

2. The system needs stronger governance

Ineffective governance and weak regulation of aged care must end. The final report calls for much stronger governance, regulation of the quality of care, prudential regulation, and an independent mechanism to set prices.

These changes would ensure the “quasi-market” aged-care system, as commissioner Tony Pagone described it, was much better regulated, holding providers to a higher standard of care, and better able to address any service gaps in the system. We might see the introduction of home care in locations where home-care services were not previously available, for example.

This change would require all aged-care providers to be accredited against the new standards. We hope that process would weed out some of the poorest performers in the sector. The new system would have offices across the country, to provide on-the-ground support to older Australians and providers.

Unfortunately, the commissioners diverged on the exact mechanisms for these changes. Pagone wants an independent commission to be responsible for aged care, at arms-length from the health department. Meanwhile, commissioner Lynelle Briggs wants governance to remain with a reformed department, but with quality regulation managed by an independent quality commission.

Given the department’s poor track record on managing aged care, we need to see a major change of culture. We urge the government to accept commissioner Pagone’s recommendation.

3. We need to improve workforce conditions and capability

The final report makes numerous important recommendations to enhance the capability and work conditions of formal carers. It calls for better wages and a new national registration scheme for all personal care workers, who would be required to have a minimum Certificate III training.

Residential care facilities would need to ensure minimum staff time with residents. By July 1 2022, this would be at least 200 minutes per resident per day for the average resident, with at least 40 minutes of that time with a registered nurse.

The facilities would be required to report staffing hours provided each day, specifying the breakdown of residents’ time with personal care workers versus nursing staff.

While these measures are good, they are the bare minimum, and would only give facilities a minimum 2 or 3 star rating. But coupled with recommendations for stronger transparency, including the publication of star ratings and quality indicators to compare provider performance, providers might be incentivised to go above this minimum standard.

4. A better system will cost more

The final report makes a series of complex recommendations about fees and funding, with the commissioners diverging in view as to the specific arrangements. But essentially, the proposed new funding model would provide universal funding for care services, such as nursing.

This means there would be no requirement for aged-care recipients to pay a co-contribution, like public patients in public hospitals. Instead, the expectation is people pay for their ordinary costs of living, such as cleaning, subject to a means test and up to a maximum amount in residential care.

A carer holds the hand of an elderly person.
A rights-based system means funding is determined by each individual’s needs.
Shutterstock

These changes would coincide with the phase-out of the burdensome refundable accommodation deposits, which some residents currently pay as a lump sum to providers when they enter residential care. This approach is a shift away from the current muddled set of means-tested arrangements, and may help offset some of the additional spending needed to pay for a rights-based system.

Unfortunately, the report does not touch on how much the recommended changes would cost. Australia should be prepared to pay the price of a better aged care system.

The government has been underspending on aged care. Most Australians agree the government should provide more funding for aged care. Commissioner Briggs has the more persuasive proposal for funding the new system. She wants the government to introduce legislation by July 1 2022 that establishes an aged-care improvement levy of 1% of taxable personal income.

Commissioner Pagone is weaker on this point. He wants the Productivity Commission to investigate the establishment of an hypothecated aged-care levy (meaning the money raised by the levy can only be spent on aged care).

Either approach will be politically difficult, but Australians should demand their government lock-in a secure funding supply. That will help produce an aged-care system that protects the rights, upholds the dignity, and celebrates the contribution of all older Australians.The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We Won Gold at the 2019 LGBTI Inclusion Awards!

Last week we received the great news that Reliant has received the Gold Service Provider Award for the Health and Wellbeing Equality Index (HWEI) at the 2019 Australian LGBTI Inclusion Awards. This award is the national benchmark for LGBTI inclusive service provision in Australia. We are committed to continuously improving our knowledge of and service to the LGBTI community. We are very proud to have received this award and we will continue to strive to maintain an inclusive and safe environment for our clients. Congratulations to all our team!

Reliant achieved Gold status in the 2019 Health + Wellbeing Equality Index.

A moment to say thank you…

As a healthcare company that provides workers to help support and care for our clients we would like to take a moment to pay respect and acknowledge the amazing work that the 2.7 million unpaid carers contribute to healthcare. Without carers, people who need support due to illness, disability, mental health, addiction or other problems would be lost.
 
It is due to their dedication and perseverance, which we are sure many of these carers are unaware they possess, that the health of numerous people in our society manages to stay stable.
 
As a company we have been privileged to work alongside and support the amazing contribution of the carer to help our clients engage in a life that that can live. Sometimes our work comes in the shape of well-earned respite, the giving back of the role of family member or to bring some order in an often stressful or unsustainable situation. Before this point, however, it is the pivotal role of the carer that should be noticed and acknowledged.
 
For us then to take a moment during National Carers Week to pay respect and be in awe of the dedication that carers show to their family members or friends is the very least that we can do.
 
As part of National Carers Week there are many activities that are happening throughout NSW. Have a look at the Carers NSW website for activities that may be close to you. 

LGBTI Ageing Health Outcome Strategy

Dr Justin Koonin, Alexandra Conroy, Kathryn Greiner, Auntie Millie Ingram at the launch of ACON's Ageing Health Outcomes Strategy  2017-2021
Dr Justin Koonin, Alexandra Conroy, Kathryn Greiner, Auntie Millie Ingram at the launch of ACON’s Ageing Health Outcomes Strategy 2017-2021

We were very proud to help launch ACON’s new Ageing Health Outcome Strategy 2017-2021 which outlines the health disparities, and needs, of older members of the LGBTI community. We were invited to share our experiences in catering for the needs of our older LGBTI clients. 

The Productivity Commission’s 2011 report, Caring for Older Australians, recommended an emphatic focus on consumer-directed choice in aged care, highlighting the need for the system to be overhauled so it could accommodate not only a significant increase in numbers, but also a more diverse range of seniors with a less homogenous set of requirements. The Ageing Strategy will seek to develop healthy ageing programs, including those to address social isolation, increase uptake of healthy ageing behaviours, and to support self-management skills and capacity for self-advocacy.

Reliant  provides truly consumer directed care and place huge emphasis on enabling people to live their lives as they choose and to facilitate that choice. We are proud of our commitment to encouraging clients to be themselves and of our service to our clients who are members of the LGBTI community.

Congratulations to our CEO

Reliant’s CEO, Alexandra Conroy, has been awarded the NSW Young Manager of the Year in the AIM Excellence Awards.

The Young Manager of the Year category recognises the most successful young entrepreneurs and business leaders up to the age of 30. The category acknowledges rising stars and aspiring leaders from business, government and industry and who are making their mark in the industry in which they work.

AIM (Australian Institute of Management) is Australia’s largest membership organisation for managers and leaders. Every year at AIM, 25,000 professionals take part in over 80 training programs and study towards any one of 24 management qualifications in 11 locations around Australia. AIM has provided training to at least half a million people in its 75 year history and is a trusted training partner to over half the companies on the ASX200.

In her acceptance speech, Alexandra said “I’m really pleased that what we do as an organisation as well as the part that I play can be acknowledged in this way.” Alexandra has dedicated her award to her valued staff.

Please click here for more information on the event.

Who moved the goal posts?

Let’s face it. You’ve finished two degrees, worked hard and smart most of your adult life and are just coming to the top of your career; so you should be able to handle this, right? But your elderly parent coming to live with you and your family petrifies you to the bone.

Firstly, you are not alone. With the population ageing at a frightening rate and the government cutting health care budgets at every turn, this is not an inconceivable scenario in a lot of people’s lives and it can be tricky. Just when you finally have the corner office, after years of pouring all your energy and focus into your career, you have to learn about chronic diseases. Not to mention you have also, with some success, juggled your home life, encouraged (supported) two teenage children, a dog and some sort of social life, you are now also needing to learn about incontinence, early stage dementia, respite care, the stubbornness of the ageing population and how to navigate a host of other “what else could go wrong” scenarios.

Feelings

At this time a mix of resentment and guilt is probably flooding through your veins, tick that box. You can also see your “me time” or date night with your partner slowly dwindling down the proverbial kitchen sink, another tick, and where the hell do you learn about incontinence pads, tick. These are all valid glitches and although this is probably not in line with the goalposts that you cemented at the beginning of your working life you will find yourself learning to function just outside their parameters. Not only can this be stressful for you but also for your aged family member who is losing a significant amount of independence as their age becomes a reality.

Taking time out

This is a very stressful time in many people’s lives but we do need to learn to be kind to ourselves and, of course, kind to the family member who needs care. It takes time to readjust your life when a parent comes to live with you. Talk to family members who are still living at home about what changes are expected and that there may be a period of “settling in” where life will be hectic and demand more of your time until a pattern can occur. Making time for you alone and you as part of a couple is vital to keeping you feeling supported and connected with your life. Enlisting the help of professional  carers or family and friends, if your parent’s needs are constant, will give you a well-earned time out.  If the move has been planned there may be an opportunity to talk to professionals about what to expect and how to find help. General practitioners or your parent’s specialists can be a great source here (Practice Nurses are generally the way to go).

Running on Schedule

Remember even with the best laid out plans THINGS WILL GO WRONG.  Frustration and resentment  are common feelings that may raise their head again, (especially when you are racing out the door for your 9.00 meeting that you have spent weeks preparing for and your parent will just not go on their day out). This is normal if you feel frustration or resentment, and there are many people feeling the same way, remember these are feelings generally towards a particular situation that is happening in the present time rather than long term scenarios. Having back-up plans can help alleviate some of these hiccups, where for example having family, friends or again professional carers who can help-out at short notice can help ease stressful situations.

Did someone say commode?

Having the right equipment can help ease your role as a care giver as well as ensure that your parent is cared for in a safe and secure environment. There may have to be changes made to your home and this could be as simple as giving them a bedroom that is closest to the bathroom or to hiring hospital beds, commode chairs and other wonderful devices. Again asking experts for advice is invaluable to ensure that the equipment is appropriate and is used correctly. Occupational therapists are encyclopaedias of knowledge and they are attached to hospitals as well as private practice.

Remember the little things

This is by no means an complete list of how to prepare for an aged parent, specifically with health concerns, coming to live with you. There will be changes to you and your families lives and there will be times when you will want to hide in the closest, but sometimes it may be realising that the little things get us through. Be easy on yourself, remember that there will be a time of adjustment needed and yes someone may have changed the goalpost when you weren’t looking but that doesn’t mean that you can’t get used to their new position.

Ageing From The Start

I recently attended a conference in The Netherlands about “A life course approach to Healthy Ageing” where esteemed health professionals from Universities around the world engaged in a day’s discussion about the role that social context factors play in healthy ageing and well-being. The program involves conducting and examining research and developments at the individual level during the life course as well as the level of groups and the general population.

Knowledge from the research is showing that there is a direct link between our health in old age and that of our health and social factors as young as 8 years of age. Studies of groups of individuals in the population have been conducted over many years to see what role the influence of society plays in our health. Without any surprise, the incidence of obesity in children today, which is much higher than when I was a child, does not bode well for our future oldies.

Coming from a generation that had no access to the technological play toys of today, my free time was spent playing outside, competing in athletics or playing netball. Downtime was meeting your friends at the local swimming pool and trying to look cool. So with those thoughts in my mind I was feeling confident that my level of activity in my youth was sufficient enough to look after me later in life. My concern however is the here and now – I am now in my middle age years and how can I continue to ensure that my approach to Ageing is healthy? After all, I am happy to survive until old age but I want to maintain the highest level of functioning for as long as possible. My focus going forward should be active ageing, well-being and quality of life.

The usual anecdotes come to mind, about healthy eating, exercise, no smoking, reducing alcohol intake and keeping my mind busy. This is all well and good but with the fast-paced lives that we find ourselves living in, it is easy to forget or frankly to find ourselves too tired to be healthy.  Looking for some inspiration, I find myself thinking about my mother who will turn 80 this year. Her knee troubles her tremendously and she has recently acquired a walking stick. Determined to be healthy in her old age, and to keep her knee on the straight and narrow, she exercises regularly 3-4 times a week at either water aerobics classes or self-paced exercises in a heated pool. The outings also give her time to socialise with other people which helps keep her mind active and sharp.  Boredom and social isolation can have just as much detrimental effect on our health as an unhealthy lifestyle.

As my mother points out: “There are people in our group with many different backgrounds, some have disabilities or dementia who are with carers, others come on their own, some are as young as 60 or in their 90’s. Being older is not an excuse for not exercising, it is just about finding the exercise that best suits you. Being older shouldn’t mean that you cannot have a social outing and not be connected to the word. It just must be right for you and your circumstances”.

Looking back I was definitely on the right track in my youth and early adult years. I somehow seem to have misplaced that outlook and need to pay some attention to my health now, so that I can ensure that I maintain my highest possible level of functioning as I age.  After all Healthy Ageing should have a life course approach.

Opening Up About Men’s Health

While doing research for this article I came across the fact that nagging men is good for their health. Let me explain. Apparently, men are much less likely than women to look after their health and see their doctor… 25% less likely to have visited a health care provider in the past year and a whopping 40% more likely to skip recommended blood screening. In fact ‘nagging’ from women is given as the main reason men ever get their health checked out1.

Change is definitely needed and we need to encourage men to speak about their health and listen to their bodies. Serious diseases and health conditions can affect men at any time in their life, though statistically, the age between 60 – 68 is documented as the average age to develop different cancers, heart disease and other nasties. Unfortunately the thinking of men around this age can be equated to a lifelong masculine behaviour of not showing weakness and a she’ll be right mate! attitude.

The top five causes of premature death for men are chronic disease such as ischemic heart disease, lung cancer, stoke and prostate cancer. Diseases which, in general, are less likely to occur or could be avoided, by adopting healthy lifestyle changes and regular health checks. So what stops our men from seeking help early or talking about their bits. Historically it has never really been socially acceptable for men, in general, to speak openly about their health problems or to ask for help. Whether for health related issues (general or mental), work issues or social guidance. It has in the past been seen as a weakness for our masculine society.

Women on the other hand have been more open with friends and even to some extent supported by the media in health issues. Pink Ribbon Day is one example where events are organised, Facebook pages dedicated, and merchandise companies involved in painting their stock pink. This is not the same when prostate or testicular cancer is discussed. Could it be that as a society we are more used to seeing breasts out in the open, whereas men’s prostate and testicles are hidden behind clothing not noticeable (well only maybe if speedos are being worn!!).  Breast size, gravity and sexuality of breasts is discussed by women and men and in most cases in normal everyday conversation. I feel that this is not the same for the size, gravity and sexuality of men’s balls.

So is there an answer? Men’s Health Week can at least be a start, it may be a way of beginning a conversation and to check with your partner or family member if they have had a health check-up recently. Have they had their prostate checked and how often do they feel their balls? Of course it is not only physical body parts that need checking – mental health issues are also important.  A wonderful program for men has been the “Men’s Shed” which brings men together in a social situation that may make them feel more at ease.  Generally talking about health problems should be encouraged and acted upon if there are any concerns or questions.

So, this Men’s Health Week I will hang up my shower-proof poster about self-examination of testicles, ask my men: R U OK? and hopefully open up more discussion around health that will make it easier for them to talk. I just have to nag them first to take out the rubbish – after all, doing that job for me may also save their life.

1. http://www.apa.org/monitor/2011/06/men-die.aspx

Bridge Builders

“Bridge helps you think. It’s a game you can play your entire life and keep getting better and better.” Bill Gates.

Bridge players who live on the North Shore or Eastern suburbs, who feel that they may have to give up the game they love, due to problems with eyesight, mobility or speed (not being as fast as they once were) are in luck. Bridge Builders is a supportive new bridge group working in conjunction with Grand Slam Bridge Centre in Double Bay, Trumps at Mosman and Gordon Bridge Centre to help players who are experiencing difficulties with the game they love.

With the help of an experienced carer from Reliant Healthcare, you will be welcomed and assisted with everything from larger playing cards and scoring to getting refreshments or having a bathroom break. Players can also get help with transport to the club if required.

Our General Manager, Jillian Conroy (who hatched this plan) believes that time spent playing bridge is a hugely positive experience for older people. “Bridge requires skill and concentration but it is a very social game as well. As we get older, it’s more important than ever to stay mentally active, maintain our social circle and continue to do things we enjoy. Bridge Builders enables people to continue to play bridge in a supportive social environment.”

As people continue to play bridge well into their twilight years, Bridge Builders may be just what some people need to gain back confidence to enjoy not only the health benefits but also the social component of playing bridge.

If you would like more information regarding Bridge Builders please contact us at Reliant Healthcare.