OPAN report highlights areas of improvement for aged care providers

The Older Persons Advocacy Network (OPAN) has released its third annual report covering the key issues raised in its National Aged Care Advocacy Program (NACAP) and highlighting recommendations for aged care providers to address. 

As reported in The National Aged Care Advocacy Program Presenting Issues – Report 3, the 2022-23 financial year saw a total of 36,904 information provision and advocacy cases, with 56% of those cases occurring in 2023. Combined with a 36% increase in total cases from 2021-22 it’s clear there is an increasing number of older people and their representatives reaching out for advocacy and information.

Key points

• NACAP is a Government-funded program delivered via OPAN that provides free and confidential advocacy support to older people, their families and representatives who are concerned with their rights or need help to resolve issues related to aged care.
• Communication issues and limited choice/decision-making were the most common concerns that frequently led to people seeking advocacy support.
• OPAN has called for both issues to be addressed in the new Age Care Act, including embedded supported decision-making principles.

In total, two-thirds of cases raised with NACAP were related to home care packages or Commonwealth Home Support Programme services. Less than one-third of advocacy cases were related to residential care. That’s not to say residential aged care is not without its challenges, as the report goes on to highlight most cases within residential care settings related to care delivery and finances. 

Poor communication is all too common in cases relating to care delivery with numerous examples showing that residents often feel as though their care needs are not being heard or actioned. Often they do not feel listened to, whether it’s a staff member ignoring call bells or residents not being included in their care planning.

“An older person sought aged care advocacy support because they were frustrated and upset about the poor communication they experienced at their residential aged care home,” one case example outlined.

“They had requested to be assisted to shower between 7:00 AM and 9:00 AM so that they could participate in the morning exercise class. Although they had asked several staff members, they never received assistance and they felt their entire morning was wasted waiting to be showered.”

Although the advocate was able to achieve a positive outcome for the resident as a meeting with the Care Manager led to their involvement in care planning and specific requests being accommodated, such a simple request should not need to be elevated to an advocate. 

Other examples of residents requesting to not be dried after a shower so roughly or to leave the facility and go to the shopping centre were seemingly simple requests that unfortunately required advocate intervention to achieve a positive result for the consumer.

As for financial concerns, a lack of fee and charge transparency was one of the most frequent issues raised, as were unexplained debts, invoicing errors and extra service fees. While there will often be cases of human, OPAN reported that aged care providers often failed to communicate with consumers about the different fees and charges associated with residential aged care. This included standard charges such as basic daily care fees and means-tested care fees. 

With examples of residents paying for unwanted extra services and instances of means-tested forms not being submitted, OPAN recommended providers adopt preventative measures to avoid these mistakes. This includes additional education regarded the means-tested fee system and Government monitoring of overcharging. 

Recommendations for improvement

As the issues spanning the aged care sector relate to key features such as care delivery (43% of issues raised), care access (28%), financial concerns (15%) and challenges with substitute decision-making (3%), OPAN has provided a wide range of policy recommendations. 

These range from solutions to help improve access to aged care, including better engagement with My Aged Care, improved communication services for Culturally and Linguistically Diverse (CALD) people and stronger person-centred processes for service providers.

Although many of the recommendations do sit at that policy level, there are several that providers can consider implementing themselves. For example, OPAN called for a greater investment in skills development to address knowledge gaps in dementia support, palliative care, continence care and medication management. 

They would also like to see more information and education services for the general public regarding My Aged Care, a space that providers could occupy. Some would argue no one is better positioned to educate and support people entering the aged care system than service providers. 

Finally, the incoming Aged Care Act (coming into force in 2024) must address breaches of aged care rights. A lack of communication and information in preferred languages for CALD people, no recognition of identity, culture or spirituality and recurring older person fears of backlash for making complaints were all singled out as leading issues by OPAN.

Again, there is scope for providers to take the initiative and address those concerns without being told to by the Government. Many already do. But if we’re to see the numbers in OPAN’s next report go down, the onus is on service providers to act now.