OPAN’s Presenting Issues delivers a sense of déjà vu for aged care providers

As some things change, others stay the same. 

The freshly released Older Persons Advocacy Network (OPAN) National Aged Care Advocacy Program Presenting Issues reveals a 20% increase in the number of requests, all while the top issues for older people and their families remarkably remained the same.

Poor communication, lack of information, limited supported decision-making and concerns over aged care fees and charges were once again the top problems across the 2023-24 financial year. 

OPAN’s report said this suggests many issues are fundamental to the design and delivery of aged care in Australia and further action is urgently needed in addition to planned reforms. 

Key stats

• Issues surrounding service delivery, aged care access and finances were the most common in the advocacy space
• Home Care Packages were the most common aged care program seen in advocacy cases (46%), followed by residential care (25%)
• OPAN’s advocacy accounted for 32% of services provided by network members with information provisions making up the remaining 68% of services
• Information provision doubled in the last 12 months while advocacy cases actually decreased by 16%

Speaking to Hello Leaders, OPAN CEO Craig Gear said it’s likely a mixture of advocacy awareness and recurring frustrations with the system that have driven up the rate of advocacy requests. 

“It is people being aware of advocacy programs and having the confidence to raise their concerns. Obviously, we want to resolve the issues as close to the coal face as possible because that maintains trust between providers and the care recipient or participant,” Mr Gear said.

“44,428 cases last year show that we still need reform changes to happen in aged care. That’s why we need a new rights-based Aged Care Act. Fundamental to that is putting the older person first, listening to them and supporting them to resolve their issues.”

Standing in their shoes

At the heart of the issues in aged care are several recurring trends: poor or unprofessional communication, a lack of consistency in communication by providers, unclear information, a variety of delays and feelings of being pressured or coerced.

Providers are not alone in being at fault, with My Aged Care regularly at the centre of consumer issues. However, it is arguably service providers who can make the most direct change. 

“I think this is about putting yourself in a place to walk in older people’s shoes, to understand this can be frustrating for someone. We still have work to do around the journey into the aged care system and navigating it,” he said. 

“Anyone would expect clarity about things such as when someone is coming to their house or if they need to change times. Partnering with the older person and negotiating for those changes rather than just providing a vague ‘Sorry, we’re not coming at this time we’re coming at this other time’ is important.”

Mr Gear acknowledged the ‘hundreds of thousands of people receiving really good aged care services’ while he called on providers to partner with their clients. 

Building on policies and recommendations

With Presenting Issues outlining that older people are struggling with things such as finding enough information about aged care services/programs, being supported in choice and decision-making and achieving positive complaints resolution, OPAN built on its list of recommendations from last year’s report.

In total, it lists 47 recommendations, including 23 that continue from the 2022-23 report. These recommendations encompass aged care rights, workforce issues, service delivery and more. 

Many recommendations tie in with the ongoing aged care reform journey. The transition to Support at Home is a focal point given many requests received by OPAN and its partners involved home care services. 

One example includes a call to provide increased Commonwealth Home Support Programme (CHSP) funding between now and 2027 to ensure those with lower-level service needs can receive the most appropriate service. 

Other recommendations revolve around investing in provider education and information provision regarding fees and charges in aged care. 

“We need the information from Government about how this reform is going to be operationalised. But it will also come down to that relationship with the provider and having the care managers, staff, etc saying this is how things are changing. It’s important we have transition support moving forward,” Mr Gear added. 

Another recommendation retained from the previous report calls for enforced National Aged Care Advocacy Program (NACAP) education sessions in residential care settings. This would enable staff to learn more about advocacy. Additional provisions would also be made to educate residents about their rights and responsibilities. 

“One of my messages for providers is they shouldn’t be afraid to have an advocate involved. There is a real benefit of providers, advocates, older people and families all working together to understand what someone wants, what their needs and preferences are and how to resolve any issues,” Mr Gear said.

“Early intervention, open disclosure and honest communication go a long way. We’ve had some challenges with providers not understanding that an independent aged care advocate is there to support them. 

“Providers who have been open to us coming in have found rights-based education or education about preventing staff abuse for staff, or even our Who’s Missing planning for diversity education really beneficial. There’s enhanced trust in the organisation. People understand that the organisation is open to feedback and is willing to learn from the people using the system.”

A new power dynamic

This week, OPAN also labelled the Senate Committee’s recommendation to pass the Aged Care Bill a significant step towards enshrining older people’s rights into Australia’s legislation.

However, Mr Gear reinforced that the Act ultimately is just the framework of rights and expectations. It sets the benchmark but doesn’t necessarily translate into positive outcomes. Providers must make that happen themselves. 

“The implementation and people bringing those rights into aged care practice is what’s going to make a difference. It’s about how care is delivered in partnership by consulting for the wishes and preferences of older people,” he said. 

“That’s what we saw a lot through this report. It was the preference of older people to be considered and not be overridden. Things that don’t take a lot of time or cost to get right, that’s where we want to see the focus in the coming years to build trust and relationships between aged care workers, providers and the older person receiving care and support.”

Mr Gear said the new Act will help balance the power dynamic between older people and those who provide the care. He said consumers will no longer be vulnerable with all providers set on a path where they must listen to how individuals want their care provided.