CHCAC3C Orientation to aged care work - Tasks

Tasks:

Element 1:
Demonstrate an understanding of the structure and profile of the aged care sector.

The aged care sector has policies and legislature that are aimed at protecting clients. It encourages client participation in drawing up a care plan or during interation with care worker.

Element 2:
Demonstrate a commitment to the philosophy of ‘positive ageing’

Funding to the tune $1.4 million dollars by the office of Senior Victorians to support the positive ageing project which aims to build the capacity of local government to plan for an ageing population. It also aims to provide leadership in promoting "age friendly" communities that create opportunities for senior Victorians to live active and fulfilling lives.

Element 3:
Support the rights and interests of older person


KEY ISSUES
1. Attach/describe a news item from television, radio, newspaper or magazine relating to older people.

The age-old quandary

The age-old quandary
By Karen Kissane
April 20 2002
You are 75. You break a hip in a fall and need surgery. While in hospital, you pick up a post-operative wound infection and develop pneumonia. Your forgetfulness intensifies into more serious dementia symptoms as you struggle to cope with the twin assaults of illness and a strange environment. You are now frail and will need weeks or months of care and rehabilitation; perhaps you will never go home again.
The hospital is not set up for convalescents and wants your bed for more urgent patients. Who will look after you, and how will it be paid for?
It is the kind of question that is central not just to your future but to Australia's, according to Treasurer Peter Costello. This week he warned cabinet of a $50 billion-a-year budget blow-out in health, aged care and income-support programs within a generation unless the sharply rising costs of a greying population are curbed. A visionary attempt to grapple with the future - or an attempt to soften up the public for cuts to Medicare and social welfare?
"This analysis is scaremongering designed to frighten people into accepting public sector budget cuts when, in reality, they are probably not going to be required," says Stephen Duckett, professor of health policy at La Trobe University.
But an administrator in a private hospital disagrees about the need for concern about the community's ability to pay for the needs of older people. "Future horror scenario?" she says. "The system has trouble coping with the elderly now."

In the next 40 years, the number of Australians aged over 65 will rise from 2.4 million to 6.2 million, with the proportion of older people doubling from 12 to 25 per cent. Towards the middle of next century, after the baby boomers have retired, there might be only 2.5 people of working age for every person over 65, compared to more than five people currently.
According to a report by Access Economics to the Federal Government, the number of workers and the level of income tax revenue is predicted to slow down from now; pension outlays will increase from 2010; health spending will rise from 2020; and aged-care demands will increase from 2030.
The figures sound daunting, and some researchers are warning about the necessity to budget for the needs of the elderly. Other analysts, however, say the outcome is unlikely to be dire, with many comparable countries already coping well with higher levels of older people. "Australia in 20 or 30 years' time is going to be like France is now," Duckett says. "We will be older, but we will be roughly the same as several European countries are now. These European countries aren't bankrupt, so what makes us think that we're going to be bankrupt?"
The current banner of the doom-and-gloom brigade is a landmark report due to be released by the government with next month's federal budget. The Inter-generational Report by Treasury's Retirement Incomes Modelling Unit is the first official government study of the future cost of current policies, and it predicts that advances in medical science that allow people to live longer will place a massive burden on taxpayers, mostly due to expensive new drugs and medical technology. The report is designed to trigger a public debate on the sustainability of existing health and aged-care programs.
News of the report came as the Myer Foundation announced a million-dollar project to develop a vision for aged care in Australia, and as the United Nations ended its world assembly on ageing in Madrid.
Greying is a global issue, says Professor Gary Andrews, of Adelaide's Centre for Ageing Studies, who attended the assembly. He says developed nations face a significant increase in the very old (those aged 80-90), but ageing is also relevant to the developing world. "Already in a country like China you have more than 100 million people aged 60 and over," he says.
While the details of the Treasury report are still under wraps, others have previously tried to estimate what ageing will cost Australia. Aged-care spending will more than double in real terms from 1997 to 2031, from $5.8 billion to $14.3 billion, warned a staff research paper by the Productivity Commission in October, 2000. But Australia will probably be richer and more able to afford it; even with relatively conservative estimates of gross domestic product, the report said, "spending grows by only about 25 per cent when expressed as a share of GDP".
The report, Long-Term Aged Care: Expenditure Trends and Projections, predicted that nursing home beds would need to increase from 78,600 to 158,500 in 2031. But, while the aged's health costs would rise in real terms each year to 2031, they would fall, relative to GDP, until 2021; by 2031, they will be 2.9 per cent of GDP.
Several health economists claim that the view of the elderly as a drain on health resources is wrong. Duckett has researched whether age is a factor in the cost of hospital stays, examining whether 70-year-olds cost more than 55-year-olds with the same condition. He found no systematic variation. "People think they should worry because older people stay longer, but in reality they often have substantially less investigation and interventions than younger people," he says.
Andrews agrees: "The fact that more people are in their 70s and 80s and 90s has a relatively small impact on total health costs. A lot of research in the past decade (confirms) less than 5 per cent of the increase in health care costs is accounted for by the population ageing."
Professor Jeff Richardson, of the Centre for Health Program Evaluation at Monash University, says it is not ageing itself that is the problem: "It's ageing plus new technology."
But another question raised by the Treasury report is acknowledged by many analysts as a problem: the ever-rising cost of drugs. John Goss, principal economist with the Australian Institute of Health and Welfare in Sydney, says: "The growth for the Pharmaceutical Benefits Scheme has been 9 per cent per year in real terms. If you have growth of 9 per cent, the doubling period is about eight years. It quadruples in 16 years, and it's eight times (higher) in 24 years. It has huge momentum."
An unknown factor in the future equation is the health status of the next generation of oldies. Does living longer just mean more years of disability and degeneration, or will increased life expectancy also mean more years of good health?
Duckett believes the latter. "The reason people are living longer is that they are healthier in old age. An 80-year-old in 20 years' time will be healthier than an 80-year-old today."
And it has always been the case that people usually chew up the largest amount of health care in the two years before they die, whether this is at 65 or 85, because that is when their health breaks down. "The general view across demographers and health planners is that the need for health care is not based on years from birth but rather is based on years to death," Duckett says.
There is another, gloomier possibility. People who live longer because of a reduction in one disease might contract another that disables them; if you avoid the coronary at 70, will you face dementia at 72? The Productivity Commission report says advances such as artificial joint replacements and improved treatments for osteoporosis, arthritis and dementia might lessen disability among the aged. But technology might also increase the survival time of people with disabilities, the report says. "Dialysis for renal failure increases survival time, but the aged person receiving such treatment will still typically be unable to perform many tasks unaided."
Then again, disability does not necessarily mean institutionalisation. The Productivity Commission estimates that, while about 18 per cent of those over 65 have a profound or severe disability, only 3 per cent of old people are in residential care.
For some people trying to care for the aged now, the question of whether the future poses problems is nonsensical. There is already a national shortage of nursing home and hostel beds, long delays for elective surgery and cancer treatments, and problems with elderly patients acting as "bedblockers" in acute hospitals (too sick to go home, but with nowhere else to go).
"An acute hospital is not a convalescent home for looking after elderly people when they are not acutely ill," says Denis Hogg, chief executive of Epworth Hospital. "But where do you refer them to for their on-going care?"
He denies that private hospitals cherry-pick to avoid bedblocking - "In our emergency department, 75 per cent of people admitted are over 75" - and he says Epworth has had to set up its own self-funded aged-care coordination team to try to find places for older people who need care following discharge.
"Step-down" care, between a hospital visit and home, is unfunded by private insurance and often unavailable, says Angela Magarry, director of policy for Catholic Health Australia. Like many other organisations, CHA wants aged care and health to be run by one level of government to prevent buckpassing of responsibilities and gaps in the system. CHA has also called for a Medicare "grey card" to be established to protect older people's right to care.
Denys Correll, national executive director of the Council on the Ageing, agrees that Medicare should be strengthened and says problems such as the blowout in pharmaceutical costs can be managed by price volume agreements between the government and manufacturers.
Goss points out that anxiety over costs tends to ignore benefits: "There's no need for doom and gloom if any increase in expenditure produces more benefits than costs in terms of older people being healthier, suffering less pain and having a lower chance of dying."
An extraordinary number of older people are involved in the informal economy through their care of grandchildren, he points out.
"There's often strong interests behind the position saying that 'the world is falling apart'," says John McCallum, professor of public health at the University of Western Sydney. He is concerned that an atmosphere of pessimism might encourage the belief that more health and aged-care services must be privatised if the government is not to go bust. In his view, "there are serious issues and they do have to be dealt with, but they're not necessarily going to break the bank or destroy the Australian way of life".
Karen Kissane is an Age senior writer.
This story was found at: http://www.theage.com.au/articles/2002/04/19/1019020708222.html


What issue is the focus of the item?

There is a general belief that older people are expensive to maintain and that as a result, they will bankrupt the economy eventually. To add to this notion is the ageing population. The problem with this argument is that it assumes such things as the the older you get the more time you spend on hospitals beds which is not the case according to research. Furthermore, many private hospitals and insurances do not have facilities for older members of the community. Economic participation of the ageing population must instead be recognised and appreciated.

2. Present a case study of a client who is affected by this issue (can use case studies in this manual)






CURRENT PHILOSOPHIES
Identify three principles which support the current philosophies.
Give examples of how they impact on aged care services.
Refer to Learning Resources - The Vision For Community Care, Principles, What Choices Are Available To Older People And Carers In 2007?
1.
2.
3.


DEMOGRAPHICS OF AGEING
1. How has aged care funding changed in the past 5 years, give two examples? What has been the impact on the HACC Program?

In the past 5 years, aged care funding has focused on training qualified practicioners for example,
1.Employer sponsored training places
2.Scholarships for students

The Impact on HACC program is that it is more industry relevant because employers are involved.

2. How has local/regional demographics impacted/changed service delivery in your workplace?

Because of an ageing population service delivery has been negatively impacted because of limited skills personnel.

3. How have these changes in demographics impacted on your day by day work?

Longer working hours and increased emotional strain



IMPACT OF LEGISLATION
Consider your workplace policies and procedures/consult your supervisor. Organisations must comply with the laws of the land. Choose two examples of a policy/procedure which ensure compliance with legislation.
How do these two policies/procedures impact on your work?

1.Policy ;Health services must be available to all clients and free from any form of discrimination related to a person’s country of birth, language, culture, race or religion.

When providing health care, it is given to all without prejudice in the worklplace



2 All clients shall receive fair treatment.

Clients in the workplace have a care plan that is customised to their needs.

IMAGES OF AGEING
Referring to the Learning Resource: Images of Ageing
1. What is a myth about aged people?
• How does this myth impact on their lives?

2. What is a stereotype of aged people?
• How does this stereotype impact on their lives?

3. What is an assumption of aged people?
• How does this assumption impact on their lives?


INDIVIDUALITY OF AGEING
What are three choices that impact on the ageing process for individuals?
How do they impact? eg on the physical body, the psychological health

1. Physical Activity & Diet
2. Emotional Integrity
3. Spiritual harmony
Physical activity keeps the body fit and strong and hence slow down ageing. People with emotional burden or depression and who are not spiritually at peace accelerate their ageing.


RIGHTS AND RESPONSIBILITIES
Attach client information that details client rights and responsibilities, including the process for compliments and complaints.
1. How is this information distributed and explained to clients?

When clients sign up, the complaint policy is made available to them to read and ask questions if there are any. This ensures that they know the available routs they can take should they have complaints and for them to also know their rights.

2. Use a case study to describe the process for client complaints.

If a client has a complaint, they call a customer relations coordinator who reports directly to the general manager on a toll free number. If their complaint is not satisfactorily resolved, they can contact the Community Services Commission or Disability Complaints Service whose numbers the client is provided with.
ACCESS AND EQUITY
1. How does your workplace demonstrate a commitment to access and equity for clients?

It is policy that health services will be provided free from all forms of discrimination and that health care will be developed and delivered on the basis of fair treatment.

2. How does this impact on your work? Present a case study of a diverse client.

Mrs Ho is originaly from Hong Kong and does not speak English very well. Consequently, she has an interpreter and as part of her activities, Hong Kong celebration days are celebrated by her care workers.

PARTICIPATION
1. How do clients participate in decision making about the service?

Through advocating for their preferences and interest in the development of a care plan. 2. How do you encourage this?
By asking clients to voice their opinion regarding service delivery.