Problem: Over the next 40 years, population ageing and growing
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Problem: Over the next 40 years, population ageing and growing diversity among older people - in terms of their care needs, preferences and affluence - are expected to pose a number of challenges to Australia's aged care system. These include a significant increase in demand - those aged over 85 tend to be the main users of aged care services, and their numbers are expected to increase at least four-fold by 2047 Background:it has been seen that generally the older Australian wants to remain independent. For this purpose, they want to have control over the way they live. They want to remain linked and significant for their relatives and community. Moreover, they also want to have some level of choice regarding their care. Therefore, in view of the changes that have been introduced in the HDS system during the last decades have resulted in widening the scope and improving the class of care and support that is being provided to the older people in Australia, significant deviations are present in the quality of services (McDonald and Russell, 2012). Consequently, fundamental reform is necessary for overcoming the delays, constraints, discontinued these and shortages that are present in the current system and also for responding to the challenges that may be created in the future. Some of the challenges that are present in this regard can be described as follows: ï‚·A rise in the number of older people in Australia. ï‚·Rising number of incidents related with disability and disease caused by old age, particularly dementia. ï‚·Concerns of the community regarding the variability in the quality of care.
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ï‚·Rising expectations regarding the flexibility and the nature of care that is being provided. ï‚·The need for considerable number of more nurses and personal care workers having improved skills. Therefore, it is clear that the care being provided to the aged can be improved significantly. The policies of the government as well as the relevant programs and rules and services being provided by the community groups and industries should be reshaped, keeping in view the well- being of the elderly and they should be provided in the manner which compliments the self- esteem and supports freedom of the older people. At the same time, it is very important that the servicesshouldbeinexpensivefortheelderlyandalsoforthesociety.Underthese circumstances, the present report is being made for the Minister with a view to develop detailed options related with redesigning and reforming the aged care system in Australia and also for recommending the path of transition to a new system (Fine, 2000). The present system in Australia: most of the people in Australia reaching old age can expect to require the services related with aged care. Within restrictions, the intensity, kinds of services and their period, are delivered in accordance with the assistant needs of each older person. Mainly care and support is provided by partners, family, friends and neighbors of these persons. Therefore, out of the elderly in Australia who are getting assistance in the community Oedipus and are receiving this care from informal carers. At the same time, the services subsidized by the government also being provided to more than 1 million older people in Australia every year. After these persons, more than half are getting low intensity support provided by Home and Community Care (HACC) program.
The strengths and weaknesses of the system: the strong point and flaws that are present in case of the present system are known well. Therefore, in terms of the sense of the present system, the quality and range of care and support that is being provided to the older people is increasing. Similarly the safety and quality standards are also improving continuously. Generally the workforce is having the appropriate skills and is dedicated to caring. Nonetheless a result of the adjustable quality of training, it is possible that certain workers do not have the sufficient skills. On the other hand, there are a lot of weaknesses also present. The necessity for basic and extensive reforms has been identified by the Hogan Review, 2004, the National Health and Hospital Reform Commission Report, the Henry Review and the reports of the Productivity Commission made in this regard (Yu and Qian,2018). Therefore the concerns that have been expressed by the experts in this regard can be discussed as follows. The delay in care assessment and limits that are present on the number of dead licenses and care packages, the elderly may have to deal with excessive waiting period and may have a limited choice of carers. Alternatively, the care providers also have reduced incentive for, improving quality, becoming more efficient and to innovate and respond to the requirements of consumers (Chan and Chan, 2018). The discontinuous care across the packages of services based on community is also an issue. The changes that take place in the care needs of an older person may result in a change in their care package, personal carer and care provider.
Constrained pricing: these concerns embrace the small charges for high care accommodation, the reducing hours of service in the care package funding level and the need for 'temporary' conditional adjustment payment. Difficulties have also been seen in arranging finance, particularly for building like residential facilities. There is a variable quality of care present across the system. Due to this reason, the older people and their carers find it difficult to navigate through. There is also uncertainty regarding the availability of care. It results in limited confidence among the persons needing care that they can leave the care package during the periods of independence and greater wellness and in case their circumstances change they can re-engage readily. At issue is the shortage of workforce. Partly as a result of low wages, higher administrative loads that is the result of regulation and the limitations placed on the scope of practice and strenuous work environment, these problems arise. There is also overlapping, complex and costly regulations. The government has an entrenched culture of unwarranted aversion to risk and also the want of freedom in case of certain regulatory activities.
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There is inadequate independently of the complaint handling process from the Department of Health and Aging, and the development of policy and administration of regulation has been combined as it is the best practice. Future challenges: as the proportions of the challenges that are faced by the aged care system in Australia are known well, still they are worth of brief review. It is anticipated that by 2050, more than 3.5 ml older people in Australia will be accessing the aged care services every year and nearly 80% of the services is going to be delivered in the community. In the same way, by 2050 the number of people in Australia at least 85 and more is estimated to rise to 1.8 million and become 5.1% of the total population of Australia. Diversity is also rising among the older people in Australia regarding their preferences and expectations, comprising a larger desire for free living and accessing care that is culturally relevant. This is particularly true in case of several culturally and linguistically diverse or sexually diverse and indigenous communities (Henderson et al., 2016). Read further advancements being made in the administration of some diseases, more and more persons will be going to need intricate care for dementia, diabetes and other commodities that are related with longevity and also the palliative/ end-of-life care.
Option 1: A large number of elderly in Australia having low income, have substantial wealth, which provides them the capability of dealing with their lifetime accommodation costs and also for making a small contribution to the cost of their care, subject to the presence of a rational protection net. It is estimated that there will be a drop in the accessibility of casual carers, which will reduce the capability of some elderly persons to obtain home-based care. The aged care workers will face the necessity of significant expansion caused by the tightening of age induced in the overall labor market. There will be a predictable drop in family support and casual caregivers. At the same time there will be a significant call for care workers from other segments of health organization. As a result there will be need for adopting the new models of care. Under the circumstances there will be a need for harnessing new and cost-effective, information and assistive technologies that provide the opportunity for the productivity gains and also high quality of care. Therefore it can be stated that as the system has been configured at present it is not in a position to deal with these challenges. Under these circumstances, basic reforms are necessary and tenure arrangements should be created on the clear statement of the policy objectives of the government regarding the caring of older people in Australia. Policy objectives: Robust rationale is present for the participation of the government in aged care including the equity of access to suitable care, protecting vulnerable consumers and also correcting market
failures like the gaps that are present in the information provided. In principle, the government of Australia has the responsibility for the planning, funding and regulation of easy chair and also to support informal carers. It has been said by the government in this regard that it tries to make sure that all the older people in Australia have timely access to appropriate care, and the support services are available required at their age, through a safe and secure aged care system. In this regard, the common theme regarding the vision of future system of care is that the focus needs to be on well-being; independence should be promoted by the services provided; and the people should have the ability of making their own life choices, even if it results in the people accepting a higher level of risk. Therefore the older persons should be treated with respect and dignity. The result is that the carers of old people are also required to be supported adequately. Option 2: The main purpose of public policy should be to advance the well-being of the society as one. Therefore regarding ACK policy, the emphasis concerning the older persons should be on their bodily and emotional requirements, connectivity with other people, the ability to have an effect over the environment and their safety. At a wider level, the well-being of the members of family, friends and neighbors providing care to the older persons and the persons providing formal care should also be considered (McInnes and Ibrahim, 2013). The effect of these policies on the present and future taxpayers, who fund daycare subsidy, should also be considered. Therefore in order to guide the future policy changes, it is required that the objective of the easy care system should be to:
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Promote wellness and independence of older people and their continuous contribution to the society. But he sure that all the older people, requiring care and support have the access to person centered services that have the ability of changing according to the change in their needs. The system should be consumer directed, which allows the older people to have a control and choice regarding their lives and also to die well. The older persons receiving care and support should be treated with respect and dignity. The system should be easy to navigate. Therefore the older people should know what care and support is available to them and how they can access the services. The system should assist informal carers in performing their role. The system should be affordable for the persons who need care and also for the overall society. It should provide incentive for making sure that the resources dedicated to caring for the older people in Australia are used efficiently and broadly equitable contributions are made between different generations.
It is worth mentioning in this context that even if a distinction is present between different components of each care costs, unpacking change the care is significant for the purpose of designing the funding principles for the future and also for making sure that consists in subsidies and user contributions are present across the care settings (Rogers, Barrett and Swanson, 2011). Consumer directed care: it has been expressed by the older people in Australia that they are not willing to remain the passive recipients of services which depend on funded providers. Instead what to remain independent and have the ability of selecting where they live, which provide their they're going to use and also the way in which the services are being provided to them and if they want to purchase additional services or higher standard of accommodation. In this regard, significant empirical evidence is present, which suggests that the choices made by the consumer's result in improving well-being which includes greater life expectancy, higher life satisfaction, independence and also the better continuity of care (Lau, Willetts, Hood and Cross, 2014). Apart from the competition at its present between the providers in a system where the consumers have the choice results in a more dynamic system, which has increased incentives for greater efficiency, quality and innovation. At the same time, greater flexibility in the system will also allow the providers to increase the scope of services provided by them, which frees them from the present highly regulated and averse to risk the regime. Therefore it is required that the regulations it should revert back to more appropriate role of making sure the safety and quality and also protecting the one level and to deal with the market failures. Option 3: It has been pointed out by several experts that there is significant complexity present in the current system and it is difficult to navigate. In order to exercise their choice, the older people need accurate,relevant and informationthat can be understood easily buy them.
Therefore it can be proposed in this regard that such information should be delivered by a new national platform. Such platform should be able to indicate, simplify and increase the current disparate information networks. Therefore a single agency should have the responsibility for the information platform. The older people in Australia should be able to directly access the information or through general practitioners, health clinics or other entry points. If a large number of information centers are enabled, it will have significant advantages and all the services will be based on one coherent and integrated information source. Such gateway is also going to consolidate several different assessment processes that are undertaken by HACC providers and present and also the Aged Care Assessment Teams. In order to receive an entitlement for proving an entitlement to approve the aged and skill system to the older people, first of all, they should be assessed by the gateway or by a local team of professionals. In the same way, the evaluation of the capacity of informal caregivers and any support required by them should also be a part of the functions but the carers should be allowed to separately approach the Carer Support Centers in the area wide range of persistence which includes emergency respite (Tham and Hardy, 2012). A particular set of criteria is going to be used by the assessors. That is going to apply in case of all levels of care and support, both in residential and community settings. The Gateway is also going to arrange for the Centrelink for undertaking a distinct assessment of the financial capability of the older person to make contributions wherever required. At the same time, other low intensity carers and community support services outside the Formal Aged Care System is going to be continuously access to directly or being offered as a part of gateway assessed entitlement (Stargatt et al., 2016).
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Recommendation and Solution: It also needs to be mentioned that the care needs of the older people in Australia are different in case of each person and they also change passage of time because aging is a unique experience. Therefore the care needs of the people depend on their functional capabilities,culture and language, physical and mentalhealth and their living environment. Consequently, the older people in Australia should have access to a wide range of care and support services that can deal with their particular needs and to the extent possible, help in restoring their wellness and independence. On the other hand in case of the prison system, the care needs are not being fulfilled on account of the inflexibility of the system. Therefore even if the HACC program has some ability of delivering a wide range of services for dealing with the particular needs of the clients, community care packages to not have such flexibility in its services. Limitations are present regarding their supply and funding and at the same time, significant cats are present between the packages. Under the circumstances a model of care and support needs to be proposed that can provide a flexible range of services for dealing with individual requirements of the older people by using a mixed approach to access. This uses an entitlement based approach along with providing direct access to certain services (Tang, 2009). The older people who are facing an increase in freight he may need personal care services like help in eating, toileting, showering and dressing, oral hygiene and regular monitoring of their health. The number or the intensity of care services that may be required by the older people can increase but these can be temporary instead of being permanent or even a decrease after some time. The older people may also increasingly need specialized care, like the care needed for wound management and other health and nursing care. This includes dementia, incontinence, challenging behavior palliative and end-of-life care as well as rehabilitation and restorative care, which includes transitional and sub-acute care.
References Chan, D. and Chan, L. (2018). Aged care services in Australia and commentary on lessons learnt.Aging Medicine, 1(1), pp.50-54. Fine, M. (2000). Coordinating Health, Extended Care, and Community Support Services. Journal of Aging & Social Policy, 11(1), pp.67-90. Henderson, J., Willis, E., Xiao, L., Toffoli, L. and Verrall, C. (2016). Nurses' perceptions of the impact of the aged care reform on services for residents in multi-purpose services and residential aged care facilities in rural Australia.Australasian Journal on Ageing, 35(4), pp.E18-E23. Lau, R., Willetts, G., Hood, K. and Cross, W. (2014). Development of self-efficacy of newly graduated registered nurses in an aged care program.Australasian Journal on Ageing, 34(4), pp.224-228. McDonald, T. and Russell, F. (2012). Impact of technology-based care and management systems on aged care outcomes in Australia.Nursing & Health Sciences, 14(1), pp.87-94. McInnes, J. and Ibrahim, J. (2013). Preparation of residential aged care services for extreme hot weather in Victoria, Australia.Australian Health Review, 37(4), p.442. Rogers, A., Barrett, S. and Swanson, M. (2011).Aged care in Australia. Meadowbank, N.S.W.: TAFE NSW, Training and Education Support, Industry Skills Unit.
Stargatt, J., Bhar, S., Davison, T., Pachana, N., Mitchell, L., Koder, D., Hunter, C., Doyle, C., Wells, Y. and Helmes, E. (2016). The Availability of Psychological Services for Aged Care Residents in Australia: A Survey of Facility Staff.Australian Psychologist, 52(6), pp.406-413. Tang, J. (2009). Aged care in Australia: A guide for aged care workers- by D. Dawbin & A. Rogers.Australasian Journal on Ageing, 28(1), pp.47-48. Tham, R. and Hardy, S. (2012). Oral healthcare issues in rural residential aged care services in Victoria, Australia.Gerodontology, 30(2), pp.126-132. Yu, P. and Qian, S. (2018). Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care.PLOS ONE, 13(1), p.e0190749.