Aged Care in Australia: Dignity Risk, End of Life Care Analysis

This report examines aged care in Australia, focusing on the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018, highlighting the increasing aged population and the importance of ensuring their well-being. It explores dignity risks, drawing on research by Zirak et al. (2017) and Tadd et al. (2011), identifying factors that compromise dignity, such as lack of attention, knowledge, and training, as well as staff turnover. The report then delves into end-of-life care and palliative care, referencing the Australian Institute of Health and Welfare (2016) and the World Health Organization (2014), outlining the scope of these services and the factors that qualify patients for such care. It also provides recommendations for enhancing public awareness, patient choices, and the restructuring of services to better meet the needs of the elderly, concluding that the Aged Care Quality and Safety Commission Act 2018 is rooted in end-of-life care studies.

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New aged care in Australia
Dignity Risk
Enactment of Aged Care Act 1997 and its subsequent application and implementation provided
the background for ensuring wellbeing of families. According to Royal commission (2019),
Australia has seen a gradual increase in ageing population, meaning the number of aged persons
grows by the day on account of care accorded to them that postpones the time of their demise. It
is projected that that increase is likely to register a tremendous growth going forward.
Attainment of the above was prompted by productivity Commission’s report which identified
gaps and voids in the system which was initially in place to assist the aged. In a bid to bridge the
gaps, and in light of recommendations by the said Commission, a number of efforts were
initiated and followed up which culminated into Aged Care Quality and Safety Commission Act
2018 (Quality and Safety Commission Act) whose main purpose was to augment the earlier Act.
This Act can be said to be timely, a watershed and a hallmark in efforts to give the aged the best
that the government and the society can offer owing to their vulnerable states. Undoubtedly,
dignity risk study contributed a big deal in successes in terms of legislation that have thus far
been registered and enjoyed by the aged. This can be deduced from the coverage of the Acts
which includes: eligibility, accreditation and quality of review, and responsibly of health
providers; complaint services; advocacy and community visitors.
Zirak, Ghafourifard & Mamaghani (2017) discussed the contribution dignity has on the health
system on individuals including the aged persons. They began their discourse by underscoring
the fact that dignity is not only a fundamental human right but also a human need that ought to
be inviolable and sacrosanct. To them, dignity must be construed in a broad sense to include

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aspects such as respect for the patient, respect for privacy and their independence in terms of
decision making and participation in decisions that affect them. Additionally, it entails in their
assessment proper nutrition, provision of adequate and relevant information, and provision of
required standards of hygiene; all being done in a courteous manner (Tadd, Hillman, Calnan,
Calnan, Bayer & Read, 2017). In their considered view, dignity not only buffers recovery but
also ensures that the patient is emotionally taken care of.
In analyzing the data that Ted et al considered, they expressed the view that a number of factors
barricade and hamper efforts to attain dignity of patients depriving them of what has been
characterized as fundamental human need and a sacrosanct right. First, lack of attention was
explained to deprive an individual of the self-worth and the ability to be taken of note of.
Second, lack of knowledge not only on the part of the patients but also the staff of the institution
whose services are direly needed. It was said that when a staff is insufficiently educated on the
components of dignity that they need to uphold, it is very unlikely that they will respect dignity
of the consumers of their services. Third, lack of training. Training was opined to not only
augments the knowledge acquired prior to joining the institutions but also covers the voids the
acquired knowledge has or has exposed the staff in question to. Untrained staff are therefore
unlikely to embrace the dynamics of their services and thus falling short of the required
performance levels and standards leading to commission of deprivation of dignity to the patients
they attend to.
Lastly, perpetual movement of staff was opined to result to denial of dignity. It was explained
that, constant movement of staff comes with adaptability issues in that during the period that the
staff is in the process of getting used to the environment, they are highly unlikely to meet the

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required standards of dignity accorded to patients. Involuntarily therefore, violation of dignity
may ensue.
In conclusion and having had regard to a number of obtaining factors that was before them, Zirak
et al made a number of recommendations (2011). First, having noted that acute hospitals are
unfavorable to the aged patients, they recommended that attention must be paid to physical
environment that the aged are exposed to. Whereas, the youthful proportion of the population
exhibit flexibility in terms of adaptability with the stimuli, the aged are slow if not unable to
adapt to a new environment. It was their view, that exposing the aged to vagaries of harsh
environmental challenges is not only unfair but also contributes to violation of dignity.
Second, provision of training to the staff serving in various hospitals was recommended. In their
assessment training is boosts a big deal the staffs’ knowledge, filing the gaps that their education
might have exposed them to, and also building their motivation towards ensuring dignified
treatment of patients. Third, and that which is connected to the second recommendation is staff
appraisal which goes into assessing the level of understanding of the training offered, the
application of the skills imparted and the way forward in terms of whether further training is
needed.
Fourth, adequate staffing was noted to be a big contributor to dignity of the patients, more so the
old who require close and adequate attention. Adequate staffing was opined to reduce the burden
shouldered by an individual staff creating an environment for division of labor hence quality
standard of services. Lastly, it was pointed out that courtesy in communication is inevitable.
Courtesy not only ensure respectful provision of information to the patient but also shows the
signs that the patient is highly regarded.

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End of life care
According to Australian Institute of Health and Welfare (2016) the term end of life care is
multifaceted. It is wide in its scope appreciates health in totality. It covers bodily fitness,
behavioral tendencies in light of social set ups, and spiritual aspects of care offered (Australian
Institute of Health and Welfare, 2016). It entails services such as advice and coordination care,
nursing a personalized care, emotional and practical support, and access to medical equipment; it
is noteworthy that there is no limitation here in terms of the place of operation, in this regard
even homes provide a forum for provision of medical services (Australian Institute of Health and
Welfare, 2016). Accordingly, medical services can be said to be accessible at all times and places
when demanded with limited or no restrictions in terms of personnel and equipment.
The services under end of care are not a preserve of professionals but opened up for everyone
willing to offer their expertise including ancillary staff (Australian Institute of Health and
Welfare, 2016). It is therefore an all-inclusive approach that embraces all the health service
providers. Accordingly, the following personnel are engaged: nurses who are not necessarily
registered and who must not bear specialized or pain relieving and sedative qualifications;
physicians or surgeons who includes specialist in pain soothing matters and trainees whose
operations are either domiciled in hospitals and elsewhere; other medical specialists whose areas
of specialization are not necessarily in the field of pain relieving specialization or in training;
non-specialists based in medical institutions; and volunteers who must not exhibit any special
expertise but willingness to accord services as and when demanded(Australian Institute of Health
and Welfare, 2016).
Tied to end of life care, is Palliative care. Palliative care is described as a provision of medical
services approach whose aim is to better and ameliorate the quality of patients’ life together with

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their families; its focus is not on the root cause of the health issues in question but on the pain
relieving aspect (Australian Institute of Health and Welfare, 2016). It can be said, in that regard
that palliative care is concerned at a cursory consideration of the health issues aimed at
mitigating the pain that the patient experiences.
Under Palliative care, it is recognized that health service providers embrace homes and families
as critical aspects of provision of health services as does end of care life care (Australian Institute
of Health and Welfare, 2016). In the main, in palliative care is provision of optimum health
services through prevention and mitigation of suffering once the disease sets in (Australian
Institute of Health and Welfare, 2016).
Further similarity of end of life care and palliative care is that their foci is on patients whose
demise is imminent and are likely to die within a span of one year. They include patients facing
diverse number of conditions which are: first, those that exhibit advanced, progressive, and
incurable conditions; second, are patients that have overall body weakness which is coupled with
other issues such that their projected death cannot go beyond a year; third, are those with resident
conditions such that they are susceptible to death resulting from severe conditions which may
arise all of a sudden resulting to loss of life; last, are patients with signs and symptoms of severe
and dangerous conditions caused by sudden extremely harmful events (Australian Institute of
Health and Welfare, 2016).
End of care and palliative care services in Australia are advanced such that in terms of global
ranking, Australia ranks fourth best (World Health Organization, 2014). This is informed by the
fact that, it is not only funded by the government but also non-profit organizations. Efforts to
offer the best that there are in terms of the twin medical services provision the focus of this
paper, are necessary. Recommendations in that regards, were as follows during the conduct of

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case studies. First, it was opined that there ought to be more public awareness and a discourse on
the limitations that confine and influence health care when demise is impending, and changes
that are appropriate in improving the situation. As concerns this recommendation, it was not lost
on the researchers that health services are public services that are not only essential but also
indispensable. Second, there ought to be increased and advanced focus on choices that are
available to the patients when their lives approaches their untimely end in a bid to enhance
compliance with medical directions. This ensures that individuals are able to follow through the
prescriptions and the mannerism that are advised by the service providers. Third, and which is
tied to the second recommendation, is that there is supposed to be enhanced application and
implementation of patient’s individual choices that are in tandem with relevant medical
prescriptions. Last is the need to restructure the services to appreciate the need by patients to
have medical services administered from a home like settings. Such environments are familiar
and more favorable to patients as compared to medical institutions (Australian Institute of Health
and Welfare, 2016).
The inescapable upshot is that; Aged Care Quality and Safety Commission Act 2018 (Quality
and Safety Commission Act) finds basis in end of care unit case study. This is not only in terms
of its legislative spirit and text but also its implementation.

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Reference list
Australian Institute of Health and Welfare, ‘end of life care’, (2016). [online]. Available from
https://www.aihw.gov.au/getmedia/68ed1246-886e-43ff-af35-d52db9a9600c/ah16-6-18-
end-of-life-care.pdf.aspx (Accessed 10th September 2019)
Tadd, W., Hillman, A., Calnan, S., Calnan, M., Bayer,T., Read, S., ‘Dignity in Practice: An
exploration of the care of older adults in acute NHS Trusts,’ 2011. [online]. Available
from https://www.dignityincare.org.uk/_assets/Resources/Dignity/OtherOrganisation/
2011/Dignity_in_Practice_Report.pdf (Accessed 10th September 2019).
Zirak, M., Ghafourifard M., Mamaghani E.A., ‘Patients’ Dignity and Its Relationship with
Contextual Variables: A CrossSectional Study’, Journal of Caring Sciences, 2017, 6(1),
49-57 doi:10.15171/jcs.2017.006. [online]. Available from
https://pdfs.semanticscholar.org/3326/911a49fd4559acb152679fd6327cac01aa35.pdf.
(Accessed 10th September 2019)
World Health Organization, ‘Global Atlas of Palliative Care at the End of Life’, Worldwide
palliative care alliance, 2014. [online]. Available from
https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf. (Accessed 10 September
2019).