“The way policies are framed around running these [aged care facilities], it is as if they are running a factory.”
That’s the disturbing assessment by University of NSW emeritus professor Richard Hugman, a social worker who specialises in the caring professions.
Prof. Hugman says that when the government responds to the current aged care royal commission, which is due to report in February, it must go beyond providing a significant injection of funds and ensure older people are treated with dignity and care rather than regarded as objects.
“[The government needs to] focus on improvements to the aged care sector that are not reflective of a sense that older people needing care are a burden on society,” he says.
“[Instead, they need to focus on the fact] that older people are part of society and that a good society is one that values all its members.”
Prof. Hugman says there must be an emphasis on positive values and our elderly people must be treated as human beings.
“Frankly, there are some places I’ve visited in the last few years, either because I’ve had friends or relatives who are living in them or I’ve gone to visit for professional reasons,” he says, “[that] I wouldn’t go anywhere near.”
The dramatic increase in COVID-19 deaths in Australia’s aged care homes – more than 580 – lays bare the ethics around our treatment of people in such places, says Prof. Hugman.
“To use a similar ethos in caring for human beings that you would use in producing physical things for sale, I think is an unfortunate way to think about the world.
“… it is as if they are running a factory. I understand good management techniques are transferable across settings, but you also need to understand the content of what you’re managing.”
COVID outbreaks in care facilities have been blamed on a lack of available staff and insufficient training in the use of personal protective equipment (PPE), plus staff working across multiple facilities to earn enough to survive on.
Melbourne’s aged care homes have been the worst hit, with all but five of the 115 aged care homes affected by the virus. St Basil’s recorded 44 deaths, Epping Gardens 36 and Twin Parks Aged Care in Reservoir 21. In Sydney, Newmarch House recorded the state’s highest death toll in aged care with 19 cases.
Prof. Hugman says the alarming death toll at Newmarch and St Basil’s was due to a decision not to transfer patients to hospital – a decision exacerbated by the fact that there are now very few qualified nurses in nursing homes.
“Some nursing homes don’t even actually have a nurse on duty at all times. If they’re looking after 100 people and they’ve got one nurse on duty to supervise other people, then they might have somebody who has a certificate from TAFE administering drugs and medications.
“In a hospital, someone would actually have to be a qualified nurse to be doing that.”
Prof. Hugman says that while the royal commission creates an opportunity for people to speak up, the real challenge will be in how the government responds and whether that produces a positive change in society generally.
Regarding funding, he says there is a lack of transparency in how government funding is spent by management in aged care facilities in comparison to community-based social services where monitoring is stringent.
Claims by some aged care homes, particularly those from the for-profit sector, that they have to spend less on staff relative to residents in order to cover their costs, just don’t stack up.
“And those claims about non-profitability do not explain how or why the [aged care] for-profit sector remains [in operation].”
For-profit aged care homes have reported more cases of COVID-19 than facilities operating on a not-for-profit framework, heightening concerns about staff numbers, training and supplies.
Do you believe a sense of humanity is missing in some aged care facilities? Is it profit first and people second? Do you believe the royal commission will initiate meaningful change?
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