Sue Kedgley: Elderly Kiwis in care deserve national watchdog

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Older New Zealanders need to be protected against any form of abuse.
Older New Zealanders need to be protected against any form of abuse.

Most people will welcome Grey Power's call for an Aged Care Commissioner to tackle the rising incidence of financial abuse of vulnerable older Kiwis.

This is a serious and growing problem.

But why confine the role of an Aged Care Commissioner to investigating financial abuse among the elderly?

Why not extend the role of a commissioner to investigate the quality of care of the more than 40,000 older New Zealanders in aged residential care? As Age Concern New Zealand points out, many of these residents are "vulnerable to abuse and neglect", too, and many have nobody to protect their interests.

There are about 700 rest homes around New Zealand. Many provide excellent care for their residents. But there are persistent stories of abuse in aged care homes, the most recent being a resident of the Malvina Major rest home in Wellington who was found by her daughter, on three occasions, covered in her own faeces.

It's clear that these are not just isolated incidents, but symptoms of a more widespread problem in an industry that is largely unregulated and chronically short-staffed.

There are no mandatory staff-to-patient ratios in the sector, and most of the care is provided by caregivers, who earn abysmally low wages, have heavy workloads, and are largely unregulated. There are no minimum training or qualifications needed to work in a rest home, either, and some walk straight off the street with no training or experience of working with older New Zealanders.

Acute staff shortages, inadequate training and high turnover rates across the sector can all compromise the quality of care residents receive.

When I was a Member of Parliament, I conducted an inquiry into aged care, with former Mana MP Luamanuvao Winnie Laban. We were dismayed by some of the stories we heard about the quality of care some residents receive. We heard stories of residents who had not received proper medical treatment for common conditions such as urinary tract infections, dehydration, bedsores and falls, and ended up in hospital as a result.

We heard stories about residents losing their mobility as a result of not being walked regularly; residents being left in front of the television all day; residents suffering from chronic dehydration or malnutrition; residents being left for hours on their own, or being treated as little children, not adults.

We were informed that around 30 per cent of residents in aged care homes are on antipsychotic drugs; that caregivers often give out medication; and that up to 22 per cent of residents in hospitals are placed in beds with restraint rails so they can't get out of bed, or even tied to beds or chairs for hours on end.

These are just some of the many serious issues in aged care that need to be addressed. But there is no one agency that is tasked with ensuring the safety and wellbeing of the40,000 residents in aged care. Instead, a number of disconnected agencies are involved in providing their care, including the Ministry of Health, District Health Boards, the Health and Disability Commissioner's Office, Health Cert and other organisations.

This fragmented responsibility makes it difficult for people to advocate for family members in aged care, or resolve issues around the quality of care. A watchdog in the form of an Aged Care Commissioner, who could advocate for patients, develop quality standards and provide leadership across the sector, would help to fill this vacuum.

Another problem is the lack of accountability in aged care. Aged care providers receive more than a billion dollars in taxpayer funding each year. Yet there's no requirement for providers to publicly account for how they spend this money, as there is for public hospitals. Nor are they required to disclose the number of adverse events that occur in their facilities, or to report on medical mishaps, infection rates, or other indicators of the quality of care. So it's hard to get a clear picture of how good or bad the standard of care is in many rest homes, despite the fact that rest home audits are now published online,

A star rating system, which would measure the quality of care in rest homes, and enable consumers to check the rating of an aged care facility, would help lift standards in the sector. So would a public ranking system.

Health Minister Tony Ryall has announced that he intends to roll out a nationwide system for ranking public hospitals next year, which will enable patients to score hospitals and post them online.

Why not extend this ranking system to rest homes as well, so that family members could score rest homes on the quality of their care, and post them online.

These innovations, with improved wages for caregivers, mandatory staff-to-patient ratios and the appointment of an Aged Care Commissioner, would radically improve the quality of care in this vitally important sector.

Sue Kedgley is a Wellington regional councillor and former Green MP.

- NZ Herald

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