Why Aged Care In Australia Needs An Allied Health Revolution

We have been at the forefront of calling for more allied health services to be available to aged care residents for some time now. I must say I find it staggering that though we are all aware that our population...

We have been at the forefront of calling for more allied health services to be available to aged care residents for some time now. I must say I find it staggering that though we are all aware that our population is ageing, and that our aged care sector is rapidly growing; many residents still have not got access to the basic allied health services they need.

There is a fundamental obligation for aged care providers to examine their service offering to their residents, and to ask honestly and frankly whether they are in fact living up to that obligation. As I mentioned in a previous article, I am in awe of the people who dedicate their working lives to providing care and assistance to the aged care sector; but I do feel more must be done. There is increasing pressure on policy makers and facility management to grow their allied health offering and access for residents, and we at Australian Health Professionals support that move whole heartedly.

I was discussing this very matter last week with the director of a 50 bed facility in Sydney, and I was really buoyed by the fact that they had indeed implemented a strategy to grow their offering over 2015, and was even more impressed to find they had almost tripled their budget to do so. In our discussion, when asked, these were some of the reasons I gave to support their move.

Increased allied health services improves the health of your residents

This is a simple and demonstrated fact, and given the entire goal of aged care facilities is to provide care to the older generation, should be why this debate should be won immediately. Care facilities that have onsite physiotherapy services see an increase in their resident’s energy, rehabilitation and mobility from the very outset. Providing something as simple as quality dental care increases their resident’s oral health and most facilities never consider this, but it’s important. Over the past thirty to forty years more and more people have retained their natural teeth, and this number will continue to rise as the population ages. With age comes mobility issues, and often when services are difficult to access, oral health becomes less of a priority for older people. What many people don’t realise is that poor oral hygiene and the presence of periodontal disease enables the build-up of pathogens which, if aspirated, can lead to pneumonia. Poorly fitting dentures and dental caries can also inhibit chewing and swallowing function. This increases the risk of aspiration pneumonia, the second most common cause of infection, hospital transfer and mortality in long term care.

Another aspect of allied health that can significantly improve resident’s health is an onsite psychologist. Mental health, as we are all aware, is a significant area in Australia and one that should be addressed in aged care facilities as much as anywhere else. There are a myriad of reasons why mental health services will be required in a facility, one major one being Alzheimer’s; however, many aged care residents experience depression due to the reality of their ageing lives and often due to loneliness for friends and family now gone. Developing a strong mental health program in a facility that includes the provision of psychological services can have a huge effect in the health, mental well-being, and happiness of your residents.

Mobility issues are the single most important factor you need to address

If you were to survey a thousand residents in aged care facilities I would be shocked if mobility were not the highest issue they would have identified. Everyone knows this, and what is more is that as we all get a little older we feel, and expect to feel, that many things do not come as easy to us as they once did when we were younger. So it still surprises me that many facilities across Australia still do not have a comprehensive service offering in place incorporating Physiotherapy and Exercise Physiology. Apart from the mobility issues that invariably come with age, I read recently that almost half of people over 75 years of age will experience a fall in any given 12-month period. That is a staggering number of our elderly and yet another reason for a concise strategy to be put in place. Exercise physiology can help with the treatment and recovery from these falls, but also can prevent them by allowing residents to gain more mobility and strength. Physiotherapists are also the largest contributors to allowing residents to improve recovery from accidents and gain greater independence through restorative programs. If your facility doesn't have a Physiotherapist or Exercise Physiologist in place, or not on a full time basis, you need to reconsider your service offering, and quickly.

If you feel I'm being an alarmist – you’re wrong

So we've established that most people know the Australian population is getting older, and we probably can all agree that the provision of allied health services to the aged care community is a good idea. Then you’ll probably be as surprised as I was to learn that the number of allied health professionals working in the aged care sector has actually dropped. Yes, there are less allied health clinicians in aged care today than there were in 2007. Actually it is estimated that there are in fact almost 25% less clinicians in aged care than there was eight years ago. So forgive me if I appear to be an alarmist to you, but I certainly feel that this may be reason enough to be alarmed! Why is this? From what I can understand from conversations and the strategies in place throughout Australian aged care facilities, one of the biggest issues is funding; more specifically where the funding is directed. Associate professor Debra King, dean of the school of social and policy studies at Flinders University, was recently quoted as saying:

'It does seem to be that the focus in funding is on nursing and personal care assistants in residential aged care and that allied health professionals and assistants are seen as a beneficial ‘extra’.'

Now I am not saying in any way that we should not be funding nurses, but I do feel that a new thinking needs to be employed. Increased mobility and the provision of physiotherapy services can actually save you money in terms of what you need to channel into nursing hours. A recent study showed that if a 50 bed facility increased their physiotherapy offering from part-time to full time, it equated to a savings, in terms of nursing dollars, of $283 per bed, per year. Now consider if you were to implement this new thinking and had the result of happier, healthier, more mobile, and more independent residents; while your nursing staff did not remain over-worked and were focused solely on the provision of quality clinical care to the residents who really needed it.

So this is my call to arms for all aged care facilities in Australia – challenge your thinking, review your allied health offering, and let’s all work together to fulfil our obligation in aged care to offer the highest quality care to the people who deserve it the most; those who have spent their lives building this amazing country which we are so lucky to enjoy today.

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