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How to choose a Residential Aged Care Home

Choosing a Residential Aged Care Home for you or a loved one is a big decision and can be daunting. Navigating the aged care system is a challenge for many. How do you know you are making the best choices when choosing a Home for your loved one? Bina Brown, Contributor for the Australian Financial Review asserts it is what is going on inside the Home that really counts. 

Navigating the aged care system is a challenge for many. How do you know you are making the best choices when picking a facility for a loved one?

With residential care vacancies on the rise, particularly in major cities, there may be several accommodation options – from grand hotel-like establishments to older more established facilities.

The outside appearance will certainly matter to some – but it is what is going on inside that really counts. And that comes down in large part to the quality of care – in which respect, humanity, kindness are also a key indicator. Without doubt, when it comes to aged care, you don’t necessarily get what you paid for.

In the push for more to be spent by the provider on providing the best resident care possible, it is too simplistic to immediately rule out private aged care in preference for not-for-profit or government-run facilities.

Even the not-for-profits – which account for 61 per cent of residential aged care services and include names like Blue Care, Uniting, Catholic Healthcare and Baptistcare – should be aiming to make money rather than operate at a loss. It is where they direct any surplus that matters.

For-profit companies can operate well-run and respected facilities. They account for 26 per cent of residential aged care service, and include names like Opal, Bupa, Regis and Japara among the largest and TLC and Arcare among the smaller operators.

Government-run services make up about 12 per cent of places overall, but account for one-third of residential care services in outer regional areas and half of all facilities in remote regions. They are often considered among the best. Perhaps coincidentally, most are small and attached to state- or territory-run hospitals that operate under different regulations and requirements, including ratios and wages for nurses and staff.

As discussed at the Royal Commission into Aged Care Quality and Safety earlier this month, it is time for transparency of ownership and the use of funds in aged care – particularly as billions of dollars of taxpayer money is being directed towards the sector.

Decision time

The process of placing a loved one into residential care is generally initiated under pressure, in a situation fraught with sadness, anxiety and confusion. It’s not a joke to say that many decisions about whether to enter a particular aged care are made in the carpark of a hospital.

One positive move to help with making a choice has been the availability of easier access to compliance or performance reports for facilities, published on the Aged Quality and Safety Commission website.

However, nothing beats looking at a place – having the opportunity to take in the look, feel and smell. It is a chance to see the rooms and try to picture some of your loved one’s furniture and personal possessions there. It also shows you the layout and geography of the place: whether there are any breakout areas where individuals or families could sit; whether there is plenty of light; the dining room set-up; and whether there is easy access to the outdoors.

A visit to the facility also gives you a chance to see what residents are up to, and whether they look relaxed or well cared for, in clean clothes and well-dressed. Whether they are engaged in activities with each other and whether staff are interacting with them.

Care has to be at the top of the list, so the questions to ask might include how many registered nurses are in the building at any time over a 24-hour period. It’s not mandatory to have a registered nurse on duty 24/7, but it is more comforting if they do.

Ask about staff qualifications and training. There are no mandatory requirements but you'd expect a minimum Certificate III in aged care at a reputable teaching institute plus ongoing training.

What to look out for

Care staff numbers are also vital. Without mandatory staff-to-resident ratios (except in Queensland), it is hard to get a good grip on this, but it would be a worry not to see any staff during a tour.

It’s getting more common for facilities to talk in terms of daily care hours spent with a resident. With the minimum acceptable level considered to be 2½ hours a day, this measure can be a very useful indicator.

Food matters a lot, and some people will care where and how it is prepared - whether it is on site by a resident chef, what the options are and whether they cater to specific diets.

While meal times might be a good time to socialise, not everyone wants to eat every meal with the same people and may prefer to eat in their room.

In the current COVID-19 environment, facility tours aren’t always possible. This can make the selection process harder. Families have been asked to pay $550,000 as a refundable accommodation deposit for a room which no-one has seen and then wave goodbye to their loved one at the front door.

Isolation on arrival and visiting hours within a facility are decided very much on a case-by-case basis in the current environment. However, these can change at any time. Even in pre-coronavirus times, a facility would be shut to visitors during an outbreak of flu or gastro, to prevent further spread.

You may be left with a very long list of questions to ask the facility, and hopefully you’ll get truthful answers that help guide your decisions. It is not uncommon to only get to speak to the marketing or client liaison staff – rather than the manager or care team leader – so some answers may need a follow up with the right people.

Medical services

Additional questions around care may include what level of input a family has in the care plan of an individual and which allied health professionals –such as dieticians, physiotherapists and occupational therapists – are available and how often. What’s the communication process with family when someone is unwell?

Visiting podiatrists are common and most places have a hairdresser on site a few days a week.

If you have an existing GP who will visit the facility, that may be a bonus; or you may be asked to choose a GP from a list that do regular visits.

Most facilities prefer to get medication delivered from their chemist of choice.

Questions about the protocols for infection control are particularly relevant, including asking for an explanation of the resources and training provided for staff in medical and personal protection equipment. What is their plan if COVID-19 does strike their facility?

Aged care is one of those areas most people know little about until they have to. Once you enter the system, the questions can be endless – as they should be.

This article appeared in The Australian Financial Review on 22 September 2020.

To find out more about Catholic Healthcare’s Residential Aged Care Homes go to www.catholichealthcare.com.au/residential-aged-care/