According to Dr Omar Khorshid the president of the Australian Medical Association there needs to be a change in the terminology used to describe residential care facilities in Australia. She argues that high quality medical and health care delivered by doctors and nurses must reside at the heart of the Australian aged care system.
She claims that despite the best efforts of hard-working GPs, nurses and specialists, our broken aged care system suffers from a critical deficit of healthcare.
Importance of terminology
Dr Khorshid says “we used to call them nursing homes. Where our grandparents, our aunts and uncles, and our mum and dad went when their needs were greater than their families could deal with. Now we call them “residential aged care facilities”. It’s a bureaucratic term that brings dread to most of us.
Why don’t we call them nursing homes any more? Well, how can you run a nursing home with no nurses? And if what they live in is nothing like a home, why not just call them facilities?
But is this where any of us want to end our lives? Or want our parents to end their lives? We are all entitled to much more. Care that goes beyond someone to help us shower or wipe our chins.
It is time we stopped viewing aged care as long-term accommodation for older people and accepted that aged care is healthcare and put doctors back into aged care and nurses back into nursing homes.
The royal commission into aged care quality and safety unequivocally agreed with the AMA that we need mandated minimum staff ratios that deliver more nurses and better trained staff in aged care.
They also say we need to bring older people’s general practitioners to the centre of planning for ageing and aged care. We say, high quality medical and health care delivered by doctors must reside at the heart of the aged care system.
To achieve this we need to attract more GPs and other specialists to work in aged care by incentivising them better. The investment in aged care will need to be complemented by adequate investment in healthcare. We want to make sure the GP is adequately supported and compensated for time away from their practice for nursing home visits.
Person-centred care primarily involves GPs clinically assessing the older person’s medical needs, health and wellbeing and designing a specific and individualised care plan for them. All the better if it’s their regular GP with the long-established doctor-patient history. All other services – social, nursing, and allied health – should be based on that plan and underpin it.
Prioritising an older person’s health enables them to continue doing the things they value in life, while maintaining their independence for as long as possible. This is the sort of relationship and future of aged care we would like to see for our people and our country. Comparisons with the UK
In the UK research has shown that most people would prefer to receive care in their own home. Consequently, people will be seeking admission to a care home at a later stage in their life when they will need more support to deal with health and dementia issues.
I have always taken the view that care homes are places where as far as possible, people can still enjoy quality of life with support provided by healthcare professionals. I do not subscribe to a medical model that will drive the culture of staff and residents in a care home.
We all recognise the valuable contribution made by nurses in care homes and the great difficulties providers have in recruiting them. To that end we need to introduce a career structure to incentivise people to work in them.
I do not agree that a change in terminology would benefit care homes in the UK. A focus on the medical model brings with it cultural issues that could deprive people of a better quality of life. I also take issue with Dr Khorshid description of care staff as chin wipers. Care staff play a critical role in the lives of residents in care homes that support quality of life, changes in terminology nor a greater number of nursers will change that important fact.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy