The Interim Report from the Royal Commission into Aged Care Quality and Safety has recommended the removal of all younger people with disability from aged care and to stem the flow of younger people into a system that cannot provide appropriate care.
This recommendation is one of three that was suggested by the Commissioners, the late Richard Tracey AM RFD QC and Lynelle Briggs’s AO, to be implemented as soon as possible.
While the Interim Report is rocking the aged care sector, it has an important focus on younger people with disability who are ending up in nursing homes out of desperation.
Commissioners say the very nature of aged care is designed for older people, which is why it is not appropriate for younger people with disability.
Since 30 June 2018, there are 6,045 people under the age of 65 living in residential aged care.
The report highlights that it is deeply concerning that the disability service system is not providing appropriate support and services to younger people, which is resulting in the inappropriate admission of younger people with disability into aged care.
Commissioners believe the failure to understanding the circumstances of young people going into aged care coupled with the continuing entry of young people into aged care indicates a “lack of sufficient interest by the Government” for these people and a “level of complacency” for existing policy settings that could solve the problem.
“The presence of younger people in residential aged care is a symptom of the failures of other systems, and too often residential aged care is offered as a default response,” the report says.
“The Royal Commission heard multiple accounts from younger people who have been, or remain, in residential aged care. They spoke of the social isolation, neglect, loss of function, sense of hopelessness and grief associated with their time in aged care.
“There are also issues with the quality and range of care available to people with complex care needs.”
The Commission also raised concerns in the paper that many younger people in aged care may not be receiving all their rights under the United Nations Convention on the Rights of Persons with Disabilities.
They believe these rights for younger people in aged care are being compromised while in aged care.
“In order to provide real choices for younger people in or at risk of entering residential aged care, alternative options for both accommodation and care are critical. There is, however, a substantial shortfall in Specialist Disability Accommodation. Governments have known this shortfall for a considerable time,” says the report.
However, the Commission doesn’t believe the market alone will be able to sufficiently provide Specialist Disability Accommodation to meet the demand within a reasonable timeframe.
Getting adequate support for younger people has been a constant struggle, with the main challenge coming from State and Territory Governments and Federal Government fighting over who has to fund the supports.
The report says, “At worst, it seems that some people have been denied these supports while the various Commonwealth, State and Territory Governments have debated who bore responsibility for funding them.”
Bringing attention to the current Government’s Younger People In Residential Aged Care Action Plan, the Commissioners believe there are significant gaps in the project and won’t support people with disability in aged care who are not on the National Disability Insurance Scheme (NDIS).
“The Action Plan also lacks ambition, with modest targets that still allow the admission of unacceptably large numbers of younger people into residential aged care well into the future,” says the report.
Commissioners do no consider the Action Plan likely to “achieve even its limited targets and should not be relied on as a solution to the policy failures that have consigned so many younger people to a life lived in residential aged care.”
Now that NDIS is in existence, the Royal Commission refutes the claims of the Australian Department of Health that younger people in aged care is a “somewhat intractable problem”.
Commissioners finished their assessment, saying, “The rhetoric and buck-passing that has perpetuated the admission of younger people into residential aged care, particularly those who are admitted from hospital with a disability or with palliative care needs, has been going on far too long.
“Australia now finds itself with a human rights issue that is costing people their independence, dignity and wellbeing. Action must be swift. It must be thorough. And it must be considered.”
What the industry says
Disability advocacy organisations across the country have welcomed the recommendation from the report and hope that the removal of younger people from aged care will be implemented as soon as possible.
In a joint statement, The Summer Foundation, the Young People In Nursing Homes (YPINH) National Alliance and Youngcare have welcomed the targets asking for the end of young Australians entering residential aged care by 2022, and no young Australians in aged care by 2025.
The organisations want these targets adopted by the Government immediately.
YPINH Alliance Director, Dr Bronwyn Morkham, says the Commission’s acceptance of these targets was critical.
“We cannot risk another policy failure for these younger people. These targets give us a measurable objective by which we can solve this longstanding problem,” says Dr Morkham.
“No single government agency can fix this issue by itself. Health, disability and aged care systems must work together to achieve these targets and end the flow of young people into aged care.”
Chief Executive Officer (CEO) of Summer Foundation, Dr Di Winkler says, “We must make sure that the Royal Commission’s work leads to solutions where human rights are upheld and where young people can choose where they live, who they live with, and how they are supported.
“The funding is there in the NDIS, the will is there in the community, and with a good plan and dedicated focus, the issue can be resolved.”
Youngcare CEO, Anthony Ryan, says the report has shown a positive step in the right direction towards ensuring young Australians with disability are able to choose how they live their life, which is not in aged care.
“Our passion is to give young people the choice that everyone deserves. In coming out so strongly, the Royal Commission gives a guide to what we all need to do to bring this about,” says Mr Ryan.
CEO of Australian Federation of Disability Organisation (AFDO), Ross Joyce, says the peak body fully supports the recommendation of the Commission to ensure younger people with disability are taken out of aged care facilities and relocated into accommodation which best meets and respects their needs.
“There are many people under 65 years of age inappropriately placed in aged care facilities as there are little or no alternatives to cater for their needs or supports,” says Mr Joyce.
“This is a disgraceful outcome and significantly impacts on their quality of life, is contrary to the social model of disability and their human rights.
“We support the work of our many colleagues who have been tirelessly advocating for this very action and in particular the Young People in Nursing Homes National Alliance.”
“There has already been agreement for this to happen and we just need to get on with it.”
Aged care consumer and industry peak bodies, the Council of the Ageing (COTA) Australia and Leading Age Services Australia (LASA), have outlined their own wishes for younger people with disability to be removed from aged care, as it is not an appropriate place for younger people with disability to be receiving care.
To access the Interim Report, visit the Aged Care Royal Commission website.