Last week, Community Industry Group hosted the second meeting of the Regional Health & Aged Care Taskforce, with leaders from a huge range of stakeholders who have the ability to impact the region’s current ‘Delayed Discharge’ or ‘Bed Block’ crisis. The Illawarra Shoalhaven has the worst levels of bed block in the country. Every night between 120 and 150 older people or people with disability who don’t need hospital care are spending the night in hospital because they don’t have access to safe and appropriate residential care.
The taskforce brought together key stakeholders to be briefed on the activities and outcomes of projects to address bed block. They included Hon. Ryan Park MP, Minister for Health, Minister for Regional Health, and Minister for the Illawarra and the South Coast; Hon. Paul Scully MP, Minister for Planning and Public Spaces; Alison Byrnes MP, the Member for Cunningham; Margot Mains, CEO of ISLHD; CEOs and executives from leading aged care providers.
One of the key projects has been to research the issue. This is not to admire the problem. The reality is that there has not previously been accurate data on the patient journey and the state of the aged care sector. Thanks to researchers Paul Sadler and Professor Kathy Eagar, we now know how many active aged care places are available in the Illawarra Shoalhaven – and that we are 1025 aged care beds short. And 1115 home care packages short. We also know what developments are in the planning, and what further growth is needed to meet future demand.
We also now know that 92% of older people who will need aged care are admitted through the Emergency Department. We know that falls and urinary tract infections are the primary cause of presentation to hospital.
While the average patient stay is four days, we know that older people stay on average 66 days, during which time they are moved an average of four times. Many stay much, much longer. We know that bed days for these older people totalled 73,434 over a 16-month period, and that the estimated cost to the NSW Health system is approximately $86 million per annum.
Well-known local dementia advocate and member of the Minister’s Council of Elders, Val Fell, represented the consumer voice and spoke about her own experience in the hospital system and the aged care system. As a result of a serious infection, Val ended up in hospital for 35 days. The first two weeks were spent in a locked geriatric dementia ward – despite the fact that Val is not living with dementia. While Val praised the quality of care she received from hospital staff, the experience of being in a locked ward with a changing group of people living with dementia was harrowing.
As her condition improved, Val decided she did not want to be assessed for residential care. She was confident that she was capable of going home, and that was her preference. But that meant she couldn’t be assessed for in-home care until she had left hospital so the assessment could be done in her home. Val was eventually assessed as needing a Level 3 Home Care Package and she applied immediately. That began the waiting game.
In his magnum opus work, Oh, The Places You’ll Go!, the great philosopher Dr Seuss calls waiting ‘a most useless place’. While most of us spend some time ‘waiting for a train to go or a bus to come, or a plane to go or the mail to come, or the rain to go or the phone to ring, or the snow to snow or waiting around for a Yes or No or waiting for their hair to grow’, no one should be waiting for vital supports for activities of daily living at the age of 96!
The Illawarra Shoalhaven region desperately needs an increase in aged care services to meet the needs of its current ageing population, and to meet future demand. Aged care providers are keen to expand and grow, with exciting new models of care being proposed by both residential and in-home providers.
We are calling on government to provide incentives for providers in an area like this where the market has failed to meet the needs of the people. Government policy has changed aged care to a free market, but their stewardship responsibilities surely mean that some structural adjustment is required to ensure market viability. We are calling for capital grants to encourage development of residential aged care homes, and a targeted growth in in-home services.
Because we all do enough waiting through our lives. We deserve not to wait in our later years.
About the writer
Nicky Sloan is committed to working to build a fair and inclusive community where are all people are valued and enabled to live rewarding lives. She is the CEO of Community Industry Group and has extensive experience across the community services industry. Her diverse work history also includes local government, marketing, the tertiary sector, the finance sector, and owning and running small businesses. She has extensive governance experience and is currently an Independent Non-Executive Director of Warrigal, a substantial not-for-profit specialising in the provision of services for older people and Chair of the Board of Wollongong Conservatorium of Music.
Nicky has degrees in Dementia Care, Community and Environment, Marketing, and Project Management. She is a Graduate of the Australian Institute of Company Directors and an Honorary Fellow of the University of Wollongong.
