Can we put the ‘care’ back into aged care?

1 December 2019


by Peter Westmore, News Weekly.

The Interim Report of the Aged Care Royal Commission, which was released at the end of October, is both an indictment of our society’s treatment of the aged and infirm, and a call to arms to fix the deep deficiencies revealed in the course of the royal commission’s investigations.

There have been many complaints about mistreatment of residents in aged-care facilities over the years, but there does not seem to have been a particular incident that triggered the formation of this royal commission. Rather, it seems to have been established not long after Scott Morrison became Prime Minister to rebut claims that the Government was ignoring the plight of aged-care residents in the run-up to the 2019 federal election.

Labor had been attacking the Coalition Government, claiming that, when Morrison was previously Treasurer, he had cut $1.2 billion from the aged-care sector. The royal commission, with wide terms of reference, was designed to show that the Federal Government was serious about the problem.

The Interim Report states that earlier inquiries and reviews into the aged-care sector over the previous 20 years had had little impact, as successive governments failed to act on most of their recommendations.


As often happens with royal commissions, this one assumed a life of its own. It required both government departments and aged-care providers to inform the commission of complaints and deficiencies that they had earlier swept under the carpet, invited the public to make submissions, which were dealt with in public hearings, and conducted wide-ranging community consultation in both urban and rural areas.

Within a year, it had crisscrossed Australia collecting evidence, and it has produced an interim report which has put the plight of vulnerable elderly Australians squarely in the public arena, to the relief of many people who had complained about the quality of aged care but been ignored.

The findings of the Interim Report are damning. Commissioners Richard Tracey (who died on October 11, only seven weeks after a diagnosis of cancer) and Lynelle Briggs’ investigation led them to describe the aged-care system as “a shocking tale of neglect”.

The major quality and safety issues that came to the attention of the royal commission were:

  • Inadequate prevention and management of wounds, sometimes leading to septicemia and death.
  • Poor continence management – many aged-care residences do not encourage toilet use or strictly ration continence pads, often leaving distressed residents sitting or lying in urine or faeces.
  • Dreadful food, nutrition and hydration, and insufficient attention to oral health, leading to widespread malnutrition, excruciating dental and other pain, and secondary conditions.
  • A high incidence of assaults by staff on residents, and by residents on other residents and on staff.
  • Common use of physical restraint on residents, not so much for their safety or well-being but to make them easier to manage.
  • Widespread over-prescribing, often without clear consent, of drugs that sedate residents, rendering them drowsy and unresponsive to visiting family and removing their ability to interact with people.
  • Patchy and fragmented palliative care for residents who are dying, creating unnecessary distress for both the dying person and their family.

The commission actually went so far as to contrast the treatment of people in aged-care facilities with the love shown by family members.

It said:

“Just as striking is the love, dedication and determination of people who are, or have been, a parent, relative, friend, carer or advocate. We have been left with a sense of great pride in the way most ordinary Australians care for their loved ones and overwhelmed by their devotion and commitment.

“We have heard about spouses who visit their partners every day to tend to their care and to keep them company. They stop doing other things or give up or reduce their work to do so, and accept the financial and other costs that are imposed on them.

“Such is their devotion.

“At a time in their lives when an older person and their family members and friends should be able to spend peaceful time together, we have heard how these relationships can become subsumed by the battle with staff and managers in aged-care services to advocate for basic personal care. We now know these battles go on every day.”

There are, of course, aged-care facilities that treat people with loving care and respect. These are often not-for-profits, particularly those run by churches and religious orders.

The fact that many aged-care facilities are run simply as businesses, whose function is to deliver the maximum profit to their owners, clearly contributes to the appalling neglect of many vulnerable aged-care residents.

Yet it is not surprising, given the push by governments for euthanasia and physician-assisted suicide, that vulnerable elderly Australians are being so ruthlessly exploited.



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