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Fairway – the best of care
Despite bracing ourselves for a torrid second episode of the Four Corners expose of Aged Care, nothing prepared for the sickening sight of cruelty metered out to a bewildered elderly lady by a carer at The Poplars Nursing Home in NSW.
I still re live the sight in my mind’s eye and have heard or staffs responses of disbelief and disgust. We are all tainted by this act; it has diminished our collective consciousness as carers and protectors of the vulnerable elderly.
How could such a thing happen?
What kind of Aged Care system are we accepting in Australia?
To those of us who have worked in this sector for years the knowledge that funding cuts are hurting across the board is not new. In fact the stress we feel at Governance level, as Administrators, Medical and Nursing Staff and Carers has been unremitting.
Over the years I have written letters to papers (never printed), sent reports to Government hearings (no response) and generally railed and ranted along with so many others doing the same thing. We all knew that one day a crisis would come that would blow the reality of the situation into the eyes of the public. The scenes from Oakden Nursing Home were outrageous—a Dickensian and soulless place which looked as miserable to work in as to be one’s home. No doubt many good staff gave of their best in an utterly substandard and awful environment.
But will a Royal Commission get to the bottom of such appalling dysfunction, such breathtaking hypocrisy? No government has taken any responsibility for the state we are in and it’s not just as simple as more funding (though this would ameliorate a huge amount of the problem and is absolutely essential).
But Aged Care is no longer what it once was when it originated from ‘protective asylums’ in the 1900’s then morphed into charity based benevolent societies through to the 70’s.
After this, bed numbers grew but homes were scattered and patchily funded leading to unequal access across the states. It was until recently always regarded as a welfare model of care and to a large degree still is.
In truth, Medical advances have pushed longevity out so far that on average we appear to have at least 10 years more added to our lifespan perhaps 20 years if you go back to our grandparent’s day.
Drugs now strengthen hearts, reduce cholesterol, improve circulation, stabilise blood pressures, reduce clotting risks and better manage chronic illness and autoimmune diseases. We have advanced cancer treatments and an ever increasing array of pharmaceuticals to ward off illness or even prevent it in the first place.
Societally we have an educated public, a consumer expectation of the highest standards and a public health system and universal coverage via medicare that enables folk to avail themselves of excellent health services; the economics of well-being cannot be over exaggerated and many countries inhabitants simply cannot afford to have even a fraction of the benefits we enjoy.
But in many cases what has this extra time provided?
No doubt many elderly are living much more productive and comfortable lives but across the board we now see diseases and conditions associated with advanced ageing that were once rarities. Folk can come into Aged Care being treated for cancers, having renal dialysis for failed kidneys, being supported with immunotherapy for autoimmune diseases and in advanced stages of neurological disease which would have been terminal even a decade ago. Though these folk live longer and deserve every effort we can make to honour and care for them it begs the question of how Aged Care can still be seen—and funded—through the lens of the welfare state “shelter and feed” mentality.
Aged Care is now a medical and nursing speciality and it takes “special” medicos and nurses to work in a field so disrespected and underpaid.
We all read with alarm in July this year that the Australian Medical Association Aged Care Survey showed that 1 in 3 doctors planned to cease all contact with patients in residential facilities due to their poor remuneration and the lack of suitably trained nurses to provide safe care.
What we see now in our specialisation is not only the raft of conditions mentioned but an acute vulnerability to outside threat on many levels. A urinary tract or chest infection can have devastating effects as can a minor fall or even side effects of medications. Constant vigilance and awareness demands excellence of clinicians not that of 6 week trained carers from other cultures; But above all in this changed face of ageing— and one of our greatest challenges— is the proliferation of dementia.
Once a perverse “luxury” people did not live long enough to succumb but now we have large numbers of folk in cognitive decline and it is only going to grow as the percentage of the elderly in our population will increase vastly.
Realising that funding was utterly inadequate to care for the special needs (clinical, lifestyle and nursing) of these folk the Government introduced a ‘Dementia Supplement’ some 4 years ago. It was certainly not generous but we all felt that finally acknowledgement was being given. All facilities had to apply and provide objective evidence of need. The outcome? So huge was the demand and the need, that the supplement was shut down without discussion or debate. The excuse being “You’re all rorting the system”.
To say we were all shocked and disgusted is an understatement. Indeed we are all so sick of being side-lined, blindsided, ignored and patronised that many have simply given up being advocates.
But not at Fairway.
Our motto is crash or crash through. We have never accepted second best and have fought to maintain standards and demand that we can continue giving the best we can to our fantastic residents and families. It has meant utilising some ‘user pays’ to exist and refusing to employ anyone we feel unfit to work to our standard.
Our voluntary Board is equally uncompromising in all areas of governance. Our board is simply our bedrock.
Of course with more funding we could do better. All Aged Care could. I have no idea how the huge conglomerates make profits and (thankfully) have never been part of this system.
As a not for profit community organisation we are still passionately wedded to our values of care and service but getting this to work in the business sense becomes ever harder. And if the latter fails the former perishes.
I have not always worked in Aged Care but the last two decades within this sector have been the best. I have met glorious families, magnificent residents and wonderful staff. It is such an abiding privilege to share a journey of life’s fulfilment of itself. Each resident remains the fantastic person they always have been. We cannot conquer ageing itself though we work very hard to reduce the aches, illness and disablement which can accompany it.
Hospitals are where we go to recover from disease, injury or surgical treatments. Once managed its discharge time and folk go home. But Aged Care is simultaneously an acute clinical specialisation but enacted within an environment in which life must be lived with meaningfulness, dignity and pleasure 24 hours a day 7 days a week. We ‘achieve’ this on less per day than the state pays for a prisoner.
We have as many staff as we can possibly afford. 5 Div. 1 Nurses (Bachelor of Nursing), (offering 24 hour on call), 20 Div. 2 Nurses (EEN’s), (Diploma in Nursing) and a body of well-trained Personal Carers.
We are well above the norm in every category of care and service utilizing far fewer Personal Carers per trained nurse than other facilities. We are not perfect but as close to ‘damn good’ as could possibly be wished for in the current climate; Let me share a recent letter…
It has now been over 3 weeks since Mum passed away at Fairway. On behalf of the family I want to say Thank You. The family is grieving in different ways but one thing is common among us, she has left an enormous hole in our lives. One that cannot be filled.
The other common factor among us is our view of the level of care that she received over the past 6 and half years at Fairway. Over that period, we watched as Mum progressed from being quite independent through to her very dependent state during the past few months. The care she received at Fairway was always relevant to her current need. A light touch at first through to full hands on in the final stages. The love, care and attention in House 5 over the past 2 years was amazing. Especially so when you consider the constraints that you are working under when it comes to funding commitments.
Mum loved the staff and the other residents. From what we can see the staff loved her and we saw genuine affection, especially when she went through difficult times. Towards the end Sandy, your guidance following the last hospital attendance was critical in helping us navigate Mum’s poor health to ensure an appropriate end to her life. In the current climate where Aged Care is under the spotlight, with harrowing images being put in front of us almost daily, we are so thankful that we found Fairway for Mum 7 years ago
The stories we are seeing are very upsetting and we watch with mixed emotions: glad Mum didn’t suffer like that, but what is stopping other facilities being like Fairway? I also wonder how you must feel when you see how other facilities treat their residents. Let us hope the upcoming Royal Commission looks at well run facilities like Fairway and holds them up as role models for what our elderly parents and their families should expect.
Thank you very much for genuinely caring for your residents and treating them with respect during their final years.
Ken Archibald and family
I can hardly add anymore to this.