Date: 12 November 2013

Quality of Residential aged care - the consumer perspective


A report for Alzheimer's Australia (Paper 37 - November 2013)



This paper discusses concerns about the quality of care in a minority of residential aged care facilities, and puts forward strategies to address them.

The 2013 Australian Of The Year Ita Buttrose addresses the National Press Club on the topic ‘The society I want to live in’. Please watch this video of her address: National Press Club: Ita Buttrose Read the full transcript of Ms Buttrose’s address here

Following her address to the National Press Club, Linda Belardi wrote Buttrose decries aged care standards, published on Wed, 01/05/2013, 05:24:04.

“Alzheimer’s Australia national president, Ita Buttrose has given a scathing speech to the National Press Club decrying the quality of residential aged care standards for people with dementia. In the hour-long address, Buttrose said basic human rights violations and examples of discrimination were occurring every day and the majority of facilities were failing to properly care for people with dementia…” Read the full article here


Supporting media release:

Collaborating for a Better Future for Australians Living with Alzheimer's Disease
12 November, 2013

Ita Buttrose: Common decency and respect costs nothing.

2013 Australian of the Year and Alzheimer’s Australia National President, Ita Buttrose, has released a report, Quality of Residential Care: The Consumer Perspective, which calls for urgent action to improve the quality of residential aged care.

Speaking at the Aged and Community Services Australia Conference in Melbourne (Nov 12), she said that “the report was prepared on behalf of the courageous people who have told their stories about their experiences of residential aged care – some good but many of concern.”

“We have much to be proud of in terms of our aged care system in Australia,” Ms Buttrose said.

“There are many dedicated, compassionate people who are working hard every day to provide the best care they can.

“But what worries me is that a minority of facilities are not providing good care, and that residents are not being respected and, in some cases, are subjected to physical or psychological abuse.

“The objective of the report, which was developed by Alzheimer’s Australia, is to articulate the concerns of consumers, to set out for discussion possible strategies to address them and to seek a higher priority for tackling them.” Ms Buttrose said.

”It proposes strategies that aim to bring providers, staff and consumers together to address the systemic issues in the aged care system that have led to breakdowns in quality care.

“Two lines of action are proposed. Firstly, to take the short term action necessary to give consumers greater confidence in the complaints scheme and accreditation and to ensure minimum standards are in place and being upheld for all residents.”

Secondly, to develop a more consumer oriented system by the greater involvement of consumers in the monitoring, assessment and complaints processes and by much greater transparency in the care outcomes being delivered ” Ms Buttrose continued.

“Funding issues are important but equally so are the leadership and culture that respects the rights and dignity of older people. Common decency and respect costs nothing.”

Glenn Rees, CEO Alzheimer’s Australia said that the Quality of Residential Care: The Consumer Perspective report supports the findings identified in another report also being released today, Collaborating for a better future for Australians living with Alzheimer’s disease.

“The report is an important reminder that if the quality of dementia care is to improve, coordinated action is necessary across the health and the aged care system,” Mr Rees said.

“Over the years there has been inadequate recognition of the importance of timely diagnosis, dementia care in hospitals and dementia risk reduction.”


National Dementia Helpline: 1800 100 500 An interpreter service is available (The National Dementia Helpline is an Australian Government Initiative)

Media enquiries: Krystal Craig: 0407 019 430 / This email address is being protected from spambots. You need JavaScript enabled to view it.

Key short term strategies from the Quality of Residential Care: the consumer perspective report:

  1. The requirement of reporting of alleged physical or sexual assaults to the Department within 24 hours should be expanded to include assaults which are perpetrated by a person with a cognitive impairment. Families of the resident who was assaulted and of the resident who is alleged to have perpetrated the assault should be notified immediately after the incident.
  2. The Aged Care Standards should be expanded to require aged care providers to encourage residents to complete advance care plans as soon as appropriate.
  3. Aged care providers should ensure access to appropriate end of life care for all residents including through:
    • Ensuring that residents have a Palliative Care Plan that includes providing information to consumers about what palliative care services and supports are available in the facility or can be brought in and how they can be accessed.
    • Supporting staff to receive additional training on palliative care supports and also the legal rights of people at end of life.
  4. Increase the reach of the Community Visitors Scheme and the role volunteers can have in the quality and accreditation process, possibly as part of the accreditation scheme.
  5. Ensure that the Aged Care Complaints Scheme escalates complaints to a manager which relate to serious incidents in the use of medications, use of restraint or assault within set timeframes to ensure the safety of residents.
  6. Further work should be done to increase awareness amongst consumers about the role of the Scheme and to address consumer concerns about retribution.

Key long term strategies from the Quality of Residential Care: the consumer perspective report:

  1. Review the Charter of Residents’ Rights and Responsibilities in the context of the commitment in the aged care reforms to consumer directed care, including a focus on rights in relation to end of life wishes and consent to the use of physical and chemical restraints.
  2. Funding arrangements which support appropriate care for people with BPSD through:
    • Supporting staff members to receive additional training on BPSD.
    • Ensuring that staff have access to appropriate specialists, including the Dementia Behaviour Management Advisory Service (DBMAS) to assist with the care of people with BPSD.
    • Encouraging all residential aged care facilities to participate in benchmarking and selfaudits of the use of restraints and antipsychotic medications to ensure that these are used appropriately, with consent and only when all other options have been exhausted.
  3. The Government to commission an independent cost of care study into residential care to ensure that providers are receiving appropriate funding to employ sufficient staff and an appropriate skills mix to provide quality of care during the day and at night.
  4. Reforming the accreditation process to reduce unnecessary administrative burden, increase focus on quality outcomes and provide opportunities for consumer involvement in the monitoring and assessment process.
  5. Shifting the primary approach of accreditation to unannounced visits rather than planned visits.
  6. The new quality indicators published on the ‘My Aged Care’ website should include information about use of restraint and psychotropic medications. The site should also have information about staffing and skills mix and about the outcomes of consumer satisfaction surveys.
  7. The Younger Onset Dementia Key Worker Program should be expanded to provide support to all people with dementia of all ages, with an initial focus on supporting people from disadvantaged groups including people who are Culturally and Linguistically Diverse, Aboriginal and Torres Strait Islanders, homeless and those living alone.

Notes to Editors:

To obtain an embargoed copy of the report, please contact Krystal Craig / 0407 019 430 / This email address is being protected from spambots. You need JavaScript enabled to view it.