Page 2433 - Week 08 - Wednesday, 18 August 1993
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The mid-term review emphasised the need for balance of care for the aged. This was to be achieved through planning of an integrated health care system that recognised the links between the three main program elements of nursing home care, hostel care and HACC. Flexibility and the ability of services to adjust as circumstances alter in any one element of aged care were proposed as key areas of future program planning.
Madam Speaker, the review recommends major changes to the planning framework for aged care to further improve balance of care, particularly for services provided under the home and community care program. The latest in this package of aged care reforms was published in September 1992 and is entitled "A National Action Plan for Dementia Care - Putting the Pieces Together". This paper outlines the following goals for people with dementia and their carers: Access to quality community care; access to quality residential care; and quality of life.
Under these broad headings a number of useful initiatives are proposed. These include: Assistance to carers and service providers with information regarding practical ways of overcoming the difficulties people with dementia and their carers experience within the home environment; improvements in the design of residential and day centres in relation to people with dementia; improvements in the capacity of aged care assessment teams in relation to the management of assessment of people with dementia - an initiative in this area was announced in last night's budget; improvement of access of carers, including the carers of people with dementia, to respite; and enhancement of the knowledge and skills required of carers of people with dementia in carrying out their caring role.
Within the ACT the issues surrounding services for people with dementia revolve around the need to provide an integrated network of services that coordinate psychiatric-mental health services, appropriate residential and acute care options within a common framework, and offering support to carers through training, seminar assistance and respite care. Provision of more dementia respite care, crisis accommodation, dementia nursing staff and purpose built long-term hostel and nursing home-type accommodation will be required within institutional settings or in day care units. Where it is appropriate there may be a need for close supervision and provision of safe wandering space, which demands high levels of staff and purpose built accommodation. The types of service provision need to be diverse to cater for the varying needs, including dementia patients who are physically ill. Madam Speaker, carer support mechanisms are crucial to the survival of carers of dementia sufferers at every stage, since the care of these people can be very debilitating.
The various responsibilities of the Commonwealth and ACT governments in this area are quite complex. The Commonwealth has responsibility for provision of capital and recurrent funding for non-government hostels and nursing homes, and regulation of the number of nursing home and hostel beds in the region. The Commonwealth and the ACT Government jointly fund home and community care services which provide a wide range of community based support services enabling frail aged and people with disabilities to remain in their own homes. In ACT Health the main service funded by HACC is the community nurses. The ACT Government provides the following services: Jindalee is a nursing home offering extended care accommodation for 128 frail aged and younger disabled adults from the ACT and surrounding districts.
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