01 Apr 2015
Australian Ageing Agenda, National
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Aged care stakeholders say specialist care units and better
industry-wide training must form part of a comprehensive
strategy to improve the care for residents with severe behavioural
and psychological symptoms of dementia, AAA reports.
EXPERTS AND SERVICE
providers are calling for
additional resources to
support the new Severe
Behaviour Response Teams
the Federal Government
announced in February,
saying that specialist teams
alone won't help meet the
care needs of those with
very severe symptoms of
dementia. [See box for details
of announcement.]
Professor Henry
Brodaty
Professor Henry
Brodaty, who is co-director of
the Centre for Healthy Brain
Ageing at the UNSW, said the
government's response teams
needed to be backed up by a
national network of specialist care
units for those requiring more
intensive support than can be
provided in mainstream facilities.
it is estimated that approximately
1 per cent of people with
dementia fit into this category.
This is on top of the 10 per cent
of people with dementia in aged
care that experience severe
behaviours.
"It is now timely to plan for a
national approach to help those
Bernie McCarthy
residents who are even more
severely disturbed and who may
be at risk to themselves or to
others," Professor Brodaty told
Australian Ageing Agenda.
Residents who cannot be
managed in mainstream facilities
can be accommodated in special
care facilities, sometimes called
psychogeriatric units, for a
period of time before returning to
mainstream care, he said.
"Such facilities, which require
secure grounds, more and better
trained staff than mainstream
nursing homes, and support from
multidisciplinary specialist mental
health services for older people,
have been shown to reduce
Catholic Health
Australia CEO Suzanne
Greenwood similarly
said specialist high
dependency units were
needed to provide a
more comprehensive
response to addressing
severe behavioural and
psychological symptoms
of dementia (BPSD).
Dr Stephen Judd
Carol Bennett
Mrs Greenwood
said this suggestion
was included in CHA's
problematic behaviours and
2015-16 pre-budget submission
increase socialisation," he said.
as part of a three-pronged
Models of these special
approach, which also included
care units exist and are usually
funding
directed to services that
developed in partnership with
demonstrated capability to offer
commonwealth and state
step down care services
funding, he said.
for those residents with very
severe behaviours.
SIMILAR CALLS
FROM PROVIDERS
Professor Brodaty's comments on
the need for the specialised units
echo those of HammondCare
CEO Dr Stephen Judd who
also called for the introduction
more broadly of special care
units, such as those units run by
Southern Cross Care in Perth and
Linden Cottage at Hammondville.
CHALLENGES OF
NEW RESPONSE
TEAMS
While Professor Brodaty
welcomed the Severe Behaviour
Response teams to be
introduced later this year, he
said organising them across
six states and two territories
01 Apr 2015
Australian Ageing Agenda, National
Section: General News • Article type : News Item • Audience : 7,196 • Page: 10
Printed Size: 1359.00cm² • Market: National • Country: Australia • ASR: AUD 9,958
Words: 1072 • Item ID: 380677457
Copyright Agency licensed copy (www.copyright.com.au)
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to provide comprehensive
coverage with around $11 million
of funding per year would create
a logistical challenge.
Coordinating the teams with
the current Dementia Behaviour
Management Advisory Services
(DBMAS) would further present a
structural challenge, he said.
Adding much stronger
criticism, clinical psychologist
and dementia educator
Bernie McCarthy said he was
disappointed the initiative was for
teams to provide advice, which
the DBMAS already provided
enough of, rather than resources.
"All the advice in the world
will not resolve the issues staff
face when severely disturbed
situations arise," said Mr
McCarthy.
"They need better training
in person-centred approaches
to relating, communicating and
problem solving, and they need
leadership trained in leading
dementia care settings in a
person-centred manner so that
issues like pain and emotional
distress due to inappropriate or
ineffective interactions from staff
can be addressed."
He said until there was a
person-centred focus that flowed
into care decisions with detailed
knowledge of the individual there
would continue to be excessive
levels of behavioural disturbance
and "short-term fixes" like this.
Mr McCarthy said it also was
unclear how the new Severe
Behaviour Teams would differ
from the work of DBMAS.
BUILDING
FRONTLINE
EXPERTISE
CEO of mission-based provider
peak Aged and Community
Services Australia, John
Kelly, said that building
industry capacity through a
whole-of-workforce approach
needed to be a priority in future
workforce development policy
and funding.
He also raised concerns
over timely access to the new
service, especially in rural and
remote areas.
"If this is a city-centric
fix to a large problem, it will
disadvantage many people with
severe behaviours all across
Australia," Professor Kelly said.
Leading Age Services
Australia said it was concerned
the new mobile teams would not
help build long-term capacity
within the industry.
"There is a risk that the
specialist response teams will
simply be a quick fix with no
enduring increase in skill levels
for those dealing with severe
behaviours," said CEO of LASA
Patrick Reid.
Chief executive of Council
on the Ageing (COTA)
Australia Ian Yates said
the creation of the response
teams was a positive first step
in improving dementia care
in the industry but ensuring
the new teams worked closely
with DBMAS in each state and
territory would be critical to
their success.
"People living with dementia
are core business of aged care
and aged care providers have to
do much better than most do now
in responding positively to their
needs," he said. "Indeed many
behavioural challenges are the
result of provider failings rather
than resident behaviours."
He said this included better
recognition and treatment of
symptoms of pain.
As part of a broader strategy
to improve quality dementia care,
Mr Yates said the government
could also use its control over the
allocation of aged care places
through ACAR to direct priority to
those providers with a solid track
record in dementia care.
Alzheimer's Australia said it
supported the specialist teams
and hoped it would lead to a
reduction in the use of physical
and chemical restraints in
residential aged care.
The peak body's CEO Carol
Bennett said she welcomed the
government's acknowledgement
that this was only one part of a
longer term strategy to support
people with dementia who
experience severe behavioural
symptoms of dementia.
HammondCare's CEO Dr
Judd added the government's
strategy should include education
for nurses and carers in identifying
and treating pain experienced by
people with dementia.
National Director of
UnitingCare Australia
Lin Hatfield Dodds said
the government had clearly
understood the concerns raised
at the Ministerial Dementia Forum
on 11 September and that it was
right to trial a new initiative to
improve care capacity.
"It is a positive step forward
both for the people who need
specialised care and for the
services doing their best to provide
that care with limited resources,"
said Ms Dodds, who was speaking
on behalf of UnitingCare's
provider agencies. •