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) Page 1 of 2 back up * 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) Page 2 of 2 back 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. •
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