A COVID-driven backlash against residential care could contribute to increased demand for community-based care in coming years, a dementia symposium has heard.
John Pollaers, the former chair of the aged care workforce strategy taskforce, predicted the provision of community care will be the most important question for aged care over the next five years.
“We’ve got about 300,000 people in residential care and 1.3 million at home needing home support and those numbers will grow to about 3 million by 2050,” Professor Pollaers said in a keynote address to the Dementia Australia National Symposium Series on Tuesday.
“We’ve got to start to develop community capability and we need to start to engage the whole health system and the government around how to support the more serious support needs within the community … for me it’s the most important question of the next five years.”
The symposium heard from Dementia Trainging Australia director Dr David Sykes that COVID-19 has raised questions about the safety in residential care, and there is anecdotal evidence that some people are taking older family members out of aged care facilities, placing more demand on the community sector.
Professor Pollaers said it was important to not just think about dementia in terms of residential care settings.
“We need start to think about it as a broad challenge in the community with more and more people needing that support living in their own homes,” he said.
This could mean a larger role for libraries, volunteer networks and organisations like Rotary and Probus, to provide a network of dementia activities and also give carers and families a break.
Improving dementia care would not only improve life for people with dementia, but would raise the bar across aged care, Professor Pollaers said.
“If we can solve it or people living with dementia we can actually solve issues and concerns that go right to the heart of quality of life for all people within our ageing community.”
Failure to act
Professor Pollaers also took the government and the industry to task for the failure to implement recommended aged care reforms despite two key reports, including the workforce taskforce’s 2018 report, A Matter of Care, and Dementia Australia’s 2019 Quality Care for people living with dementia.
“Lo and behold we’ve had nearly two years now with a lack of progress,” he said.
“I am absolutely bemused at how long it’s taken to get the industry and government to recognise the need for these elements to be properly included in a well resourced system.”
Dementia had been at the heart of the aged care road map for years but there had been no progress, and the time for talk was now over, he said.
Professor Pollaers also said bureaucracy and cumbersome a training system was delaying upskilling in the industry, and accused the government of continuously “kicking problems in the aged care system to the next review”.
He also condemned the industry for dragging its feet on a voluntary code of practice, one of the recommendations of the workforce taskforce originally set to be signed in May 2018.
“We’re nearly two years on and these simple two pages have not been fully embraced and taken on board,” he said.
Professor Pollaers said the industry was underfunded by about $3.5 billion and future funding models needed to consider specific case needs and separate infrastructure funding, and recognise both fixed and variable funding.
He also said the thorny question of who should pay for aged care must also be addressed.
“We’re going to have to tackle this issue of does the government pay the entire bill or can those who can afford it make a greater contribution. I fundamentally believe that those who can are going to have to contribute,” he said.
However he warned that funding wasn’t the only solution, and making it the sole focus risked pushing other issues onto the back burner.