Just 12 of a promised 35 specialist dementia units the government committed to have running by 2023 are operational, a health department spokesman has said.
To respond to a growing number of people with dementia and suffering from severe behavioural and psychological symptoms, the federal government in 2016 announced the Specialist Dementia Care Program [SDCP].
Under the SDCP, 35 residential aged care homes throughout Australia were to get a specialised care unit for people with severe symptoms of dementia that were unmanageable in a mainstream residential aged care facility. The units were to be staffed by people specially trained to respond to severe dementia symptoms such as aggression, and a registered nurse was to be on site 24 hours.
The first 14 units were to be operational by 2020, and the remainder by the end of 2023. But a federal government spokesman told Guardian Australia 12 [SDCP] units were operational so far. An additional six units would open by the end of 2024, he said.
He did not respond to questions about when the total 35 units would be running, or about the cause of the delays.
The ability of residential aged care facilities to care for the growing number of Australians with severe cognitive impairment has again come under question following the tragic case of 95-year-old Clare Nowland.
Nowland was Tasered by a police officer on 17 May in her residential aged care home while using a walking frame and wielding a steak knife. She died on Wednesday. Questions are now being asked about why police were called, and what dementia training those caring for her had received.
As Guardian Australia previously reported, there is no mandatory dementia training requirements for residential aged care staff, despite the condition overtaking coronary heart disease as the leading cause of disease burden in elderly Australians.
The executive director of advocacy and research at Dementia Australia, Dr Kaele Stokes, said the number of Australians living with dementia was expected to exceed 800,000 by 2058.
She said quality dementia care should be mandatory for all aged care workers, regardless of whether they worked in a specialised unit.
“By building the leadership and capability of the workforce to understand dementia better, staff will know what to do in situations where there are changed behaviours from residents,” she said. “By understanding the behaviours, the triggers and the impact of the environment, many challenging situations can be avoided.”
The final report of the royal commission into aged care, handed to the government in 2021, stated “dementia care should be core business for aged care services, and particularly residential aged care services”.
Mary*, who is a carer to her husband with dementia living in residential aged care facility in Tasmania, told Guardian Australia the reality was anything but.
“The issue of dementia residents in aged care and their potential unmanageable behaviours is a timebomb,” she said.
In January, Mary wrote to the health minister, Mark Butler, and the aged care minister, Anika Wells, about the need for “urgent increased support for people living with dementia in residential aged care facilities”. She also asked the ministers to mandate dementia education and training for residential aged care facility staff. She has not received a response.
The ministers did not directly respond to Guardian Australia’s request for comment, however a government spokesperson said there was free training for the aged care and health workforce available through the national Dementia Training Program. The introduction of registered nurses on site 24 hours a day from July, and the requirement of an average of 215 care minutes per resident day from October 2024 would improve the quality of residential care, particularly for people living with dementia, he said.
But Mary is concerned not enough is being done to address a revolving door of staff in aged care who do not know residents well, and she is concerned that staff need to do any additional training in their own time.
While Mary said her husband did not become aggressive, other residents in his home did, which left her husband feeling unsafe. She had made three complaints to the Aged Care Quality and Safety Commission (ACQSC) regarding the lack of well trained staff and poor staff-to-resident ratios in her husband’s home. “After many months of work, my complaints got me nowhere,” she said.
In 2022, the government commissioned an independent review to assess the ACQSC’s capability as a regulator. This report was delivered to the government in April.
The federal Department of Health and Aged Care would not provide Guardian Australia with a copy, saying it would be released with the government’s response “in due course”.
The director of Aged Care Matters, public health researcher Dr Sarah Russell, said there remained a lack of transparency from government about progress being made to address the issues highlighted in aged care by the royal commission and progress towards providing safe, humane aged care.
“The government was given the report on 20 April, so why the delay making the capability report public?,” Russell said. “Didn’t the Labor government promise us transparency?”
*Name changed to protect husband’s medical privacy
