Responses to the Inquiry’s issues for consideration
COTA Queensland believes older people, their family and community supports play a key role in the delivery of aged and end of life care and support. It is essential the service providers and health professionals are knowledgeable and respectful of the role of the person’s informal support system and ensure user-friendly information and good communication at all times.
COTA Queensland recognises that the aged care system is maintained by vast numbers of informal and unpaid carers who provide the majority of care received by older Queenslanders. Support for these carers must be a priority.
COTA Queensland believes that aged care services in Queensland can continue to be improved through a person and relationship-centred approach that supports healthy ageing, wellness in all its forms (physical, mental, social, spiritual) and inclusion. Services must be designed around consumers’ needs, not providers’ needs. Person-centred care supports services in responding to the diverse needs of individual Queenslanders.
COTA Queensland believes that the aged care system is failing to meet the needs of all Queenslanders:
- Older Queenslanders express a clear preference for home-based care, with demand currently outstripping
- Waiting times for both residential aged care and home-care packages suggest that current levels of demand are not being met. Waiting times for home-care packages are a particular concern, most notably for higher-level
- Population projections suggest that service availability must rapidly increase simply to maintain current service
- Aged care services are not consistently available across Queensland, with supply in outer regional, rural and remote locations of particular
COTA Queensland believes that the aged care system is unnecessarily complex. Many Queenslanders do not understand what services are available. It is likely that many Queenslanders who would be eligible for aged care support do not apply because they do not understand how to navigate the system. The current system places responsibility on consumers to understand what is possible and to complete the necessary applications.
COTA Queensland believes that most Queenslanders are satisfied with the aged care services they receive. However, some pockets of concern are evident, particularly about the quality and safety of services, the administration charges for home-care services, and the availability of services to meet the needs of diverse or vulnerable groups. Monitoring and review is required to ensure that standards for quality, safety and consumer satisfaction are continually improved.
COTA Queensland believes that the aged care sector needs to develop the skills of its workforce to ensure that suitably qualified staff are available to meet the care needs of older Queenslanders. Current concerns relate to staff qualifications and ensuring that appropriately trained staff are available when needed. Longer- term staffing concerns relate to a potential skills shortage, particularly in regional areas. COTA Queensland does not support mandated staffing ratios in residential aged care, but advocates for accepted care standards and published staffing levels.
COTA Queensland argues that hospitalisations for older people should be minimised, particularly hospitalisations at the end of life. Unnecessary hospitalisation is a burden on the health system, often with little gain for patients.
COTA Queensland proposes that aged care services in Queensland should focus on home-based and community-based approaches that capitalise on existing community support and readily available technology. Communications technology offers great potential for providing equitable, home-based care for older Queenslanders.
COTA Queensland believes that palliative and end-of-life care services are not meeting the needs of older Queenslanders. Palliative and end-of-life care is poorly understood and little discussed. Older Queenslanders are frequently asked to make decisions about their end-of-life care at times of stress and ill-health.
Queensland needs to have a community conversation about the role of palliative and end-of-life care. Queenslanders must be encouraged to plan ahead for their end of life.
COTA Queensland believes that Queenslanders are ready for a genuine conversation about voluntary assisted dying. Our research suggests that it is supported by most Queenslanders, provided suitable legal safeguards are in place.
Key Priorities for the Future
- Individuals and communities need easy-to-access user-friendly information which enables people to plan ahead and make well-informed decisions. This information sharing and decision making ideally occurs within communities prior to the need for interaction and negotiation with the health and aged care systems. Facilitated conversations and group discussions assist people in identifying what and who is important for them and can assist in documenting and sharing their wishes and preferences for aged, disability and end-of-life care. COTA Queensland would welcome the opportunity of collaborating with Palliative Care Queensland and older members of the community in co-designing and delivering community-led education and information that supports people to make well-informed decisions through ageing, disability, dying, loss and grief phases of life.
- Individuals, carers, family and trusted decision makers want to be involved in decisions that impact their lives and those of their loved ones. People want to be recognised as partners in the provision of health and aged care, and treated with respect and inclusion in decision making, including in the design and evaluation of services, policies and processes, and information. COTA Queensland assists and advises organisations and government departments to engage with older Queenslanders.
- Government responses to aged and end of life care must extend beyond the aged and healthcare systems. Government support for community services, housing, transport, financial security, information provision and social inclusion are all relevant to supporting adequate care for older Queenslanders. COTA Queensland encourages the Queensland Government to continue to advance their Age-Friendly Strategy and actions, and to ensure that people are engaged and supported in living – and dying – as well as possible, within their communities.