There's so much wrong with the current aged care model, it's hard to know where to begin!

In the first place it's scandalous that we have a for profit private model that's seems to be touted as such; and in too many cases on the back of ultra generous government subsidies?

It's not like consolidated revenue was swimming in surpluses as far out as the eye can see.

Moreover, the two different models have different funders, which stymies getting a new preventative care model started, A vastly less costly model, keeps people at home with a full range of services offered, costing around half that of nursing homes.

In home care, the responsibility of buck passing state governments, with severely rationed nursing homes funded by the Fed.

Consequently, in home care doled out as miserably as poss; to limit state hospital bills?

And nowhere is this more evident than in rural and regional Australia, where housing for oldies is still affordable?

We need to step aside from the interests of big pharma and multimillionaire aged care, and just focus on best practice outcomes rather than the ever upward profit curve!

Some proven low cost efficacious out of patent therapies need to be reinstated. The first being PROVEN EDTA based chelation therapy.

Almost all age related disease is degenerative and caused or contributed to by hardening of the arteries, decreased blood flows and consequent decreased oxygenation of essential organs. All of which depend on good oxygenation for regeneration!Oxygen being implicated in all healing!

Meaning hyperbaric oxygen therapy must be a routine part of aged care, as should HRT; given adequate levels may assist in collagen production and greater elasticity of arteries and veins; and age depression busting zest for living and interactive socializing.

HRT for blokes and H.O.T.,mostly only available in expensive private city clinics!?

Currently, preventative medicine is insanely, mostly limited to diet and exercise, which though important are only half the best practise story.

Keep old folk at home and inherently healthy and intellectually agile enough to take care of most of their end of life needs.
Alan B.

Private enterprising any public service, is a recipe for failure. Private enterprise for profit, hollows out the usefulness of the essential service, and leaves a facade which hides the crime against the public, as services decline in quality and number.

A classic example is the distribution of electricity. The cost of this public service, has escalated to heights which are unaffordable to many in the community; due in most part, to profit taking.

The answer? The answer to the reduction of quality in nursing homes,is in the hands of the government which directs funding. State run institutions are the obvious answer.
With these, the Government has direct responsibility to the community, and any failure reflects on the credibility of that Government. That's called "skin in the game"!

EDTA based chelation therapy as an approved FDA treatment was used and limited to the removal by intravenous induced precipitation eliminated via the alimentary canal, of elemental lead.

And in spite of the fact that chemists have been using it for decades to also precipitate mercury, Arsenic,carcinogenic cadmium and various other toxic substances.

Hugely pilloried and oft professionally punished practitioners, were instructed they couldn't claim anything more for this very low cost and easily administered by a nurse practitioner, therapy, couldn't be claimed for anything but the removal by precipitation of elemental lead.

This in spite of over six million case studies (none in the Isa?) which seem to also conclude it claws out plaque from the arteries.

with around a 1% reporting of renal burning being cited as a cause to arrogantly reject it out of hand in favor of vastly more expensive invasive vascular surgery.

Even where it can be shown that inexperience has meant too large a dose was introduced or if not, was simply infused far too quickly, however, it seems introducing it as an easily tolerated suppository overcomes much of that?

Even so, a preferred outcome if it also reduces or removes the risk of pulmonary embolisms, (the largest cause of sudden death in old folks?) heart attacks or stroke, particularly hemorrhagic strokes caused by partial blockages that can only balloon up so far before bursting?

Kidney disease is almost impossible to detect until it's too late and if a relatively safe therapy produces some renal burning to illuminate just that, how is that a bad thing?

Why do kidneys fail so spectacularly long before the condition becomes symptomatic? Well like dementia, how about significantly impaired oxygenated blood flow? But particularly at a capillary level?

We here in Australia lead the world in the number of arterial related amputees we create? And indeed the cost of that and related vascular surgery?

Reducing or removing sugar from the diet, while laudable, is better done before we lose a limb than after it! Now that is how you do optimised aged care!
Alan B.

Sudden death should be read as sudden unexplained death. Sorry.

Optimized age care just has to include routine HRT. And given the tiny risks with clinically managed doses, better than the other which includes increased fragility and consequent fractures that then almost invariably swell the waiting lists for places in nursing homes!

Moreover, HRT for the sake of our arterial health and function, must include mandatory HGH, helps prevent obesity and its constant companion, type 11 diabetes.

Hyperbaric oxygen therapy is about as cheap as medicine gets, has some history with optimised stroke recovery, efficacious treatment of tropical ulcers, diabetic ulcers and if started soon enough, (hours not days) I've read, can somewhat ameliorate spinal injury.

Moreover, there seems to be some evidence emerging for it as part of a menu for cancer treatment, and possibly because O2 is implicated in all healing!

A couple of hours a day, twice a week for several months is claimed to be beneficial. And even if supplied as individual in house modules, cheaper than a single year of nursing home care!?
Alan B.

A good and thoughtful article. Highly structured and centralised organisations like the aged care system are designed to meet the needs of government and market – not aged care.

1. They do not adequately encompass all of the complexities. They lack flexibility so cannot adapt to the varied needs of the system or of the individuals there.
2. The structure of the system was imposed from outside by people who had little understanding of aged care. It is not fit for purpose. The real needs of the community are overlooked.
3. Because of its complexity there are multiple loopholes in the funding system, which is readily gamed. Funds are readily shifted from care to profit.
4. Because of its tight regulatory focus it is process driven and the activities become routinised. Services are task focused and not person focused. This inhibits, reflection, imagination and common sense. These are critical components of our humanity. To invoke our humanity we must imagine and reflect on the plight of others so that we can empathise with them. The system entrenches inhumanity. Providers and regulators are blind to the consequences as they follow due process.
5. The free market system is based on patterns of thinking that downplay the role and importance of the customer, and reject notions like social responsibility and the public good.
6. That there are serious problems in a complex system designed to support markets and not the frail aged, a market that does not recognize its social responsibilities, should surprise no one.
7. Regulations created within such a system frequently do not work.

Aged Care Crisis has a web site where we are looking for

i. ways to move from a centralized system to one where responsibility is delegated to flexible local structures.
Ii. ways to create effective customers and
iii. a way to place social responsibility at the heart of aged care. It currently floats about at the periphery, mostly on web sites marketing the sector.

Some well written insights like:

"Government subsidies in aged care often serve the interests of the providers more than residents. When a resident is reclassified as requiring a higher level of care, the provider receives more money from the government. However, staff levels rarely change nor are extra services provided to the resident."

But then unremitting negativity.

The point is that as people get very old they do actually become more dependent.

Also many old people have high levels of shares (with good earnings) including in aged care companies

Aging (with eventual death) is not even the fault of private industry.