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.

The problem with modern western medicine is the messianic deity that presides over it and whose word is gospel?

This singularly revered deity is called big Pharma and many seeming intelligent doctors apparently still able to accomplish entirely independent research and their own critical thinking, appear to be its devotees; particularly those specializing in extremely lucrative aged care?

None of these folk will know or care very much about approved EDTA based chelation therapy, which like all out of, [no longer quite grossly profitable,] patent medicine,` is disapproved of by their deity?

And a shame given how much frailty and osteoporosis figure in non optimized aged care?

You see, it seems EDTA based chelation therapy claws out calcium from hardened arteries, which apart from opening them up again? Reverses the decalcification of the bones, which as a matter of interest can apparently continue for up to three months after the cessation of the therapy?

Which given suppositories can be undertaken quite independently at home. Moreover, hyperbaric therapy able to be towed in a van by a nurse practitioner, doing (district nurse) rounds to minimise all and any outlays? And could easily be tasked with managing prescribed (preventative medicine) HRT and complimentary chelation therapy at the same time?

From where I sit, it's very much about improved quality of life not quantity!

Almost any well meaning moron can create a system that allows old folk, deprived of their marbles by the (highly profitable) medical management model in current vogue, to vegetate in front of a tele, playing interminable repeats of that riveting soap, days of our lives slipping through the hourglass?

However it takes an independant thinker able to still do their own critical thinking; to actually optimise affordable (not for profit) aged care, we can all live with; and the obvious pun was intentional.
Alan B.

Alan B, I don't know why you are going on about chelation therapy in a thread discussing aged care. Such therapies are only useful for people who have heavy metal poisoning, and even then can be dangerous. There is no scientific evidence that it is any good for any other conditions, just like most 'alternative therapies' promoted by quacks.

As for the Aged Care system in Australia, there will never be any improvement in the care for the elderly in nursing homes until the Government realizes that paying low wages for non-nursing trained care-staff with very little education is not working.

Many of these Aged Care Certificate 3 'trained' carers have been forced to do these courses because they can't find work anywhere else (especially in rural areas) and the Government thinks this is a good idea to take these chronic unemployed, or non-English speaking immigrants, or chronically mentally disabled people off the dole queue.

We are putting low paid, poorly educated people in charge of our vulnerable elderly sick people...often with only one trained nurse per hundred residents. This is a cost-cutting measure that puts our elderly at risk. The Government also wants the Care Providers to jump through hoops with massive amounts of documentation for 'the department' to pay anywhere near what it costs to keep these people in these residential care facilities.

There is no point ranting and raving at the Care Providers....they are only following the strict guidelines laid down by an ever cost -cutting government, who then expresses surprise when the care of the residents is compromised.

Suseonline,

It should be of deep concern to the recipients of aged care and to their families that gerontology is as you imply, the lowest interest for doctors and nurses of all of the specialties. And yes that affects the resources and expertise available, the research, the attention available to it from health professionals, administrators and eventually the policy makers, and the wages of course.

However before all of that can be addressed there needs to be a challenging and redefinition of what ageing is and means. It is rather obvious for instance that many people and some seniors themselves still regard 'old age' (whatever that is) as a time when one is restricted to siting on a park bench and dribbling one's way through time-occupying rituals. Either that or seniors forever touring.

Through volunteering I very rapidly learned that the 'past seventy' population are even more diverse in their abilities, capacities, possibilities and expectations than the largely youthful or middle aged people I worked with.

Another learning was that government is content to patronise the aged and deny them a say, relying instead on vested interests such as aged care entrepreneurs, NGOs and public bureaucrats to 'represent' the aged. Yet most 'aged' with few exceptions (and other ages have exceptions too) are alert, switched on and keen to express what they are learning as they age about 'old age' and how it is entirely different to what they ever imagined and were led to believe.

It rather reminds me of a regional health conference I was invited to some years ago. The CEO of the State Health Department and minister had enthused about how advanced their planning was that all of the stakeholders were there to have their say and that would feed in to policy. They were shocked when asked why there were no members of the public attending. Their response was that there was no need, the health bureaucrats, NGOs and developers already knew what the public needed. OK, so what consultations did they have with the public and what were the outcomes? Dead silence!

onthebeach

Yes we have to redefine aged care but the politicians and the market believe in what they are doing and instead of the solution you are seem as the problem.

This needs the families and community to get together to become effective customers, and an effective "civil society" with the capacity to insist on getting what we want. Some families at bad nursing homes are forming groups, organising, documenting failures and fighting back. But that is only a small beginning.

With a community that is confused and disinterested combined with intrinsic ageism its not an easy task.

Its one that we at Aged Care Crisis are trying to stimulate by suggesting the direction that we might take.

www.agedcarecrisis.com

The biggest money spinner of all time for big pharma, statins, which in a recent publicized double blind study, showed only those receiving the placebo avoided some level of cognitive impairment?

The second is inherent in chronic nerve pain management with opiates, which a recent Australian study; shows instead of quelling pain extends it.

And given a (aged care) practise of ever increasing medically managed doses, may even and unavoidably suppress the life force?

Now from where I sit, that's unmitigated quacky writ large?

A very large scale 30 million dollar double blind study into chelation therapy was commenced in 2003 in Canada and America, but was pulled for some inexplicable reason, months before the assembled results could be published?

Well America does own the most profitable and influential medicine based business model in the world? And even certified cardiologists and directors of very large medical facilities can be placed under career threatening pressure by folks with billions at risk as skin in the game?

I prefer medically supervised chelation therapy and all my marbles, over statins, which remains big pharma's biggest profit earner of all time?

Now Chelation therapy is not for everyone and needs to be supervised by a properly credentialed orthodox medical doctor!

And strangely there are many more of them, with private orthodox clinical practises in and around Brisbane than before the trial. All operated by registered doctors with more training and knowledge than an average aged care RN?

Not all that long ago a couple of doctors in the west were pilloried by conventional medicine for daring to believe; and set out to show, ulcers were caused by bacteria rather than stomach acid, which for big pharma was a very nice money spinning repeat business with life long customers.

And there and predictably the all knowing medical establishment rallied round with cries of quacky etc. And were forced to Zip it; but only when those same two researchers won a noble prize for medicine.
Alan B.

Onthebeach "should be of deep concern to the recipients of aged care and to their families that gerontology is as you imply, the lowest interest for doctors and nurses of all of the specialties."

Back to your old twisted tricks of trying to put words into my mouth again I see OTB?
You know well enough that wasn't what I was saying at all. I was a Clinical Aged Care Nurse for 10 years, working in a residential care facility, so I obviously liked working with the aged, as did the other dedicated nurses and doctors I worked with

Volunteering for fun times with the aged is not even in the same league as the work I did, of which neither you nor AlanB have any idea about. Obviously it isn't just this plain old RN who is against chelation therapy now is it AlanB? They stopped that trial because they were concerned about the adverse effects that the therapy was having on the trial recipients.

It seems to me that you should keep well away from all those professional mecical doctors, nurses and pharmacists, and all those drugs from 'big pharma' that you are so suspicious about, and just refuse all medical care from them as a matter of principle?
I am assuming you have never taken, or are taking, any medications prescribed for you by a doctor? Nor have you ever taken conventional painkillers? Because all those medications were brought to us by research through 'big pharma'....

Suse, clean arteries have absolutely everything to do with age related care.

Simply assuming I'm against conventional medicine is a mistake given I studied it an even managed to pass some final exams with an average passing mark of 98%, which broke an unassailable 70 year record in the AH ME institution that trained me and the young doctors I trained beside.

Now I should think that would at least indicate I'm nobody's fool, moreover I don't suffer fools lightly, particularly those who bring their superiority complex and intellectual arrogance with them as their invariably elitist debating style.

When I enter a medical establishment I check in the hat and coat, rather than my brain and critical independent thinking!

As someone who started their medical career in a geriatric home for the blind, I have some insight into the problem; and am simply not arrogant enough to dismiss over six million case studies out of hand as you and every other big pharma devotee does!

No anecdotal evidence, however convincing, is not proof, even so it's the basis of eastern medicine, already over a thousand years old, when western medicine began, in french epocrates, less than four hundred years ago?

And used herbal medicine as its principle method, with aspirin in vogue in aged care to reduce heart attacks and strokes coming from much older willow bark, nurofen the other perennial favorite in pain management coming from the monkey puzzle vine.

Why even penicillin had a start as mould and used by the american indians in a variety of moss they used to treat wounds in traditional medicine. There's a toxic plant in New Zealand called the tutu, and used by native women to procure an abortion. I could go on but there's hardly any point debating the closed mind that is a big pharma devotee.
You have a nice day now y'hear.
Alan B.

Great Post.

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