Action for young people in nursing homes

By: Di Winkler, Chief Executive Officer, Summer Foundation

The Senate Inquiry into the adequacy of residential care for young people with disability highlights the wasted potential of young people who are forced to live in nursing homes because there is no where else for them.

The Summer Foundation congratulates the Community Affairs Committee of the Senate on taking the time to listen to and understand the lived experience of people with disability and their families. This comprehensive report documents the range of complex issues and factors associated with this marginalised group of people who get lost in the gaps of the current service system.

The report that was tabled this week in parliament has 12 practical recommendations that relate to five key themes:

  • Better data
  • Slow stream rehabilitation
  • Prevention of new admissions
  • Housing
  • Accountability and co-ordination


Better data

The report makes two recommendations that will obtain better data on young people living in RAC. The report recommends a development of a national database (Recommendation 1) of all people under 65 living in RAC. This national database will utilise the data already routinely collected through the Aged Care Assessment Team program prior to any person being admitted to RAC. This national database will assist to ensure that young people do not get lost in the system. Both the national database and a longitudinal survey (Recommendation 2) will inform the strategic implementation and progress towards solving the issue of young people in RAC.


Slow stream rehabilitation

Most (59%) young people are admitted to an acute or rehabilitation hospital before their first admission to RAC. Many people at risk of admission to RAC are not eligible or suited to existing rehabilitation services. They need slow stream rehabilitation that allows a more extended timeframe to achieve small but functionally significant gains. While there are pockets of excellent transitional and slow stream rehabilitation throughout Australia, the Senate report recommends the development of a national rehabilitation strategy (Recommendation 8).


Prevention of new admissions

The report identifies the urgent need to prevent new admissions of young people to nursing homes. Once young people move in to nursing homes it is hard to get them out; they lose skills and their social connections. It is a much better use of resources to stop people from entering than letting them enter and then trying to move them out.

Recommendations aimed at preventing new admissions include:

  • Comprehensive assessment and placement tool and guidelines (Recommendations 3 & 4)
  • Information (Recommendation 9)
  • Advocacy (Recommendation 9)
  • Intensive case management (Recommendations 4)
  • National rehabilitation strategy including slow stream rehabilitation (Recommendation 8)
  • Extension of the National Younger Onset Dementia Key Worker Program (Recommendation 9)

Together, the implementation of these strategies will go a long way to prevent new admissions of young people to nursing homes. 


Housing

The Senate Inquiry report highlights the facts that the National Disability Insurance Scheme (NDIS) alone cannot solve the issue of young people in nursing homes in Australia. The disability supports, equipment and home modifications provided by the NDIS are not enough. Very few young people will move out of nursing homes as a result of the NDIS because there is no where to move to. Housing is the most complex part of the puzzle. However, it is also the most urgent because of the 2-3 year lead time required to plan and build new housing and support options. The Senate Inquiry report recommends a further inquiry to determine what can be done to address the dearth of affordable and accessible housing for people with disability in Australia (Recommendation 7). The report also recommends that the federal government:

  • Release the discussion paper on housing and the NDIS (Recommendation 6)
  • Consider options for funding the capital of housing for people with disability (Recommendation 6)
  • Establish a fund for housing for people with disability similar to the Supported Accommodation Innovation Fund (Recommendation 6).


Accountability and co-ordination

The Senate committee has strategically directed each recommendation to one of three key groups: the Federal government, the Joint Standing Committee on the National Disability Insurance Scheme or the Council of Australian Governments (COAG). As highlighted in the report, government departments currently tend to work in silos and young people in RAC tend to fall between the gaps. No one sector has the expertise or resources to solve the issue of young people in nursing homes in Australia. The report recommends that COAG establish a joint taskforce to facilitate the development and implementation of integrated service pathways across state and federal government portfolios including health, housing disability, transport and aged care (Recommendation 11). Ideally, the joint taskforce will issue a half yearly report on the progress of implementation to COAG (Recommendation 12).


Next Steps

The Senate committee report provides a comprehensive evidence base and a range of strategic and pragmatic recommendations. The Summer Foundation looks forward to working with the National Disability Insurance Agency, state and federal governments, the Young People in Nursing Homes Alliance, Youngcare and other key agencies to develop and implement an action plan. A proactive and co-ordinated effort could solve the issue of young people in nursing homes in the next ten years.

More information: Senate Inquiry

Jun. 29, 2015

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