ROYAL COMMISSION: Aged care isn’t appropriate for young people with disability

The Commonwealth Departments acknowledged that the reason many young people with disability are being admitted to aged care is due to the lack of available supported living accommodation.

First Assistant Secretary for the In-Home Aged Care Division at the Department of Health, Dr Nicholas Hartland PSM, says there still needs to be more improvement in available housing for younger people needing support, however, the process has been a lot slower than the Department would have hoped.

In Dr Hartland’s opinion, aged care should be a last resort provider for younger people with disability, but adds that even then aged care still isn’t appropriate.

Deputy Secretary in the Disability and Carers unit at the Department of Social Services, Michael Lye, says even with the Younger People in Residential Aged Care (YPIRAC) initiative back in 2006-2011, the Department has failed to make a difference to the number of younger individuals entering aged care settings.

“[At the Department], I think it is important to say that we don’t think it’s an appropriate setting for young people with disability. I think it has been an issue, which we have failed, manifestly failed to make inroads into,” says Mr Lye.

“We have made some attempts to address the issue… But we have manifestly failed and that’s evident in the number of people who still live in those settings. I think we have a very important job to do with the introduction of the National Disability Insurance Scheme (NDIS) to correct that.”

8 years for a new fix

Aiming to reduce the number of younger people living in aged care settings, the YPIRAC initiative was meant to help those people with disability to access more age-appropriate housing and supported living options.

The initiative had modest outcomes over a five year period and didn’t follow-up with the participating people who were supported to move out of residential aged care facilities.

Counsel Assisting Peter Rozen QC asked Mr Lye to do some “homework” and follow up with the relevant States and Territories to evaluate the current condition and experiences of the people who participated in the first YPIRAC initiative.

In that five year period, around 250 people were moved out of residential aged care facilities with nearly $250 million in funding to implement.

Mr Rozen inquired whether that the simplistic maths essentially showed $1 million was spent per person to move them out of aged care.

Mr Lye responded, “Someone wiser than me will tell me that there’s a reason why that maths is too simplistic, but I think that your point about a lot of money spent, $240 odd million dollar for essentially 250 plus, 244 people either diverted or taken out of aged care. I would add those two figures together, I think it probably represents what we got for our money.”

He adds that overall 1,400 people were assisted in some form, but hard outcomes from the initiative’s aims had a lower number, around 500 people.

Mr Rozen queried Mr Lye about whether it was only a coincidence that the new YPIRAC initiative, implemented in March this year, was put in place by the Commonwealth Department only after the announcement of a Royal Commission into Aged Care.

Mr Rozen also added that it was incredibly interesting that nothing had been done for a full eight years until now.

In response, Mr Lye says he believes that focus has always been there for the Government, who wants to shine a light on the issue, and it was just a coincidence that this framework was put in place after the Royal Commission was called.

Draft was more ambitious than the actual initiative

Mr Rozen stated to Mr Lye that the original draft of the YPIRAC initiative was more ambitious than the actual implemented system, which Mr Lye accepted was the case.

This included the draft planning to half the young people in residential aged care facilities by 2022, but was changed to supporting young people in moving out of nursing homes.

Mr Lye says the draft was genuinely testing options with the sector of what they could do, but the current initiative was what they found was more practical.

“We can’t say to you that we have a goal to – for everybody who is under 65 to be out of aged care. We have that goal, we’re very clear about that, that it’s not an appropriate venue for people with disability, and we will get to the entire cohort of people,” says Mr Lye. 

“We will seek to get [people with disability], to give them the option and seek to encourage them to live in the community because of that primary belief, but we can’t make them.

“I think we are working very hard and are very committed to helping people get out of aged care and into the community. I think that the reality is that unless we have cultural change to divert people from coming into aged care and also available accommodation and supports, people in the community, then that’s a practical impediment.

“I feel like a prisoner”

Neale Radley, a 52 year old former truck driver, has been living in residential aged care for the last four years.

He attended the Royal Commission to give evidence about his life living in an aged care facility and the painful decision he had to make about moving into a nursing home. 

Out on a houseboat with friends, he dove into shallow water and severely injured himself. The accident left him a C3/C4 incomplete quadriplegic. 

Prior to his injury, he was a very active person that loved camping, fishing, sport, socialising and being fit.

“Every day, I am reminded of how different my life is now, compared to before the accident. My accident was a mistake that I have to deal with for the rest of my life. My accident has forced me to learn how to live again,” says Mr Radley.

“[My family] mean everything to me. My parents visit me nearly every day… It’s hard because I thought I’d be the one looking after my parents at this time of their life, but they are having to look after me instead.

“I have nicknamed my room, Cell 14, because I don’t have the freedom to get out. I feel like a prisoner. The outside doors are kept locked. When my bedroom door is shut, I cannot open it on my own. I have to ask someone to let me out and then to let me back in.”

Mr Radley has been waiting a long time to find a place in supported living accommodation, however, there are currently no places available where he lives in Bendigo, Victoria.

He is soon to be in talks with a housing developer in the region, but doesn’t want to get his hopes up too high.

Mr Radley wants to move somewhere that can take care of his medical and personal needs, with his current nursing home unable to provide appropriate medical care in an emergency. This has been evident after nearly dying three times on his way to hospital.

When his family is not around or visiting, Mr Radley says he feels isolated and alone, and that he can’t do anything but sit in his chair in his room.

Mr Radley’s evidence provided a firsthand experience of the reality for younger people with disability living in aged care settings.

The next hearing will take place tomorrow, on 11 September in Melbourne, Victoria, at 10am.