The Aged Care Industry

The Aged Care Act 1997 is the overarching legislation that outlines the obligations and responsibilities that all Australian aged care providers must follow to receive subsidies from the Australian Government for their services.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) provide standards for high-quality practice in health care. These standards contribute to positive health outcomes and experiences for all patients and work towards industry improvement in health care quality. They work under the Aged Care Quality and Safety Commission Act 2018 to provide best practice guidelines to help reduce the number of falls and resulting harm experienced by older people in care.

The guidelines are written based on evidence-based practice in line with a key medical advisory group. They encourage advocacy for and autonomy of older people with the knowledge that there is always some degree of risk when elderly people engage in autonomous and active lifestyles. The Quality and care Principles 2014 are a legalisation that outlines the expected practices in aged care when caring for an individual’s wellbeing and care within various aged care service provisions.

The offices of the health ombudsman, under the Health Ombudsman Act 2013, are the place to contact if you have a complaint or notification to make about a health service. These offices are managed independently through State and Territory provisions with the aim to:

• protect the health and safety of the public
• promote professional, safe and competent practice by health practitioners
• provide high standards of service delivery by health service organisations
• maintain public confidence in the management of complaints and other matters relating to the provision of health services
• establish a transparent, accountable, and fair system for effectively and expeditiously dealing with complaints and other matters relating to the provision of health services.

There are many key organisations that support the aged care sector in Australia. Below is the that includes some of the key organizations involved in shaping policies, regulations, and service delivery in the aged care sector in Australia. There are also various state-specific organizations and local service providers that play significant roles in the provision of aged care services. Here is a list of key organizations within the aged care sector in Australia:

1. Australian Aged Care Quality and Safety Commission (AACQSC): The AACQSC is responsible for regulating and monitoring the quality and safety of aged care services in Australia.
2. Aged and Community Services Australia (ACSA): ACSA is a peak body representing not-for-profit providers of aged care services in Australia. They advocate for the interests of their members and promote quality aged care.
3. Aged Care Guild: The Aged Care Guild is an industry association representing some of the largest private providers of aged care services in Australia. They work on policy development and advocacy on behalf of their members.
4. Council on the Ageing (COTA) Australia: COTA Australia is a national organization representing the rights, needs, and interests of older Australians. They advocate for positive aging and work towards policy and service improvements.
5. Leading Age Services Australia (LASA): LASA is a peak body representing the aged care industry in Australia. They support and represent providers across the residential care, home care, and retirement living sectors.
6. Aged care Australia: Aged care Australia is the national peak body for aged care. They provide support services, advocate for aged care-friendly policies, and promote awareness and understanding of aged care.
7. Health and Community Services Workforce Council (HCSWC): The HCSWC supports workforce development and capacity building in the health and community services sector, including aged care. They provide resources, training, and support to the workforce.
8. Aged Care Industry Information Technology Council (ACIITC): The ACIITC focuses on promoting the effective use of information technology in the aged care sector. They work towards developing and implementing IT solutions to enhance the delivery of care.
9. Aged Care Financing Authority (ACFA): The ACFA is an independent body that provides advice and analysis on aged care financing and funding arrangements in Australia

Funding and accreditation systems play crucial roles in the aged care sector in Australia. Here is a detailed explanation of these systems:

1. Funding System: The aged care sector in Australia is funded through a combination of government subsidies, user fees, and contributions from individuals. Funding sources include the Australian Government's Aged Care Funding Instrument (ACFI) for residential care and the Home Care Packages Program for community-based care.
   • Aged Care Funding Instrument (ACFI): The ACFI is the primary funding instrument used to determine government subsidies for residential aged care services. It assesses the care needs of residents across three domains (activities of daily living, behavior, and complex health care) to assign a funding classification and corresponding subsidy level.
   • Home Care Packages: Home Care Packages are government-funded packages that provide funding for home care services for older individuals who wish to remain in their own homes. There are four levels of Home Care Packages, with varying levels of funding based on assessed care needs.
   • Commonwealth Home Support Programme (CHSP): The CHSP provides funding for entry-level support services to help older individuals live independently in their own homes and communities. It covers a range of services, such as personal care, domestic assistance, and social support.
2. Accreditation System: The accreditation system in the aged care industry in Australia is a regulatory process designed to ensure that aged care facilities and service providers meet specified quality standards. Its purpose is to promote and monitor the delivery of high-quality and safe care to older Australians. Through the accreditation system, the Aged Care Quality and Safety Commission assesses facilities and providers to ensure they comply with the Aged Care Quality Standards, fostering continuous improvement and accountability in the provision of aged care services. This system plays a crucial role in safeguarding the well-being and rights of older individuals and maintaining a high standard of care across the aged care sector.
   • Australian Aged Care Quality and Safety Commission (AACQSC): The AACQSC is responsible for accrediting and monitoring the quality and safety of aged care services in Australia. They conduct audits and assessments to ensure compliance with standards and regulations.
   •  Aged Care Quality Standards: The Aged Care Quality Standards outline the expected outcomes and requirements for quality care in aged care services. These standards cover areas such as consumer dignity and choice, clinical care, and service environment. Compliance with these standards is a key component of the accreditation process.
   • Quality Indicator Program: The Quality Indicator Program monitors and measures the quality of care provided by residential aged care services. It includes indicators related to resident health, well-being, and quality of life, and these indicators are used as part of the accreditation process.

The funding system ensures that aged care services receive financial support from the government to provide care and support to older individuals. It helps determine the level of subsidies and funding allocated to residential care, home care packages, and community-based support services.

The accreditation system aims to ensure that aged care services meet quality and safety standards. Accreditation involves a process of assessment, auditing, and ongoing monitoring by the AACQSC. Services must demonstrate compliance with the Aged Care Quality Standards and meet the requirements for care provision, governance, and operational practices.

The funding and accreditation systems work together to promote high-quality care and support in the aged care sector in Australia. Adequate funding enables the provision of services, while accreditation ensures that these services meet the necessary standards to safeguard the well-being and rights of older individuals.

Aged care industry Standards

Industry standards and the industry standards body play significant roles in ensuring quality and best practices in aged care services in Australia. Industry standards in the aged care sector set out the expected level of quality and safety for services provided to older adults. These standards are developed based on best practices, evidence-based approaches, and input from industry experts. They serve as a benchmark for organizations and professionals, guiding them in delivering high-quality care that meets the needs and expectations of elderly individuals. Here is a detailed explanation of industry standards and the relevant standards body:

Industry Standards

• Aged Care Quality Standards: The Aged Care Quality Standards are a set of national standards that outline the expected outcomes and requirements for the quality of care and services in the aged care sector. They cover areas such as consumer dignity and choice, clinical care, personal care, and service environment. Compliance with these standards is mandatory for all aged care providers in Australia.
• Home Care Standards: The Home Care Standards apply specifically to home care services and cover areas such as personal care, clinical care, safety, and service quality. These standards ensure that home care providers deliver services that meet the needs and preferences of older individuals in their own homes.
• Code of Conduct: The Code of Conduct sets out the behavior and ethical standards expected of aged care workers. It promotes respectful and person-centered care, confidentiality, professionalism, and adherence to legal and regulatory requirements.
• Privacy and Confidentiality: Aged care services must adhere to privacy and confidentiality standards to protect the personal information of older individuals. This includes obtaining informed consent, securely storing and handling personal data, and respecting privacy rights.

Industry Standards Body

Australian Aged Care Quality and Safety Commission (AACQSC): The AACQSC is the regulatory body responsible for overseeing the quality and safety of aged care services in Australia. It is the industry standards body that administers and enforces the Aged Care Quality Standards and other related standards. The AACQSC conducts audits, assessments, and monitoring activities to ensure compliance with these standards.

The industry standards body relevant to aged care services in Australia, such as the Aged Care Quality and Safety Commission, is responsible for setting, monitoring, and enforcing industry standards. It ensures that aged care providers adhere to the required quality and safety standards, promoting continuous improvement and safeguarding the rights and well-being of older individuals in aged care.

The industry standards and the relevant standards body, the AACQSC, work together to uphold quality and safety in aged care services. The standards provide a framework for providers to deliver high-quality care, while the AACQSC oversees the implementation and enforcement of these standards. Through audits, assessments, and ongoing monitoring, the AACQSC ensures that aged care services comply with industry standards, promoting the well-being and rights of older individuals.

Legal and human rights frameworks are essential in the context of industry standards for aged care services in Australia as they provide the necessary guidelines and regulations to ensure the protection and well-being of elderly individuals. These frameworks set the minimum requirements for quality, safety, and ethical practices in the aged care sector, promoting a culture of respect, dignity, and person-centred care.

Aged care providers must stay informed about the industry standards, comply with them, and work closely with the AACQSC to maintain and improve the quality of their services. Regular reviews and updates of the industry standards help to align aged care practices with evolving best practices and regulatory requirements.

In Australia, the aged care industry operates within legal and human rights frameworks to ensure the protection and well-being of older individuals accessing care and support services. Here is a detailed explanation of these frameworks and the roles of safeguarding bodies, national and State/Territory legislation, and the Office of the Health Ombudsman: Legal and Human Rights Frameworks:

• Legal Frameworks: The legal frameworks in Australia encompass various laws and regulations that govern the provision of aged care services. These frameworks include legislation such as the Aged Care Act 1997, which sets out the rights and responsibilities of aged care providers, consumers, and the government. Other relevant laws may include privacy laws, anti-discrimination laws, and guardianship laws that protect the rights and interests of older individuals.
• Human Rights Frameworks: Australia is a signatory to international human rights treaties, such as the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights. These frameworks establish fundamental human rights principles that apply to all individuals, including older persons. Human rights principles, such as dignity, autonomy, non-discrimination, and the right to health, guide the provision of aged care services.

Role of Safeguarding Bodies

Safeguarding bodies in the Australian aged care system play a crucial role in protecting and promoting the rights and well-being of older individuals. These bodies are responsible for overseeing compliance with legal and human rights frameworks within aged care settings. They provide independent oversight, investigation, and advocacy to ensure the safety, quality, and dignity of care for older Australians. Roles and responsibilities of various safeguarding bodies in Australia:

• Australian Human Rights Commission (AHRC): The AHRC is an independent government agency responsible for promoting and protecting human rights in Australia, including the rights of older people in aged care. Its responsibilities in the context of the legal and human rights framework includes Investigating and addressing complaints related to human rights violations in aged care settings, Advocating for the rights of older people, including their right to dignity, privacy, and freedom from abuse and discrimination and Conducting research and providing guidance on human rights issues in aged care.
• Aged Care Quality and Safety Commission (ACQSC): The ACQSC is responsible for assessing and monitoring the quality and safety of aged care services, handling complaints, and ensuring compliance with quality standards. Aged Care Quality and Safety Commission (ACQSC). The ACQSC is the primary regulatory body overseeing the quality and safety of aged care services in Australia. Its role includes monitoring compliance with standards, conducting audits and investigations, handling complaints, and taking enforcement actions to ensure the safety and well-being of aged care recipients.
• Office of the Public Guardian (OPG): The OPG is responsible for safeguarding the rights and interests of adults with impaired decision-making capacity. It works to protect vulnerable individuals in aged care by providing advocacy, investigating concerns of abuse or neglect, and making decisions on their behalf when necessary.
• Department of Health(DOH): The Department of Health is a government agency responsible for health and aged care policies and funding in Australia. Within the aged care system, the DoH develops and implements policies related to aged care services. It oversees the allocation of funds to support aged care providers and ensures that the aged care system adheres to the legal and human rights frameworks.
• State and Territory Health Departments: Each Australian state and territory has its own health department responsible for regulating and overseeing aged care services within their jurisdiction. They work in collaboration with the federal government and other agencies to ensure compliance with standards and address issues related to the safety and well-being of aged care recipients.
• Aged Care Complaints Commissioner: The Aged Care Complaints Commissioner handles complaints related to the quality of care and services provided in aged care facilities. Their role includes investigating complaints, mediating disputes, and working towards resolution to improve the quality and safety of aged care services.
• State and Territory Ombudsman Offices: State and territory Ombudsman Offices have jurisdiction over aged care services and investigate complaints related to service delivery, abuse, neglect, and breaches of rights. They aim to address individual complaints and systemic issues, promoting accountability and improving the quality of care provided.
• Elder Abuse Prevention Units: These units, established in various states and territories, focus on preventing and addressing elder abuse, including within aged care settings. They provide information, advice, and support to individuals experiencing abuse and work to raise awareness, improve prevention strategies, and coordinate responses to elder abuse cases.

How the safeguarding bodies protects the rights of older Australians

Safeguarding bodies contribute to the protection of older individuals' rights through various means:

• Conducting investigations: Safeguarding bodies have the authority to conduct investigations into complaints, reports of abuse, neglect, or violations of rights within aged care settings.
• Monitoring and oversight: They monitor compliance with legal and human rights frameworks, including conducting regular audits, inspections, and assessments of aged care services.
• Advocacy and support: Safeguarding bodies provide advocacy and support for older individuals and their families, helping them understand their rights, making complaints, and accessing necessary services.
• Reporting and recommendations: They issue reports and recommendations to improve the aged care system, highlight systemic issues, and drive policy changes that promote the rights and well-being of older individuals.
• Older Persons Advocacy Network (OPAN): OPAN provides free and confidential advocacy support to older individuals and their families, empowering them to exercise their rights and resolve concerns within the aged care system.

Role of National and State/Territory Legislation

• National Legislation: The role of national legislation in Australia in aged care is to establish a legal framework that governs the provision of aged care services across the country. This legislation sets out the rights and responsibilities of both aged care providers and recipients, as well as the standards that must be met to ensure quality and safety in aged care services. The Aged Care Act 1997 is a key national legislation that governs the provision of aged care services in Australia. It sets out the responsibilities and obligations of aged care providers, funding arrangements, quality standards, and the rights of older individuals accessing care. Australian Human Rights Commission Act 1986 is also a key National legislation. This act establishes the Australian Human Rights Commission (AHRC), which promotes and protects human rights in Australia. The AHRC has the authority to investigate complaints related to human rights violations, including those affecting older individuals, and works to resolve disputes and provide remedies.

• State/Territory Legislation: State/Territory legislation in aged care complements national legislation and provides additional regulations and oversight specific to each state or territory. It may address issues such as licensing of aged care facilities, local compliance requirements, and specific provisions for aged care services within the jurisdiction. Each Australian state and territory also has specific legislation that may regulate aspects of aged care, such as guardianship laws, mental health legislation, and public health laws. These laws complement the national legislation and provide additional protections and safeguards for older individuals. Both national and State/Territory legislation contribute to upholding human rights in aged care by establishing legal frameworks that prioritize the rights, dignity, and well-being of elderly individuals.

These legislations ensure that aged care services are provided in a manner that respects individual autonomy, non-discrimination, and the right to live free from abuse or neglect. State and territory legislation complements this framework by addressing specific areas of aged care, such as guardianship laws, advocacy services, and facility regulations. State and territory legislation may vary to some extent, reflecting jurisdiction-specific requirements and provisions.

1. Guardianship and Administration Acts: Each state and territory has legislation that governs guardianship and administration, which protects the rights and welfare of individuals who may have impaired decision-making capacity. These acts provide mechanisms for appointing guardians or administrators, setting out their responsibilities, and ensuring decision-making is made in the best interests of the individual.
2. Anti-Discrimination and Equal Opportunity Acts: State and territory anti-discrimination and equal opportunity acts prohibit discrimination based on various grounds, including age. These acts protect older individuals from age-related discrimination and ensure equal access to services, employment, and opportunities.
3. Public Health and Safety Acts: State and territory public health and safety acts establish regulations and standards for health and safety in various settings, including aged care facilities. These acts set requirements for infection control, environmental safety, and emergency preparedness to protect the well-being of older individuals and prevent harm. By enacting and enforcing national and state/territory legislation, Australia aims to uphold legal and human rights frameworks

Role of Office of the Health Ombudsman

The Office of the Health Ombudsman is an independent statutory body responsible for handling complaints about health services, including aged care service. It investigates complaints, resolves disputes, and promotes transparency and accountability in the healthcare system and works to improve the quality and safety of health and aged care services. The office acts as a resource for information, support, and advocacy for individuals accessing aged care services.

The Office of the Health Ombudsman ensures that healthcare service providers comply with legal requirements, regulations, and standards. It investigates complaints regarding breaches of legal obligations, including issues related to patient care, privacy, informed consent, and professional misconduct.

The Office of the Health Ombudsman safeguards human rights in healthcare by addressing complaints related to discrimination, violation of patient rights, and breaches of confidentiality. It advocates for fair treatment, respect for autonomy, and equitable access to healthcare services. These legal and human rights frameworks, along with the roles of safeguarding bodies, national and State/Territory legislation, and the Office of the Health Ombudsman, work together to ensure that aged care services in Australia are provided in a manner that respects individuals' rights, promotes quality and safety, and provides avenues for complaint resolution and accountability. They aim to safeguard the well-being and rights of older individuals accessing aged care services and promote a culture of transparency, accountability, and continuous improvement in the aged care sector.

Consent

Consent is a legal requirement in aged care in order to both seek and accept care. Consent is required for referrals and to provide information about the person within the service and externally as required. Consent is a requirement for assessment and also intervention for the person. The aim is for the person themselves, their family, carer or others identified by the person, to be made fully aware of what will occur to them and their information and to accept these terms in order to provide services.

Informed consent

is when a client has their proposed care and treatment explained to them along with the terms around it. They then give their permission to be provided with this proposed care or treatment. It is important within the legal and ethical frameworks as it respects an individual's autonomy, promotes their right to make decisions about their own healthcare, and ensures transparency and accountability in the provision of care.

Before you begin any assessment, always ensure that you obtain the older person and their carer’s consent. For people that have certain conditions such as Aged care, Parkinson’s disease and blindness this consent may need to stem from, at times, their power of attorney or nominated guardian. This consent requires a signature. possibly a signature form both from the person who has power of attorney or is the enduring guardian as well as the person being cared for, a legal obligation to ensure the person being cared for is given the opportunity to ask questions, view any documentation on them, express their feelings, needs, and concerns, and contribute to their risk assessment where possible, those who have English as a second language to have an appointed interpreter. Interpretation services may be necessary to obtain consent from these clients that are truly informed. Where a client is unable to understand a treatment being proposed because of intellectual disability, consent will need to be obtained from their legally appointed guardian carer

The key elements of informed consent in Australia include providing relevant information to the individual, such as the nature and purpose of the proposed action, potential risks and benefits, available alternatives, and the right to refuse or withdraw consent. The individual must have the capacity to understand the information, make a decision based on that understanding, and provide their consent voluntarily, without coercion or undue influence.

Uninformed Consent

Uninformed consent is where a person directly or indirectly ‘agrees’ to care and treatment without knowing the full scope of what is involved. There is no formal acknowledgement of understanding or agreement to proceed.

Uninformed consent may be applicable in emergency situations when an individual is unable to provide informed consent due to their medical condition or incapacitation. In such cases, healthcare professionals must make decisions in the best interest of the person, considering their preferences, prior expressed wishes (if any), and consulting with family members or substitute decision-makers when necessary.

Examples of uninformed consent include:

• giving a treatment without any discussion taking place (e.g., injecting someone, manipulating a body part)
• pressuring someone into a treatment – ‘you need to do this, or…’
• taking advantage of, or not considering a language barrier or someone’s vulnerability (e.g., people may agree to something because they do not understand either the language or the situation and what is being proposed).

Uninformed consent displays a lack of communication regarding: explanation permission and the opportunity to ask questions about what is being proposed. At times older Australians may not wish to know about the risks involved or details regarding procedures or care. They may just want to give consent or state ‘that’s okay, I trust you’. This can become both a legal and ethical concern for the carer or other professional.

Avant (2014) provides the following advice when this occurs:

1. Explain to the patient that you are ethically and legally obliged to inform them of such risks.
2. Ascertain the basis for their hesitation or anxiety about being informed of the risks and if possible address their issues.
3. Explain why it will benefit them to know about the risks, for example they may decide against having the investigation, treatment or procedure.
4. Explain in broad terms at least that the investigation, treatment or procedure carries with it a risk of complications.
5. Provide the patient with written information about the risks, including the consent form if one is being used for the investigation, treatment or procedure, and invite the patient to ask any questions arising from this material.
6. Explore whether the patient would feel more comfortable with a family member or friend sitting in the consultation in order to discuss the risks.
7. Keep clear and accurate records of the patient’s request not to be informed of the material risks. In an appropriate case, for example when the material risks are significant, consider asking the patient to sign an acknowledgment that they have declined to be informed of the material risks. If this situation makes you feel very uncomfortable, you are entitled to (other than in an emergency) cease treating the patient and refer them to another practitioner. You should, however, do this empathically, professionally, and in a way that maintains the dignity of the patient For guidance on consent and other aged care rights,

The Charter of Aged Care Rights covers 14 points and includes rights around privacy, consent, the dignity of self-determination, having your cultural values and needs supported, and living free from abuse and neglect.

Code of conduct

Code of Conduct In 2015, the Council of Australian Governments (COAG) released a National Code of Conduct for Healthcare Workers. It has since been implemented in each state and territory and covers: It has since been implemented in each state and territory and covers safety, ethics , treatment advice ,consent ,scope of practice ,how to report concerns ,standard protocols for infection control , record keeping things healthcare workers must not to do (e.g., financially exploit client, practise under the influence of unlawful substances, engage in sexual misconduct), the need for healthcare workers to have appropriate insurance, and more.

As part of their responsibility to older people, your workplace also has a responsibility to ensure you receive adequate and up-to-date training. For example, if you are expected to do lifting and transfers, you need to have been trained in this for everyone’s safety and any support you need with doing your job, such as the chance to ask questions, check in with your supervisor, attend courses, receive mentoring from more experienced support workers and training in health and safety for both you and the older person along with adequate time off and time between shifts so you can work safely and effectively as a support worker.

In 2013, the Australian Human Rights Commission developed a report on their findings regarding the attitudes of the Australian public around aging and found that young people, in particular, had negative stereotypes towards aging, stating:

Younger Australians are more likely to associate ageing with the concept of loss (loss of health, loss of hearing, loss of mental capacity, loss of income). Younger Australians find it extremely difficult to identify any benefits associated with ageing and indicate it is simply not something they have given much thought to at this point in their lives

Agism (or Ageism)

Ageism is the stereotyping of and discrimination against individuals or groups based on their age. This may be a casual or systemic (within a broader community or group) stereotype. The report from the commission found that 71% of all Australians feel that age discrimination in Australia is common and found that it is most likely to occur in:

• the workplace (88% community respondents, 92% business respondents)
• retail situations (60% business and 60% community)
• social situations (56% business and 57% community).

The report also states that: 35% of Australians aged 55-64 years and 43% of Australians aged 65+ years have experienced discrimination because of their age. The most common types of age-related discrimination experienced by over 50% of older Australians are: • being turned down from a position (67% of Australians aged 54-65; 50% aged 65+) • being ignored (59% of Australians aged 54-65; 66% aged 65+) • being treated with disrespect (51% of Australians aged 54-65; 64% aged 65+) • being subjected to jokes about ageing (53% of Australians aged 54-65; 53% aged 65+).

Ageism can take many forms, including being viewed as a burden on the family or society, being viewed as having less value than a younger person, being assisted without being asked, being viewed as automatically being dependent, having people assume you are experiencing aged care or hearing loss and communicating with you with excessive volume or in ways that are patronising, being more likely to be made redundant, being encouraged to stop working or give up hobbies when you do not want to people assuming you any longer have sexual feelings or need love and companionship.

Paternalism

Paternalism can be a common feeling or action towards older Australians and their perceived capacity for self-determination and agency. This can be when younger people feel or act on a belief of superiority over older people and minimise their opportunity for autonomy within their own life and the community.

The idea of Paternalism is that the act of the potential lack of autonomy is for their good, such as the law to wear seatbelts in Australia- this is an example of paternalism.

Paternalism can be defined as choosing a course of action in the person’s best interest but without their consent. This can be seen as serving as an integral value in ethical decision-making and as an ethical obligation to neither withhold guidance nor professional responsibility. A condescending or overprotective attitude towards older adults, assuming they cannot make decisions for themselves or their choices are not in their best interest. This means that professionals need to clear boundaries around giving the person opportunities for self-determination and shared decision-making, but also keep in mind the professional judgement required to keep them safe.

Awareness of the fine line between dignity or risk and duty of care is essential. In health, this may look like 71% of all Australians feel that age discrimination in Australia is common and found that it is most likely to occur in:

• promoting and restoring the health of the patient
• providing good care
• assuming health and care responsibility.

Younger people tend to feel sorry for older people due to their beliefs that older people experience:

• complex health problems
• require extra time to be explained complex topics
• avoidance of conversations about technology
• poor hearing and requiring others to speak loudly to them
• a higher risk of being made redundant
• fewer opportunities to be promoted
• difficulty adapting to change
• others feel that they are more difficult to teach new things.

Stigmas and Common Misconceptions

stigmas and attitudes towards older Australians stem from media and advertising, which portray older people in a negative light. Even though almost half of the surveyed population think their portrayal is unfair, it continues to happen in Australia today. The Australian Human Rights Commission reported in 2013 that the Australian people feel that older Australians are most likely to be:  lonely or isolated, victims of crime, forgetful, feel negative when being told what to do by someone younger, sick and have difficulty learning complex tasks, experiencing difficulty learning new things, not having sexual relationships, not concerned about their appearance.

Social Devaluation and the Danger of Judgements

Social devaluation is a response to attitudes from people in society that leads to a diminished sense of value, identity and self-worth in a person. Social devaluation is often rooted in factors such as ageism, ableism, racism, sexism, etc. It can make groups of people more vulnerable to abuse, neglect, exploitation, and not receiving the support they need and have a right to. As a result of age discrimination and a feeling of community invisibility, older Australians commonly report feelings of: shame, anger and sadness.

Attitudes and stereotypes related to the dangers of value judgments for older people often stem from ageism and assumptions about what constitutes a good quality of life for them. This can lead to misconceptions and negative judgments about older individuals' abilities and well-being based on preconceived notions rather than their preferences and needs.

Psychosocial Disability

Psychosocial disability in the context of ageing

Psychosocial disability refers to a condition or impairment that affects a person's mental health and social functioning. In aged care, it refers to the impact of mental health conditions on the overall well-being and daily functioning of older individuals.

Psychosocial disability can significantly impact the life of an elderly person. It can affect their social interactions, relationships, daily activities, and overall quality of life. It may lead to feelings of loneliness, isolation, decreased self-esteem, difficulties in managing daily tasks, and challenges in participating in social and community activities.

Differences between psychosocial disability and mental health

Psychosocial disability specifically refers to the functional limitations and impairments in social and daily functioning caused by mental health conditions in the elderly. It focuses on the impact of mental health on an individual's ability to engage in daily life activities. Mental health, on the other hand, encompasses a broader concept of psychological well-being and encompasses both positive mental health and the presence or absence of mental illness.

Episodic nature of psychosocial disabilities in the elderly

The episodic nature of psychosocial disabilities refers to the fluctuating periods of stability and instability that individuals may experience in their mental health. In the context of the elderly, there may be times when their psychosocial disability is more pronounced or active and other times when they may experience periods of relative stability or improvement.

Additional or alternate supports that may be required during different periods of episodic psychosocial disabilities in the elderly:

1. Increased monitoring and support: During periods of instability, the elderly person may require more frequent check-ins, monitoring of their mental health status, and closer supervision to ensure their safety and well-being.
2. Adjustments to treatment plans: Treatment plans may need to be modified or adjusted during different periods. This could involve changes in medication dosage, therapy frequency, or the introduction of new therapeutic approaches to manage the episodic nature of their psychosocial disability.
3. Enhanced community support: During challenging periods, it may be beneficial for the elderly person to have access to additional community support, such as increased participation in support groups, counselling sessions, or peer support networks to help them cope with their condition.
4. Flexibility in caregiving arrangements: Caregiving arrangements may need to be more flexible during periods of episodic disabilities. This could involve increased support from family members, respite care services to provide temporary relief to primary caregivers, or the involvement of home healthcare professionals who specialize in mental health care for the elderly.
5. Collaborative care coordination: During different periods of episodic disabilities, it becomes crucial to ensure effective coordination among healthcare providers, mental health professionals, and support services.

This collaborative approach helps to address the changing needs of the elderly person and ensures a comprehensive and holistic support system. Ways in which psychosocial disability interacts with other disabilities

Psychosocial disability can interact with other disabilities in various ways.

Here are some examples:

1. Impact on physical health: Psychosocial disability can contribute to or exacerbate physical health conditions. For instance, chronic stress and anxiety may worsen symptoms of cardiovascular diseases or autoimmune disorders.
2. Co-occurrence of mental and physical disabilities: Individuals with pre-existing physical disabilities may be more susceptible to developing psychosocial disabilities due to the emotional and psychological impact of their physical condition. For example, someone with a spinal cord injury may experience depression or anxiety as a result of their disability.
3. Cognitive impairment and mental health: Psychosocial disabilities can intersect with cognitive impairments such as aged care or intellectual disabilities. In such cases, individuals may experience challenges in communication, decision-making, and emotional regulation.
4. Social interaction and developmental disabilities: Psychosocial disabilities can influence social interaction in individuals with developmental disabilities, such as autism spectrum disorder. Difficulties in social communication and emotional regulation may further complicate their overall well-being.
5. Sensory disabilities and mental health: Individuals with sensory disabilities, such as visual or hearing impairments, may be more susceptible to psychosocial disabilities due to the challenges they face in accessing information, communication barriers, and social isolation.
6. Substance abuse and mental health: Substance abuse disorders often coexist with psychosocial disabilities. Substance abuse can contribute to developing mental health conditions or be used as a coping mechanism to alleviate the distress caused by psychosocial disabilities.
7. Dual diagnosis: Dual diagnosis refers to the presence of both a psychosocial disability and a substance abuse disorder. These conditions can interact and complicate treatment and recovery processes, requiring integrated and specialized interventions.