Home' Australian Ageing Agenda : AAA Mar-Apl 2015 Contents Mitch Fifield
to provide comprehensive
coverage with around $11 million
of funding per year would create
a logistical challenge.
Coordinating the teams with
the current Dementia Behaviour
Management Advisory Services
(DBMAS) would further present a
structural challenge, he said.
Adding much stronger
criticism, clinical psychologist
and dementia educator
Bernie McCarthy said he was
disappointed the initiative was for
teams to provide advice, which
the DBMAS already provided
enough of, rather than resources.
"All the advice in the world
will not resolve the issues staff
face when severely disturbed
situations arise," said Mr
"They need better training
in person-centred approaches
to relating, communicating and
problem solving, and they need
leadership trained in leading
dementia care settings in a
person-centred manner so that
issues like pain and emotional
distress due to inappropriate or
ineffective interactions from staff
can be addressed."
He said until there was a
person-centred focus that flowed
into care decisions with detailed
knowledge of the individual there
would continue to be excessive
levels of behavioural disturbance
and "short-term fixes" like this.
Mr McCarthy said it also was
unclear how the new Severe
Behaviour Teams would differ
from the work of DBMAS.
CEO of mission-based provider
peak Aged and Community
Services Australia, John
Kelly, said that building
industry capacity through a
needed to be a priority in future
workforce development policy
He also raised concerns
over timely access to the new
service, especially in rural and
"If this is a city-centric
fix to a large problem, it will
disadvantage many people with
severe behaviours all across
Australia," Professor Kelly said.
Leading Age Services
Australia said it was concerned
the new mobile teams would not
help build long-term capacity
within the industry.
"There is a risk that the
specialist response teams will
simply be a quick fix with no
enduring increase in skill levels
for those dealing with severe
behaviours," said CEO of LASA
Chief executive of Council
on the Ageing (COTA)
Australia Ian Yates said
the creation of the response
teams was a positive first step
in improving dementia care
in the industry but ensuring
the new teams worked closely
with DBMAS in each state and
territory would be critical to
"People living with dementia
are core business of aged care
and aged care providers have to
do much better than most do now
in responding positively to their
needs," he said. "Indeed many
behavioural challenges are the
result of provider failings rather
than resident behaviours."
He said this included better
recognition and treatment of
symptoms of pain.
As part of a broader strategy
to improve quality dementia care,
Mr Yates said the government
could also use its control over the
allocation of aged care places
through ACAR to direct priority to
those providers with a solid track
record in dementia care.
Alzheimer's Australia said it
supported the specialist teams
and hoped it would lead to a
reduction in the use of physical
and chemical restraints in
residential aged care.
The peak body's CEO Carol
Bennett said she welcomed the
that this was only one part of a
longer term strategy to support
people with dementia who
experience severe behavioural
symptoms of dementia.
HammondCare's CEO Dr
Judd added the government's
strategy should include education
for nurses and carers in identifying
and treating pain experienced by
people with dementia.
National Director of
Lin Hatfield Dodds said
the government had clearly
understood the concerns raised
at the Ministerial Dementia Forum
on 11 September and that it was
right to trial a new initiative to
improve care capacity.
"It is a positive step forward
both for the people who need
specialised care and for the
services doing their best to provide
that care with limited resources,"
said Ms Dodds, who was speaking
on behalf of UnitingCare's
provider agencies. n
What are the new
ASSISTANT MINISTER for Social
Services Mitch Fifield announced on
4 February that a mobile workforce of
clinical experts would provide advice
to residential aged care facilities under
a $54.5 million program that would
replace the axed dementia and severe
Senator Fifield said the Severe
Behaviour Response Teams would
target those with the "most severe
behavioural and psychological
symptoms of dementia."
"These teams of aged care experts will visit residents
exhibiting extreme behaviours, assess the cause and advise
care staff on how to best care for the resident," he said.
The government confirmed the teams would initially "work
closely" with the existing Dementia Behaviour Management
Advisory Services (DBMAS) in each state and territory but
would ultimately be integrated with the DBMAS from 2016-17.
The response teams are expected to get underway later this
year, following a competitive tender process.
In addition to the new response teams, the government
announced it will conduct a review of the $130 million worth of
existing programs that provide support to people with dementia
and their carers to ensure "national coordination, integration
In early February, a spokesperson for Senator Fifield told
AAA the tender documentation was still under development
in consultation with the sector, which would provide a clearer
picture of how the response teams will operate.
The idea of multidisciplinary response teams that would
provide specialised support to residential facilities struggling
to care for residents with severe BPSD was one option that
received "broad support" from the almost 70 industry
and expert stakeholders who attended the Ministerial
The official report from the meeting that took place in
Melbourne late last year showed there was "broad consensus"
among participants of the need to improve access to
specialised support services.
It was thought that the response teams, or what
participants called "flying squads", would be cost effective
and would provide earlier intervention, according to
KPMG's report on the meeting.
However, while a pilot to trial the mobile teams was put
forward as one possible replacement to the axed dementia
supplement, the participants raised several concerns about
the proposed model. For example, how many teams would be
required to service the whole country. Further, the participants
noted that it may be difficult for the mobile team model to
sustain long-term change and service improvements in
Discussing the feasibility of the response teams, the
participants felt that "further work" was required to develop
the model and clarify how the teams would differ from,
complement, or build on existing DBMAS, particularly in states
where DBMAS was less established. "This is an option for the
medium term," the forum's participants concluded.
The KPMG report said the specialised support teams could
be led by a geriatrician, GP or nurse practitioner and involve
specialised assessment and multidisciplinary input. Such
models were considered to be highly effective where they were
available, the report noted.
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