Home' Australian Ageing Agenda : AAA Jul-Aug 2017 Contents Martin Bending
Current system acts as barrier
ALLIED HEALTH care plays an integral part in the
management of those with conditions that impact
upon an individual’s functionality, quality of life and
The strength of allied health is its diversity and expertise
to address multiple care needs to maximise wellness,
reablement and successful ageing.
However, despite the potential of allied health, a
reoccurring theme I hear from providers, consumers,
their families and allied health professionals has been
how to improve the provision of allied health ser vices in
A key barrier is the current system and funding.
Given the changes to home care packages where the
system, culture and funding have enabled consumers to
exercise options to choose and fund allied health, it’s
disappointing that we have not seen the same progression
in residential care.
The release of the report into the Aged Care Funding
Instrument by the University of Wollongong provides
recommendations that would address this issue.
Of note, its recommendation for a model that combines
fixed and variable funding would meet common and
individualised care needs of residents.
The variable component in particular would give scope
for allied health to be funded and provided to residents. In
doing so, it would allow consumers to exercise choice as
seen in home care, thereby enabling a similar client journey
and experience through the sector.
This compared to the restrictive and prescriptive nature
of ACFI would be a significant step for ward.
As the report highlights, significant
change requires time and adjustment.
If implemented it would not occur
overnight and the sector needs time
A means of transition should adopt
elements of the recommended model within the ACFI.
As a stepping stone, there is scope for the allied health
elements in the complex care domain to be less restrictive
and more flexible to resident need.
For example, we have seen time allocations given to
items 4a and 4b for allied health led pain management.
Why not give residents the same time allocation but
enable them and their families to choose the type
of allied health professional and care that they want
provided for them?
This would also provide a means for residential care to
support an individualised and holistic approach to wellness
and reablement in practice.
Many of us are in the aged care sector due to a desire
to help and care for others. In order for us to make a
difference, the system and funding needs to mirror this
desire to be applied in practice. Allied health has a lot more
to offer residential care and only through change can the
provision of allied health be improved and the benefits to
our residents realised.
Martin Bending is an exercise physiologist and service
delivery manager (NSW) at Remedy Healthcare/
Lack of access to allied health is being recognised
AS PEOPLE get older they are more likely to experience
illness and injury as well as reductions in independence
and level of function. This process is too often seen as
an inevitable part of ageing, particularly once a person
is living in residential aged care where most people have
high care needs.
However, the right care and support may reverse some
or all of the effects of ill-health. Allied health interventions
can help improve health across a wide range of areas.
These range from assistance with hearing or visual
deterioration and medications management to exercise
and strength conditioning that supports falls prevention,
foot care and supporting people experiencing mental
Unfortunately, many aged care residents are limited in
their access to allied health ser vices. Key funding programs
such as the Medicare Better Access to Mental Health
Ser vices and Chronic Disease Management are both
inaccessible to older people living in residential care.
Instead, residents depend on private funding or funding
through the Aged Care Funding Instrument.
The design of the ACFI means that it does not provide
an effective means of accessing allied health ser vices. The
instrument’s focus is on day-to-day, high-frequency care
needs and on funding the operation of residential facilities
rather than individual wellness and restorative care.
The lack of access to allied health services is increasingly
being recognised. The recently released Alternative Aged
Care Assessment, Classification System and Funding
Models report identified a range of factors likely to reduce
access to allied health funding under ACFI.
Specifically, it found the model has no
provisions for reablement and restorative
care programs to address potentially
reversible functional decline.
These issues are exacerbated by
aged care assessors who frequently lack
knowledge about allied health ser vices resulting
in these not being identified during the
We believe that a range of changes are required to
improve access to vital allied health ser vices:
• Eligibility restrictions for Medicare funding should be
removed to ensure consistent access to ser vices in the
community and in residential care.
• Aged care funding requires reform to provide
explicit funding for wellness and reablement. The
implementation of key recommendations in the
Alternative Aged Care Assessment report could be an
important foundation for reform.
• Increased training must be provided for aged care
assessors and workers to assist them in identifying
a broader range of needs including needs relating
to sensor y loss, communication impairment, and
psychosocial needs, as well as how to work with older
people to develop shared care planning.
• Increased research into goal setting and outcome
measurement for individual wellness and reablement goals
in aged care should be funded.
Lin Oke is executive officer of Allied Health
Professions Australia, the national peak
representing allied health professions.
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