The new Charter of Aged Care Rights came into effect in Australia on July 1st 2019 and dovetails nicely with the New Aged Care Standards, which are what services will now be assessed against in Quality Reviews and Audits. And, like the new Aged Care Standards, the new ‘Charter’ of Rights apply across the board whether the person is accessing residential care, flexible care, transition care or home care supports.
The Charter of Rights are written in plain English, but let’s look at each of these Rights a bit closer. After all, you do need to explain these to your clients and you need to sign the Aged Care Client Rights document to acknowledge you have done so.
Aged care clients have the right:
1. To safe and high-quality care and services.
While each person’s concept of what constitutes ‘high-quality’ differs, we all understand what safe care is. Safe care is delivered by staff who understand the client’s needs, are trained, supported and equipped to carry out a service safely. It also includes making sure the person has the right equipment in place, such as rails in the bathroom or a correctly sized shower chair. It’s staff using personal protective equipment (PPE) and the organisation having an immunisation training system in place.
When it comes to high-quality care, well, that is up to the individual to define; and while the person might have high expectations this has to be managed within the funding available and needs to respect the rights of others, including support staff.
2. To be treated with dignity and respect.
This ‘right’ is linked closely to Standard One in the Aged Care Standards – Consumer Dignity and Choice. All of us wish to be recognised as individuals and to be treated with respect. We can support dignity in care by giving clients opportunities to make their own choices, such as what to wear or what activity they would like to participate in. We can involve them in decisions that relate to their care and support, we can respect personal space and belongings, as well as the choices they have made, even where we may not agree. We can be sensitive to the feelings of clients when providing personal care and seek to put them at ease. We should also be using preferred titles and names, treating the client as a person, not a number or ‘just another old person’.
Respect also means listening to what the person has to say, acknowledging their concerns and speaking civilly and politely to them.
3. To have my identity, culture and diversity valued and supported.
Each of us holds a perception of ourselves – this is our identity. Our cultural identity is shaped by the people we grew up with and where we grew up. It’s shaped by our ethnicity, religion, social class and shared experiences of our generation. As people age it is important that caregivers are sensitive to, and understand, the identity that people hold and respect client lifestyle choices.
For example a male client from a remote Aboriginal community might have a preference for a male care worker from his family group to provide personal care. A Muslim or Jewish person might have specific dietary requirements that need to be met. A person who identifies from the LGBTIQ community shouldn’t have to hide their sexual identity or relationships just because they are now in residential care.
4. To live without abuse and neglect.
As people grow older and more frail, it is important that they are supported to feel safe and secure. The feeling of being safe is central to a person’s health and wellbeing. When people feel secure they are able to relax and enjoy life more fully. People should be able to live without the worry of other people, including family, abusing or neglecting them simply because they are too frail to defend themselves.
It is important for care staff to be aware of the signs of abuse and neglect, and to assist clients to access support where concerns are raised.
5. To be informed about my care and services in a way I understand.
For me, there is nothing worse than being given a heap of paperwork with lots of fine print to read through, then be expected to understand and apply something. I much prefer to sit down with someone and talk it through, or be shown how to do something, and I am sure I am not alone in this.
Actually, creating plain-English, accessible resources is one of the main activities that CDCS is involved in. There is little sense in sending out a text-based document to a person who has minimal or no literacy, which is why we help services to develop colourful, pictorial-based client handbooks and spend time helping staff learn how to deliver relevant messages appropriately to clients. Clients have the right to understand how and when services will be delivered and how much this will cost them.
If you have clients from a NESB who need these Client Rights in a translated format, these are available on the Quality and Safety Commission website.
6. To access all information about myself, including information about my rights, care and services.
Yes, that’s right – anything you write or information that you keep on a client is available to them or their authorised representative. Are you providing the client with a written care plan (in a way that they understand), a budget and monthly statements if they have a Home Care Package, and is your paperwork in order should someone request a copy of the information you keep on them?
How about your client progress notes? Do these reflect a professional approach to documentation? If you’re unsure, check out our free resource on writing progress notes.
7. To have control over and make choices about my care, and personal and social life, including where choices involve personal risk.
I think the perceived loss of control over choice is one of the major deterrents to people entering residential care; they want to retain the ability to make those small daily choices, such as when to get up in the morning, whether to take a shower or not, who they will see that day and what they will eat for lunch.
Seniors have been making these simple daily choices for most of their lives and they don’t want to lose that right just because they are older and more frail. If they want to have a glass of wine with dinner, stay up late reading past midnight or dance in the rain, it’s their choice. And while we might need to counsel against certain activities that can lead to adverse outcomes, we need to be mindful of supporting well thought-out choices.
8. To have control over, and make decisions about, the personal aspects of my daily life, financial affairs and possessions.
Like the previous right, seniors have often been managing their finances and possessions for most of their life. Just because an elder is frail in body doesn’t mean their mind is not sharp. They are often well-aware of their finances and are able to continue to manage these appropriately, although they may need assistance with new financial practices.
It is often more appropriate to assist a person to understand and learn how to use internet banking than to commence financial management on their behalf if the problem is simply that getting to the bank is now more difficult.
9. To ‘my’ independence.
So much is encapsulated in this simple statement. As a support organisation, we seek to support, not take over, control or manage every aspect of the individual’s life, even where they are living in a residential environment. We should be encouraging support networks for individuals that help them to maintain control and independence.
Assisting a person to exercise their independence is also important. This links back to Right number two and Aged Care Standard One, providing opportunities for choice and respecting those choices and decisions.
10. To be listened to and understood.
This is not just about using interpreters, although that is important if they are needed; it’s also about taking the time to really hear what the person is talking about and the message they are trying to convey.
11. To have a person of my choice, including an aged care advocate, support me or speak on my behalf.
We know that some older people find it difficult to make themselves clearly understood or they feel awkward about speaking up for themselves. The aged care sector can be difficult to navigate and even when people have a reasonable grasp of the programs, they feel uncomfortable about asking for some things. In these instances a third party can be helpful for the end consumer, and service providers need to understand and acknowledge the position of an advocate.
12. To complain free from reprisal, and to have complaints dealt with fairly and promptly.
The complaints process is a cornerstone of what makes a good aged care system. It is through the complaints and feedback that people raise, that helps us improve the care and support to seniors in our communities. Clients need to feel that they are listened to – see Right #10 – and that their complaint is taken seriously and not brushed under the carpet, so to speak, and that management respond to issues in a timely manner according to the severity of the complaint.
We want people to feel they are a partner in making the care industry better and that they can escalate any concerns freely and in confidence, and that things will be better for them and others as a result.
13. To personal privacy and to have my personal information protected.
None of us like to have our privacy violated, and here in Australia we have strong privacy laws to uphold our right to privacy. When people age they may experience increasing frailty and as a result become more vulnerable. It is important that we secure all personal information about clients by ensuring our computer systems are password protected, that written information is correctly stored, and that staff understand and respect the confidentiality of client information. We want people to feel confident that the personal information we hold on them is secure and that only those who require specific information have access to it.
14. To exercise my rights without it adversely affecting the way I am treated.
Lastly, we want people to exercise their rights. To exercise their rights, they first need to know them, so it is important that care staff continue to remind clients and residents of their rights. It is helpful to have these rights displayed on the walls of the aged care centre or facility, or discuss specific rights with client groups, helping consumers and their carers to understand these better.
If the organisation consistently upholds the rights of consumers, if they remind them regularly of their rights, if they respond appropriately and in a timely manner, then clients will have more confidence that they will be supported to exercise their rights, especially whenever they feel a right has been violated.
If you would like to access some great resources that support consumer understanding of the new Aged Care Rights, you can find a handbook on the Aged Care Quality and Safety Commission’s website.
Next week we’ll look at the flip side of rights – responsibilities.
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