Monthly Archives: November 2017

Healthy Ageing in ViTa Facility

Healthy Ageing: Turning Conviction In Care Into Reality

Aged Care Group (ACG) achieved a new milestone with ACH Group – Australia’s leading aged care organisation – to provide innovative care for diverse markets and healthy ageing.

In conjunction with the collaboration, the ACG team had an opportunity to tour some of their aged care facilities. In an interview regarding their experience, members of the visiting team shared aspects of ACH Group’s care delivery that were adaptable in Malaysia and unique to them individually.

Branding Aged Care Articulately – Reeca Lim

For Reeca Lim, ACG’s marketing professional who conceptualises design and development, the tour was a chance to study the success model of care in a developed country, how it articulates their delivery of care and the distinctive approaches in cultivating aged care branding and prominence, as well as its impact on people.

The brand isn’t just about the building, it is about the continuous endeavours in developing and improving a comprehensive innovation framework (from software to hardware) and ensuring the message is effectively relayed to the public. This garners their stakeholders’ involvement to create changes that add value to the ecosystem.

What stood out was how aged care is expressed and communicated to people. There is a dedication to the philosophy of healthy ageing and that care comes first, which is deeply internalised within the organisation from the grass roots to top management.

That philosophy; conveyed via service design and product innovation that is supported with evidence-based research is the pillar to success.

Care Is About People – Paramjit & Tze Lin

Malaysia’s approach in healthcare has typically revolved around being illness-centric, but there is a paradigm shift of living better and not just longer. Nurse Manager, Paramjit Kaur stated that the approach in aged care has to focus on restoration, rehabilitation and supports healthy aging.

According to her, the best practices revolve around a person’s right to make choices for themselves. While healthcare providers give support by providing the necessary services, there must also be an emphasise on the care recipients’ participation to put effort into being healthy.

At ACH, residents are encouraged to view ageing as a journey, not a destination. This cultivates a mindset to be healthier and as independent as possible which is reflective in their involvement in social activities etc.

Additionally, the homes didn’t seem institutionalised. There are signs of the personal touch everywhere in the way the rooms were done up. No two rooms are the same and there is a homely atmosphere all around. The residents are well dressed and groomed, and had varying meal times to suit their needs.

This practice emphasises the care recipient’s restoration, not institutionalising them.

Registered nurse and care administrator, Tze Lin echoed her agreement with this sentiment, stating that parties who are interested in the aged care business need to perceive the elderly as unique individuals with their own goals in life – not as statistics – and then provide the conditions that will allow them to maintain their dignity.

Is important to embed such a culture in your team and organisation as it will be reflected in the service provided and the care that people receive. For example, developers need to be mindful when designing the space and layout of a facility centre. If you’re building a facility for dementia patients, space needs to be taken into consideration as dementia patients value space.

She also stated that inter-professional learning – between medical and non-medical disciplines – need to be cultivated to ensure there is a continuity or integration of care. This would also lead to aged care offerings that are disruptive to the norm, spurring innovative solutions that improves the quality of care for the elderly.

Adapting Operational Practices & Culture Specific Care – Derrick Chan

Quality standards are fundamental in the provision of service. Having shadowed and observed the day-to-day operations in a residential aged care facility, Derrick Chan – who conducts Research & Development in aged care affairs – stated that some of ACH’s standard operating procedures could be adapted in local practices.

This includes activity planning, meal preparation, care provision, health and safety, equipment usage, front and back office management, staff planning and so on.

The similarity in what ACH practices and what we want to achieve overlaps in terms of the services, procedures and the administration required to ease a care recipient’s transition from the home to an aged care facility. For example, the utilisation of financial planners and downsizing consultants.

Another aspect of ACH’s endeavours that struck a chord with Derrick was the provision of care to diverse cultures and how talents are developed to ensure sustainable human resource.

There were programmes created as part of the good practice in aged care. For example, ACH Group has cultural-specific programmes that engages groups of participants from varied cultures to promote diversity in aged care, such as the Cambodian and Muslim community programmes. I believe this is relevant to Malaysia’s cultural experiences.

There are also tailored programmes designed to equip staff and volunteers from across the organisation with skills and specialised knowledge to carry out their duties. ACH Group has a Dementia learning programme which trains providers to enable people living with dementia to live a good life.

Moving forward in Malaysia, a dementia specialist advisory service can be setup as there is a lack of expertise and services in this area.”

Melinda U: Conviction In Care, Not Convenience

Given the similarities of the care delivery models and practices, General Manager of Managedcare Sdn Bhd, Melinda U shared her interest in understanding how ACH Group has come to refined their model over the course of their 65-year experience.

Similar to Managedcare has done, ACH Group has made partnerships with universities for initiatives such as their ViTA project. I wanted to know in detail what did these partnerships entail, what is the business model and what were each party’s role in it. I also wanted to know the operational details of running an aged care facility on a day-to-day basis, what went well and what pitfalls to avoid. So when we operate our own facility, we’ll know how to do it right.

She further stated that the basis for any operational designs and their subsequent modifications comes down to embodying the concept of person-centred care.

For example, ACH assists people to retain their previous lifestyle and take steps – such as providing transport – to achieve it. They don’t turn life upside down just because its more convenient. Operations flow according to the care receiver’s rhythm.

There are challenges for organisations and businesses to balance operational and cost efficiency, but it can be done while maintaining sustainability. So for us it’s important that no matter how we balance these factors, we must stay true to what we believe in and keep our priority in line with our beliefs.”

In conclusion, we can look forward to the outcomes of this partnership as the synergy between the ACG and ACH Group’s care model and practices will open Malaysians to new possibilities of quality care.

Bill, Eyeglasses & Policy

Bill To Regulate Nursing Homes Tabled In Parliament

The Private Aged Healthcare Facilities and Services Bill 2017 was tabled in the Dewan Rakyat on Monday.

The Bill was tabled by Health Minister Datuk Seri Dr S. Subramaniam for its first reading, and is expected to be passed during the current Parliament meeting, which ends on Nov 30.

Once the Bill is passed, centres caring for four or more persons above 60 years old must obtain an operating licence from the ministry’s director-general.

Consideration for approval will be given to matters such as the centre’s premises and the types of services offered.

An operating license is valid for a three-year period from the date of approval and cannot be assigned or transferred unless approved by the director-general.

The centre operators must also ensure that their staff are trained in basic life support.

The proposed law also prescribes that centres or facilities must provide a policy statement to a care recipient upon admission.

This includes providing a grievance mechanism to allow care recipients, their relatives or any person acting on their behalf to lodge a complaint.

Centres for the aged will be subject to inspection by two officers appointed by the director-general to ensure compliance of regulations.

The ministry’s director-general has the power suspend or revoke the licence of a centre, or order its closure.

A centre operator may voluntarily close the centre or facility, but must give three months’ notice to the health ministry’s director-general, which includes a report on the status of accommodation of care recipients.

The centre can also receive care recipients who are below 60 if it complies with the Care Centres Act 1993.

Failure to comply with the law could see offenders liable to fines ranging between RM5,000 and RM30,000.

The proposed law does not cover those providing care to their aged relatives, care centres or private healthcare facilities.

 

This article first appeared in The Star, on 23rd October 2017.

ACH Group Vision Of Providing Care To Diverse Markets

ACH Group sign MOU with Malaysian company, Aged Care Group, to deliver an innovative care model

ACH Group and Malaysian care provider, Aged Care Group (ACG), signed a Memorandum of Understanding to officialise a joint initiative to provide better care in both Australia and Malaysia.

The MOU affirms that ACH Group and ACG will work together to share knowledge of each other’s countries and experiences to better provide care to older people.

The signing of the MOU was witnessed by the Honourable Zoe Bettison, Minister for Ageing, recognising the Office for the Ageing played an important role in developing Age of Opportunity: A Policy Framework for the Development of the Ageing Well Industry in South Australia, which was launched in August. This policy sets a framework for cross government, industry and community collaboration to support business growth and innovation throughout the Ageing Well industry in South Australia.

The new agreement will bring together both organisations and provide ACH Group the opportunity to learn and develop tools such as how to provide care to different populations in a multicultural society.

“We have many things to learn about providing care for such a diverse market place,” said ACH Group CEO Ray Creen, “Australia is one of the most ethnically diverse societies in the world today and as an aged care provider, we need to continue to learn how to cater for such an extremely broad market, something that ACG does in Malaysia so well.”

As well as diversity in the market place, ACH Group hopes to learn about ACG’s advanced use of technology to develop their already strong community-based care model. A model which involves community, public and private sectors.

“ACH Group’s integrated continuum of care is made up of a comprehensive array of health services,” Creen said, “developing this even further and combining it with a progressive use of technology will mean South Australia’s aged care sector is a leader for the Nation.”

The bilateral relationship between South Australia and Malaysia will elevate and introduce a care model of international standards to the state.

Dementia

Paying For Dementia Care – How to Plan Ahead

In 2015, the Alzheimer Disease International’s world report had estimated that 46.8 million ageing people worldwide were affected with dementia, Alzheimer’s disease, and other related memory disorders, with the majority of 22.9 million people affected residing in Asia.

The numbers were estimated to double every 20 years, with the number reaching 131.5 million by 2050. That is one new dementia case in every 3 seconds. In Malaysia, the last estimated number of dementia cases is projected to reach 261,000 in 2030 and 509, 000 in 2050. The estimated cost for dementia care is said to reach 705 million in USD.

Depending on the stage of these diseases, dementia individuals may require 24-hour supervision or care. With medical inflation being 10 – 15%, the cost for care is growing steeper. For the vast majority, family members – and sometimes friends – are the main providers of care is provided by friends. However, what happens when there isn’t enough money to pay for care?

As September 21st is World Alzheimer’s Day, it is prudent that we consider our potential encounter with dementia and make appropriate counter-measures. Hence, it is helpful to understand the different types of dementia, its varied stages and what to expect in order to make feasible financial plans if/when one faces dementia – be it for yourself or a loved one.

 

Dementia Types
Dementia is an umbrella term that describes a group of symptoms caused by many diseases associated with an on-going decline of the brain and its abilities. Dementia is an irreversible loss of cognitive capacity and memory, such that there is a decline in a person’s ability to function socially, physically and emotionally over time. While it usually appears in ages above 65, it should not be mistaken for simple forgetfulness due to old age as dementia is not a natural part of ageing.

As a brief overview, there are several types of dementia. However, the most common are listed below in descending order:

1. Alzheimer’s Disease (AD) – The most common type of dementia which looks at the accumulation and depositions of abnormal proteins) inside the brain cells that disrupts messages from the brain to body.

2. Vascular Dementia (VaD) – Also common, this dementia type is formed by the accumulated effects of multiple Cerebrovascular accident (CVA) on brain function. It is commonly associated with hypertension, atherosclerosis and inadequate blood flow to brain.

3. Dementia with Lewy Bodies (LBD) – This is a progressive type of dementia in which Lewy bodies (abnormal deposits of a protein called alpha-synuclein) build up in areas of the brain that regulate behaviour, cognition, and movement. LBD is usually difficult to distinguish from Alzheimer’s, VaD or Parkinson’s. Some symptoms of LBD include visual hallucinations and Parkinson-like symptoms such as a hunched posture, balance problems and rigid muscles.

4. Dementia associated with Parkinson’s Disease – This is a progressive disorder of the Central Nervous System (CNS) that affects the body’s motor functioning. Some people with Parkinson’s disease may develop dementia in later stages of the illness through the accumulation of Lewy Bodies.

 

The Stages Of Dementia
There are several stages that one should anticipate when preparing to create an outline of what is needed for one’s care in terms of finances, services and products. The list below will help you understand what to expect in the following stages:

Stage 1: The Early onset
During this stage, an individual can live a reasonably normal life. The dementia individual may experience short-term memory loss and he/she may misplace, forget and lose things from time to time. During this stage, dementia is not easily diagnosed.

Stage 2: Mild
The individual starts experiencing significant short-term memory and impairment of self-care tasks that require more complex thinking skills, including organisational skills such as managing finances – e.g. paying bills and managing financial assets. Another symptom to take note of are personality changes such as a sudden lack of motivation.

Stage 3: Moderate
Apart from prior symptoms, the individual will experience difficulty with basic Activities of Daily Living (ADL) routines that people tend do every day without needing assistance such as eating, bathing, dressing, toileting, transferring (walking) and continence. At this stage, the individual is extremely dependent and require close supervision.

Stage 4: Severe
By this stage, the individual requires constant 24-hour care in ADL routines. They are unable to use or understand words, recognize family member, find their way home. They are unable to walk.

Care & Estimated Costs
Estimating the amount of financial resources required for dementia care is difficult as the cost varies depending according to dependency and needs. However, it helps to know what are the resources available and their estimate cost to better gauge dementia care expenditure.

1. Day Care Centres
Adult Day Care Centres are a viable option to seek assistance that helps the dementia individual maintain their mental health via programmes and activities, while the working adult caregiver is away from the home.

Adult Day Care Centres can charge an estimate of RM100 per day. This works out to approximately RM24,000 annually if the individual attends day care for 20 days per month. However, it should be recognised that day care centres are not able to accommodate individuals in the later stages of the dementia.

2. Caregivers
Unlike a domestic worker, a professional caregiver is fully trained to handle matters regarding caregiving. Hiring a trained caregiver would typically cost between RM15 – RM25 an hour on a daily basis. This adds up to caregiving expenses ranging from RM2,000 to RM2,800 per month.

3. Nursing Homes
Almost all nursing homes are not equipped for those stricken with Alzheimer’s or dementia. Most would not charge additionally since dementia individuals do not require more care than other nursing home residents.

According to research conducted by Care Matters in 2014, the cost for staying in a nursing home could range from RM1,200 – RM2,600 a month for basic care services in a semi-private room, while a private room is about RM2,650 to RM3,500 a month. Bear in mind that sharing a room is not always an option for individuals with an aggressive nature due to dementia.

4. Daily Expenses, Consumables & Medical Check-Ups
Effective in 2017, the EPF has revised their figures regarding daily expenses an individual should be able to afford for 20 years. The EPF website stated the new minimum threshold provided is now RM950 per month. Furthermore, on-going medication and medical check-ups is at least RM235 per session with a Specialist Consultant. Additionally, expenditure on consumables such as adult diapers is at least RM400 per month.

 

Future Prospects
The potential of encountering dementia in our latter years is a real possibility as Alzheimer’s Disease and other types of dementia is said to be one of the most rapidly growing healthcare issue facing the healthcare industry. As ‘baby-boomers’ age and our population continues to live longer, care and supervision of those with a cognitive impairment is predicted to overwhelm our health care system and budget. While there is little in the way of early detection, it is known that dementia doesn’t occur overnight and there is a grace period for us to prepare for its possible occurrence.

Families and those who find themselves facing this predicament can do two things to help relieve the stress so often experienced through the caregiving years – EDUCATE yourselves on the resources for care and the progression of the disease, and PLAN AHEAD.

As a starting point, Malaysians could seek out the Alzheimer’s Disease Foundation of Malaysia (ADFM) at www.adfm.org.my to find educational resources, support groups, events and workshops that would help provide insight on the condition.

 


First Published: Smart Investor, October 2017

Written By: Aged Care Group

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