When a change in facility might be needed
Sometimes a move in care facilities is necessary.
A change in the condition of your family member may mean that they require a higher level of care or specialised care - this may involve moving to another residential care facility.
Carers and families will sometimes disagree with staff about a proposed move - you may want your family member to remain in the place they now call home. It can be hard to weigh up what is in the best interests of your family member.
Moving from low level care to high level care
If your family member's needs can no longer be met in low level care, they may be reassessed as requiring high level care. This may be due to a gradual decrease in their independence or sudden deterioration.
Some facilities will be able to provide the increased level of care, without your family member having to move. An 'Ageing in Place' policy means that residents can often remain in the same facility and receive the additional care required.
Not all facilities have an 'Ageing in Place' policy. Some will ask carers and families to find a place elsewhere. Check the Resident Agreement provided at the time of admission - it will state the circumstances in which residents can be asked to leave or seek more appropriate care.
Often residents who have deteriorated are admitted to hospital for further investigations. The residential care facility may then voice its concern that the resident requires high level care and should not return. This can come as a shock to family who may not have heard the extent of these concerns before.
If this happens to you contact Residential Care Rights (ph: (03) 9602 3066) for information, support and advocacy. In some cases the facility has an obligation to readmit your family member, at least temporarily while you find a more suitable facility. This is preferable to staying in hospital as much pressure is placed on families in this situation.
When specialised care is needed
Whether your family member is in low level or high level care, there may come a time when specialised care is required - often when challenging behaviours cannot be adequately managed in the facility. This may include wandering, aggression or persistent screaming.
Sometimes admission to hospital is a necessary first step to exclude any medical reasons for the behaviour. When a diagnosis has been made the most appropriate specialised care options may become clear. The two most common of these are:
- dementia specific care
- psycho-geriatric care
While any move may be unsettling for your family member, a move to a facility providing specialist care could be beneficial. The local Aged Care Assessment Service (ACAS) can provide you with a list of dementia specific facilities in your region - phone 1800 500 853 for contact details. If psycho-geriatric care is required, your family member will be assessed by the Aged Psycho-geriatric Assessment and Treatment Team (APAT) and then referred to appropriate facilities.
Request further investigations first
Before any decision is made about your family member's future care needs, adequate investigations should be undertaken. Sometimes there is a simple solution or a way of working around the problem.
Involve the GP - seek their advice. Ask them to arrange for specialist assessments at the facility. They may refer your family member to:
- The Aged Care Assessment Service (ACAS)
- The Psycho-geriatric Assessment and Treatment Team (APAT)
- An appropriate therapist (e.g. physiotherapist or dietician)
- A specialist service (e.g. palliative care service)
- A specialist clinic (e.g. a continence clinic).
Following the specialist assessments, any unresolved concerns or issues may indicate that another type of care is required after all.
Here is some advice from other carers:
- You are entitled to request specialist assessments first. Don't just accept that a move is required, if you feel otherwise
- Take an active role in the assessments. Be present and voice your concerns. Speak up on behalf of your family member
- Involve the GP but don't expect them to have all the answers
- Contact the Aged Care Assessment Service for information and advice on further investigations and options available
- Remember to balance your family member's best interests against your own wishes - this is sometimes hard.