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Care of Older People - 1998. Amended 2000 and 2011 - Under review

31 Jul 2012

General

1. Ageing is a normal process and does not, of itself, imply illness, impairment or disability. However most older people will be subject to a range of physical and/or psychological conditions resulting in functional impairment that can be reduced by involvement of medical practitioners and other health care workers.

2. The quality of medical care for older people at home, in hospital and in residential aged care facilities should reflect those principles considered to be optimal medical practice. Standards of care should not be compromised through discrimination on the basis of age, restriction of resources or economic rationalisation. It is a basic right for all older people to have access to a medical practitioner of their choice.

3. Health care and social services, including comprehensive assessment and effective rehabilitation, should be directed towards the restoration and maintenance of each person's optimal level of independence.

4. With the increasing proportion of older people in the population, health care services for older people should be expanded within the community setting, in hospitals and in residential care. The effectiveness of these services must be evaluated regularly to ensure that older peoples' needs are being met.

5. Health services for older people should both acknowledge and meet the special needs of older people and respect cultural values.

6. Formal prior delegation of authority and an advanced care directive should be sought whilst the patient is still competent, and should be regularly reviewed. When an older person is incapable of requesting or refusing health care services, the views of family or a legally recognised guardian should be sought.

7. The resources allocated for the health of older people by federal and state governments should be reassessed regularly, in consultation with older people, as well as with health care professionals, providers of residential care, and carers.

8. Medical practitioners should encourage health service planners and funders to provide funding for the needs of older people and of their carers, and to consult older people on all issues which affect their needs.  

Home and community care

9. Community care, including domiciliary services for older people, is of crucial importance. Services should be matched to the needs of each individual, be comprehensive, linked to the medical services received by the patient, and co-ordinated at the practice level.

10. Services for older people should complement and enhance, rather than replace, the supportive care of family members and should, therefore, include respite for carers.

11. The role of individual carers, and voluntary and private organisations in the care of older people is to be recognised and encouraged, and not used as a substitute for deficiencies in the provision of government services.

12. The points of access to domiciliary support services should be easily identifiable and available to the older person, their carers and their general practitioner.

13. The AMA acknowledges the increasing use of team care arrangements. However, co-ordination of, and responsibility for, the health care of an older person should remain with their general practitioner with increasing use of practice nurses. General practitioners must be involved in the decision-making process relating to the care of their older patients, including involvement with Aged Care Assessment Teams, geriatric and rehabilitation services, Home and Community Care and other community services.

14. Medical practitioners should be able to authorise urgent access to government-subsidised aged care services. 

Residential aged care facilities

15. When an older person is no longer able to remain at home, a range of residential care options, which can cater to their physical and psycho-social needs should be available.

16. High level care in a residential aged care facility should be available to any person who is in need of such care irrespective of their financial position.

17. The application of standards for residential aged care facilities should enhance and improve delivery of resident care, promote efficiency and be practical.

18. The associated documentation should facilitate face-to-face contact or services by staff and medical practitioners. There should be close communications between general practitioners and residential aged care facilities including the capacity for remote electronic access to files by doctors. 

19. All staff employed in residential aged care facilities should be appropriately trained and be involved in continuing educational programs. 

20. Regular discussion of patient care issues between the patient's general practitioner and the other providers of care should be encouraged. Quality assurance procedures must be established in residential facilities to facilitate monitoring by medical practitioners of the clinical services provided to residents.

Hospital care

21. Older persons must not be denied access to hospitals on the basis of their age or because of their co-morbidities.

22. Hospitals should provide a designated geriatric medical service with beds for acute care, assessment and rehabilitation, according to their size and specialisation.

23. Medical practitioners with expertise in aged care should be an integral part of each hospital's service and be available for consultation and advise. 

Dementia and psychogeriatric care

24. Dementia and psychogeriatric care require access to specialised medical and other staff, and facilities, to complement geriatric services. The staff and facilities should be able to provide appropriate assessment and management, whether the older person is at home, in hospital or in residential care. Adequate staff must be available to provide quality care.

Elder abuse

25. Elder abuse includes physical, psychological or financial abuse or neglect and may be intentional or unintentional. It violates basic legal and human rights. Older people should be able to live in dignity and security and be free from abuse.

26. Carers should receive adequate information, education and support at the time the person is registered for care to reduce the risk of elder abuse.

27. Education and training programs on the recognition, intervention and management of elder abuse should be available to all health professionals involved in the care of older people. 

28. Medical practitioners, especially general practitioners, have a pivotal role in the recognition, assessment, understanding and management of elder abuse and neglect, with effective reporting mechanisms available when required.

Research related to the care of older people

29. Improvements in care will result from properly designed, analysed and reported biological, clinical and public health research. Resources should be made available by governments to ensure the funding of research programs that focus on age related issues.

30. As a matter of urgency, research, especially clinical research into age-related issues, should be encouraged and supported.

31. This research should be multidisciplinary because of the complex inter-relationships between genetic, psycho-social, environmental and economic factors causing dysfunction from disease, disuse, and the effects of biological ageing.

Health promotion and education 

32. Disability in old age is often influenced by prior lifestyle.

33. Health authorities, hospitals and community based services, should co-operate with general practitioners in developing programs to promote the optimal health of older people before disabilities develop. Programs should target high risk persons.

34. Undergraduate, postgraduate and continuing education of health care providers has an important role in promoting recognition of special needs of older people as well as the value of health promotion in reducing disability in older age.


Published: 31 Jul 2012