In 2016, the Australian Government announced it would establish Specialist Dementia Care Units (SDCUs) to support people who experience very severe behavioural and psychological symptoms of dementia (BPSD).
Many of you who read this blog will know, I don’t believe in BPSD, and in fact, feel strongly against this term, and the very negative labels it provides. Many others are also questioning it now, and there is emerging evidence it causes more harm than good. But that has been written about before, and at this point, is irrelevant to this consultation, so I won’t focus on it.
The Australian Government has committed to establish at least one Specialist Dementia Care Units in each of the 31 Primary Health Network regions. Specialist Dementia Care Units are intended to complement similar existing and planned state and territory government investments in services for people with very severe behavioural and psychological symptoms of dementia (BPSD).
For now, I actually believe we currently need these units, only because BPSD is so entrenched, and the lack of quality care in responding to the needs of people with dementia is what has caused this need.
Dementia Alliance International will probably submit a response, so if you want to provide us with any feedback for that, please send it to email@example.com by 15 January, 2018. See below a brief outline of why they are being set up, and the questions to consider.
Individual submissions to the consultation paper are also invited through the Department’s website by 21st January 2017.
You can download the consultation paper from their website Specialist Dementia Care Units consultation paper November 2017
SPECIALIST DEMENTIA CARE UNITS
Why are SDCU’s being set up:
SDCUs are being established to:
- provide care for people with very severe BPSD who are unable to be effectively cared for by mainstream aged care services due to the risk of harm they present to themselves or others
- deliver care within a dedicated 8–12 bed unit with a residential aged care setting
- offer transitional support that focuses on reducing or stabilising symptoms, with the aim of enabling the person to transition to a less intensive care setting
- operate as the ‘third level’ of Australian Government programs to assist people with dementia, complementing the existing Dementia Behaviour Management Advisory Service and Severe Behaviour Response Teams
- enhance the existing health and aged care service systems for people with very severe BPSD, including complementing state and territory government funded services and supports for people with BPSD.
The consultation is aiming to address the following issues (please read attached consultation paper for more context to these questions).
Q1) Are there are other system reforms that would impact on, or be impacted by, the establishment of Australian Government-funded SDCUs?
Q2) What other risks and issues need to be considered in introducing SDCUs into the existing service systems for people with very severe (tier 6) BPSD?
Q3) Are there alternatives to the establishment of SDCUs that would better address the current system issues, which should be considered by Government?
Q4) Do you consider 1,450 to be a reasonable estimate of the national demand for SDCU-like beds for people with very severe BPSD? If not what other factors and/or methodologies should be considered?
Q5) Are the proposed SDCU service principles appropriate? If not, how should they be amended?
Q6) Are the above benefits what SDCUs should be aiming to deliver? If not, why?
Q7) What are the pros and cons of the SBRT performing the SDCU assessment service role? What other body (or bodies) might appropriately carry out this role?
Q8) Might the requirement for evidence of a primary dementia diagnosis (as described above) impact on timely access to SDCU services for some people with BPSD?
Q9) Are the proposed assessment arrangements appropriate? If not, why not?
Q10) What other factors should the SDCU assessment service consider in deciding whether to recommend a person for a SDCU placement?
Q11) Is an 8–12 bed unit (within a larger residential aged care facility) the appropriate care setting for SDCUs? Are there circumstances in which larger or smaller units would be more appropriate?
Q12) Should there be a maximum limit on the duration of an individual’s residence within a SDCU? If not, why not? If so, how long?
Q13) What is a reasonable period for transitional support from a SDCU to the new accommodation provider?
Q14) Might existing security of tenure arrangements pose a significant issue for the ‘transitional’ operation of SDCUs? If so, how?
Q15) What strategies could be used to facilitate SDCU ‘throughput’ within existing security of tenure provisions?
Q16) What mechanisms should be used to support partnerships between SDCUs and acute services?
Q17) Should there be any additional requirements for SDCU providers caring for people from Aboriginal and Torres Strait Islander, CALD or other diverse backgrounds?
Q18) Would it be feasible to establish SDCUs in rural and remote locations? How can SDCUs (or alternative initiatives) best support people with very severe BPSD living in rural and remote areas?
Q19) What specific costs would contribute to the ‘top up’ amount?
Q20) To what extent might these costs vary across SDCUs, for example in response to geographic location or local mix of people with BPSD?
Q21) Which ‘top up’ funding option do you prefer? Why?
Q22) Are there other funding mechanisms that should be considered?
Q23) Is block funding, occupancy-based funding or a combination of both most appropriate for SDCUs? Why?
Q24) Are the proposed uses of ‘top up’ funding appropriate or should there be other costs included or excluded?
Q25) With no specific capital funding for SDCUs proposed – is there a minimum funding period to justify an operator investing to establish a SDCU?
Q26) Do the proposed provider funding arrangements pose any financial sustainability risks?
Q27) Should any special resident fees and payments arrangements apply to people receiving care in a SDCU?
Q28) Are the proposed provider selection criteria appropriate? Do you consider some selection criteria mandatory?
Q29) Which factors should be prioritised in determining the regional rollout schedule and why?
Q30) What factors should be considered in evaluating the SDCU program?