As baby boomers retire over the next twenty years, what impact will this have on the delivery of aged care services?

Forecasts of the impact of ageing baby boomers point to problems in the provision of aged and community care in Australia, particularly as the expectations and needs of baby boomers differ from previous generations in many areas. They will expect retirement villages to provide a ‘lifestyle’, with extra services such as upmarket dining, Internet access and two-car garages, testing the designers of future aged care facilities. There will also be demand for additional community-based care, ensuring that more people stay in their own homes for longer.

Unfortunately, research has shown that baby boomers have reduced overall superannuation, due to introduction of the compulsory super scheme late in their working life, and they are less likely to plan for retirement. Consequently, they may need to fund their retirement by selling their home, rather than leaving it as an inheritance, which will impact on the following generation.

Australia currently has about 2,800 residential aged care facilities providing care to more than 160,000 elderly people. Over the next ten years, the number of residents is projected to reach more than 250,000 and the highest area of growth will be among residents aged 95 or over.

One of the key challenges for the aged care sector is in relation to dementia, which is the major reason that people seek admittance to residential aged care. It has been estimated that around half of aged care residents suffer from dementia and that the number of people who develop the condition will increase from 220,000 currently, to 730,000 in 2050. As a result, the high-care proportion of residential aged care is going to need to increase dramatically to keep up with demand, requiring a skilled health workforce incorporating medical, nursing and allied health professionals, carers and assistants.

In comparison to these figures, nursing statistics are bleak. According to an Access Economics report published late last year, in the four years between 2003 and 2007, the number of registered nurses in aged care within Australia fell from 21 per cent to 17 per cent, enrolled nursing numbers fell from 14 percent to 12.5 per cent and allied health workers fell from 7.6 per cent to 6.6 per cent. The average age of aged care nurses is now around 50 years and they are increasingly required to supervise more residents and more staff members across multiple sites, despite being paid at least 10 per cent less than their public-hospital-based colleagues.

According to Adjunct Professor Belinda Moyes, Chief Nursing Advisor, when planning for services, we need to stop saying that ‘We need x number of nurses, x number of carers for this group of clients or residents,’ and we need to start saying, ‘What are the clients' needs, what skills and competence do we need to care for this group of clients, who has the skill and competence and who could acquire the skill and competence to manage the care more efficiently and effectively?’.

Back in March 2009, the Because We Care campaign was launched by the Australian Nursing Federation to raise awareness and recognition of Australia’s aged care nursing and care workforce. It focuses on balancing skills and nursing hours, including pushing for the introduction of minimum staffing levels, recognition of the professional skills of assistants in nursing and care staff through a national licensing system, and ensuring that taxpayer funding is used for the nursing and personal care for each resident. It also highlights the inequality of pay for nurses and carers working in aged care, which has lead to a substantial decrease in aged care nursing numbers.

In May, the Budget 2010 delivered on some of these issues, pledging a $60 million education incentive for aged care nurses, assistants in nursing and personal care workers to upgrade their skills, encouraging them to stay in the aged care sector and deliver high-quality care. In addition, almost $19 million was allocated for 25 nurse practitioners to work across 100 nursing homes, and a national licensing system will be introduced for assistants in nursing and personal care workers to recognise their skills, while ensuring high standards of care, safety and protection for residents. According to Ms Ged Kearney, Federal Secretary of the ANF at the time, ‘You can’t fix the problems in aged care overnight, but this budget is a great start.’

Rather than basing the future of aged care on the requirements of the current generation, the aged care industry must anticipate not only the needs, but the expectations and attitudes of baby boomers, who are well-informed and know their rights.

By Bridget Willett