In October 2022 we saw the introduction of the new AN-ACC funding model, which was implemented across all aged care facilities nation-wide. With this new model, we saw the constraints on Physiotherapy interventions lifted, allowing Pcare to expand its scope of practice across the board. Previously, Physiotherapy interventions were limited to primarily therapeutic massages and heat packs for chronic pain management. At Pcare, our Physiotherapy services have always aimed to provide maximal quality of life for our residents, ensuring the most optimal health outcomes are achieved. With the commencement of services under AN-ACC, our Physiotherapy services now focus on patient centred care. All residents are now able to choose what form of therapy they would like, in line with Standard 1 of the Aged Care Quality Standards: Consumer Dignity and Choice.
For the transition from ACFI to AN-ACC, Pcare set about developing a new model of care to better assist our clients through the provision of evidence-based treatments to their residents. Following several discussions with members of our senior management team, our Physiotherapists on the floor and most importantly our clients, a new model was formulated: Restorative Care and Reablement.
The Restorative Care and Reablement model revolves around goal-oriented therapy. That is, listening to our residents, assessing them in a collaborative manner and identifying their personal short and long-term goals. I think there is always a common misconception that those in our elderly population don’t really have goals, especially once they have booked in at a residential aged care facility. Knowing that we are no longer limited to pain-based therapy, our Physiotherapists have been able to broaden and expand on their assessments, to help identify our residents’ primary impairments, and what we can do to help them reach their goals.
From more personal experience let’s take Mrs J as an example. Mrs J was admitted to a facility I was overseeing post left Neck of Femur fracture. Following a brief period in rehab, Mrs J was transferred to the facility as a “Full Hoist” meaning she was unable to weight bear when moving from one surface to another. Prior to her admission Mrs J was very independent and mentioned that her dignity and independence were the two things she cared about most. She told me that if she could just get back to walking, even just a few steps from the bed to the bathroom, it would mean the absolute world to her. From an ACFI point of view, Mrs J would only receive treatment to help target any pain associated with her hip fracture. A massage a few times a week and perhaps a heat pack.
Following the implementation of the Restorative Care and Reablement model, Mrs J was assessed for her impairments and goals in collaboration with both herself and her son. Considering her lower limb weakness, general deconditioning, and ongoing pain post-surgery, a clear impairment list and treatment plan was formulated, keeping Mrs J’s goals in mind the entire way. From bed exercises to functional retraining which focussed largely on sit-to-stand practice and weight bearing exercises, Mrs J was shortly on her way from bed bound, to completing transfers with the assistance of care staff. With each day, Mrs J regained her confidence and character, and before I knew it, she was back to mobilising with the assistance of 1 staff member and her 4-wheel walker. Proud would be an understatement when I draw back on this resident interaction. Realising that all residents from this precious population can now finally receive the comprehensive treatment plans they need really does put a smile back on my face.
From all reports received, we have seen a real change in the way that our Physiotherapists go about their days. A revamped and newfound energised approach has seen our residents being provided with the best possible Physiotherapy care, which has been praised by facility management and family members throughout. Our therapists continue to complete comprehensive reviews and assessments of all residents, whether they be mobility, pain or general in nature. We continue to provide our aged care provider partners with up-to-date education and mentoring sessions, as well as frequent manual handling presentations to ensure all aged care staff remain confident and up to date with their workplace requirements.
Given that it’s only been half a year since the AN-ACC transition, only time will tell what the future holds for Aged Care and Physiotherapy. Physiotherapy is a paramount service in Aged Care, and hence why at Pcare, we Care.
Sai Sivayogarayan
Clinical Manager
Physiotherapists Aged Care
May 2023