Royal Commission into aged care facilities

https://www.smh.com.au/politics/fed...n-should-ask-but-may-not-20180917-p50472.html
Well, who would have thought that in the year 2019 we have to have yet another Royal Commission, this time into nursing homes.
How long does Australia need to get things right...incompetence personified....
The 7.30 report on the ABC covered this fiasco tonite, and we were even given an interview with the illustrious Minister Ken Wyatt, who up to last weekend denied the need for a RC
Wyatt admitted that he received a report 18 months ago, but he was still working on it....
In a pretty lame interview Wyatt was let off for his lack of action by an amateurish
presenter...

Morrison announced the inquiry on Sunday, with the decision triggered in part by the Oakden nursing home scandal in South Australia, News Corp Australia reports.

The prime minister could no longer ignore the alarming number of aged care operators “flouting the law and putting lives at risk”. Well does that mean that he can ignore the "flouting of laws and putting lives at risk" up to a point..and then he decides to do something.
And this pos is leading our country

There was an 177 per cent increase in the number of aged care homes where a serious risk to residents was identified in the last financial year, according to new government figures
There was a 292 per cent increase in the number of facilities that refused to comply with rules.

“Walking by these statistics was not possible,” Mr Morrison said. “I want to be satisfied, I want to know how widespread it is.” The Oakden nursing home for elderly people was shut down last year following a damning report by South Australia’s chief psychiatrist highlighting ongoing neglect and mistreatment of residents.

Health Minister Greg Hunt has labelled the Oakden case “one of the greatest disgraces in Australian mental healthcare history”.
The royal commission into the aged care sector will examine whether nursing homes are unnecessarily turning elderly residents into “zombies” amid high rates of sedative medication use.

The first hearing is scheduled for Adelaide on Friday and commissioners Richard Tracey and Lynelle Briggs will outline their vision for how the inquiry will operate.

Their main task is to examine evidence of substandard aged care, abuse, systematic failures and draw up recommendations for improvement. The controversial practice of “chemical restraint” in aged care homes will also be examined.

Ian Yates from the Council on the Ageing said the practice is widespread and unregulated.
Why in 2019, is it still unregulated......ffs..shouldnt the blame for this be on the shoulders of the Minister....

“A lot of families will complain that their mum or dad, although frail, went into residential care still alert and within a month are like a zombie,” Yates said.

A University of Tasmania study of 11,500 nursing homes residents found that more than 60% are taking one or more psychotropics drugs.

Senior lecturer in dementia care, Dr Juanita Westbury, has been trialling strategies such as staff training to encourage homes to reduce dependency on medication.

“We found that de-prescribing or lowering doses did not increase behavioural symptoms of the residents, in fact some aspects of behaviour improved upon dose reduction, for example sleep and calling out, when antipsychotics were ceased,” she said.

“If someone can’t communicate because they are dozing in a chair most of the day, is that a good thing? If someone can’t eat their lunch because they are really a bit too disengaged because of the medication, is that a good thing?”

Some residents are on the medication for up to 12 months when they should only be on it for a few months, she said.

Aged care staff were often not aware of side effects associated with use such as a higher risk of falls, pneumonia and stroke, she said.

“Many of the staff believe that these medications are a lot more beneficial than the evidence suggests,” Westbury said.

Anxious or agitated behaviour sometimes masked underlying pain, discomfort from environmental factors such as heat or cold, or fear about certain activities, she said.

“It’s about proper assessment before you start on the drugs,” Westbury told Guardian Australia.

Labor’s aged care spokeswoman, Julie Collins, hopes drugs aren’t being used to make up for a shortfall of staff, programs and rehabilitation or activity sessions.

“I hope there are sufficient checks and balances and they are being used appropriately,” she said.

Yates expects resourcing will also be a big focus of the commission and hopes the interim report due by the end of October makes solid recommendations around funding in order to feed into the budget cycle.

He believes cultural change in the sector is needed, in particular the acknowledgement and willingness of facilities to learn from mistakes.

“Aged care has been a bit of a forgotten ghetto in this area,” he said.

Negative publicity around substandard care in the past year was already causing some people to delay entering facilities, Yates said.

He said the commission was likely to uncover “a few” more scandal-plagued nursing homes like the notorious Oakden facility which was shut down in South Australia.

Sean Rooney, the chief executive of the aged care industry peak body Leading Age Services Australia, insists the vast majority of services and their dedicated staff deliver outstanding care.

“The whole industry is judged by the behaviours of the participants in the industry. So where there is an issue of abuse and neglect … when they do happen it reflects poorly on everybody in the system,” he said.

The prime minister, Scott Morrison, announced the royal commission last year and warned the country is going to have to “brace itself for some difficult stories” Poor choice of words mr pm....you are the one overseeing this system....

Collins has spoken to a few families who will come forward with stories of abuse following the death of loved ones at nursing homes.

“One of the problems in the system is that people don’t have the confidence to make a complaint at the time; they wait until their loved one is deceased because they fear retribution,” Collins said.

The commission will hold hearings in February and March in Adelaide before travelling across Australian cities and regional hubs.

The commission’s final report deadline is 30 April, 2020
Opposition leader Shorten does not support the Royal Commission...he must think that everything ok....more incompetence....

 

We need a Royal Commission into Capitalism. Why a system based purely on greed and power is better than one based on the needs of the people.
We could investigate the banks again, insurance companies again, developers and construction companies like those of Opal Towers, the cotton farmers and the politicians. Now we can add the nursing homes, the list goes on.

They are all about greed, power and position. The entire system is based around looking after one's self, the motto should be "I'm alright Jack". It's not my problem, he should have been prepared, we have to compare the cost of making it off shore as the labour costs are less, and surely they would have employment insurance.
People die due to the greed of capitalism, I believe a significant amount of suicide is due to failing in capitalism. It is by its very nature inhuman, driven by greed and based around protecting your own R's.

 

Then of course we can't have groups of workers, unions etc. It gives them power.

What about the Banker's Associations and the Employers Associations and Manufacturers Associations?
Oh no we need them.
Why?
They give us more power.

 

My god this is horrible... they're drugging them, house of horrors

 

Once again, the question I ask is....
Its 2019...how long does it take for the politicians involved to get it right.
The RC will operate for another 12 months and its findings will be released in 2020. How long after that will it take for any changes to occur....the delay is just bloody ridiculous...12 months for RC, which goes from state to state..are they telling us that aged care facilities are somewhat different in every state...
Politicians are not attuned to any of these "real life' issues...they are asleep at the wheel.
My late father often said "bill, theyre just in it for the lurks and perks, they really dont do anything constructive....." how right he was......

 

I think the staff and management are running these places any way they want... if someone with no compassion is in charge, elderly residents are screwed. They definitely need oversight.

 

You dont need compassion to follow rules...just follow them....
The problem is, no rules...the 7.30 report stated we have no legislation regarding the use of restraints....
I repeat...no legislation...why not...dont politicans have enough brains to realise that restraints will be used from time to time in a nursing home...what about the elderly man/woman who falls out of bed...hhmm..he might need restraining...maybe a special bed with a safety rail around it, instead of a restraint...ffs its not rocket science........why is an elderly person locked into a chair with restraints....because there is no legislation setting out the manner in which, and the circumstances which restraints can be used.....
I remember many years ago reading the NSW issue of the Dividing Fences Act..briefly one could go to court and seek an order that a neighbour had to pay half the cost of the dividing fence...but until the Act was amended, the Court could not order a specific amount to be paid...and if the neighbour refused to comply with the "unspecified amount order" the applicant couldnt do a thing about it...
In brief, bad legislation, fuked up again...
But there is a difference between bad legislation and no legislation...and nursing home practices
in certain areas have no instructive legislation...in other words in some areas, the proprietors of each nursing home can do as they please......and people die.........

 

Honestly Billy, didn’t read the entire comment. So just my opinion that may or may not clash in many areas.


And I know those haters out there will try demonise me upon this…


We have Royal commission into institutional child abuse which has brought about the situation of apologising to all those abused children for the abuse and NOT LISTENING to them. We can blame many things, some chose a religious group some all religion. Some blamed government some blamed authorities. Put all these things together and you see that the entire community is to blame. Did we learn anything new from the royal commission??? NO, all that happened is that people could no longer ignore the atrocities that happened to the children of this nation…

We have a Royal Commission on financial sector, which brought forward the reality that the Australian financial sector was far more interested in working out ways to separate people from their money under legislation which legislated against many actions carried out. We found out that not only the financial sector actually proactively set out to break the laws of Australia, the bodies in charge actively ignored the situation and that penalties were insignificant and in some areas repugnant. Things not known??? No, it just put in front of everybody so they could no longer ignore it.

Both these Royal commissions alone have shown how people will continue to hide from the truth. We already have the anti-establishment movement trying to blame inanimate objects with human traits as some excuse. We have seen in the past, people excuse poor or even illegal actions due to their perception of lack of resources or funding or just complacency but never actually demand they are held to account.

So now we have a Royal commission into age care, possibly should be all institutional care I would suggest. It could be argued, I would agree, that disable care institutions should have their own commission, but that is another.

ALL a waste of money… Why??? Because we should not have to wait for government to tell us what we should be complaining about. We should not be waiting for government to tell us what we should be demanding to be fixed. We know there is major problems in this industry and we know there is a failure in processes, policy and authority to keep Australians safe and respected. WHY in god’s name do you need to have a multi-million dollar Royal commission to tell you people should go to jail over this???

Australian has inquires, studies and investigations into all these areas often. Millions paid to provide best of care. Millions paid to police and prosecute this area of care with the result of nothing. Now I know, those haters will sit there and justify such for lack of funds or resources but the truth is, it is because they really don’t care as it doesn’t affect them.

 

This is a perfect example of why conservative policy cannot work.

A purely conservative government would have no government intervention and very little regulation or control.

They work on the theory that people will stop using bad providers and use the better ones. The "Market" will regulate itself, providers will see that those offering the best quality get all the clients. Sounds good in theory but it just doesn't bloody work.

The bad facility is cheaper to run and the income is the same and profits go up.
The better facility gets a bigger share of the market, but the increase in costs to get a bigger share is not the same as the increase in income from having a bigger share so he makes less profit. He isn't happy about this and puts it up for sale.
The much lower standard but more profitable home buys out the other business.

 

As we see the haters have already started. While this is a serious subject they would rather play petty partisan politics than demand real and decent change…

BUT here we have one very fine example of what I talk of

https://www.abc.net.au/news/2018-11-02/bupa-aged-care-facility-in-south-hobart-fails-accreditation/10456122

How many care residences does Bupa run in Australia??? One or two??? Several complaints have been made around Australia and I do believe many have not met accreditation standards. This clearly is a endemic problem with management that needs addressing. Not just it must be a problem at this one place. No matter what you believe in this case, either you have to condemn Bupa management for not making sure decent service is provided or that they didn’t know what was happening in their business. I am sure the haters will work out some way to forgive them as they want to remain ignorant of the problems.

So they were found to be deeply lacking in this facility, what is the penalty???

https://www.abc.net.au/news/2018-11-02/bupa-aged-care-facility-in-south-hobart-fails-accreditation/10456122

No they talk about losing accreditation for one of their facility; no they are just not allowed to take new clients for a period of time….

Unbelievable, does Australia need a Royal commission???

https://www.abc.net.au/news/2018-11...-in-south-hobart-fails-accreditation/10456122
Why is it not that Bupa itself not losing its accreditation??? Force them to change the culture of poor management, poor service.

Hit the company where it hurts most the wallet, Because even though the haters want to make it political, the truth is care is reduced because demand for profit is correct.


The nation needs to stand up and stop these companies from cutting care for the mighty dollar. Stop allowing them hide their shameful practices into one centre who didn’t manage to hire the right auditor who just turned up for the coffee and check but actually did their job. Unfortunately for those accreditors they will suffer with lack of work until they toe the line. BUT hey, while nobody is saying anything everything is fine.

Just remember, someday it might be you in these centres. What you want to ignore now for expediency of you opinion is the acceptable level you live with.

 

It's a horrible, shameful situation which does need the airing brought by a Royal Commission.
Aged care now is in the hands of a number of powerful NH proprietors.
Deregulation of nursing homes has resulted in inadequate supervision of inadequately trained and motivated care staff by inadequate numbers of Division 1 nurses.
It's a business run for money, and the poor old residents care is a poor second.
Restraint (chemical or physical) is supposed to be approved by the residents doctor.
Physical restraints aren't allowed in Victoria- no bedrails, no tying to toilets or chairs. Don't know about other states.

 

I know the case you refer. There is issue that at some time they may require to restrain patients for their own and others safety. Last resort I would hope and constant supervision in place with alternatives provided in such circumstances. Serious issue in itself.

But the rest of your comment hits the nail in the head. Governments continue to regulate and soften needs of the industry. Happenstance, I am aware of several locations that have only one registered nurse in place for an entire centre. I cannot talk for the training for the rest of the staff but it is clear that this one nurse is incapable of 24/7 responsibility of the centre.

Corrupt practices??? I would suggest, governments continue to ignore the failings of this “industry” while trying their best to score points from it. We see people excusing the industry over lack of training due to lack of staff. This would be considered lack of training due to lack of resources.

I think we have to stop the talk which disassociates the reality of what is happening. We need to immediately stop referring to it as an “INDUSTRY”. Allowing governments, business and people to refer to age care as an industry allows people to disassociate themselves from the atrocities that are occurring.

A Royal commission is a waste of money and resources. Do we need to have it??? YES, it appears the only way to have people demand better is to bring all these bad practices together and bash them with it over and over, day after day. Before they will actually think “perhaps this needs to change”. Why in hell do we need these wastes of resources before good people will actually think, “this is wrong”??? Unfortunately we do.

 

Of course there should be a RC...
Im not disputing that......
My beef is why isnt there any legislation on the topic of restraints.
The aged care "industry" needs a shakeup.......but wait a minute......
...there has been 20 extensive enquiries and reports into how to improve the
sector over the past decade and their recommendations have largely remained just that...
...reports with no action....

OK...why havent the politicians acted on the reports and enquiries of the past decade
and LEGISLATED ON THE TOPIC OF RESTRAINTS.....
The issue regarding use/overuse of psychotic drugs will be handballed from nursing home
to doctors, and from doctors back to the homes...and from the homes to the various skills
levels of the staff within...obviously opinions will vary from doctor to doctor as to what dosages
are required for what patients....and of course the patients are not in the doctors surgery being examined...the drugs are prescribed in accordance with the information given to a doctor
on the phone.....
The result is that patients are drugged out of their brains
Why arent our hospitals in the same type of mess as nursing homes....
BECAUSE THEY ARE COVERED BY REGULATORY LEGISLATION....
Why isnt there legislation covering the use of restraints in nursing homes.....after 20 reports/enquiries
in 10 years....
Because, once again, politicians have been proven to be incompetent...

The Commonwealth has launched an independent review to determine how federal regulators failed to detect the scale of the issues at South Australia’s Oakden facility.

Critics of the aged care accreditation system have persistently described it as a “tick box” exercise that focuses too much on providers demonstrating compliance through paperwork rather than evaluating actual care outcomes.

Mr Wyatt said the review needed to identify any gaps or deficiencies in the Commonwealth’s aged care regulatory system which might have prevented the “early detection and swift remediation” of failures in care at the Makk and McLeay wards.

The review would look at the role of the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and the Department of Health.

Terms of reference for the review have been developed and independent reviewers will be announced in coming days, he said.

The review is to report to government by 31 August 2017.

The new review comes as the Commonwealth moves to implement a streamlined aged care quality framework from next year.

The proposed changes would see different levels of assessment and monitoring for providers depending on their history of compliance and nature of services.
So we just had a review due on 31.8.2017 and now we're having a Royal Commission....
This whole scenario absolutely reeks of political incompetence over an extended period of time....
How long does it take for our politicians to get it right....ffs.....

https://www.australianageingagenda.com.au/2017/05/01/review-aged-care-accreditation-failure-oakden/

 

Restraints… Just the tip of the iceberg. Working with patients in such places find many need restraint to be moved or to be treated. BUT restraining a patient for the convenience of carers should be outlawed with heavy penalties. But I get your point.

Unfortunately, government will only act when there are enough voices to force change. A Royal Commission will show just how much the people of Australia will respond and set the seriousness of the future of age care for the next 20yrs.

Partisan politics has helped to find ignorance in the system so successive governments can gloss over the issues. Shorten blames Morrison for inaction and greens can posture on their so called real care after they align their ideals with who should be look after and who should not, while Morrison points to the opposition instead of actually just standing up and saying lets change this for the better.… ALL of which comes back to the issue of the failure of people to stand up and say “THIS IS WRONG”

 

I could not have said it better

It is not incompetence but greed and corruption

 

You want a Royal commission into an economic principle, because people who operate within the principle are greedy and corrupt??? Now that would be a real waste of money and time. Of course you do know, it is the people within not the principle itself???
I laugh, but I do know it was only to draw response and here it is…

 

Well, call me old fashioned, but I wasnt aware of the deregulation...
Deregulation in Australia
The current Australian government, led by Prime Minister John Howard, is the only example of a simultaneous attempt to cut welfare, encourage rapid growth of private care by large corporate organisations, and deregulate nursing homes. In 2000, 55% of the new beds in nursing homes that were funded by the government were in the private sector compared with 27% historically. About 12% of the new funding for beds went to one provider, the Health Care Group which is owned by Doug Moran, a prominent member of John Howard's Liberal Party. The result has been a disaster both politically and in terms of policy
In the lead up to the 1996 election the Liberal Party promised the politically active nursing home industry that it would seek to make the provision of care in nursing homes more competitive and also increase the industry's income by introducing means testing and new admission fees. Additionally, then candidate Howard promised that he would shut down the state run standards monitoring process and replace it with an industry controlled accreditation scheme. Once in government, he also ended public funding of the Australian Pensioners' and Superannuants' Federation, which had been the leading advocacy group for improving standards in nursing homes, and cut funding to other non-governmental organisations in the belief that this would silence criticism of the accreditation scheme.

Prime Minister Howard's aspirations for trimming the welfare state and deregulating a private market are now in tatters. The government has been forced to backtrack by public opposition to means testing and paying fees in advance. Commonwealth funding for nursing homes increased by $A1.4bn (£505m; $715m) to $3.9bn between 1996 and 2000. The accreditation regime is still in place (now known as the Aged Care Standards and Accreditation Agency), but the government has been forced to double the amount initially allocated to support it, eliminating nearly all the savings made from abolishing the inspectorate. The government has maintained the integrity of the old standards monitoring process by continuing to make accreditation reports on nursing homes available to the public. However, when critics complained about the weak enforcement of standards and about nursing homes that were providing poor care the Aged Care Standards and Accreditation Agency removed its accreditation reports from its website so as “not to put undue pressure on homes” (in the words of the minister).5 This was another political disaster: a rogue website posted the worst accreditation reports. The secrecy of self regulation, which had led the United States to reject accreditation and self regulation, had become reality in the supposedly superior Australian accreditation system.
25.8.2001
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121038/

.Well, who woulda thought..........privatize the industry, but give 12% of the new funding to a mate....
Graft and corruption at its worst.......
Great work, Howard, you useless bastard......
This report is from 17 years ago.
Since then 20 reports in the last decade...and now a RC....
The government has failed miserably in this area....miserably...
https://www.uow.edu.au/~bmartin/dissent/documents/health/moran_nurshm.html#Defamation
Scroll down to 2000 to begin...interesting reading......

 

Remember when Bronwyn Bishop said aged only requires kind hearted older women?
Residents in aged care are complex- often with multiple co morbities which require skilled monitoring. Beyond the scope of kind hearted women without nursing skills.

 

They can use some restraints here in qld. My mother is in a very very good facility and they HAVE to restrain her in a chair at times otherwise she would break her hip. She has come close. They let her out to wander when they can supervise her but at meal times there is only the option of either using a restraint or risk her falling again.

 

I think pretty much anything would be beyond the scope of Bishop...
Couldnt run a choko vine over a sh1thouse....

 

I am going to be accused of being hateful again because again I am going to attack the system.

The capitalist system in it's purist form, is totally devoid of any consideration of the humanitarian aspects of governance.

Pure capitalism aims at minimal government. They get elected due to greed, they get into government for either reasons of greed and/or power. It cannot be because they care about the people, that is against their ideology.

Their ideology is that of self regulation, personal responsibility and a market driven economy.

Wonderful in theory but there is one floor .The system may not take into account the human factor, it is humans that control it.

The problem is this kind of system is much more likely to attract those that will exploit the system then those that have humanitarian ideals.

It can also turn good people with good intentions. Money and power control everything.

 

Ken Wyatt has just announced new legislation covering the use of restraints and the use of
psychotic drugs in nursing homes after he saw the 7.30 report last nite.
He said it disturbed him to see the report.
ffs...how long have you been in the job Minister.....(12 months)
You have prevailed over this issue for how long....
And at last you get off your big fat arse because of a report on the ABC, showing patients
strapped into chairs, trying to get around by pushing themselves with no help from anyone......with other patients sitting around like zombies...drugged out of their brains.....
You are a disgrace to Australia, and to your people (first indigenous minister)
You are out of your depth and the portfolio should be taken off you immediately....
(Mr Wyatt’s extensive knowledge working in health services, and as the assistant minister handling aged care issues, meant he was well placed to assume the role of Minister for Aged Care, Mr Turnbull said.)
BS
.

 

No, you’re not being called hateful because you attack the system. I call you hateful because you post your hate not only of me but in many places trying to portray something you’re not. We don’t have to look to your racist rants or bigoted replies or simply the fact if others don’t agree you insult and hide.

and here is why..

Now what you say is populist, not incorrect To a degree. IT is so populist it has even provided a terminology born from itself called “anti-establishment” . BUT the fact people want to simply point to an economic principle demonstrates a complete devoid of principles. In other words, you just posted the very point of a complete lack of conviction.

Comments as such sound like the people who want to ban guns because they kill people. They don’t seem to understand the concept that people kill people not the guns. BUT in Australia it is popular to support gun control so it is safe to do so. When confronted with the problem of supporting th populist ideal, nothing.



It is populist to stand outraged at criminals being dehumanised REGARDLESS of crime over the victims, because it is popular, in your face and easy to pretend humanity. Victims can rot in the gutter because there is no mileage in supporting the people who pay for the populist to sound like principled people.

We saw a Royal commission into institutional child abuse and all those feeble minded sat behind their keyboards to demean and humiliate the efforts of many to support the end of the act. As pointed out, some blamed religion, some blamed a religion, some blamed government while some blamed everything else (including the system). And what came of it???

Just the same with a Royal commission into financial sector, without pointing out the stupid efforts of some to marginalise the results, what will come of that???

Both find some band aid measures of compensation for the illegal acts and some token policy changes, but generally business as usual. Maybe rearrange the deck chairs but nothing of consequence to actually do anything.

Why??? Because Australians would rather blame a system, principle or anything else than people who actually commit the crimes and unethical behaviour.

IT all sounds good till you actually have to support your principles and beliefs. But hey we have some very good examples in Australian leadership of a distinct lack of convictions. Rudd??? Well who would know, rather spend his time trying to accumulate the most frequent flyer points in the shortest period it would seem. Did he have any convictions??? I don’t think so, his handling of the pink batts debacle demonstrated that. Now Gillard, Cannot deny her. That woman was strong in convictions and defended them to the end. I take my hat off to her for that, just was a terrible leader IMO. Abbott another strong candidate, but Turnbull. The most spineless leader Australia has ever had. Have a minister announce a policy, gauge reaction and decide what is the most popular. And now we have Shorten, we all know I say scum because he refuses to condemn domestic violence and violence against women for political expediency. Just like Wong voting down same sex marriage in a supposed conscience vote for political expedience stating “I can change from within” NO moral convictions at all.

So with leadership like that, who only look for the populist ideals so as to appear to be what they are not, how do we expect the ordinary people to act themselves?

I have stood many times on my principles and walk away from many lucrative deals and community projects over the wrong people do. Racism, bigotry, greed and corruption being major in those areas. People talk about standing in support and pushing for change until that time comes, then they stand on the other side and demonise those who stand for what is wrong. I grew up believing people would stand up for what is right, not what is popular but the truth is, if they can minimise the capability of people in some of the most repugnant acts they will. It takes GREAT courage to stand for what is right in Australia, not just talk about it anonymously.

Now, I know people pretend a lot of things, but this area of the board is so empty these days because nothing pisses an Australian off more than people who have no moral compass or conviction of belief preaching how they should be thinking.

Ergo, preaching hate is why you are called hateful.

 

Well I am pleased for you that you have set judgement on me. Not just on what I say ,but the motivation behind it.
I am pleased you have learnt enough to know me.

I personally couldn't give a rats at looking that close or to make assumptions ,because with all of your learnt knowledge, they are still just that. Assumptions .

 

And I usually say it in 100 words or less. I suppose it is depending on how much you need to push the point