Learn more about AgeFriendly Robertson
Saying aged care in Australia is in a crisis is stating the stunningly obvious. That's the easy bit. What is equally obvious is that the waiting for a government fix is futile. As we have seen with bushfires and so much other government responsibilities; better to leave it to the volunteers and private fund raisers.
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There have been 20 inquiries into aged care in 20 years. If you are hopeful for major changes from the current Royal Commission into 'Aged Care quality and safety', good luck. But you may have to put your ageing processes on hold for a while. Consider banking behaviour improvement since their Commission hearings. As a former NSW Commissioner said Royal Commissions are like a trip to the toilet. First there is a resounding report and then the whole matter is dropped.
So what is the current situation? Historically especially since World War II improvements in surgery and drugs changed hospitals. They have gone from places for sickness to places of hope and cure. Numbers of hospitals have increased the industrial world. Now most people have a hospital nearby. Pensions provided a way to assist older people to manage independently but they didn't provide a plan for the final stages of mortal life. Hospitals then became places for the infirm.
So nursing homes grew up to clear the hospitals. That is why they are called 'nursing homes'.
Though, as Atul Gawande points out in 'Being Mortal' 'The basic problem persists. This place (the nursing home) where half of us will typically spend a year or more of our lives was never truly made for us.' He continues, 'Medical professionals concentrate on repair of health, not sustenance of the soul. Yet-and this is the painful paradox-we have decided they should be the ones who largely define how we live in our waning days.'
A lot of what people want in their ageing years has nothing to do with medicine. Maintaining contact with friends, for example. So where is this going and how can we all make it better for our loved ones and ourselves? We need to look at some of the underpinnings of the current structures.
Firstly, the economic model is neither working nor sustainable. Secondly, options for care and services for ageing people need to change.
There is a myth, almost an article of fundamentalist faith that the private sector provides better and cheaper services than the public sector. Governments love this one because one thing they can regulate is where our taxes go especially to their lobbyists and marginal electorates.
And when there are problems they can always blame the service providers not themselves. Private providers skim off public monies to provide services at a profit.
Private companies argue that their shareholders demand huge profits so cutting costs of food and staffing increases profits. That is why a Journal of Nutrition and Dietetics found in 2017 the average food spend in Australian aged care homes was $6.08 per day.
In fact, calling aged care an 'industry' is insulting to the community. Several providers have closed down. Several 'not for profit' bodies are not a lot healthier, nor accessible considering their service charges. Governments are challenged by the size of the aged care situation. Some have called this 'a grey tsunami'.
The World Health Organisation calls this the most serious problem facing the world. More older people than ever in history; less people to look after them. Governments after decades of neglect crow they are spending more on aged care than ever before. Hello? More of course, there are more people than before, so naturally there will be more money needed.
But is the government getting the money out where it is most effective? Most needed? Is the current model working? Are there more options which are more effective? More productive and less painful? Are there unused resources in communities, especially among recently retired, able bodied, people?
What is clear that a huge bureaucratic system is not the answer. The future will be in smaller local hubs managed by local people.
The three challenges of nursing homes are boredom, loneliness and helplessness. Where nursing homes succeed is where they provide the closest sense of being 'at home'. The longer people have the option to actually stay at home the better. One of the Domains of Ageing well that the WHO has specified is appropriate housing.
The AgeFriendly Robertson group seeks to make Robertson a place where people can grow old at home among friends and relatives affordably. The coming forum on Robertson Housing and Accommodation will help address these needs by building a picture of what is wanted here for residents, and their relatives, to guide government, builders and newcomers.
We look forward to an inclusive, lively and constructive event. This will be held on February 29 at 3pm at the School of Arts. Refreshments and a gold coin donation for expenses. Details: 0428 456 273.
