Older people ageing at home face the highest risks

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While all attention has been on aged care facilities during the pandemic, those who wish to age at home may not be as safe as they think, according to findings from the aged care royal commission.

Around 3.6 million people will want to age at home by 2050.

Many say they don’t trust aged care facilities. Some say they can’t afford them. Others just prefer to live their lives for as long as possible at home.

However, people ageing in place are at higher risk of health complications, neglect, injury or even death at home, says NSW Ageing and Disability Commission chairman Robert Fitzgerald.

He told the commission that the absence of oversight meant the highest risk for older people in the aged care system was within the home.

“I know all of the attention focuses in on the residential settings and there are high risks in those,” he said.

“It’s not to say that people are more harmed or more damaged in the home, but without the line of sight that exists, the risks are higher.”

With insufficient advocates for older Australians; a high risk of elder abuse and neglect, and an absence of quality indicators or checks, successful and safe ageing in place will be a major challenge for the healthcare sector and the government in coming years, he told the commission.

“The reality [as we] get older is that not only do we become invisible, but our voice becomes unheard … It’s critical that the voice of the individual is heard and their preferences are acknowledged,” said Mr Fitzgerald.

The number of older Australians ageing at home will more than triple from the current count of one million to around 3.6 million by 2050, says an article in the Brisbane Times.

Add to that number three times as many in residential care – rising from 200,000 to 600,000 in the same period.

Based on current spending and support, Australia will not be in a position to support people with dementia and other vulnerable people in care at home without re-engaging the community, said Mr Fitzgerald.

“The notion that the community itself is part of the solution is something that Australia has lost. COVID has demonstrated, beyond any shadow of a doubt, that a society doesn’t function well when that’s gone,” he said.

“In the case of older people … neighbourhood connectedness is very important.”

Currently, the monitoring of aged care quality indicators in the home “simply doesn’t exist”, said principal research fellow with the South Australian Health and Medical Research Institute, Associate Professor Gillian Caughey.

Assoc. Prof. Caughey and her team are developing a set of quality indicators, which could be implemented within six months.

Former NSW Police deputy commissioner Rosemary Milkins used her 95-year-old mother Dorothy Urch as an example of why it pays to plan ahead for ageing in place.

When Mrs Urch developed dementia in her 70s, she told her family she wanted to “retain her dignity and her ability to live her own life” in a familiar environment.

She was able to stay at home for 17 of the 20 years she lived with dementia.

Her mother’s experience led Ms Milkins to understand the importance of planning a home adequate for older age.

Ms Wilkins said this included becoming familiar with available services early on, installing brighter lights in the home to cater for ageing eyes, and getting used to having helpers and carers around earlier so that doesn’t come as a shock after cognitive decline or eventual admittance to an aged car facility.

“I’m starting to, if you like, age-proof my home now, in the same way that you child-proof your home when you’ve got children around,” said Ms Milkins.

“We need to think about ageing before it gets to the crisis point.”

Have you started preparing your home for your later years? What types of arrangements or additions have you made to cater for ageing in place?

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Written by Leon Della Bosca

Leon Della Bosca is a voracious reader who loves words. You'll often find him spending time in galleries, writing, designing, painting, drawing, or photographing and documenting street art. He has a publishing and graphic design background and loves movies and music, but then, who doesn’t?



Total Comments: 27
  1. 0

    My wife is 78 and has a degenerative neurological condition (CBS). She is continuing to live a good life at home, with limited support from a not for profit aged care provider and some privately organised support as well. As far as we are concerned the last thing that we need is some external oversight intruding into our lives, undoubtedly with increased costs that we will have to cover. Leave us alone – apart from her CBS my wife enjoys good health, has excellent medical support and engages with our community as she sees fit. Please, no unnecessary regulation and PLEASE, no intrusion of the unregulated private profit making aged care industry into our lives.

    • 0

      Excellent response Buggsie.

    • 0

      The loneliness that many people have due to nursing homes is very real. I work in the industry and I’m so pleased to read your story.
      Unfortunately not all homes are like yours. Unless there is some kind of “ intervention” abuse including financial psychological, neglect Of basic needs will continue. As a carer who visits the homes we are bound by law to report any of this.
      So there still needs to be a form of monitoring to keep our most vulnerable safe.
      And as the theme goes if you are doing the right thing then you will be left alone.

  2. 0

    There in fact does exist quite strict monitoring of the home care system and there has been for quite some time. All the standards apply to all approved providers. The issue in the home care system is the fact that for many years the standards required for PC to work in this industry has been watered down to the point where they don’t really exist. Fast tracked courses for immigrants to get work has seen a marked decline in the home care industry and that is solely the government’s fault because they have allowed it. Then there are the laws which allow workers to get away with things like theft. We had a client who has had personal items stolen several times by different workers and the company did not report the worker or had her charged, but simply shifted her to a different area. The worker should be fired and in jail. So we also ensure through not enforcing companies to standards the voicelessness to increase! This ever increasing round of talk fests and finger pointing must one day surely end up in action?

    • 1

      What about the fact that significant sums allocated to home care are in fact being skimmed off through “management fees”. In many cases the bulk of funding is going to those fees.
      This is yet another case of privatisation not delivering to the community but only to a few.

  3. 1

    Given the state that all aged care services are in, due largely to the influence of profits to be made at the expense of the taxpayer, it is little wonder we oldies resist trying to access those services.
    A huge overhaul is sorely needed but given that the current party in power in Canberra put most of the aged care systems in place don’t hold your breath waiting.

    • 1

      You say people resist trying to access home care services. There are literally thousands of old people who are waiting for those services and many die before they get them!
      Have you not read the papers or seen comments on this on tv?
      This does not mean that I am advocating for the services. As far as I aware, most are a total rip off.

  4. 0

    Excellent! Now I have a choice between dying in misery at home, or dying in misery in a Home. Nobody plans for death as it is a forbidden subject.

    If you all stopped voting for right wing greed oriented governments, we might have some decent state-run facilities. For those on the Right who dismiss this, have a quick look at the Covid related deaths in State-run facilities, then check the private-run facilities. Not convinced? Then refer to the federal minister, and his agreement that the private facilities are definitely run for profit, not for care, and that is the Liberal policy.

    The politics of Greed, or the Politics of Compassion. Take your choice.
    (An unpaid advertisement from the moderate Left…)

    • 0

      Most people don’t plan in life.
      Situations change life happens. We make mistakes and rebuild our lives. Unfortunately elderly people when young never thought they wouldn’t be able to dress undress turn on the tapsIn shower not burn themselves dry themselves running out of puff just doing simple tasks but that’s what happens.
      Only when you care for the elderly do you get first hand insight into these things.
      As we age we become people with disabilities poor eyesight / hearing weakness of limb / muscles, poor memory.
      I’m preparing because I work in the industry.
      Getting a stair lift to my second floor moving washing line closer to the house organising easier access to my house. Throwing out unnecessary items. Buying safer newer car.
      This is the age where you need to prepare or family members will take over and we can’t stop them!!

    • 0

      Dying in misery at home or in a home are not your only choices Janus. There are other options besides succumbing to greed and politics, you just need to explore them.

  5. 0

    My partner has just secured a job in an Aged Care facility after more than 12 months trying to do so. Combination of age discrimination and no one wanting to give her a start due to ‘no experience’. Of course one follows the other, but hard to get someone who would give her a chance. She is a natural and connects well with residents. She has a very kind and caring disposition and has been an immediate hit with residents.
    It is a shame that ‘narrow minded’ personnel cannot see the ‘forest for the trees’, new ideas and new enthusiasm are always needed. Where she works are very professional and she is snowed under with study units at the moment, but will be a very skilled worker when finished.
    From what I can see, there is a turn around in the mind think of facility administrators.

  6. 0

    I am eligible for Home help, and my husband for a package 3. I have piles of information forms, booklets etc. All which I realize cost money. But at the end of the day the service is only as good as the actual service we the receive. Maybe because we did so much of our own house repairs etc etc, I find the charges way over the top. To me it does not matter that I don’tpay for these services, because someone does.

  7. 0

    My wife is in aged care for over one year now. Accommodation is adequate, very much shortage of staff, blend food but because of her total blindness caused by severe macular degeneration she can not participate in most of the activities.
    One month ago a man came in ton her room at 2 AM and severely attacked her and left her with bruises on the face and upper body. Because he was a dementia patient nothing could be done about it.

  8. 0

    Further to my earlier posting, we paid $550,000.00 to get her in and on top of that around $140.00 per day. You would expect something more for that sort of money.
    The facility manager in a meeting admitted “that the man had problems, but he was improving.
    The geriatrician specialist at the hospital where he was sent to made the decision that he was not allowed to return and that is all that was done.
    Aged care, it stinks!

  9. 0

    There is no other way for me other than aging in place. I live in a church independent living unit and if by any chance I am unable to get the services I will need I am prepared to go into the nursing section at the very end of life. This will only happen if I have extreme dementia. Our family has no record of having ordinary dementia. My great grandmother was at home untill she died at 98 in the middle sixties.

    • 0

      My Mum died last year at home, at my sister’s place, at 96 years of age. Went to see her every year and she just got weaker. Refused any more medications towards the end and died as she wished. Hope we all can go a similar way.

  10. 0

    Yes I’ve started the process of modifying my home for myself in old age; raising the level of elctrical outlets, grabrails in the bathroom and so on. However our local ‘tradies’ seem to see the elderly as an easy meal ticket, ripe for plucking; down here the smiling bastards are as vile as our politicians in ripping us off.

    • 0

      My sympathy Neil
      – we are doing the same using local handymen and plumbers. We are getting good service as long as we pay in cash. They do not to see a credit card or a checkbook but everything is done to our satisfaction. Stimulus money in action!

    • 0

      My home was built for the elderly and even the young family members love it. All homes shou k d be built this way.

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