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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