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In a reflection in Saturday’s Age (11/5) Merle Mitchell explained that institutionalization in aged care left her without a home. Institutionalized care can mean a loss of social networks and community. In her opinion, there was the feeling that death would be a better resolution for everyone. Fortunately, though, she did not lose contact with all her friends, and that helped preserve her “cognitive capacity”. She presses the case for a counsellor for all residents and for staff. And suggests that if the effort was made to keep residents engaged that may enable stimulating discussions on all manner of issues. Merle also enjoys extra exercise half an hour a day, but that is an ‘extra’ that has to be paid for ($50 a day). Many cannot afford it. In the end, some of the biggest problems are the lack of ratios, and of personal control over everyday life. With ‘institutionalization’ you get up when you’re told to; you eat when you’re told to; you go to bed when you’re told to.

Merle’s story is one of an extraordinary number being considered by the Aged Care Royal Commission. Unless the process is somehow corrupted the Commission will almost certainly advocate for better ratios for nurses and staff. It will consider the quality of food; the provision of privacy; the provision of mental stimulation – whether through discussion of politics, philosophy, religion; or if you prefer – a discussion of the football; and remembrances of years past. Just sitting people in common rooms to stare at televisions is not the answer!

Better ratios would mean more time to dress and wash in the morning. It could help ensure residents stay healthy and actually eat their food. Gentle exercise should be provided for everyone capable – regardless of cost. There must be a wide range of books, and increasingly internet access as well. A nurse on site 24/7 is crucial in the case of emergencies. And morphine must be made available to the dying. (I have been told it’s only available in hospitals). There must be outings for those capable. And preferably facilities must include gardens where residents can relax and be at peace. Personal choice must be extended as far as possible.

At home care must also be a viable option and there has been progress, but some are still left waiting too long for packages. Staying at home in familiar surrounds full of memories is very important. But again maintaining social engagement is crucial. Including several outings a week; taxi vouchers; gatherings with like-minded individuals; in short – general quality of life. The support of family is crucial in all this, but some families neglect their elders (and some lack family as well), and in such instances, communities must step in to provide support and affection. Obviously, not everyone can do that work; only people whose hearts are ‘in the right place’.

A lot has been made of elder abuse recently. And there are some shocking stories. But Conservatives prefer to focus on individual instances and deflect attention away from SYSTEMIC ELDER ABUSE in the form of insufficient regulation and funding. So far in the current election campaign, neither side has had anything much to say about Age Care reform, and provision of extra funding. The initiatives suggested here are crucial to the well-being of our loved ones; but they come at a cost: probably billions a year. Meanwhile, Conservative PM Scott Morrison focuses on tax cuts for the already well-off and thinks he can hoodwink us with mantras on ‘economic management’. Those tax cuts will also mean austerity; some of which will hurt the poor and vulnerable.

Sometimes Aged Care workers (mainly women) need better training; and to retain the best workers a Labor government should subsidise Aged Care worker salaries – as it is doing with child care workers. It can be a gruelling job, but it is one of the most important jobs of all to care for the most vulnerable of all. Loved ones we would not forsake for all the world. Those workers need respect, and they need support.

Labor is bringing in money from tax reform; closing loopholes and so on; but is not yet committed to significant aged care reform. Beyond already-mooted reforms, it is emphasizing its attempt to outbid the Coalition on a Surplus. But when the Aged Care Royal Commission hands down its findings it must urge Labor to somehow dedicate comparable funds to those made available for the National Disability Insurance Scheme (NDIS). (Assuming Labor wins the election). Even if it means imposing a dedicated-purpose, progressively structured levy. The political parties have treated this issue like a political football for over a decade. That has to stop, and we need real action on Aged Care NOW.

Shorten is beginning – tentatively – to ‘break the mold’ – on small government. The sufferings of the aged; and their need for love and dignity is too important to again “leave it until next time”. Morrison is a hypocrite; parading his ’Christian credentials’ while preferring tax cuts to caring for the vulnerable. But Bill Shorten needs clarity and resolve. It is an argument he can win. We’re talking about our loved ones here; and possibly of our own futures. Bill Shorten must foreshadow the necessary commitment of resources now; or he must support an immediate shift of policy on funding, ratios and standards following the Aged Care Royal Commission. Lack of funds amounts to the systemic abuse of our elderly. Elder abuse cannot be ‘fixed’ without the provision of extra billions every year.

Aged Care Reform NOW!

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  1. Dr Tristan Ewins

    Could someone pls help me with this? I tried to publish in the Social Justice section but it’s not showing up. I also want to delete the second (small) image ; but can’t work it out.

  2. Dr Tristan Ewins

    it shows when you click on ‘Social Justice’ ; but it doesn’t show up in the list of articles when you scroll down the main page.

  3. paul walter

    So many tens of $billions have already been offshored that it is a wonder the ALP proposes even the modest program it does.

  4. paul walter

    Don’t worry Tris, it’s up where I am or I read it in my sleep.

    It’s the substance that is important.

  5. Kathy

    Hi Dr Tristan Ewins. I’m taking care of the AIMN at the moment, I will have a look to see what I can do.

  6. Dr Tristan Ewins

    Thanks Kathy ; I hope some one can take care of promoting the article also as usual.

  7. New England Cocky

    Uhm … what about NDIS recipients who remain compus mentos and have the ability to organise their own NDIS provider services? This would increase the amount of funding of recipient preferred services by reducing the seemingly very expensive present provider organisation NDIS services.

    I am advised that there is a trial programme in Frankston Vic looking into this useful and financially sensible alternative to profiteering by NDIS Provider organisations. Perhaps it should be replicated elsewhere. Many recipients have managed careers or businesses successfully before retirement and certainly would not have lost the skills necessary to ensure that they personally get the best deal from provider service organisations.

    Otherwise it is just like the NDIS providers are shooting fish in barrel, with the persons for whom the NDIS was initiated by the Gillard Labor government simply giving provider organisations a guaranteed income stream for minimal effort.

    A nice scam likely set up by a bank that knows the cost of everything and the value of nothing.

  8. Kathy

    Those other images just needed to be removed from the gallery and just keep the one for the featured image. Also, I think selecting the Social Justice category should display it in the Social Justice section on the front page automatically.

    It might just take a bit to come up there. Yes, It will be published out to Facebook AIMN and shared out to groups.

  9. Kaye Lee


    John Howard’s Aged Care Act 1997 was responsible for many of our problems.

    How John Howard contributed to the aged care crisis

    One of the real problems is the funding is not attached to the resident. In education, when we get extra funding for children with special needs, it is spent specifically on support for that child. Not so in aged care. They have a rating system dependent on the needs of the aged resident but that does not in any way relate to extra support for that specific person. My mother is in an aged care home – her rating is High in all three categories of need but she gets no extra care. She is in a dementia ward where most of the residents are two-assist meaning it takes two people to help them dress, shower, toilet etc but there are only two AINs rostered on which means there is no-one helping or supervising the others. I have argued till I am blue in the face that her ward needs more staff and I have done the sums on how much they get for these high care residents. With the government subsidy and the daily fee that mum pays, they are getting more than enough just from her for another staff member. One general manager had the hide to tell me that I don’t understand how big their electricity bills are. I wanted to punch her and I am a non-violent person. I burst into tears instead.

  10. Dr Tristan Ewins

    Kaye Lee ; we got my grandma into the best place we could find that we could afford. Still there weren’t enough staff to ensure she ate. Mum went in just about every day for that purpose. When grandma was dying we were told they couldn’t administer morphine ; but my Mum kept insisting; and in the end the doctor relented. Basically there was just a common room where people were sat down every day. But at least we got grandma a private room with her own phone. Compared with other places we’d seen that was ‘luxury’.

  11. Karen Kyle

    Hi Tris…..this has been a big problem for as long as I can remember. Not enough money. Too little spent and too much going into the operator’s pockets. It is a wretched situation and a situation where the profit motive is just plain immoral.

  12. king1394

    We tried to keep our mother at home and ran into a strong opposition to this from the Aged Care system and community nurses. It seemed everything we did was wrong. For example my mothers eldest grandson and his wife agreed to live with her and see she ate her meals and took her medication. The aged care nurse seemed to think there was the possibility of abuse. My mum had dementia and did not recognise modern currency so when she said she had no money he took it that she was not getting enough money from the family for her needs. The aged care nurse disapproved of our keeping the gates out of the mums property locked even though mum would wander onto a busy road. Eventually he called in the Guardianship Board and we the family had to attend a hearing , (which we won for what it was worth.)
    Among the major mistakes we made was taking mum to casualty every time she had a fall. That put us onto some sort of secret watchlist, it seems.
    The funny thing was, after we got her into an aged care place, mainly due to this harassment, she didn’t have anyone helping her to eat, and, although she fell just as often, no one felt the need to take her to casualty. And she was in a locked ward.

  13. wam

    my gentle lovely mum developed dementia and would do crazy things like jump out of the car at traffic light and run away. Once she wanted money so I took her to the bank and she got out $200 then looked at me and said to the teller no he’ll steal and gave it back. We she got violent she went to a home where if a patient looked at her she would punch his lights out or undress him.we bought her a big luxurious chair which she couldn’t get out of quickly giving victims some time to escape but she was close to 1:1.It was no reward visiting her behind sets of locked doors with large powerful nurses.
    I am almost the age my mum’s brain slipped and the thought of subjecting my kids to such experience is scary but as luck would have it they are prepared to take the task on.
    The may be a chance for penultimate year nurses to take a years leave on work experience in the homes with a year’s hecs debt relief???

  14. ChristopherJ

    Thank you Tristan and others who’ve commented. I ‘manage’ 85 yo Uncle John (Dad’s bro), who has been in care for about 18 months (bipolar, early onset dimentia…, old),

    My view of the sector is that it is broken. The profit model does not work as it reduces ratios to the bare minimum, regardless of the income side and capacity to employ more clinicians, for example. The daily activities are a joke (bingo ffs) and people are left in their rooms or set up in front of the tv, the same as I set up my children so that they would be quiet.

    When a huge sector like this becomes useless in its job of care, all the assets (every single nursing home) should be vested in the State and the staffs all become public servants.

    The current model separates state from the patient, removing the accountability and responsibility – just as intended.

    Yet the RC will show that the government and the Parliament is responsible for the mess, not the operators. Companies do what companies do, so we should not be surprised that the corporate outcomes of care do not meet the standards we expect for our elderly.

  15. Glenn K

    Kaye Lee, i am so sorry to hear how badly your mother is neglected. Shameful in such a rich country.
    To the article…. $50 per session for 30 minutes of exercise?? That is criminal at a number levels. My Australian mother living in Canada in an aged care home….. i pay $12.50 per session for a music stimulation class which lasts for 60 minutes. It is a sing along class led by a woman with an acoustic guitar who takes song suggestions from the 6-10 residents that attend, then leads them singing it. This is for dementia patients because apparently music is good for cognitive engagement, etc. $12.50 for 60 minutes! My mother loves it. She has dementia so it’s almost like every class is the first one, and she always suggest a Frank Sinatra song! This isn’t rocket science. It’s about what is more important, profit or care.
    Interestingly, when i visit her home, most of the nursing assistants (and about half of the RN’s) are from Phillipines. Why? Apparently the government has an agreement with a university to provide working visas and residency permits for suitably qualified staff. They cannot get enough trained Canadians, or locals interested in that as a career path. So i am told. The staff are brilliant, and really focused on providing quality care. Interesting.

  16. Keitha Granville

    My mother died 7 years ago – in her own home, thank heavens. She fought against going into a care home and I believe she allowed herself to slip away when she knew it was imminent. We had wonderful day carers, but she really disliked needing people to provide personal care. I am so relieved she didn’t suffer any indignities in care. It must be absolutely dreadful for families to know that their family member has been neglected at the least, and abused at the worst.
    Why do they have to be treated like cattle? Why don’t they have the ability to enjoy the life they had at home in a place where there is help if needed, but some level of autonomy ? It should be possible.

    Perhaps those responsible for delivering the care, and politicians who legislate, should spend some weeks as residents, being fed the same, and treated the same – maybe there would be a lot of changes !

  17. Dr Tristan Ewins

    pls share this on facebook to get the message out.

  18. Aortic

    Just read a submission to SMH letters from a fellow I know who admitted his mother to an aged care institution. It was administered by a medical officer he knew who had retired. He was happy with the care until the institution was handed over to a well known privatised brand. Their ” man”, his words not mine, stated they ” were going to do more with less.” He discharged his mother from the facility the following day in fear that his mother would be a number rather than a patient with consequences for her care if profit had prominence over appropriate nurturing.

  19. Peter F

    Reading all these sad stories makes me realise just how fortunate I am that I live near a small country town (under 5000) with a community run aged care residence. It is not-for-profit, and puts all earnings into service. My mother lived there until she died in her own bed just weeks before her 99th birthday. The care from staff could not have been better, with a strong relationship allowed to develop between staff and residents.

    I believe that when service is placed above profit, wonderful things can result.

  20. Freethinker

    I just wonder if it is a matter of only funds or is more about the moral values of those responsible to take care of the old and sick.
    I have a relative over 90 years old that is resident and under care, on a Freemasons, Masonic care facility in the Sydney region and their care and services providing to the old are second to none.
    They receive the same funds by the government that the other institutions so how we can justify the problems are funds related?
    Comments are appreciated.

  21. Phil

    Harry sums it up. The treatment of our old has got five fifths of seven eighths of FA to do with funding. When my mother who is ninety can no longer wipe her date and starts to dribble eating her porridge, she will come and live with my wife and I. At the moment she is happy where she is. Children that are too busy for their parents welfare are shit bags end of. I don’t blame anyone except for the children of old people that are being abused in old peoples homes. It is just an extension of how we treat single mothers, the unemployed, the sick and people with disabilities. Yes there are exceptions yada yada yada.

    Harry Chapin – Cats in the Cradle

    A child arrived just the other day
    He came to the world in the usual way
    But there were planes to catch, and bills to pay
    He learned to walk while I was away
    And he was talkin’ ‘fore I knew it and as he grew
    He said, I’m gonna be like you, Dad
    You know I’m gonna be like you
    And the cat’s in the cradle and the silver spoon
    Little boy blue and the man on the moon
    When you comin’ home Dad?
    I don’t know when but we’ll get together then
    You know we’ll have a good time then
    My son turned ten just the other day,
    He said “Thanks for the ball, Dad, come on let’s play
    Can you teach me to throw?”, I said
    “Not today, I got a lot to do”, he said, “That’s okay”
    And he walked away but his smile never dimmed
    He said, “I’m gonna be like him, yeah
    You know I’m gonna be like him”
    And the cat’s in the cradle and the silver spoon
    Little boy blue and the man on the moon
    When you comin’ home, Dad?
    I don’t know when but we’ll get together then
    You know we’ll have a good time then
    He came from college just the other day
    So much like a man, I just had to say
    “Son I’m proud of you, can you sit for a while?”
    He shook his head, and said with a smile
    “What I’d really like, Dad, is to borrow the car keys
    See ya later, can I have them please?”
    And the cat’s in the cradle, and the silver spoon
    Little boy blue and the man on the moon
    When you comin’ home Son?
    I don’t know when but we’ll get together then, Dad
    You know we’ll have a good time then
    Now I’ve retired, my son’s moved away
    I called him up just the other day
    I said, “I’d like to see you, if you don’t mind”
    He said, “I’d love to, Dad, if I could find the time
    My new job’s a hassle and the kids got the flu
    But it’s nice talkin’ to you Dad, it’s sure nice talkin’ to you”
    As I hung up the phone it occurred to me
    He’d grown up just like me
    My boy was just like me
    And the cat’s in the cradle, and the silver spoon
    Little boy blue and the man on the moon
    When you comin’ home, Son?
    I don’t know when but we’ll get together then Dad
    You gonna have a good time then
    Songwriters: Sandy Chapin,Harry F. Chapin
    © Warner/Chappell Music, Inc.
    For non-commercial use only.

  22. Dr Tristan Ewins

    There comes a point where families can’t cope anymore. First class care should then be available for everyone as outlined in this article. My Mum went to see my grandma every day and make sure she ate her food. Grandma lived with us for a while, but in the end we needed help. The staff were kind – which was something ; and we managed a private room with a phone. Other nursing homes – including run by the Salvation Army – were appalling by comparison.

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