As a community we hold views of what residential aged care should look like; our understandings largely driven by a perception shaped in the last century and is perpetuated by the marketing divisions of aged care providers.
The provision of residential aged care in Australia is a highly regulated space, where funding is tight, making margins very lean. On the whole a very large component aged care has moved from residential facilities into people’s own homes.
To keep costs contained, the nation has developed a highly sophisticated system of organisations providing all kinds of supports and assistance in a person’s own home. These organisations have teams with specialist skills that are highly mobile and agile at providing the services required for people to remain in their own homes as long as possible.
Over the last couple of decades service providers have grown from tiny little community start-ups to organisations turning over many millions of dollars per annum.
So, in the meantime: what has happened to residential aged care?
Residential aged care have become places which people enter much closer to end of life.
It is strange when you enter a facility built in day the 1970’s, which may still have a large common room with a small kitchen as a focal point. The kitchen designed for service users to make their own cup of tea and perhaps a sandwich for their family when they visit. It is ironic as the kitchen lays dormant, often filled with clutter, due to service users largely not even having enough independence to make a cup of tea.
This, along with current writings, highlights the increasing gap between what WE want for our older people and what they actually need.
The average age of a person entering aged care (entering!) is over 79 and they often now have multiple morbidity including cognitive decline.
The reality of their care needs is getting closer and closer to hospital care yet our generation insists that mum wants to live her final days in a flash hotel-like built environment.
We need to find a way to bridge that gap between aspiration and reality.
Yes, it can be a wonderful time to slow down and smell the roses but it is also a time of learning to accept support and care both for ourselves and our loved ones.
There is a recent story of a lady who entered a schmicko aged care facility with a flash, restaurant style dining room. She started to lose weight and no-one knew why.
Eventually the staff realised that she was not coming down to dinner each night. The reason? Her family had not left her with any money to pay for her meals in the “restaurant”.
Our perceptions are driven by our own fears of aging and our aspirations for what our own aging journey should look like.
There is a tremendous need for all of us to talk about the reality of the end of life.