Australian Healthcare Week kicked off on Wednesday with a debate on the topic ‘Is the government’s promotion of home care a healthy option?’
Though the Australian government’s focus on home care is well established, there were strong arguments on both sides of the discussion.
Dr David Sykes, Director, Dementia Australia, kicked off the debate in the affirmative, arguing that home care is the preferable and most cost effective option for older people.
Jim Nicholson, Manager, Healthy Ageing Policy, New Zealand Minister of Health, replied in the negative.
“To age well and have a respectful end of life, being cared for, and contributing to your culture, is the way that older people want to live in their later life, dependent or independent,” he said.
Sarah Newman, General Manager Home Services, Baptist Care, paid her respects to those taking the negative view, which she said was “brave”.
Ms Newman said if health is defined as being able to adapt and manage physical, mental, psychological and social challenges throughout life, then “we’re all aware” home is the place to “optimise” those outcomes.
“Home is where we are happiest, and where we are healthiest, and the government promoting it is what it should be doing,” she said.
Dan Levitt, Executive Director, Tabor Home Society in Canada, being in a nursing home means older people no longer have to perform daily chores, such as cooking, cleaning, gardening, and looking after their home.
When you live in a care home you have “peace of mind”, he said, and you are also likely to be relieving the stress on family and caregivers.
“Seniors no longer have to worry about being a burden, or asking too much,” he said.
There are also better opportunities for older people to improve their health and physical fitness in nursing homes, he said, with classes such as yoga and gym available, as well as more recreational choices and better social connectedness.
“Who knows who you might meet in residential care,” he said.
Kylie Lambert, CEO and Co Founder, Daughterly Care, said the government has heard that people want to stay in their homes for as long as they can, and that’s why they’re supporting home care.
A UK survey found that 97 per cent would prefer to stay at home, she said.
“Older people are very bored in nursing home facilities and what they want is to be engaged in life. Part of being engaged is enjoying the things we do every day – cooking delicious meals, the joy of being reenabled and enabled,” she said.
“The problem is, we have an aged care system that disenables older people.”
By adopted approaches like Montessori, even people living with dementia can be “re-enabled”, she said. People living with dementia can learn, and make new memories. “We find that to be our experience,” she said.
Ms Lambert said putting someone into a nursing home does not relieve stress, in fact it often introduces new stresses which residents and their families have no control over.
“It’s a lot of fun to be at home. It’s where you love. It’s a place you have created, and you are connected to the people you want to be connected to, to your informal supports, your neighbours. Your friends can continue to meet you, [you can see] your own doctors, your grandchildren can run down the hallway and give you a big hug even though your are palliative care.
“I can’t think of a better place to live all my days than at home.”
“We are healthiest and happiest in our own mind and in control of our life. And the wonderful thing about home care is if the carer doesn’t meet your standards, you just say I don’t want them back. It’s very difficult to do that in a nursing home,” Ms Lambert said.
Hayley Ryan, Clinical Advisor, Alpha Care, said healthcare services, as well as entertainment, activities, and even lessons, are more easily available in aged care.
Ms Ryan said that 16 per cent of older Australians never leave their home, and 14 per cent of those at home die prematurely.
Those in nursing homes can “get a social life makeover” and “avoid isolation”.
“50 per cent of people living at home report being lonely. That’s huge. They gain more friends if they’re in an aged care environment and they become part of a community. You may even find love. You’re never too old.”
The government push to have a Home care industry is both unviable, dangerous and utopian in nature.
The “emotional cost” is lost as well on the dreamers. The few at home receiving their maximum “care” time of about nine hours a week have an awful lot of time either alone or are the responsibility of a family member. That is all well and good but what about that family carer? Basically 24//7… What is their life like? I can tell you that the health, wealth and social well-being of these carers is sadly lacking.
The stat’s are in, abuse incidents are higher in the Home… and this wouldn’t reflect the unreported issues. Abuse at home is often emotional and financial in nature but these don’t appear to be measured by the experts.
The financial aspects of Home care is coming into evidence after only a couple of years in place. A billion dollars “missing” and unrecoverable, limited justification for the spending of funds, over a third rorted in management fees, additional fees etc etc.
What becomes of the Home care recipient when the carer leaves and they are all alone? Who helps with a cup of tea, the dishes, cooking etc… and the loneliness is immeasurable.
There will never be enough funds to have one on one care in the home that can deliver safe and durable care for all.
If you have ever spoken to the family of a lot of residents entering care they nearly all say “I don’t know how I did it so long, I’m exhausted and unwell myself”.
Ignore the real facts and it will be at the peril of the aged. The evidence says Home care is failing and unsafe. Deny it if you can!