May 10, 2018

Social isolation and our future

I want to live until I am 100. It’s fascinated me ever since I was a young boy. My wife has worked in aged care and she thinks I am crazy. I think of the changes I will witness and she thinks of the struggles. One hundred years old – imagine: from cars with no seatbelts to flying cars, from black and white TVs to holograms, from social connections to… social isolation.

We all know the Australian population is aging, the 2016 Census shows that 16% of our population is now aged over 65 years old. In 2016 there were 486,800 people aged 85 years and over, almost as many people as live in Tasmania. We need to understand the risks of social isolation for our aging population otherwise living until we are 100 will be a lonely existence. Would we allow the population of Tasmania to become lonely and isolated in their own homes?

The Productivity Commission’s, “Housing Decisions of Older Australians” report highlights 60% of older Australians want to age in place. They want to spend as long as possible in their own homes in the community they have lived. But most of those homes and communities are designed for cars and for people who have great mobility. Once someone stops driving they risk losing connections to their community. They start to rely on family members who increasingly do not have the time or resources to offer the help required. Many reports show if someone loses connections to their community their health suffers, their diet suffers and other effects of social isolation set in.

Look outside your front door, is there a footpath, is it safe, slippery, hazardous or broken? Is there a bus stop nearby, a train station, a tram stop? If you could not drive how would you get to the supermarket, to the doctors? Could you still visit your friends? Chances are if you don’t live in the inner city, when you lose mobility you will be at risk of social isolation.

There is no doubt that moving to residential aged care offers better access to services and social connections. However, the average age of admission to residential aged care is 83 years old. Most people chose to live in their own home for as long as possible. If we want to age in place, even to 83 not 100 will our surroundings enable social connections or once we lose our mobility will we be isolated?

Our aging in place suits the government, it is considerably cheaper to subsidise home care support than residential aged care. Basic at home health services do not maintain social connections, they help maintain our health, but is that enough? If all we want is a nurses visit once a week then we will be OK, but if we want to not only age in place but to thrive in place, if we want friends and an active life then the services and our surroundings need to change.

Access to affordable transport can help maintain social connections. An increasing number of older Australians rely on community transport providers who in turn rely on volunteers to provide transport. Volunteer numbers are dwindling and transport costs are increasing. One community transport provider explained they receive more than 300 referrals from My Aged Care every month. 300 people in their catchment area every month are assessed as needing assistance with transport, but the organisation cannot take any more clients. 300 people every month without access to basic connections, another 300 people at risk of social isolation.

My wife’s grandma lived in her own home until she was 103. There were no footpaths near her home, she could not walk to the shops or the doctors, but she was one of the lucky ones. She had a son who spent a lot of his time providing what is termed informal care. Every day he made sure she had access to great healthcare and social connections. It was almost a full-time job for him. Unfortunately most people do not have the luxury of this type of support.

A 2015 report by Deloitte Access Economics into the value of informal care in Australia highlights the number of people able to care for an aging family member is decreasing and that trend is set to continue. The report shows within the next 10 years the demand for informal care will far outstrip supply.

Despite all of this I still want to live until I am 100. I believe our government will fund better community transport, our urban planners and councils will design better cities, our public transport will be age and ability friendly, my kids and grandkids will help me when they can. And I believe the flying cars of the future will be self-driving so even when my mobility is limited I can still visit my 100-year-old friends.

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