No one deserves to end their days isolated and separated from their loved ones, writes Adjunct Professor Dale Fisher.
As COVID-19 reasserts itself in Victoria, it’s hoped the government’s strict, new Stage 4 measures work and the trend reverses.
But it is possible that cases continue to rise and we experience a shortage of acute care beds here as has occurred overseas in China, Italy, Spain, the UK and the USA.
Many of those hospitalised are older Victorians, a cohort that is disproportionately impacted by this highly contagious virus.
Many living in residential facilities and suffering from COVID-19 have been forced to remain in lockdown, denied visitors and the comfort of loved ones, even in death.
Of Victoria’s 255 deaths, over 143 have been in aged care facilities. We learned this week that the Coroner will investigate the tragic deaths of five elderly residents at St Basil’s Homes for the Aged in Melbourne. St Basil’s, of course, is one of more than 100 aged care facilities in Victoria that has had reported COVID-19 cases.
As a result, there is every chance that this investigation could be widened to include deaths at other aged care facilities.
Home care shouldn’t be overlooked
Too often the alternate option of home care is overlooked. It should not be, particularly as we face the long-haul of the COVID-19 pandemic and its disproportionate impact on the aged.
Home care allows older Australians to stay safe, in the sanctuary of home – to receive the professional care and support they require to maintain their independence and continue to feel confident living at home for as long as they choose.
It provides those in need with control over the choice of care they receive, including but not limited to specialist health care, including wound care and palliative care, personal care, home support, and 24/7 on call support.
Families, of course, remain free to visit and provide supplementary care, support and comfort. It should be an option for all who wish to continue safely living at home.
Unfortunately, it is not.
A succession of reports including by the Productivity Commission, the Australian Housing and Urban Research Institute and the Royal Commission into Aged Care Quality and Safety have found that approximately 80 per cent of older Australians would prefer to maintain their independence and live in their homes for as long as possible.
National Seniors Australia reports, however, that many seniors were unaware of the numerous home care options available to them, and how to access them.
Informing older Australians about care options
In today’s information age there is no excuse for the elderly being left in the dark. It is imperative that older Australians are aware of and adequately informed about their care options as they age, including palliative care options, so that they can discuss them with family members and clinicians and make the best possible choices to support their lifestyle.
Home care is also not as costly as many might think and, as reported by The Aged Care Financing Authority, is certainly lighter on the public purse than residential care.
This has been recognised by the federal government who in recent years have injected additional funding into home care, including $326 million announced on 8 July.
The commitment will enable 6,000 more older Australians to enter home care arrangements by 2022-23 and to continue to live safely at home as they age.
It would be good to see the government also commit further funding to higher end home 2 care packages, ensuring those with complex health care needs could take advantage of in-home services.
This is not to say there is no place for residential aged care facilities in our community. Residential facilities can provide the elderly with a ready community and 24/7 care delivered by attentive and compassionate staff, often supported by clinical in-reach services.
However, there are simply too many instances where the standard of care has fallen too short.
The pursuit of profit over quality of care in aged care too often leads to poor outcomes. It is in part why the sector is a subject of the current Royal Commission into Aged Care Quality and Safety.
The elderly deserves a better standard of care and should not live – or die – in isolation.
Raising awareness about home care services including palliative care, improving clinical in-reach services in aged care facilities and ensuring that home care is sufficiently funded is critical to the ongoing health and wellbeing of our seniors.
It will take pressure off public health expenditure and ensure older Australian’s can maintain their independence and stay safe in their homes for as long as they choose.
Witnessing the ravages of COVID-19 in aged care facilities, we must all advocate for a shift to more complex care in the home. Our older Australian’s not only deserve this dignity they have the right to it.
*Adjunct Professor Dale Fisher is CEO of Silver Chain Group
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