Navigating aged care

Most who have been exposed to the aged care system will tell you that it is a challenging experience.  And the nursing home question – finding and funding the right care for older relatives – often ends up as the solution.
A recent Financial Review article (How to navigate the aged care maze afr.com ) clearly illustrates why this is such a difficult issue. But the biggest issue is not what the article is about.  The real issue is that the article, like much of the commentary on aged care, disguises an inconvenient reality.

The inconvenient reality

Few of us really want to live in a nursing home for the rest of our lives.  The problem is that there are few other options, available today. 

Behind the commentary are two further problems. Firstly there is an assumption that as we grow older we all become dependent and need to be looked after.  Consequently the nursing home question is just a matter of time.

Secondly, it is the industry itself that is promoting the current arrangements.  We know that the number of people over 65 years predicted to increase significantly in the next 20 years. By propagating the current reality (and stifling any real alternatives) the the industry is betting that consumers and families will put pressure on governments to increase the funding for the existing aged care model.

The article also demonstrates that so-called government reforms are just tinkering with an aged care system (and applying user-pay to fund it) when it needs a radical reform.

The alternatives

Even on today’s trends, less than 10% of people over 65 live in a nursing home.  Most of us would prefer to live at home, and we should consider affordable options that make this possible.

In the future it is likely that only those people who cannot look after themselves at all, or who are a danger to themselves or others in independent living, will need to access the high level of care found in residential aged care.  Society won’t be able to afford more than this.

Increasingly, as we, the baby boomer generation, observe the experiences of our elderly parents and confronts our own ageing, we will challenge and reinvent how we live as we live longer.

What might the future look like?

Emerging technology will either entrench existing approaches, or help build supportive local communities and encourage new approaches. These will go beyond current aged care offerings and deliver better social outcomes at lower cost to the public purse. This will depend on what kind of future we want and can afford.

This is why the Living Better Conversation is important.  Together we need to identify what we want. Only then can we usefully discuss how we achieve this.  If we don’t know what we do want, we depend on others to decide this for us. And the track record of governments and self interested groups is not promising.

This is the 2nd introduction to the Living Better Conversation where we suggest that we have an opportunity to create the new old age together.  We’re living longer, let’s also live better!

Want to live in a nursing home for the rest of your life?

How many articles have you read that predict increasing demand for care and estimate the number of new nursing home beds we need?  Most analysis simply assumes that the government will fund this, despite the reality that, at the same time, the public purse is shrinking.

Such debate about the demand for, or supply of nursing home beds hides a bigger reality. No matter how these beds are funded or how wisely the current system is reformed, no one actually wants to use it.  Nor will the majority of us be able to afford it.

What choice do we have?

Using yesterday’s attitudes, social mores and policy models to plan our futures won’t work.  We need to think about how we want to live as we grow older.  Only then can we determine the best ways to do achieve this.

Despite the scaremongering that surrounds the aging agenda, less than 10% of people aged 65 and over live in nursing homes, and only about 14% choose to live in retirement villages.

Create the new old age, together

Most of us choose to remain living at home, and will continue to do so into very old age.

• If we are honest, old age is the natural progression of life from childhood to adolescence to adulthood and on.  It is not a problem, but an opportunity to do things differently.
• The concept of “lifters” (providers) and “leaners” (dependents) is also simplistic; in reality we can all play multiple roles, sometimes changing from one to another many times in one day.

As in previous generations, we become (or remain) vulnerable in many ways as we grow old.  But we also have the potential to be active and productive, long after the traditional age of retirement.

Contributing to our family, friends and communities is an important part of life, and living well. Modern technological, economic and social environmental breakthroughs make new ways of contributing possible.

Growing old is not all doom and gloom.  Together we can create the new old age!

This is the first post to introduce the Living Better Conversation.  We’re living longer, can we also live better?   For those of us who want to continue living independently at home, we suggest that we need to change our thinking to create the New Old Age.

What’s the problem?

Many commentators have described Australia’s structural ageing. Much of the discussion is sensationalist, suggesting a silver tsunami of crisis proportions, a problem to be solved.

Such commentary is, in itself problematic because it encourages a victim mentality and implies helplessness and dependency. We constrain our thinking by assuming that older people are dependent, consumers of resources and a burden on their families and society:

• It propagates a model of ageing that defines old age as a period of decline, loss, infirmity and dependency. We medicalise ageing.
• This thinking means that we then have to provide more and more care for our elderly, which we know will be difficult and costly with funding needed from governments and individuals.

What do we want instead?

Retirement in the future is not only going to be about moving to the beach or to the golf course, even if you can afford it.

• As we grow older most of us want to remain productive members of our families and society; society also needs this.
• Family and friends want to support loved ones, or others at home. Often the care load falls on one person and it is not easy to offer the right support at the right time.

Create The New Old Age

As we, the Baby Boomer generation, experience the ageing of our elderly parents and confront our own ageing, we will need to challenge and reinvent what we now understand as retirement and ageing. We will change the way we age; how we will live, work and play as we live longer.

This conversation is about how we want to live for the rest of our lives – what the New Old Age looks like.