Concerns of lonely seniors in home care push
A new report has highlighted the social isolation and mental health risks of a shift to home-based care and calls for appropriate resources to ensure the ongoing community participation of older people.
Policy reform to support older people to live at home for as long as possible may lead to higher levels of social isolation and associated mental health issues, a new report has warned.
The report from seniors advocacy group COTA Victoria said while it fully endorsed the policy shift, there were also potential risks that had to be managed.
COTA Vic said unless community services were properly resourced and supported by investment in age-friendly housing and accessible public transport, some older people were at risk of becoming even more isolated.
COTA Vic’s community development officer – research and evidence, Anne Pate, said discussion around supporting older people to remain at home was often framed in terms of meeting people’s needs for physical care rather than their full range of health and social needs.
She said community care support should be designed and resourced to encourage older people’s full participation in social and community life.
“It remains to be seen how far the roll out of consumer directed care will actually enable a more a whole -of-person view of people’s needs,” she told Australian Ageing Agenda. “But there is a lot to hope for.”
“We hope this report contributes to the conversation about the value and importance of social participation and connection for older people.”
The COTA Vic report also pointed to international evidence from countries that had already reoriented service provision towards community care which showed the possible negative impacts of the policy reform.
For example, UK research had shown that the level of support available to older people to enable them to continue to live in their own home had not been sufficient.
Whole of community response
Ms Pate said it was clear that aged care services were only one element of the picture, and housing and transport policy were also critical to ensure older people maintained and developed social connections.
“The experience of social isolation requires a multi-faceted, holistic policy response,” she said. “We need to be thinking about what kind of society we are trying to build and whether that society enables older people to continue to participate.”
It was predicted that the number of socially isolated older people in Victoria would more than double by 2040 and may increase further as the proportion of older people from a CALD background increased.
Studies had estimated that 7 to 8 per cent of people over 65 reported were socially isolated.
The report also advocated for improved access to mental health services for older people, whose needs have largely been omitted in national mental health reform.
The report, Social isolation: it’s impact on the mental health and wellbeing of older Victorians, was launched by Dr Cathy Mead, chair of COTA Vic’s policy council last week.
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I think the researcher may not have looked at the issue fully. There are many community organisations offering transport in city areas and some in rural areas although this is mainly medically related.
People being cared for at home is not knew, HACC has been around for nearly 30 years and has always had a component for social support which includes transport as well as funding community transport organisations.
What contributes to peoples transport problems is the complicated aged care gateway which I work with clients to try to help them and their families understand. There needs to be more advertising and more money to fund these programs. Many know face loosing funding because of their main client not being eligible for packages so they will attract no funding.
A lot of the organisations themselves act as barriers because they do not include social activities that they do not provide as a part of the person’s care planning. I work with clients who often have domestic and personal care with big organisations who refuse to change a scheduled clean because it is difficult for the organisation to change shifts etc and will not recognise a social outing that is also funded by HACC as important. The client then is left sitting at home waiting for a cleaner. In many instances the cleaner cancels so the client receives no services what so ever.
I love the work COTA does in all states but I think in this case the issue is that organisations need to be forced to use the resources in the best interests of the client and that is not happening despite all claims to the contrary. Caring at home is nothing new and going without is nothing new. I agree that most people should be living in their home in the community with support and they have for a very long time. No matter what government is in charge there will never be a aged care system that has enough money to provide everyone with services so we need to start looking at using the money that is available more effectively. I don’t believe that giving the funding that is available to large organisations who pay their executives up to 25% of the funding they receive or have many layers of management that also funding is wasted on is in fact utilising the funding effectively.
I think a key point in this story is the small bit about “…investment in age-friendly housing and public transport …” Care and accommodation services for older Australians has for too long been focused on a DoHA belief that one-size-fits-all. The expansion of home care opportunities is recognition that more choice was needed. However, home care is not always the answer for anyone who is less inclined to consider their other choices when life alone in the big house in the suburbs is no longer viable. The establishment of retirement communities went some way to address the potential risks of social isolation or whatever politically correct name is attributed to it these days. But we do know that people living in full-time residential care can also experience the same things even though they might be surrounded with people all day. It’s about engagement, participation, involvement, interest and enjoyment. That is what we need to look at in both home situations (eg: day respite) and RACFs and their diversional therapy activities. All facets of the industry must address this and minimise its incidence.