Above: Dr Alexandre Kalache (image: City of Unley).
By Stephen Easton
Sustainability is the biggest challenge faced by our aged care system, according to Dr Alexandre Kalache, and greater social inclusion for older people, taking pressure of aged care services, is part of the answer.
After a month-long visit to Adelaide as a Thinker-In-Residence, Dr Kalache, one of the world’s foremost experts on the phenomenon of ageing populations, said his general impression so far had been “very positive”.
After consulting with aged care providers, politicians, public servants, researchers and older people themselves on a trip he described as a “diagnosis”, he said that policymakers seemed to be listening and the residential aged care facilities he had seen were “of high quality”.
“So far so good – the proportion of older people is still relatively small,” Dr Kalache said, “but it is going to increase sharply over the next few years. To maintain the quality and consistency of what [care] is being offered – that is my big worry.”
“Perhaps what I would like to hear more clearly, is how older people are monitoring and evaluating the services that they are getting. [It is not ideal if] you listen and you involve them in planning but then you don’t call them back – this monitoring and evaluation is very important.
“[…] Maybe what needs to be done in community care is to facilitate greater access to information – so often there are entitlements and services available, but older people don’t access them because they don’t know about them.
“Especially when you talk about specific groups – [in Australia] you have many migrants that are now ageing, often without a full grasp of English. A lot of the information may not be accessible in a language they are familiar with and sometimes, they don’t know how to read.”
The world-renowned Brazilian expert, former head of the World Health Organisation’s (WHO) Ageing and Life Course Program and the intellect behind the Global Network of Age-friendly Cities, promotes greater social inclusion in the face of broad demographic change occurring in societies all over the world.
He stresses that ‘age-friendly city’ does not mean a city exclusively designed for the elderly; it means a city designed for people of any age.
For developed countries like Australia, traditional family structures with several generations under one roof have become less common, leading to less interaction between older and younger generations, according to Dr Kalache.
Social mobility has added to the isolation of older people in the developed world, he said, with younger people often moving interstate or overseas, and leading very different lives to their parents.
“We have to shift the mental construct to the reality of today … What we have in developed countries in general, is silos – kids play with kids, teenagers mingle with other teenagers, young adults are busy in the workforce and have very busy lives, and so on.
“Unless we think and plan accordingly they will have less and less contact with other age groups.
“So for instance, if you look at this society as a whole from the point of view of a child or young person, it is likely not going to be friendly to all ages. However, if you look from point of view of an older person, it is likely to be friendly to everyone.
“A bus that is easier for older people to get in and out of is also going to be easier for a child, pregnant woman, disabled person or a teenager carrying their [school] luggage.
“That is what we are trying to instil – if we get it right for older people, it is likely that we’ll get it right for everybody.
“So avoiding the war between generations, bringing them together in harmony and solidarity – that is the best thing we can expect from a society that is ageing so rapidly as the Australian society is.”
Dr Kalache has been working with advocacy group COTA Seniors Voice and has been assisted by Megan Corlis, director of research and development at the fittingly named Helping Hand Aged Care, during his visit.
He described Helping Hand as “a very impressive set-up”, where intergenerational exchange was fostered and living in residential care was made a richer experience through reaching out to schools and art galleries, offering placements for students of allied health professions, and encouraging residents to create “a sense of home” by bringing their own belongings and furniture.
He also praised the work done by COTA, especially in raising awareness of the various forms of elder abuse, which he said had been largely ignored and “swept under the carpet”.
Dr Alexandre Kalache will be back in Adelaide as a Thinker-In-Residence for another four weeks later this year, and a third time early in 2012.