The invisible Aged: The People Politics Forgot

Former NSW Deputy Premier John Watkins writes in the Guardian:

Today over 160,000 Australians will wake to another day in one of the nation’s 2,800 residential aged care facilities. We used to call them nursing homes and we used to call their residents by name. Today we hardly see them.

More than 160,000 Australians. That’s a city the size of Geelong or Townsville. Men and women who have lived and loved, brought up families, run businesses, held positions of authority. Women who were beautiful and clever and men who were unique and quirky. People who lived among us.   

Today, in those nursing homes, many not confined to their beds will spend their hours in oversized armchairs perhaps watching birds from the lounge window or silently waiting for mealtimes.

Most have dementia, most are in their late 80s and most will die where they now live. During this election campaign, no politician will come their way seeking their views or their vote. They have become invisible to our political system.

A minority will have visitors who drop by occasionally, a former neighbour or distant relative, driven by the last bond of duty. A blessed few will have regular loving visitors. You see them sitting in the sun. Devoted octogenarian husbands who can still see the girl they fell in love with, faithful sons and daughters bringing their grandchildren and leaving the framed photo of four generations smiling out from the bedside table.

But most will have no visitors from one month to the next. No children, no partners, no former neighbours or work mates. No one from that world where they used to live. They are surely the loneliest people in Australia. They simply have no one who can speak to them in old and familiar ways, no one who will caress their cheek or hold their hand as they sleep.

For many, the only human connection left to them will be the uniformed, overworked, professional carers who staff the nursing homes. Undertrained, underpaid and unrepresented, this group of overwhelmingly middle aged, hardworking women – about a quarter of whom were born overseas – bear that last sacred duty of caring for the lonely until they ease out of this life.

Too many Australians in nursing homes will end their lives in the company of people who never knew them before they were residents, who have little knowledge of who they used to be, what their lives were like.

And so these residents will spend their days being cared for by shifts of staff following the routine, being readied for the day, hair combed, medication given, breakfast provided and then set ready for the morning.

Some will look out for the visitor that never comes; some will spend their day in a constant shuffle around the ward driven by what no one will now ever know. Many will simply sleep, too deeply immersed in their dementia to do much else.    

At day’s end all will be prepared for the night, tucked into a cot with side rails raised and farewelled by staff coming to the end of their shift, their only company, through the long hours, the winking of the movement detection monitor and the light under the door from the nurses’ station.

If you ever needed confirmation as to how invisible this group has become you only needed to look at the 2016 federal budget and its attack on residents of aged care facilities. 

These most vulnerable and needy Australians rely almost totally on the nursing home provider for their safety, comfort and quality of life and, as is appropriate in our nation, on the taxpayer that provides support from the department of health.

Appropriately, the extent of that financial support depends on the needs of the individuals, including their level of frailty, the pain they experience and the extent of their dementia. Those assessed as the neediest are able to draw the most funds.   This is determined by the aged care funding instrument, the tool that determines how much support will be provided.

This month’s budget delivered a brutal cut to this program ripping out $1.2bn over four years. That means an incredible $300m less each year to support services for the most frail and needy in aged care homes. Apparently it’s appropriate that they pay for the tax cuts for small business and those earning over $80,000 per year. It’s easy to ignore the invisible. 

The practical result of these cuts will include reductions in physiotherapy for residents in pain, lower staffing levels and longer waits for personal attention and less attention to residents who may demonstrate confronting behaviour. It’s hard to fathom a system that allows for tax cuts for the well-off to be paid for out of the misery of the aged living with dementia in the nation’s nursing homes.  

Perhaps the only justice in this sorry tale is that inevitably a few of the men and women responsible for this attack on the frail aged in residential care will themselves one day spend their final days in the aged care system that they so negligently undermine. Politicians get old, develop dementia and get lonely too.