clinical focus
Keeping couples united
ACI: Where does your passion for
this area come from, and why is
it important for couples to stay
together?
What are the options for
couples entering aged care?
Tracey Silvester interviewed by Megan Tran
A
fter spending many years sharing
their lives together, most couples
assume that when entering into
aged care this living arrangement will
remain. However, for various reasons,
some are forced to separate.
Tracey Silvester, executive manager
at Envigor Home Care in Queensland,
has explored this concept. The aged
care professional has more than 25
years’ experience in heath and aged care
services and is passionate about ensuring
elders have more aged care living options.
Silvester, who is a registered nurse and
has a bachelor of science and a master’s
in health management, says it is often a
health event that undoes couples. Most
of the time it’s unexpected, and they are
put into a scenario where they need to
be apart because one requires care. This
can often lead to loneliness, where, for
example, the couple’s once familiar social
network is challenged.
Aged Care Insite spoke to Silvester
about finding the right accommodation
for elderly couples in this situation.
26 agedcareinsite.com.au
TS: My background is in community care,
and for a long time I’ve seen couples
who have been married for 40, 50, 60
years, and all of a sudden because of an
event that neither is expecting – often a
health event – they have to be separated
because one of them requires care and
the other doesn’t, and they can’t stay in
the family home together.
What we then see happen is the
effect of loneliness on both members
of the couple. In a lot of instances they
still enjoy each other’s company; often
their social networks are very much
wrapped up in each other, and when one
member of the couple isn’t living with
the other anymore, the loneliness they
both experience is significant, and then
we feel the health impacts of loneliness
that comes with that. There’s been a lot
of research published recently which
says the impact of loneliness on people
is significantly greater from a health
perspective than that from things like
obesity and smoking.
So, where you’ve got a couple who
have lived together for a long time,
staying together as they get older is
important just from the quality of life
perspective.
What are some factors that keep
couples apart?
Sometimes it’s circumstance, but what I
say when I’m talking with groups of older
people is that it’s important to plan, to
start thinking about what it is that you
want for yourself and your partner or
spouse as you get older, and how you are
going to make that happen. The reality is,
when you’re 50 or 60 and you’re relatively
healthy, you don’t want to think about
what might happen when you get older,
but it’s important to at least have a sense
in your mind of what’s going on, and
don’t be afraid to ask for help.
We often see couples who come to us
for assistance and it’s a crisis situation,
because one member of the couple
has needed assistance, the other one
has provided that assistance and there’s
been a crisis – either the carer ends up
becoming unwell or the person being
cared for has care needs that are over
and above what the carer can continue
to provide. And obviously it’s not the right
time to make those decisions when you’re
in a crisis situation.
So you really need to have a lot of that
stuff sorted out in your own mind, and
potentially even start making changes to
your lifestyle before those changes are
imposed on you.
Thinking about where you might live is
often a conversation we like to have with
people. So don’t be wedded to staying
in the big old family home. The reality
is your children don’t necessarily have a
great level of attachment to that home
anymore, and what most children want is
for their parents to be happy and healthy
as they get older. So think about moving
into a style of accommodation that’s
smaller, easier to look after, and set up for
people who have mobility needs.
If couples plan, then the likelihood of a
crisis occurring when they have to make
those decisions is reduced.
What are the various aged care
systems’ current policies on couples
staying toge ther?
I think with home care, across the board,
the idea is to keep people together. So
if people are staying in their own home
and they’re receiving services through a
home care package or a community care
arrangement, there’s no reason why they
can’t stay together.
There are a number of retirement
village operators around the country –
I’m here in Queensland – we have our
seasons group and we actively encourage
couples to stay together. In fact, one of
the great things about the seasons model
is that we provide a 24/7 care service to
people in, effectively, what’s their own