Aged Care Insite Issue 108 | Aug-Sep 2018 | Page 29

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