clinical focus
home. If you’ve got one member of the
couple who needs care, it allows the
couple to stay together because the one
that needs the care can receive those
services and the person that doesn’t can
still live in the same place with them.
For people who need to move into
residential aged care, it’s trickier, because
the entry requirements are such that
you have to be quite frail to move into
residential aged care these days, and
often operators don’t have the capacity
to accommodate both members of the
couple at the same time, let alone have
their facility set up to deal with, say, a
couple living in the same room.
Some providers around the country
do have those facilities, but often
when couples are in a situation where
those decisions need to be made, the
availability of that sort of accommodation
isn’t there.
So it’s quite tricky, because what we
want is for couples to stay together, but
our current system in the way that our
aged care system is set up, certainly from
a rigid residential aged care perspective,
just doesn’t facilitate that as easily as
it might.
What are some options for partners if
one member of the couple has had to
move into residential aged care?
As I said earlier, it’s important for couples
to plan together for what they both want,
acknowledging sometimes however that
circumstances might mean one member
of the couple does need care.
But as I said before, if they’ve planned
together about what they want, then even
remaining in their own home, or even
if they’re downsizing to a smaller unit
or a retirement living situation, they can
frequently stay together for quite a while.
So what I would be saying is, do that
planning early. Make sure that all the way
along you are communicating what you
want to have happen to your immediate
family or the important people around
you, including your GP and members of
your health team.
Then, if you’re getting to the point
where one of you needs care, think about
what other options are available.
We have a demographic of people
coming through who have many more
expectations of the system. I think we’re
going to see a lot more couples saying,
“Well, actually, we really want to stay
together,” and so providers will need to
offer services to couples.
So if I was the partner of somebody
in care, I would not be putting myself in
a position where I’m stressed over that
situation. It is a circumstantial issue, but I
do think it is something where planning is
really important.
Also, I think policy changes will need to
happen over the next 5–10 years because
we’ve got a demographic of people
coming through whose demands are
going to be different around how couples
are treated.
How should nursing homes work with
couples and their families to ensure
they stay together as they age?
That’s a difficult issue. As I said before,
the facilities aren’t necessarily set up to
manage the needs of couples.
I know that some years ago there
was quite a significant push to create
built environments where couples
could stay together in a residential aged
care environment. The problem you’ve
got is that the funding mechanism for
residential aged care is such that you
might bring one member of the couple
in that needs the care, but the other
one doesn’t. There’s no capacity in the
way residential aged care facilities are
currently funded for the one that doesn’t
need care to have their needs looked
after as well.
So that’s going to require a significant
policy change on the part of the
government. One of the things we’re
talking about a lot is that there needs
to be a significant rethink of the way
residential aged care facilities are funded
in Australia to deal with not just the
way couples are looked after as they
age, but the way people are looked
after as they age in the context of an
increasing demand for aged care and
everything else.
I think the other thing I would say is that
operators need to think very creatively
about the way they provide services and
the way they work with families. In the
most recent budget, the government
announced that it is going to invest some
funding into looking at what consumer
directed care looks like in residential aged
care. I think that’s a great idea.
We’ve seen some great initiatives in
community care over the last 18 months
with the implementation of a consumer
directed care framework in community
care, and I don’t think there’s any reason
why that sort of framework can’t work in
residential aged care.
But what does need to happen for that
to be successful is a significant rethink
of the way residential aged care services
receive their funding. ■
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