Aged Care Insite Issue 108 | Aug-Sep 2018 | Page 30

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.  ■ Win the fight against frailty, malnutrition and low energy with Enprocal powdered food supplement. ENERGY = 609kj IN EVERY 35g Scoop PROTEIN = 15g IN EVERY 35g Scoop CALCIUM = 42.9% OF RDI* PER 35g Scoop Registered with State Government, contracts in NSW, Vic & WA For your nearest distributor, visit www.enprocal.com.au or call us on 1300 844 256 agedcareinsite.com.au 27