People over 65 will soon make up a quarter of all people living in the Hunter. The number of people over 85 will double in the next 20 years.
The Royal Commission on Quality and Safety in Aged Care has shown that the lives of older people with complex needs can be miserable if they don’t get good care. In some aged care facilities, the number of staff is inadequate, staff are poorly trained, the environment dispiriting, and the older people are lonely and neglected. The devastation wrought by COVID-19 exposed issues with this system.
People who live at home alone may not be in a better situation. Waiting times for community care packages can be more than 12 months, even once a person has negotiated the complicated My Aged Care website. Some people at home are dying waiting for appropriate care or are forced prematurely into care.
Some people living alone are lonely for substantial parts of the week and depression is common. The highest prevalence of suicide in our community is in males over 85.
Underlying this neglect of the needs of older people is ageism in our society. Older people have the same needs and desires as younger people to be physically, intellectually, socially and sexually active. This is denied to them by the organisation of our communities.
Those older people who own their home and have assets are better able to determine their own future and acquire the care they require. Unfortunately, the number of older home-owners is declining and the number of older women becoming homeless is growing.
Who is responsible for planning to make the last years of life acceptable for older people? The Commonwealth is responsible for aged care but is likely to continue to rely on market forces – which have failed spectacularly – and will dribble more money to providers, with little increased transparency.
But supporting adaptive ageing is about more than aged care. All levels of government, business, NGOs and citizens are part of the broader solution.
The way forward is for local leaders to come together to define our specific needs with regard to ageing. These needs include the features of an age-friendly community and programs to reduce social isolation and loneliness, and to help build resilience.
Solutions include options for accommodation for older people, for both the younger old and the older old. The younger old will need social housing, cooperative housing and other innovative options such as commonly seen in Europe. The older old need supportive housing.
Social housing stock is declining and waiting lists can be more than ten years. For older people, the retirement villages that they can afford are often on the edge of towns with limited public transport and access to services.
We need more low-cost housing, particularly for the growing number of women who are becoming homeless due to domestic violence, divorce, or death of a spouse. We need group homes for the younger older who have chronic mental illness, early dementia, or intellectual disability.
We need innovative retirement village options that are smaller in size, located close to shops, services, and public transport and incorporated into the community. We need high quality residential aged care, composed of smaller units accommodating eight to 12 people, specifically designed and staffed for residents’ needs, including specialist medical and nursing care for dementia, intellectual disability, or chronic mental illness.
We need end-of-life care that includes appropriate planning, physical care, companionship, palliative care and assisted dying, when appropriate. By the end of 2021, NSW may be the only state without assisted dying legislation.
A group of citizens and aged care activists is forming the Hunter Ageing Alliance. We are calling on local government, the Local Health District, the Primary Healthcare Network, state and federal politicians, universities, churches, NGOs, and the business community to join with the Alliance to play their part in making our community more ageing friendly in an integrated way. We are meeting with key representatives to gain agreement on the way forward before holding a public meeting to form a community support group.
It is time that older people receive the consideration and priority they deserve.
Dr John Ward, Dr Julie Byles, Viv Allanson, and Catherine Henry are founding members of the Hunter Ageing Alliance.