Whole of Community Focus for Healthy Ageing: Aged Care is Quickly Becoming an Outdated Term

Aged care is no longer about putting the elderly in a nursing home. With the continued growth of the aged population, that would mean that Australia has to keep building more nursing homes, something that cannot be sustained. Modern aged care is about supporting aging individuals to grow old gracefully and maintaining their dignity. This involves providing support while they stay at home, which allows them to visit with friends and family. The house can be remodelled by providing support railings, shower stools, and wheelchair friendly entrance and reachable kitchen cabinets. The elderly person can then be fitted with devices that keep track of their vital signs and activities and are connected to a primary care centre. Arrangements can be put in place for service providers to help with cooking, cleaning, laundry, and bathing, making sure the elderly in any particular community eat well and they are clean. Meanwhile the primary care clinic or GPs office can send community health carers to check on the elderly person on a regular basis, to make sure that they stay healthy.

Though we call it “aged care,” the term has become outdated as it assumes that the aged people are completely dependent on others to continue living. What is suggested is more of assisted living for the elderly people since the independence of the elderly people is encouraged while providing them with assistance where they have limitations.

Assisted living for the elderly requires an integrated health care system. The elderly people tend to suffer from at least one chronic disease, and may even have a disability, both of which require the services of the Department of Health. Added to that may be lack of money or lack of housing, and other needs that can be met by the Department of Social Services and the Department of Human Services. All these services require the elderly to deal with three different government departments. Read more here. The need to deal with three different government departments in order to get complete care is too much for the elderly who have a lot of limitations. It requires the availability of family members and friends who can drive them around. But family members are usually at work! It is this lack of proper integrated services that disrupts the provision of good care in the community.

It would be nice if these three government departments merged to form one department that provides integrated care. Unfortunately the government still cannot understand the need for providing integrated care in the community. They are more focused on mending the troubled hospital system at a cost that has risen to rates that cannot be sustained any more. With the increasing number of elderly people and increasing cases of chronic diseases and disability, the demand for more hospital space and health care practitioners keeps rising. How long can the nation keep building more facilities and training more health care practitioners? It is a no-win situation that will fill the nation with hospitals and nursing homes! Read more about it here.

The solution is to move care out of the hospital. No matter how many options are considered, nothing can beat moving care out of the hospital and encouraging the elderly to be independent. Any elderly person who has been hospitalised can be assisted, through physiotherapy and other therapies, to go back home and live a normal life. Moving to a nursing home should be the last resort when an elderly person becomes too frail. Read about it here.

The joy of living independently or close to family and friends cannot be underestimated and it can increase life expectancy. The American Association of Retired Persons found that 90% of the elderly prefer to live in their own homes and 82% still prefer living at home even when they need assistance or when they have health problems. They associate their happiness with being active members of their communities. That should never be taken away from them until such time that they have become frail and their families cannot cope with their care needs. Research done by the Capable Project in Baltimore, USA has proven this. Read more here.

It is obvious that at their age the elderly need for urgent medical care here and there. However, they do not need to go to the hospital for minor emergencies considering the shortage of beds, medical staff and facilities. As we mentioned above, Australia cannot continue to build more infrastructure and train more medical practitioners. Instead, the nation can adopt the urgent care clinic model. Urgent care units can be added to existing primary care clinics to take care of small emergencies (that are not life-threatening) like cuts, burns, coughs, and flu. Urgent care clinics have been adopted in some countries but Australia still needs to consider this health care model in order to reduce the problem of increasing demand on the health care system. Read more here. Then the elderly can live a fairly independent life, going into the urgent care clinics for urgent but small problems.

Not to be forgotten is the need to use technology for the elderly. As part of their package, the elderly can be given free access to the internet and a computer. Then they can visit their carers online with the use of video conferencing. In between visits, the health care professionals can keep an eye on the vital signs that are captured by wearable and other devices and transmitted to the health care centre. The health care practitioners only intervene if a vital sign has become abnormal, like when blood sugar levels or blood pressure levels are too high. Otherwise they wait for the scheduled visit which can be done online if there is no problem. Also, if the elderly person develops a problem, they can call their carers online. If it is minor, they can get a prescription online and the medication can be delivered by the pharmacy. With telehealth connected, most elderly people can live a happy and healthy life independent of their families and the nursing home. Read more here.

Unfortunately, Australia has spent a lot of money on telehealth initiatives but there is no interoperability between the initiatives and uptake is slow. It is time to improve telehealth so that people in remote areas, the elderly and people with mobility problems can access health care without needing to spend a lot of time and money on transport. Read more.

Now comes the question of who will assist the elderly people living at home. Few have family members available to take care of them. The government can train community health workers to look after the elderly in each community. The community health workers will make sure that the elderly people bath, eat properly, take their medication and engage in some form of activity. They will report on any need for immediate medical care. The medical experts can respond by visiting the patient via teleconferencing or by arranging for the patient to visit to either the hospital or the urgent care centre for attention. This is a much cheaper option for the nation than taking the elderly people out of their natural living environment and putting them in nursing homes where they will feel displaced and neglected.

All in all, healthcare in Australia is a shifting paradigm. People have become more knowledgeable and they demand more from the government. They are generally interested in learning as much as they can about health and how to take care of themselves. Gone are the days when they had no idea what was wrong with them or what the doctor was going to do to them. They now want to be active participants in their care, asking a lot of questions, researching their conditions, and making decisions about their treatment. Even as they age they want to be active participants who can manage themselves in their own homes. They want to maintain their pride and dignity and live normal lives as long as possible. The government cannot ignore the changes that are happening to people and the changes that are happening in the health sector in other countries. Read more about it here.

With the increasingly aging population, increasing cases of chronic disease, disability among the elderly, the shift in the people’s mentality, the rising cost of building infrastructure, and the rising cost of training and employing more health care practitioners, a paradigm shift is called for at government level. They must continue to provide the Australian citizens high standards of care at affordable costs. However, they cannot continue to work within the old model of health care in the face of all the challenges listed above. They need to adopt a different health care model. Keeping the elderly at home, within their communities, close to their friends and families is one solution that can work very well. Being independent is a source of pride and helps the elderly to maintain their confidence. And this can be achieved at a very affordable cost to the taxpayers.