I am 91 years of age and have been a resident of an Aged Care Facility since February 2016.
This followed fourteen years, with my late wife, as residents of a Retirement Village.
In view of this experience, I believe I can claim some practical knowledge of matters relating to Aged Care. So I offer my thoughts in the hope they may be of some assistance to the many families with aging loved ones.
From time to time, including very recently, there have been media reports regarding ill-treatment of residents in Aged Care facilities and this is something that should never be tolerated. There has also been criticism of privately owned and operated facilities for being “profit-oriented”.
The Aged Care Facility where I am living is privately owned and at times there are some indications of cost-cutting. However, I believe that it maintains an acceptable standard and that belief has been tested. All aged care homes receiving government subsidies have to meet quality standards. These cover management, staffing, health and personal care, resident lifestyle, catering, cleaning, continuous improvement and safety and security. These standards are monitored through accreditation assessment teams which make planned and unannounced visits. This facility was visited this month by accreditation assessors and I made a contribution to the therapy team submission with respect to the newsletter.
It is stating the obvious to say that a normal human being will pass through many phases and face many challenges during their lifetime. Phases and challenges that come to mind include education, puberty, establishing personal relationships, marriage, parenthood, developing and maintaining a career, and retirement which may eventually lead to the need for aged care and the Final Challenge. It is this final phase and challenge of which I write.
Thousands of pages have been written and millions of words have been spoken about preparing for retirement and, if necessary, the selection of appropriate home or residential aged care. I cannot too strongly emphasise the need for careful forward planning by families in the early stage of this phase. While there has been a marked increase in Government assistance to enable aging people to remain in their homes, in many cases full time care is essential. There is an increasing demand for Aged Care places and I strongly recommend families with a loved one in declining physical or mental health register their names with several facilities that are accredited and otherwise suitable. Such places often have long waiting lists and it is not illegal or immoral to apply to more than one facility.
I entered this Aged Care facility after three weeks in two hospitals having treatment for severe lower back pain. I had been on a waiting list for some time and my wife was already in the dementia wing in the facility. My application for the allocation of a room was supported by Social Workers at both hospitals and I was transferred from hospital to the facility by ambulance transport. So I was really in rehabilitation in my early days.
I was well cared for from the beginning by nurses, carers and therapists but there were some aspects of life in an Aged Care facility to which I had to adjust. One which I found relatively easy was the regularity of meal times including dinner at 5.00pm. The more difficult aspect was that all my medications were handled as in a hospital – in other words I lost control of them for the first time outside of a hospital environment. Initially I found this loss of independence very difficult to accept but in time I became accustomed to the situation. Later my doctor prescribed some basic medications such as Osteo Panadol and Mylanta to be “self-medicated”.
Another aspect which did not trouble me but which some residents find hard to accept, was the full reason why we are here. We know we are here because we need full time care but one lady was horrified one day when I said that we were in “One of God’s waiting rooms.” But it is a fact that we are in the twilight of our lives and should be actively preparing ourselves and our families for our death.
Despite my age I have never seen the body of a deceased person and have always had an innate fear that I might see one. However I have no problem now with seeing people with whom I have become acquainted, or even become friends, slowly wither away. This is often manifested by rejecting food despite encouragement by the carers. That, and the effects of a severe fall was the fate of my wife last December.
Many families of aged care residents face difficult decisions regarding their loved ones “end of life” wishes. I have signed an Advance Health Directive in which I simply state that I would refuse consent for any treatment which was solely aimed at prolonging life. I have granted to my eldest daughter an Enduring Power of Guardianship whereby she has authority to make health decisions on my behalf if I am mentally or physically unable to do so. I have also given her a Power of Attorney and appointed a son to be Executor of my will. All my immediate family are aware of these provisions. They are also aware of my intention to reject such measures as intubation or forced feeding just to keep me alive.
I strongly recommend that all Aged Care residents consider completing an Advance Health Care Directive and granting to a family member an Enduring Power of Guardianship to assist their families during what can be a very difficult time.
While they are well enough, I also strongly recommend all Aged Care residents take part in whatever Facility activities of which they are physically and/or mentally capable. This Facility has an active team of therapists who conduct activities including table games, floor games, a dance club, a knitting club, a movie club, an art class, exercises and physio, word games, quizzes and bingo. Regular and occasional entertainers provide different types of music. Two hour bus trips for various groups are arranged from time to time. Anglican, Catholic and non-denominational church services are held regularly. A Friendship Group is conducted by church-based volunteers fortnightly.
For myself, as a former public figure and historian, I like to keep up to date with the latest news through the internet and the daily papers. More particularly I like to write, and I derive much satisfaction from providing contributions for the Facility newsletter.
One area that causes problems for some residents is that of meals. I believe that management makes quite some effort to provide for the differing tastes and diets of the residents but inevitably not everyone will be satisfied all the time. Residents are given the opportunity of selecting one of two options of lunch and dinner meals on the following day’s menu. For those with gastric or other problems, residents may order other foods such as salads, sandwiches, scrambled eggs etc. There is also a choice of desserts with yoghurt and fruit always being one of those offered.
A meeting is held every second month to which residents and family members are invited and where concerns and comments may be aired. Also forms are available at the reception desk where residents may make complaints or offer suggestions at any time.
It has to be remembered that Aged Care Facilities are not hospitals but steps are taken to manage the health care of each resident and in the case of a fall or an accident an ambulance is usually called. Most residents are referred to one of the doctors who visit regularly and an “after- hours” service is available. Nursing staff include Clinical Nurse Managers, Registered Nurses (one of whom is always on duty), Enrolled Nurses and trainee nurses. There is a trained kitchen staff and a large staff of carers who are responsible for serving meals, assisting with showering and toileting, making beds, monitoring bowel movements, replenishing water jugs and assisting residents as may be required. Aged Care staff need a great deal of patience and be motivated by a deep sense of caring for others. They are entitled to our utmost respect.
In reviewing my 15 months residency of this Facility, I really appreciate the care I have been given. I have learnt the need for acceptance – that things will not always be to my liking and that I am living with people of different nationalities and degrees of cognitive ability. But above all I am grateful that I am facing my Final Challenge in a clean, well equipped Aged Care Facility.
Aged Care Home Resident
Published by the West Australian in Money Matters and on Facebook on 12-06-17