Over the past twelve months our family has experienced a heightened awareness of the consequences of aging: with the deaths of a couple of relatives in their nineties; and the need for higher level care for another – also in their nineties. In this post I share some lessons learned about how the needs of these wonderful family members have been able to be met.
Whilst our family know we are blessed to have had this wonderful longevity in our ancestry, it comes as a shock when the agile, alert and active (especially when it is so often heard – ‘he/ she doesn’t look anywhere near that old’) deteriorate from active self-management to be rated High Care on assessment by the ACAT team – all in a matter of months.
Some of the joys of having the older folk in the family include the ability to hear some of the family’s history first-hand; being able to identify in ‘those photos’ just who the elegant looking people are (in those quaint outfits); being able to hear how life was before the advent of television, jet aeroplanes, computers and high speed internet! ..and they are also a great source of information about some of ‘the lessons of life’.
Those benefits far outweigh the seeming tedium some family members might feel, having to give up valuable time to spend with them; and also outweigh distraction of hearing the occasional repetition of stories that are now firmly fixed in our minds. Whilst it may be something of a challenge to get the younger ones to appreciate the time, it is edifying for them to spend time in the company of senior family members – and you might find that they eventually admit it was worth making the effort, if only occasionally!
Are there a few tips to ensuring all goes well for the Aged?
1. Ensure their ‘care needs’ are well met, whichever ‘facility’ is employed in your family’s case.
2. Communicate as regularly as possible: visit at pre-arranged times.
3. Let their friends know where they are, how they can be contacted – and most importantly, encourage them to visit them as well.
1. So how are care needs best satisfied?
Depending on their health and competence, aged care can be provided ‘at home’ or in an ‘aged care facility’. At Home care arrangements are changing with some recently introduced ‘rules’ from the Federal government. This care can be provided at ‘the family home’ or even in a retirement village or similar self-maintained accommodation unit.
Aged Care facilities provide a range of levels of care: Interim Care; Low Care; High Care – and others. There is a huge range of aged care facilities available in different areas, ranging from privately-owned facilities through corporate-owned ‘chains’ and to those run by religious organisations and/ or charitable organisations.
[An ACAT assessment1 is required in Australia to determine which level of care is appropriate for the Aged. Be aware that there can be a waiting period of up to 6 weeks in SE Qld to have the assessment meeting – and the ‘facility’ that you are considering for your ‘aged person’ may not have a vacancy at the appropriate time.]
The selection of the most appropriate facility/ arrangement is one of the most difficult decisions that need to be made by those charged with responsibility for making the arrangements. Following is a checklist of some matters to consider –
- Is the facility accredited2?
- Waiting list length (you may need alternatives if the need is time-critical).
- Services provided by the facility (type and quality)
- access to private phone
- meal arrangements
- grounds and surrounding area
- private or shared bathrooms
- privacy provisions (especially in shared rooms)
- flexibility in daily routine
- provision for married couples (if required)
- standard of accommodation and cleanliness
- Location of facility
- convenient for family and friends (and these two groups may impose different geographical considerations)
- access to local services and transport
- Social aspects
- social activities available
- visitation rights and rules
- residency rules and rights
- Care services
- training and qualifications of staff
- number of care staff on duty and number of residents
- ability to meet dietary and/or health care preferences
- visits by health professionals and family doctor
- access to next level of care with the same provider
- attitude of staff
- Financial aspects
- charges for accommodation bond (if required)3
- financial stability of the provider
- review copy of prudential statement showing they have met obligation to repay bonds
- costs for the care
- additional fee services and costs
[Some families opt to use a broker4 to find an appropriate facility for their aged members. This is not an area with which I have had any personal experience, but hospital staff I have spoken to – those charged with preparing aged patients for discharge from hospital – all recommend the use of a broker, particularly when time is short.]
2. Communication; and Visiting
There are a myriad of small needs for those in aged care facilities: none the least of which is to have some contact and companionship with familiar members of the family – and friends. Whilst most nursing homes/ aged care facilities are very good at attending to the more necessary of the needs, some seemingly unimportant items can be overlooked (or not adequately prioritised).
It may just be a weekend newspaper, a favourite food treat, a particular item of clothing (fabric, style, size etc) – but as insignificant as they may seem to those of us sufficiently mobile to be able to satisfy such needs for ourselves, the frustration of having to compromise on such items can be a challenge for the aged in care.
For many of them, the small-talk chat is as important as their next meal – and so a visit is a significant highlight of their day. When making your visit, ensure there are topics to talk about regardless of the health or alertness of your elder-person (they will appreciate that you can talk to them regardless) – and before leaving try to commit to a time and date for your return. All the normal courtesies of communication need to apply if your circumstances change in the meantime.
3. Encourage visits from friends
Whilst this particular ‘service’ can be difficult to provide because of the practicalities of the age, location and mobility of some of their peers, to the extent possible, their friends should be encouraged to make occasional visits.
There are benefits for the family of course in that there is then less pressure to have to make your own visit, but it also helps the person in care to maintain a sense of belonging to the old network. Depending on circumstances, it could pay to have someone coordinate visits to maximise the companionship opportunities.
If physical visits can’t be arranged, at least ensure that telephone contact is maintained – and this is particularly useful if the care facility is some distance from the former home of your elder-person and their friends.
Some general observations:
I was led to write this post on reading an article under a disturbing headline in a recent edition of The Courier Mail about abuse of older persons, usually by members of their family. There is so much to be gained from having a close and positive relationship with your older family members that I was disheartened to read the article – and quipped that such a headline shouldn’t even be able to be contemplated in a civilised society.
There are reasons why not all families will be able to follow all of the tips and suggestions made above: sometimes ingrained family disharmony impede such relationships; extreme ill-health, mental and/ or physical incapacity can make the communication process a more extreme challenge; financial issues may also provide barriers to obtaining all the services we would like for our older family members in need of care – I trust however that the thoughts I have shared above might be able to be adapted to make this time in their lives, less stressful – and less lonely.
4 A Google search for ‘aged care brokerage services’ shows a number of NFP organisations who provide such services but nothing in the first couple of pages indicates that there is an association for members providing such a service. This will be a ‘referral’ appointment I suggest – talk to a friend or associate who has used such a service and take recommendations.