25 November 2016

Advancing age - some thoughts

| John Hargreaves
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Aged care

I have a very dear mate of mine who is facing the most horrid of decisions. As he gets older, he becomes more frail, and more dependent on family, friends and support agencies. The sad part is that not only does he have to face a reality, we must look on and despair with him.

It got me to thinking about the options for older people who have hitherto lived an independent life in the comfort and security of their own homes and now must face the fact that they can’t continue to do so.

Health issues seem to come with a rush. Firstly, it is just that one becomes more susceptible to bugs and viruses, because of an undiagnosed downturn in the immune system, then the palate changes and food doesn’t have the same appeal anymore. Once we could run, now walking is a problem and standing still is just not an option. Falls come along intermittently and without notice.

The older we get, the frailer we get and the more brittle our bones become. I once said that it wouldn’t happen to me but I think I might just be fooling myself.

After a number of trips in the ambulance to ED and a longer and longer series of stays in the hospital, it becomes obvious that an Aged Care Assessment Team (ACAT) assessment has to be done. This is an interesting process, because the ACAT people do everything in their power to keep people functioning independently at home and only recommend nursing home type facilities as a last resort.

But unless the Grim Reaper carries one off prematurely, the trip to an aged care facility is ultimately probable not just likely.

As an aside, I remember writing about the regard the different cultures have for the elderly form their communities. The Chinese and Japanese siblings often argue about who will look after the parents. They want to have them at home. Similarly, the eastern and southern European communities have an affection for their elderly.

I don’t see that same regard being the case within our Anglo-Celtic community. We seem to rush to dump Granny in a nursing home as soon as she becomes a burden.

So, I thought, what alternatives are there?

In looking at the circumstances of a relative and my old mate, I found that there are plenty of opportunities for seniors in their advanced years which can be accessed to prevent to trip to the nursing home.

The ACAT assessment comes with recommendations and networks to alter the fabric of a home to make it more disability effective. Remember that no-one died of old age. They died because something stopped working. This is usually a series of related events like organ failure, disease more powerful than the ability to counter it, or, in some cases, people just give up and pass away. But the key is that it is a disability which carries people off and often this can be ameliorated or mitigated.

Walking aids and mobility assistances can be brought in, modifications to steps and stairs can be arranged, bathroom and toilet modifications can be installed. Assistance with shopping, cooking, bathing, gardening, house cleaning and the like all can be delivered by agencies and volunteers geared up to assist.

When all this fails, an isolation can set in. An elderly person can find themselves imprisoned in their own home and become more averse to contact with others each passing day. This isolation has an acceleration effect on the deterioration of the body and the mind.

I congratulate our senior clubs for their approach to active minds and bodies and the way in which they try to reach out to the seniors in their areas to prevent this isolation from happening before it becomes an issue. The more successful the club, the less likely a person will find themselves in a nursing home.

I might do some further reading and talking to people in the nursing home sector and write something about this bit later.

In case some accuse me of conflict of interest, I declare that I am the current president of the Tuggeranong 55 Plus Club, which is the seniors’ club in the Tuggeranong Valley. It is not the only one but it is the one I am most familiar with.

These thoughts are those which came to me and continue to come to me, as I wrestle with the difficulty of watching those dear to me become less able to care for themselves. So, if my views wander a bit, maybe it says more about me than the issue I tackle.

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devils_advocate1:24 pm 30 Nov 16

Acton said :

devils_advocate said :

John Hargreaves said :

There is a reason people of gen X and Y in western countries do not share the attitudes towards elders as their contemporaries in other cultures (such as the east Asian cultures you have referenced).

It is because they consider that the boomer generation that is now ageing has fundamentally, systematically and irredeemably taken advantage of them in just about all aspects of life (economic, housing, education, tax transfers, etc etc).

Now before people dive headlong into a debate about who was better off, etc etc so before that happens let me pose this thought experiment: Let’s say that the current generation of boomers was able to get together in a vast conspiracy and systematically plot every conceivable intergenerational wealth transfer from the younger generation to the older generation, in every field they could think of. They went through one by one and over time systematically designed the tax system, education system, housing finance system, everything, with the twin objectives of screwing the generation that followed and collecting benefits to themselves.

What would that system look like? And how would it be different to what we have today?

The fallacy in such a nonsensical conspiracy theory is that baby boomers are parents so to have done what you propose would mean disadvantaging their own children, grandchildren, families and ultimately themselves.
Conspiracy theories are ludicrous proposals emanating from the minds of those who prefer simplistic explanations rather than having to understand or deal with the complexities of the big bad real world.
If baby boomers truly wanted to screw the younger generation there would be no schools, medicare, parental leave, youth allowance etc. Instead we would send the ungrateful little buggers to work down the mines in eternal slavery.
This reminds me of that scene from the Life of Brian, ‘What have the romans ever done for us’?
https://www.youtube.com/watch?v=Y7tvauOJMHo

Um, no. You might have overlooked the bit where I mentioned “thought experiment”. I am not actually suggesting such a conspiracy. There is no need – plenty of other explanations exist (mainstream economics and the ‘invisible hand’ of the market; political economy; etc etc). It is merely an elaboration on the broad concept that the boomers couldn’t have engineered a greater intergeneration theft if they had tried.

devils_advocate said :

John Hargreaves said :

There is a reason people of gen X and Y in western countries do not share the attitudes towards elders as their contemporaries in other cultures (such as the east Asian cultures you have referenced).

It is because they consider that the boomer generation that is now ageing has fundamentally, systematically and irredeemably taken advantage of them in just about all aspects of life (economic, housing, education, tax transfers, etc etc).

Now before people dive headlong into a debate about who was better off, etc etc so before that happens let me pose this thought experiment: Let’s say that the current generation of boomers was able to get together in a vast conspiracy and systematically plot every conceivable intergenerational wealth transfer from the younger generation to the older generation, in every field they could think of. They went through one by one and over time systematically designed the tax system, education system, housing finance system, everything, with the twin objectives of screwing the generation that followed and collecting benefits to themselves.

What would that system look like? And how would it be different to what we have today?

The fallacy in such a nonsensical conspiracy theory is that baby boomers are parents so to have done what you propose would mean disadvantaging their own children, grandchildren, families and ultimately themselves.
Conspiracy theories are ludicrous proposals emanating from the minds of those who prefer simplistic explanations rather than having to understand or deal with the complexities of the big bad real world.
If baby boomers truly wanted to screw the younger generation there would be no schools, medicare, parental leave, youth allowance etc. Instead we would send the ungrateful little buggers to work down the mines in eternal slavery.
This reminds me of that scene from the Life of Brian, ‘What have the romans ever done for us’?
https://www.youtube.com/watch?v=Y7tvauOJMHo

devils_advocate10:28 am 29 Nov 16

John Hargreaves said :

But I do know that there are people of my age as readers and contributors of Riotact and my story/opinion may just resonate with them. What is needed is a cultural and attitudinal change in both the rellies and the system. Most frustrating.

There is a reason people of gen X and Y in western countries do not share the attitudes towards elders as their contemporaries in other cultures (such as the east Asian cultures you have referenced).

It is because they consider that the boomer generation that is now ageing has fundamentally, systematically and irredeemably taken advantage of them in just about all aspects of life (economic, housing, education, tax transfers, etc etc).

Now before people dive headlong into a debate about who was better off, etc etc so before that happens let me pose this thought experiment: Let’s say that the current generation of boomers was able to get together in a vast conspiracy and systematically plot every conceivable intergenerational wealth transfer from the younger generation to the older generation, in every field they could think of. They went through one by one and over time systematically designed the tax system, education system, housing finance system, everything, with the twin objectives of screwing the generation that followed and collecting benefits to themselves.

What would that system look like? And how would it be different to what we have today?

devils_advocate10:21 am 29 Nov 16

pink little birdie said :

I think this is why there is a push for universal access in building codes for new and remodelled homes for aging in place. It means certain struts put in the frame during the building phase which allow supports in the bathroom and toilets to be added with minimal effort and corridors and doors of a certain width to allow mobility machines. I believe there is a little pushback from the builders because it’s more expense and more work during the building phrase though.

100% not the case. It is not the extra expense. It is the complete disregard from EPD/ACTPLA for the policy objectives that the elected government has put in place to make it possible for homes to be made accessible.
Making homes accessible does involve some design trade-offs. driveways and accessways must be flatter and wider, bathrooms larger, and lines of sight unobstructed, doors and latch-side approaches designed differently, garages larger, etc etc. Granted all these add expense but not prohibitive. The real barrier is planning approval. Instead of working with applicants to achieve the government’s stated aims of accessible housing (I believe they even have a target/KPI?), ACTPLA takes an adversarial approach and insists on 100% strict adherence to the design rules that apply to ALL houses in general. Even when they are directly contradictory to the design considerations of access. For most builders going through this process once would be once too many.

pink little birdie3:19 pm 28 Nov 16

I think this is why there is a push for universal access in building codes for new and remodelled homes for aging in place. It means certain struts put in the frame during the building phase which allow supports in the bathroom and toilets to be added with minimal effort and corridors and doors of a certain width to allow mobility machines. I believe there is a little pushback from the builders because it’s more expense and more work during the building phrase though.

wildturkeycanoe12:10 pm 28 Nov 16

We mustn’t forget the younger people who are afflicted with just as debilitating symptoms, such as those with injuries or illnesses that have a profound effect on independent living. Thanks to the consistently increasing age of retirement, these people may never get to see a pension and with the hap-hazard nature of superannuation returns, they mightn’t even be able to afford to be put into a care facility. What does a mid thirties or forties person who has been injured or or afflicted with some kind of disability do for the remainder of their lives? There are plenty of clubs and support groups for pensioners and the over fifties, younger folks haven’t had that extra thirty or forty years to accumulate wealth to put towards the “twilight” of their life. They can’t move in with their kids because the kids are still at school. It’d be much easier to accept being put into a home when you may only have a decade to live, if you are lucky, but imagine the heartache of needing full time or part time care when you haven’t even reached the halfway point.
I saw my own parents go through this, as my grandparents reached the point where they needed help to get by at home. My mother was already suffering from arthritis and my father had pretty much retired from work early due to a very bad accident whilst on the job. Even though they struggled with some daily chores themselves, it became necessary for my mum to go over and clean their house, help them with self care, shopping and cooking. There were few choices of outside assistance such as meals on wheels or the like, thanks to being in a small rural town. Eventually, after many years of putting up with things like trying to locate my grandfather who’d gone AWOL on his electric buggy, they were taken to live with my aunt. It was a relief for my parents and not long after, the nursing home became my grandfather’s final residence.
If not for family, many retirees would succumb to the loss of their independence and have a miserable finish to their life, but not many people realize how much that support affects the family who sacrifice their own time to look after them. Is it a cultural responsibility to help our parents when they can’t do it for themselves, or do we sell their assets and dump them in a home? I guess it is a personal choice we will have to make and factoring into that decision are many things such as our belief systems, the financial aspects and personal relationships. When/if the time comes, I know there are some things I won’t be able to help my parents with to keep them independent for as long as possible. It’d be nice to think they could get to the end of the race in their own home but if we are unable to help care for them, then finding a good nursing home will be necessary.

All the problems and indignities of old age – constant pain, frail bones, failing organs, incontinence, and dementia can be solved by legalising voluntary euthanasia.

However, the right to end our lives painlessly at the time of our own choosing is denied because of the political influence of the medical profession and international drug companies with a vested interest in protecting their lucrative market while they devise new ways and new drugs to drag out the inevitability of death.

Religious zealots also presume the authority to tell us all how to live and how to die, seeking to preserve their ever diminishing influence.

If we can legitimise and implement the means to terminate a pregnancy, then we should be able to legitimise and implement self-termination. Both are a choice, yet we allow one and deny the other.

My choice, which should not be denied by someone else, is a painless and dignified end when I have ticked all the boxes on my still very long bucket list.

Politicians who fail to act now in the interests of the community will face the consequences when they too grow old.

Add chicken wings to the obsession list.

Seniors with no teeth find these a bit of a challenge.

John Hargreaves9:51 am 28 Nov 16

dungfungus said :

While I commend you for this post and the issues you raise which I agree with you entirely, I fear that this forum is the wrong one to try and get any sympathy for the plight of the elderly.

Most contributors to this blog are obsessed with coffee, kebabs, pulled pork and smashed avocados.

All Bran and prunes are alien concepts as are mobility assistance for the aged when the latest $10,000 carbon fibre mountain bike is there to be reviewed.

And here I agree with yo as well. I have tried to bring some of the issues to light on this subject before with not much success. But sometimes the issues seem overwhelming. For example, this week, I have a mate in his 70s in hospital about to transition to a nursing home and I am assisting in this one, I have a relative in a nursing home who I have to take to the hospital and back mid week and I have to pick up a mate’s mother aged 90 at the airport today and take her home because there is no-one available to do it.

But I do know that there are people of my age as readers and contributors of Riotact and my story/opinion may just resonate with them. What is needed is a cultural and attitudinal change in both the rellies and the system. Most frustrating.

While I commend you for this post and the issues you raise which I agree with you entirely, I fear that this forum is the wrong one to try and get any sympathy for the plight of the elderly.

Most contributors to this blog are obsessed with coffee, kebabs, pulled pork and smashed avocados.

All Bran and prunes are alien concepts as are mobility assistance for the aged when the latest $10,000 carbon fibre mountain bike is there to be reviewed.

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