OPINION

Australia's aged care model prioritises profit over people

Do we judge people by their future earning capacity - and is that why we neglect our elderly? Picture: Shutterstock
Do we judge people by their future earning capacity - and is that why we neglect our elderly? Picture: Shutterstock

The lives of two people who really matter to me crossed over only briefly.

My grandson - first grandchild on both sides - was born on January 23. Light of our lives. Apple of our eyes. When I walk him in his pram in the late afternoon, he is a baby sensation. People want to come and chat. I have had to fend off people wanting to pinch his peachy cheeks. What's his name? How old? You can feel the love and happiness as strangers and friends meet our little darling.

My mother-in-law died on May 26, mother to seven, great grandmother to 10. Glorious matriarch. Still alert to the end. In the last few years of her life, she used a wheelchair. Turns out I'm a whizz steering those things, up hill and down dale. But when you steer a wheelchair, no one rushes over to greet the person within. You might get a passing nod or a hello - but what I carried on those wheels was as precious to me as my grandson. Her cheeks were at least as peachy, and I can promise you her conversation was far livelier.

We don't value the old. This frightens me because, as Bob Dylan would say, it's not dark yet but it's getting there. I am older than either of my parents were when they died (yep, reffos die young but leave their children with their burning desires) and I see how easily we are moved from the fascinating file to the dull drawer.

Our government made clear where its values lay late last year. The Coalition voted with Pauline Hanson to defeat amendments to aged care legislation which would make providers reveal how much they spent on staff and food. We had already discovered, during the aged care royal commission, how little was actually spent on food in nursing homes - about $6 a day. There are no ratios for nursing homes. None.

Not long after that vote, I came to the room where my sick mother-in-law lay. She had been calling, crying out, for urgent help, but no staff member had arrived. This was not in an aged care facility but in a private hospital. She was desperate for some physical help, but none came. I went into the corridors looking for a nurse, for someone, but no one was around. Eventually I started calling out. A young nurse arrived and apologised: I'm here by myself, she said.

We would not allow this in childcare centres. Why do we value so little those who have given us so much?

We have a financial model of health in this country. Private hospitals and private aged care providers ostensibly look after our old people, but their first loyalty is to their profit centres.

It is a question Joseph Ibrahim also asks. Earlier this year, Professor Ibrahim, a researcher into ageing at Monash University, warned that the aged care sector in Australia was totally unprepared for the impact of COVID-19. He told the aged care royal commission on Wednesday that Australia had one of the highest rates of deaths from COVID-19 in aged care in the world. We're faring very badly, he said.

Ibrahim has a fascinating view of why old people don't matter in this country. He says it comes from a capitalist mindset. Babies have a future earning capacity. Those who are retired have all that behind them. How do you measure society or worth? He believes that the view in Australia is "you are what you earn". But he also says that because the majority of those in aged care are women, there is a gendered element. He doesn't just mean the patients - the vast majority of the workforce is female.

"Is it because men are more respected, or men are more outspoken, or men make rules to look after themselves?" he asks. "If two-thirds of the population of aged care was men, would it be different?"

Ibrahim has been a researcher in this field for over two decades. He also works in clinical care in Ballarat. And after years of this work, he is sure of one thing: he will never go into an aged care facility.

"You'd have to prise me out of my home.Unless it was completely out of my control, I wouldn't even contemplate going," he says.

He recognises that for some people, there's no alternative. Those who live alone might struggle to look after themselves, struggle to access services - and it is particularly true for those who might be in a lower socioeconomic group. He says he has seen patients for whom aged care has been a safe, warm and welcoming place, and he wouldn't rule it out for everybody. It is just not for him.

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We are not seeing the good side of aged care right now. We see aged care homes as death camps, with no safe haven from COVID-19 and an overlay of staff shortages, poor food, not enough equipment. A place where profit matters more than people. We have a financial model of health in this country. Private hospitals and private aged care providers ostensibly look after our old people, but their first loyalty is to their profit centres. This works if all you are doing is stuff of low complexity - but older people have more complex needs. It is not just the doctors and the nurses, it is also the physiotherapists, the nutritionists, the dentists, the exercise physiologists; and all that costs buckets.

The federal government is doing nothing. Ibrahim describes it as a passive observer, handing out money because no one is asking tough questions (thank heavens for the brilliant work of the ABC's Anne Connolly, Mary Fallon, Patricia Drum and Brigid Andersen which led to the royal commission).

Jacqui Lambie, too, worked hard to get the amendments passed late last year, and was gobsmacked the Coalition voted against them.

She says the Prime Minister needs to "man up and show that he's actually a Prime Minister and not just a marketing man".

As she puts it: "Aged care has been a mess for a long time. The government and Prime Minister can't just blame this on the virus, and they can't blame it on the providers.

"It's about problems with the workforce, problems with the regulations, and problems with the regulator. There's no accountability."

And that is the greatest crime against those who made us. No one cares enough to make the old count.

  • Jenna Price is an academic at the University of Technology Sydney and a regular columnist.
This story Let's face it, we don't care for our aged first appeared on The Canberra Times.

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