Fu­ture of long-term care of el­derly dis­cussed

Malta Independent - - BUSINESS & FINANCE -

Should we be adding years and years to the lives of older peo­ple? Do we need to keep treat­ing cer­tain con­di­tions such as high choles­terol beyond a cer­tain age at the risk of over­load­ing the per­son con­cerned with med­i­ca­tion? Do we need to speak to older peo­ple, particularly those in care homes, as if they are chil­dren? Do we need to make them do things they do not wish to do – such as go­ing out when they don’t feel like it? Why should a per­son die still hooked up to a drip when, ac­cord­ing to ex­perts, at a cer­tain stage these be­come use­less?

These were some of the poignant ques­tions asked dur­ing a sem­i­nar or­gan­ised by the Care­malta Academy within the Care­malta Group as part of the com­pany’s events to mark the In­ter­na­tional Day ded­i­cated to older peo­ple cel­e­brated on 1 Oc­to­ber. The sem­i­nar, fa­cil­i­tated by PBS jour­nal­ist Mario Xuereb, fo­cused on the fu­ture of long-term care of the el­derly and was at­tended by var­i­ous stake­hold­ers, in­clud­ing doc­tors, nurses, pub­lic of­fi­cers, man­agers of homes for the el­derly, el­derly peo­ple them­selves and aca­demics.

Last year, Malta saw the launch of national min­i­mum stan­dards in the care of the el­derly, the re­sult of a new con­cept re­gard­ing stan­dard­i­s­a­tion af­ter years of op­er­at­ing out­side a for­mal reg­u­la­tory frame­work. The aim of the sem­i­nar was to ex­am­ine whether there was a need to look beyond ad­her­ing to stan­dards, poli­cies and reg­u­la­tions and be­gin re­ally get­ting to know the peo­ple who need care, to see what their real needs and wishes are. By do­ing this, the el­derly would be pro­vided with the per­son-cen­tred care they de­serve.

Care­malta CEO Natalie Briffa Far­ru­gia ex­plained that the sem­i­nar should serve as an op­por­tu­nity for all those in­volved in the care of the el­derly sec­tor to re­flect whether cur­rent prac­tices are el­der­lyfriendly and re­spect­ful to the full dig­nity of the per­son con­cerned. She posed the ques­tion: What about in­volv­ing them and see­ing things from their point of view and their ex­pe­ri­ence as the jour­ney we can make to­gether.

The key­note speaker at the sem­i­nar was Pro­fes­sor Pierre Mal­lia, who touched upon a num­ber of eth­i­cal is­sues re­lated to old age and the care of older peo­ple. He asked whether the hu­man be­ing is be­ing helped to live beyond the nat­u­ral life­span with con­se­quences such as the grow­ing risk of treat­ing the el­derly as a num­ber rather than as a hu­man be­ing.

Prof. Mal­lia also touched upon the is­sue of the dig­nity of the older in­di­vid­ual, ask­ing whether el­derly peo­ple are usu­ally treated and spo­ken to as if they were chil­dren. Here he men­tioned how vul­ner­a­ble older peo­ple are some­times shouted at and made to do things such as hav­ing a wash when, in fact, they do not feel like do­ing so at that par­tic­u­lar mo­ment. It of­ten hap­pens, he re­it­er­ated, that care­givers and rel­a­tives end up tak­ing de­ci­sions for them rather than let­ting them par­tic­i­pate in the process. Prof. Mal­lia sug­gested that, ide­ally, the older per­son should take cer­tain de­ci­sions that would af­fect them later in life when they are still rel­a­tively healthy.

He also said that al­low­ing some­one to die with dig­nity is not tan­ta­mount to killing them. At a cer­tain point it would be more ben­e­fi­cial to the older per­son to cease giv­ing them treat­ment but to en­sure they re­ceive the ten­der love and care that be­comes so nec­es­sary at that point in life.

Prof. Mal­lia asked whether or not it isn’t high time to think about ex­tend­ing in­sur­ance cover to com­mu­nity care, which could en­cour­age and fa­cil­i­tate the older per­son’s stay at home, even at a cer­tain stage. How­ever, he also asked if cer­tain com­mu­nity ser­vices that have been in place for al­most 25 years are still work­ing. He pointed out that lone­li­ness can be a sad re­al­ity and that, for this rea­son, pro­fes­sion­als who deal with el­derly peo­ple would do well to go the ex­tra mile to spend some time talk­ing to them, de­spite their busy sched­ules.

His speech un­doubt­edly raised a lot of com­ments when the dis­cus­sion was opened to the floor. Par­tic­i­pants spoke about the need to have trained and qual­i­fied staff pro­vid­ing ser­vice to older peo­ple – es­pe­cially those in care homes. Other par­tic­i­pants spoke about the im­por­tance of be­ing more flex­i­ble when deal­ing with the el­derly res­i­dents of care homes.

One of the par­tic­i­pants, with years of ex­pe­ri­ence work­ing in the sec­tor, pointed out that there should not be a one-size-fits-all at­ti­tude but per­son-cen­tred care that is im­por­tant in a care set­ting to re­ally get to know the per­son and provide him or her with the ser­vice he or she needs.

Pro­fes­sor Pierre Mal­lia

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