Aged care a good choice for our healthy elders?
My mum went into an aged care facility last week. To stay alive as a healthy 85-year-old in America’s pandemic, you pretty much have to avoid people outside your home. As an extrovert widow, she decided that she’d rather live in a tiny apartment with shared spaces than live more long months alone in a house. Her daily loneliness since the Covid outbreak accelerated her decision to move to residential care.
For me, trapped in New Zealand by the slowmoving cogs of pandemic-era travel, it’s brought up lots of emotions: memories of my vibrant mum in the prime of her life, guilt-tinged sadness about the Western World’s trending away from multigenerational households, powerlessness against the mighty churn of ageing, yet gratefulness that she is safe, supported, and sane.
All of this brings my own situation as an eventual senior into focus too. Most of us, like her, will spend time in an aged care facility.
In New Zealand, nearly half of people over 65 years and two-thirds of those over 85 years now use residential aged care. Between 2000 and 2015, rest homes were the most common place for women to die. For men, roughly the same number die in residential care as they do in hospital.
Much of our older population is now heading through the automatic doors of their nearest Bupa or Ryman Healthcare residences. Whether they’re independent, assisted, or full-support nursing facilities, there seems to be a level of care for every stage.
But report after report calls for higher staffing levels, better quality care, and remedies to address chronic caregiver shortfalls. We’ve all heard disturbing stories of elder neglect in some facilities.
If the aged care sector could lift its game and encourage independent older people to shift into its facilities before more intensive nursing care is needed, there could be benefits for both them and our wider community.
For one, older adults living alone might not cook healthy meals for just themselves, but catering in retirement villages is becoming ever more nutritious and appetising, bringing health gains to our elderly population. There are few healthier activities for minimising the effects of ageing than regular and meaningful contact with other people, which is made available and accessible in most aged care facilities’ social, exercise, and recreational schedules.
Domestic workloads – housework, gardening, cooking – are substantially reduced for those living in retirement facilities. While some chores can be beneficial for their physical and cognitive health, having more time for doing what you want to do rather than what must be done is a major attraction for people to shift to aged care facilities at a younger age.
Pressure would also be eased in our country’s housing crisis. As healthy older people move from their two- to four-bedroom houses to purpose-built apartments in retirement communities, housing stock numbers for families could grow.
As a working mum, there are days when the noise of work and the demands of family can start to overwhelm. Sometimes, it sounds like a wonderful plan to have a quiet apartment of my own, meals at the ready, friends down the hall and someone else doing the thinking on tomorrow’s activities. Maybe my friends and I should be booking in now.
When we hear of an elderly person remaining independent to the very end of their life and dying peacefully in their own home, it sounds like things have panned out for the best. But what we haven’t heard is how they may have struggled in silence with simple household tasks, been confused by the ways of a changing world, and spent painful moments of loneliness with a sense they don’t want to bother anyone, so will just soldier on in solitude.
So, if more older Kiwis invest in a more connected way of life in retirement villages and aged care facilities, will the companies that provide the service meet the expectations of the next generation of older adults?
Flexible eating arrangements, fast wi-fi and technology support, lots of green and exercise areas, even spaces to grow their own food, could be what older people start to demand. Car-sharing schemes so that those still able to drive don’t have the hassles of car maintenance, costs, and parking. Wine and beer served with meals. Weekend trips with a bit of adrenaline.
If the trend in New Zealand is that more of us choose living together in our final years of life, the aged care sector should be creating new ways to make their communities work for us.
My mum, so far, is loving her new life in her small but supported apartment. She’s eating better, has made new friends, and has two reasons every day to connect with ‘‘very nice people’’ at mealtimes. Despite the distance between us, it seems her final stage of life will be a happy one.
But report after report calls for higher staffing levels, better quality care, and remedies to address chronic caregiver shortfalls.