Author: Sarah Russell

Older People At Risk Of Being Financially Abused – By Their Children

14 June 2019

The United Nations (UN) has designated today (15 June) as World Elder Abuse Awareness Day. The types of abuse to be aware of include financial, physical, sexual, social, psychological and emotional abuse. Financial abuse appears to be the most common.

While some older people are enjoying their wealth – travelling the world, their luggage broadcasting that they are spending their children’s inheritance  – others live in aged care homes, with their children keeping their eyes peeled on the ‘Bank of Mum and Dad’.

As economic conditions worsen, this second group is at greater risk than ever of being financially abused. Financial abuse involves taking or misusing an older person’s money, property or assets. It also includes persuading an older person to change their will through deception or undue influence.

Research has identified adult children, particularly sons, as the most common perpetrators of financial abuse. The victims are often women over the age of 80. Like other crimes perpetrated mostly on women – domestic violence and sexual assault – financial abuse is often a silent crime, unreported and unacknowledged. As a result, there is little reliable data on its extent.

The most vulnerable include older women with diminished capacity due to dementia and depression. According to the Office of the Public Advocate, older women are more likely to be declared legally incapable than older men. This may be due to the fact that women live longer than men. It may also suggest that older men are revered whilst older women are infantilised. This was certainly the case in Julie’s family.

Julie is a middle-aged woman with four older brothers who were all educated at elite private schools and have had successful careers. With unseemly haste, a few days after her father’s death, a GP was asked to declare Julie’s elderly mother legally incapable. That she was bewildered, grieving and in the first weeks of widowhood after 64 years of marriage was not taken into account.

After Julie’s mother was declared legally incapable, the youngest son, Tony*, became her financial power of attorney. Without any guidelines to help him manage his mother’s money in an ethical manner, Tony recommended his mother gift some of her money to her children. This gift would help his siblings with mortgages and other debts. “Mum doesn’t need this money and it’s going to be ours soon anyway”.

Julie was horrified. Should middle-aged men who all have professional jobs with decent salaries rely on inherited money to help them with loans they chose to take out to support their lifestyles? Julie told her brothers they had ‘early inheritance syndrome’.

Adele Horin coined the phrase ‘early inheritance syndrome’ to describe children with a sense of entitlement to their parents’ assets. These impatient children are not prepared to wait until their parents die. Children with ‘early inheritance syndrome’ often make ageist and sexist assumptions that devalue the rights of their elderly parents.

Tony assumed his mother, who had not been the family’s breadwinner, would find discussions about financial issues complex and stressful. He arranged family meetings to discuss ‘the family estate’ without his mother present. This was not only patronising it also disempowered his mother.

Julie’s eldest brother told his siblings he was planning his retirement. He unashamedly cast his eyes towards the Bank of Mum. Without blinking, he requested regular spreadsheets of his mother’s expenses so he could know his “financial position”. He assumed what was once ‘Mum and Dad’s money’ was now his money, not his mothers’ money.

There have been several legal disputes in which sons have sued their mothers over a ‘family estate’. In one case, a former pupil of a private boys school took legal action after the family estate was left to his mother rather than to him. The judge castigated him for having a “highly developed and unhealthy sense of entitlement“.

This gendered sense of entitlement is reminiscent of the Victorian era. In those days, a wife became her husband’s property, his chattel. A married woman could neither own property in her own name nor control her own money. The laws changed over a hundred years ago. Thankfully so too did attitudes towards married women. Older women may be the last bastion of Victorian traditions.

Soon after Julie’s mother’s 90th birthday party, three brothers complained that their mother’s monthly expenses were “excessive”. They wanted Julie to curtail these expenses. They also wanted to restrict their mother’s visits to her beloved beach house. Julie’s sister-in-law explained: “Your brothers are worried about their inheritance. What’s wrong with that?”

Julie defended her mother’s right to spend her own money. One brother supported her; the other three bunkered down, ensconced with others who shared their privileged views. These brothers refused to engage with Julie. They simply dismissed Julie’s views as offensive, describing her as mad and bad, as powerful men often do.

The financial abuse of older women is on a continuum of violence towards women. It should be a criminal offence. For financial abuse of older people to become a criminal offence, attitudes towards older people, particularly older women, need to change.

 

On resuscitation and a good death in aged care

Recently, a woman contacted me because a 94-year-old woman was resuscitated in an aged care home despite having an advance care plan stipulating Do Not Resuscitate. Rather than die peacefully after breakfast, this woman had a slow and painful death in a hospital palliative care unit.

Aged Care Insite

Slinging Mud During Election Campaign Did Not Help Resolve Aged Care Crisis

20 May 2019

A confidential internal inquiry into the office of the Aged Care Minister Ken Wyatt was leaked to the media during the recent election campaign. The journalist described the leaker as a “whistle blower.”

Whistle blowers are honourable people who are motivated by altruistic intentions. Anonymous disgruntled staff members who are dissatisfied with the outcome of an internal grievance process are not whistle blowers.

I have never worked in Minister Wyatt’s office so I do not have inside knowledge. However, this leak had all the markings of a political attack. Normal administrative processes resolved this grievance. That should have been the end of it.

Instead, a confidential document was leaked to the media in the middle of an election campaign. The leakers’ aim was to throw the Aged Care Minister, the first Indigenous frontbencher in federal parliament, and his Senior Advisor under the bus for political purposes.

The leakers went so far as to accuse Minister Wyatt’s Senior Adviser of bullying. The oldest trick in a bully’s handbook is to accuse others of being a bully. Is this yet another case of the pot calling the kettle black?

Recently, false allegations of bullying have been made against many strong, intelligent and forthright women in senior positions. When a male is forthright, he is “assertive”. When a female is forthright, she is “aggressive”. This gendered disparity was ever thus.

I am a researcher who advocates for improving standards of care in residential and in-home care. As such, I have had many meetings with Minister Wyatt and his Senior Advisor. Paula Gelo is one of the more honourable political advisors I have met. She is intelligent and committed to her job.

Minister Wyatt’s Senior Advisor and I often discussed my ideas for improving the aged care sector. She was not only respectful but also provided evidence to support the government’s position. I contested this evidence. Paula welcomed this robust contest of ideas.

Others on the Executive of Aged Care Matters have also challenged both Minister Wyatt and his Senior Advisor. Paul Dwyer (Aged Care Finance Solutions) said:

“I have found both the Minister and his adviser, Ms Gelo, exceptionally devoted to the aged care portfolio. Ms Gelo has been available 24 hours, 7 days a week, in any matters. She has shown me respect and courtesy, both face-to-face and via correspondence.”

In my experience, bullies do not welcome alternate views. Instead, they react aggressively. They see disagreement as combat they must win. They either attack people who disagree with them, or ignore them. Either way, they ruthlessly shut down dialogue. Bullies perceive those who disagree with them as enemies who must be silenced. If the evidence does not fit with their worldview, they will simply ignore the evidence.

A new member of the Aged Care Sector Committee blocked me on Twitter after I questioned the value of the Aged Care Workforce Strategy Taskforce’s report. He refused to engage with my alternate perspective. In contrast, Minister Wyatt and his Senior Advisor always replied promptly to my emails and texts, including when I was critical of the government’s policies. They always picked up the phone when I called to discuss an urgent matter. Most importantly, they always did what they said they would do.

On several occasions, Minister Wyatt took my request for access to data to the Aged Care Sector Committee (ACSC). On each occasion, the ACSC denied the request. For example, when Minister Wyatt requested all reports on spot checks be made available on the My Aged Care website, the committee provided a patronising response about the data being “too technical”. According to notes from meeting on 12 May 2017 (obtained by freedom of information): “Members expressed caution about releasing unpublished reports from the Quality Agency as they believed that these reports were more technical and, without explanation, may not provide useful information for consumers or their families.”

According to the media’s report: “Ms Gelo spent $108,000 on airfares as well as $31,000 in travel allowances in one year.” Why did this spark alarm? Surely Minister Wyatt was entitled to take his Senior Advisor with him when he visits aged care homes around the country.

The Aged Care Minister, Minister Wyatt and his Senior Advisor visited over 130 aged care homes in urban, regional, rural and remote locations. Unlike Minister Ley (the previous Aged Care Minister), Minister Wyatt consulted widely with residents, relatives and staff. Both Minister Wyatt and his Senior Advisor should be praised for this, not criticised.

During her Christmas-New Year holidays in 2017, Minister Wyatt’s Senior Advisor read my research report “Living well in an aged care home”. She told me she welcomed reading relative’s critical feedback. She suggested a qualitative research project with older people who receive in-home care. Paula said it was important for Minister Wyatt and herself to hear genuine first-hand experiences of in-home care.

The Commonwealth Department of Health generally commissions research from consultants working in large organisations such as KPMG and Korn Ferry. I am critical of this research – it is not only extremely expensive but often lacks rigour.

I was excited to have the opportunity to bring some genuine ‘consumer’ voices into the debate about in-home care. However, working with the Commonwealth Department of Health was an eye-opener, to say the least. Without Minister Wyatt and his Senior Advisor’s help, it is most likely my research report “Older people living well with in-home support” would have languished in the bottom of a drawer (with all the other reports that have provided the Department with unwelcomed critical feedback).

Working in a politician’s office is not for the faint hearted. The hours are long and the stress is enormous. Minister Wyatt is fortunate to have employed a Senior Advisor who showed him such loyalty.

A smear campaign in the media will soon be forgotten. Instead, aged care stakeholders will remember Minister Wyatt and his Senior Advisor’s work to improve the quality of life of older people who receive residential and in-home care.

 

People seeking asylum

Speech at Candidates Forum on people seeking asylum in Australia  (2019 Federal Election campaign)

I acknowledge the Wurunjeri people of the Kulin Nation and recognise their continuing connection to land, waters and culture. I pay my respects to their Elders past, present and emerging. I acknowledge that I am standing on stolen land and sovereignty has never been ceded.

I also pay respect to all refugees here tonight, and I offer you a heart-felt apology for the way you have been treated by our government – both LNP and ALP.

Last night I attended a forum with some Indigenous people living in Cooper. One of the discussions involved the need for truth-telling. There is also need for truth telling in debates about refugees and migration.

The Reason Party form policies based on evidence. There is no evidence to support our refugee policies.

Human rights lawyer, Shen Narayanasamy, presented her research at the Di Gribble Argument in 2016. Shen shows how yet again those in power control the narrative – even when that narrative is not true.

Shen suggests it has been a deliberate political strategy to focus the public’s attention on a few thousand asylum seekers rather than the 800,000 people arriving each year from Asia, Middle East, India and Africa.

Historically, we have been a country that welcomed refugees. How did our narrative on refugees change so radically?

For example, we now suggest that refugees might be ‘economic migrants’. Yet we welcome 800,00 economic migrants each year. In fact, our country is built on economic migrants.

The first wave of post 2nd world war migration began with Displaced Persons. These people fled their countries that had been utterly destroyed by war. And we welcomed them.

In 1976, we welcomed the first boatload of refugees fleeing Vietnam. By 1982 Australia had accepted close to 60,000 Vietnamese refugees. And we brought them here by plane.

The current narrative: “Offshore detention is the only way to save lives at sea”. This is complete nonsense. Flying refugees to Australia would certainly save lives at sea.

Shen put the number of immigrants from 1984 – 2013 into Excel. The graph showed a steady increase that suddenly skyrocketed after the election of John Howard. By the time Howard left office in 2007, the LNP government had more than doubled Australia’s intake of migrants.

The big difference is the number of migrants that came to Australia on a humanitarian basis. Prior to Howard it was around 1 in 5. By the time Howard left office, that humanitarian intake plummeted to 1 in 50.

I regularly invite refugee families for a short holiday in my beach shack. I’ve had some fabulous holidays with people from Sri Lanka, Iran and Sierra Leone. The most recent family was from Afghanistan. The father applied for a skilled migrant visa but he was flagged by the Immigration Department. Why? Because he, his wife and children were from a war-torn country and trying to seek safety here.

This family ended up on a boat and they spent 4 years in a detention centre in Australia. They now live mostly on charity. Not working has had a terrible effect on the father. But the most dreadful thing is the trauma on the 12-year-old son. He is old enough to remember the terror of being on a boat and the terror of being in a detention centre. This young boy is deeply traumatised. And we are responsible for that.

On a positive note, this family were lucky not to become part of the Pacific Solution. What a disgrace calling our policy of transporting asylum seekers to detention centres in the Pacific Ocean, a “Solution”. A solution for who? Certainly not people from LGBTI community were have been detained in PNG, a country hostile to LGBTI people. This must never ever happen again.

The Reason Party believes the solution to the Pacific solution is to close all offshore detention centres and facilitate the immediate evacuation of Manus and Nauru.

However, if the next government delays the evacuation of offshore detention centres (as Ged suggests an ALP government might), the next government must:

  • Ensure the health and safety of people in offshore detention centres
  • Provide international NGOs and the media access to offshore detention centres

When people apply for asylum, there should be a strictly enforced time for security screening. After security screening, asylum seekers should be brought to Australia and assisted to settle in regional towns and cities while their claim for refugee status is assessed. A predetermined timeframe should be set for processing these claims.

Thank you.

We should be talking about aged care during the election campaign

29 April 2019

Our democracy depends on the robust contest of policies. Yet so far the federal election campaign has been dominated by personal insults, pork barrelling and heated discussions about preference deals. I’ve hardly heard a whisper from candidates about their party’s aged care policies.

I am standing as a candidate for Reason Australia in my local electorate (Cooper in inner city Melbourne) so I can put aged care in the election spotlight. Reason brings an evidence-based approach to all its policies, including aged care policies.

Aged care needs evidence-based, not opinion-based, policies. It also needs kindness. Rather than listen to the opinions of the usual suspects who are part of the broken system that has failed older Australians, we need new thinking. To quote Albert Einstein: “We cannot solve our problems with the same thinking we used when we created them”.

Reason Australia’s policies “Respecting older people” are:

  • Implement strategies to combat ageism
  • Establish a national framework of Healthy Ageing
  • Support the aged care diversity framework and action plans to ensure equality in care for elder Australians
  • Create age and dementia friendly environments within communities
  • Re-write the Aged Care Act 1997 from a human rights perspective
  • Transparency about how aged care providers spend government subsidies
  • Mandatory reporting of elder abuse

ALP and Greens also released new policies on ageing and aged care. The Liberal Party has not announced any new aged care election policies. Perhaps they consider their track record speaks for itself.

Consistent with LNP’s focus on the ‘top end of town’, the government recently gave $320 million to aged care providers without any obligation that this money will improve services for older people. The Reason Party disagrees with giving providers a one off cash injection without any strings attached. Taxpayers’ moneyshould be used to improve the quality of life of older people not the pockets of providers.

The numerous aged care inquiries, reviews, consultations, think-tanks and task forces over the past decade have resulted in a large number of recommendations. Both LNP and ALP governments have ignored most of these recommendations. In fact, the 2013 aged care reforms that have marketised residential and in-home aged care have bipartisan support. This may explain why ALP is not talking about aged care.

The Greens’ policies on aged care are much more progressive than either mainstream party. The Greens are the only political party to address the low salaries of aged care workers. They also support staff ratios in aged care homes though curiously their policy does not require a registered nurse to be on site 24 hours per day. When there is no registered nurse on site, elderly residents, particularly those who are uncommunicative, do not receive timely treatment when their condition changes. In some cases, this is a form of neglect.

The Greens’ policies include the government spending a further $8.5 billion – $3 billion on aged care homes and $5.5 billion on home care packages. They sensibly include a cap on the percentage of the funding given to service providers that can be used for administration rather than direct resident care.

Although more staff, better pay and releasing more home care packages are important, we do not support the government giving more money to aged care providers until providers are transparent about how they spend this money. There must be transparency about how aged care providers spend government subsidies.

Both the ALP and Greens have policies to address elder abuse. The ALP policy states: “Labor will address the prevalence of elder abuse”. 
The Greens’ policy on elder abuse is slightly stronger, but not strong enough. The Greens state: “Measures to prevent and respond to elder abuse”. In contrast, Reason’s policy makes it mandatory to report elder abuse.

According to the Aged Care Act (1997), providers must “maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met”. Although 51 ALP candidates support staff ratios in aged care homes, the ALP policy on staffing in aged care homes states: “adequate staffing levels with the 
appropriate mix of skills”. The ALP policy does not rock the boat.

Reason not only rocks the boat, we tip the boat over. Our policy is a game changer. We don’t tinker with The Act (e.g. mandate ratios), our policy is to re-write the Act from scratch.

Reason Australia envisages an Aged Care Act that focuses on the human rights of older Australians not the profits of providers. This new Aged Care Act will include transparency about staffing levels/training and data about quality indicators. Every aged care home will be required to publish data on quality indicators such as pressure sores, medication errors, weight loss, falls, infection rates admissions to hospitals. They will also need to disclose complaints and how these complaints were resolved. Finally, the new Aged Care Act will require the registration of all workers.

Reason Australia recognises that current policies on ageing and aged care are underpinned by ageism. To achieve justice for older people, we have inclusive policies to combat ageism, homophobia and racism. Our policies also focus on healthy ageing and age and dementia friendly environments within our communities. If older people choose to live in their own home, a retirement village or an aged care home, they deserve respect, kindness and love.

 

Aged Care Matters: Solutions Through Evidence And Dialogue

26 March 2019

Last week I published an article about a vigilante group of aged care advocates who bully and harass aged care providers, staff and other aged care advocates. Stewart Johnston responded to this article with his personal experience of being targeted by this group. He demonstrated forgiveness and compassion for those who had abused him.

I have known about this vigilante group for some time. My impression is members of this group are angry, irrational and mostly illiterate. The few times I visited the leader of this group’s Facebook page, I was shocked by her venom towards providers, peak bodies and government. My response has been to ignore this group.

I know there are some wonderful aged care homes because my parents lived in one. I also know some providers of in-home care deliver high standards of care and support. Yesterday I met the leadership team of one of these providers.

I do not agree with the leader of this vigilante group that aged care is “like the holocaust.”  Instead, my position is we must get the unscrupulous providers out of the sector so we only have providers who deliver high standards of care.

I have been a voluntary aged care advocate for several years. Unlike this vigilante group, my advocacy has focused on finding solutions, not screaming abuse on Facebook and Twitter.

I began analysing systemic issues in the aged care sector after my mother and father moved into an aged care home in 2010. They were both very happy living in the aged care home. Most staff treated them with kindness, respect and love. They loved the food, the activities and they made many new friends, both residents and staff. After Dad’s death in January 2012, I stopped work so I could visit Mum most days for about 3 years until her death in September 2015.

With my background as a public health researcher and a registered nurse who worked in intensive care units, I was able to analyse the aged care sector through a critical and clinical lens. Rather than writing Facebook posts and Tweeting, I began writing regular letters to the editor of The Age. I wrote letters about staffing, accreditation, aged care funding instrument, complaints scheme, living wills and polypharmacy in older people.

After Mum died, I was asked to write an Opinion Piece. The Aged Care Gravy Train catapulted me into aged care advocacy. Soon afterwards, I began a voluntary advocacy group Aged Care Matters. In addition to writing numerous opinion pieces and submissions to inquiries/Royal Commission, I met with government, peak bodies and providers. I have also undertaken a research project on aged care homes and in-home care.

Shouting abuse and sharing memes on a Facebook or Twitter does nothing to help older people. It may make the poster/tweeter feel powerful, but it is just loud noise. In my view, the aged care sector will improve when residents, relatives, staff, providers, bureaucrats and politicians collaborate to ensure older people in aged care homes and in-home care have the best possible quality of life. Engaging respectfully with key stakeholders is an opportunity to learn about different perspectives.

Over the past few years, I have received numerous phone calls from residents and relatives wanting advice and help. Yesterday, a woman contacted me. She was extremely distressed because the aged care home had resuscitated her 94-year-old mother who had a Do Not Resuscitate order in her Advance Care Plan.

It was a heart-breaking story. Rather than die peacefully after breakfast, the family watched their mother and grandmother die a slow and seemingly painful death in a hospital palliative care unit. With better systems in place, this would not have happened. With my focus on solutions, perhaps all residents in an aged care home with a Not For Resuscitation order should wear an identifying bracelet.

It has been difficult for me to step aside from aged care advocacy when there is still so much that needs to be done. However, 20-30 hours a week of voluntary work was not sustainable.

Recently, I was a victim of Internet abuse by a member of the Facebook group Actioning Change for Aged Care. This is the same group who abused Stewart Johnston, Maria Berry and Charli Maree Darragh Matterson. A member of this group said: “People are sceptical and think you are captured because you have lunches with peak bodies.”

I am not captured by anyone. I have meetings with CEOs of peak bodies because I know they are focused on finding ways to deliver the best care to older people. Although I often disagree with peak bodies, we listen respectfully to each other’s opinion. Indeed, I have much more respect for the CEOs of LASA, ACSA and Aged Care Guild than I do for those who shout abuse on Facebook and Twitter.

Yesterday, I was asked if I felt like “doing some pro-bono time for Elder Rights Advocacy”. This financial year Elders Rights Advocacy received over $1.3 million from the National Aged Care Advocacy Program (NACAP) grant. It seems that it may take some time to change people’s expectations. I am no longer a volunteer!