Research Page

Relatives bear load

Letter, The Age

Sarah Russell’s article (“We’re neglecting our ageing population”, Comment, 18/4) describes many of the serious shortcomings evident to anyone who has experienced the emotional turmoil of placing a loved one into institutional care.

Mecwacare’s Noel Miller Centre in Glen Iris is a case in point. In the high-care facility, significant cutbacks in staff numbers along with general management disengagement from resident service delivery is of great concern to those who visit daily, some twice daily. All too often relatives have to help with tasks from feeding, bathing and room cleaning because staff are too pressed. Management too often does not see what actually occurs in residents’ rooms and common areas – preferring to remain in their offices.

Curiously, Mecwacare, a not-for-profit organisation, recorded a net profit of $3.9 million for the year ended June 30, 2015, and bought a new head office in Malvern and added six aged care homes to its portfolio.

Neither the board nor the executive of Mecwacare has explained why growing the portfolio of buildings and Mecwa facilities should take precedence over the care and welfare of those already living in their facilities – especially in their high-care units.

 John Simpson, former resident relative – Mecwacare

Pain is real, not a myth

Letter, The Age

It is tragic that older people commit suicide (The Age, 17/1). The National Coronial Inquiry Service estimates that two people over the age of 80 are taking their lives every week. The most common method is hanging.

Ian Hickie suggests older people commit suicide because of myths and negative stereotypes about ageing, pain relief, hospitals and how the health system treats elderly people. Are these myths?

Recently, an elderly woman living in an aged care home died in excruciating pain because no one was suitably qualified on the night shift to administer the prescribed morphine. The woman’s daughter was so traumatised she could not remain at her mother’s bedside to hold her hand.

We do not need motherhood statements about healthy ageing. We need political action to ensure older Australians are valued and receive the quality of health care that they deserve.

 

Sarah Russell, Northcote

 

Our elderly need homes, not warehousing

estia

Language  shapes our sense of place. Residential aged care facilities are places that our most vulnerable older people call home; the home that will, for most, be their last place on earth. The term “facility” dehumanises aged care. Facilities are built to perform functions in the most efficient manner. In contrast, a home is a welcoming place, where friends and family drop in for a cuppa or a chat,   and, if we need help, assist us around the house, the garden or even with dressing.

Since the 1990s successive governments have failed to heed the forecasts of demographers on population ageing. Now with the need for housing and care options exceeding the capacity of families and communities, an investment boom is taking place. Private equity firms, foreign investors and superannuation and property real estate investment trusts are entering the residential aged care market in larger numbers. And they are building larger facilities.

According to the Australian Institute of Health and Welfare, half of all residential aged care facilities had more than 60 places in 2014 compared with 28per cent a decade ago. Increasingly built on reclaimed industrial land, aged care facilities now serve as places to warehouse our parents and grandparents,  removed from daily community life.

The Aged Care Financing Authority estimates the residential aged care sector requires $31 billion of investment over the next decade. Handy if this can come from private funds. To attract investors, the Productivity Commission recommends a competitive market with reduced regulation. In a recent letter to the editor (8/1), the chief executive of the Aged Care Guild listed “infrastructure, technology, and training and consumer choice” as the improvements “unleashed” on the sector. Care was not mentioned.

Using language of facilities, scale efficiencies, corporatised operations and the generation of better margins enables investors, industry bodies and politicians to respond in solely economic terms, forgetting they are building a home where care is provided for us, our parents and grandparents.

Policies seeking to improve care are bureaucratic and largely meaningless because they are based on the language of business facilities. While we need strong standards and monitoring of aged care services, we equally need to change the prevailing view of ageing, and what it means to provide a home and care.

We need to include the broader moral view on the question of how  we, as a community, can create an age-friendly environment for all.

We hold deeply negative attitudes to ageing, lumping together all  older people as  a drain on the economy, separating them from the life span, and pitting them against the young for resources. Fearful of our own mortality, frailness and dependence on others, we stigmatise older people. While we respect those who can take care of themselves, or who are “not a bother to anyone”, those who are frail and needing care are not accorded the same respect. This equates to a failure to recognise our parents and grandparents as full human beings. Within aged care, these social views of old people as worthless and unproductive are  reflected and magnified when faced with the daily reality of frail human bodies. When we treat people as “other”, when the stereotypes structure policies and culture, we treat people carelessly.

We need a moral approach to the care of older people based on kindness. We need to recognise in older people an inner life much like ours; complex, full of memories, filled with desires, passions and vitality even if their bodies and minds are no longer as agile. There is a significance to late life. It has purpose. Its meanings need to be seen and celebrated.

We need to shift our view of frail, older people to include the recognition of their contribution to our nation’s prosperity over the whole of their lives. We need to value the contribution people who need care can, and do, make to the lives of others.

Everyone is responsible for the culture of ageing. We need effective leadership from governments, the private sector, businesses, families, community members and older people themselves. We need to create places where we can live the end of our lives as part of the community, in homes where we receive care with respect and kindness. Our sense of belonging is deeply rooted to our sense of place and purpose. We have a moral responsibility to create age-friendly places for all.

Dr Kathleen Brasher is a member of the WHO strategic advisory committee for the Global Network of Age Friendly Communities

 

 

Respect living wills

Letter, The Age

I arrived at an aged care facility recently to find a fire truck, 2 Mobile Intensive Care Unit Ambulances (MICA), a paramedic motorcycle and an ordinary ambulance. The flashing lights heralded the death of a 94-year-old resident. The nurse in charge had dialled 000 despite explicit written instructions that the resident not be resuscitated. Residents of aged care facilities are encouraged to make living wills. These advance directives allow residents and their families to state their wishes for end-of-life medical care. These living wills are meaningless unless health care professionals respect our wishes.

Sarah Russell, Northcote

Too quick to prescribe

pills

Letter, The Age

I am the medical power of attorney of my 91-year-old mother, who lives in an aged-care facility. She was recently reviewed by a psychogeriatrician, who prescribed a new drug to slow down the progression of Mum’s dementia, despite the fact her dementia is progressing slowly without this drug. Instead, I prescribed lifestyle intervention, such as outings and conversation, to improve Mum’s quality of life.

Another doctor was concerned my mother was taking a diuretic without a potassium supplement. I explained that she ate several bananas a week, because they are her favourite fruit. Surely, this is preferable to taking a drug.

Last Saturday, my mother had a fall. The doctor was sure she had not fractured her ribs, but still ordered an X-ray. The only treatment for a fractured rib is rest and analgesia. I cancelled the X-ray and instead prescribed trips to the park in a wheelchair and The Age crossword. With burgeoning healthcare costs, I call on all medical doctors to ask: is that drug or medical test really necessary?

Sarah Russell, Northcote

Greedy son syndrome

Letter, The Age

Financial elder abuse is family violence. Senior Law suggests the contributing factor is ageism rather than gender (Domestic violence victims not just women). However, research shows that women over the age of 80 are most at risk of financial elder abuse, with adult sons being the most common perpetrators.

Some children assume that older women, particularly those who have not been the family’s breadwinner, are unable to manage their own finances. After the father dies, they encourage their mother to appoint a financial power of attorney, often a son. In some cases, the mother is declared legally incapable.

Children with ‘Early Inheritance Syndrome’ feel a sense of entitlement to their mothers’ assets. These impatient children will actively seek ways for their mothers to give them money. They claim: “Mum doesn’t need money, and it’s going to be mine anyway.”

Some greedy children keep their eyes peeled on the Bank of Mum. They curtail her expenses, such as money she spends on holidays, carers and Kingston biscuits. They protect what they see as their entitlement.

The financial abuse of older women is on a continuum of violence towards women. It should be a criminal offence.

Sarah Russell, Northcote

 

 

 

Keeping an eye on the bank of Mum

Australians are living longer and living richer than at any time in our history. The Intergenerational Report predicts that 40,000 people will celebrate their 100th birthday in 2055. Some older women will enjoy their wealth – travelling the world, with their luggage broadcasting that they are ‘spending their children’s inheritance’. Others will live in an aged care facility while their children keep their eyes peeled on the ‘Bank of Mum’.

State Trustees Victoria report ‘For Love or Money: intergenerational management of older Victorians’ assets’ shows that women over the age of 80 are most at risk of financial elder abuse. This research found that adult sons are the most common perpetrators.

Financial elder abuse involves taking or misusing an older person’s money, property or assets. Studies confirm that financial abuse is the fastest-growing type of abuse of older women. So much so that Senior Rights Victoria suggested the terms of reference for the Royal Commission into Family Violence should include elder abuse.

When a father dies, some adult children assume what was once ‘Mum and Dad’s money’ is now their money, not their mothers’. They are not willing to wait for their inheritance until after their mothers die. Children with ‘Early Inheritance Syndrome’ feel a sense of entitlement to their mothers’ assets.

These impatient children will actively seek ways for their mothers to ‘gift’ them money, or will interfere in the management of their parents’ assets to protect what they see as their entitlement. They will keep a close eye on their mother’s assets and curtail her expenses, such as money she spends on holidays and carers.

According to the Office of the Public Advocate, older women are also more likely to be declared legally incapable than older men. This may be due to the fact that women live longer than men. Some children assume that older women, particularly those who have not been the family’s breadwinner, are unable to manage their own finances. After the father dies, they encourage their mother to appoint a financial power of attorney, often a son.

Children with ‘Early Inheritance Syndrome’ make assumptions that devalue the rights of older women.

  1. “Mum doesn’t need money, and it’s going to be mine anyway.”

In cases of financial elder abuse, this is the most common justification given for taking a mother’s money whilst she is alive.

  1. “Mum finds talking about her finances stressful.”

Some children believe that their mother finds discussions about financial issues complex and stressful. This is not only patronising but it also disempowers older women to make choices about how their money is spent.

  1. “Having a large amount of money does not improve Mum’s quality of life.

Most of us take comfort in the security of having savings in the bank. Why are older women different?

  1. “Mum will be no worse off after gifting her money to her children”.

This statement is absurd. By gifting money to their children, the children are better off at the expense of their mother. The less money an elderly woman has, the less money she will be able to spend on herself. 

  1. “Reducing Mum’s income will reduce her fees at the aged care facility”.

Lower fees at the aged care facility means more money for the beneficiaries of the will (i.e. the children). However, many older women may appreciate the care that they receive in an aged care facility, and are happy to pay higher fees for receiving good care.

  1. “Reducing Mum’s income will reduce the amount of tax she needs to pay”

Gifting money to children will result in Mum paying less tax. This may be a good thing for the children, but certainly not for society.

  1. “Mum’s current will cannot be changed”.

Most people change their wills throughout their lives as their circumstances change. Why are older women different? Spending years in an aged care facility may change an older woman’s ideas about how the money is distributed after she dies. She may prefer to give some money to Doctors without Borders, The Lost Dogs Home, or even a kind nurse at the aged care facility. This is her decision, not her children’s.

  1. “By gifting money to the children, this gift reduces their children’s loans and interest payments on these loans.” 

Should middle-age professional people expect their elderly mother to assist them to manage their ‘lifestyle choices’?

Financial elder abuse may begin with the best intentions – with an elderly woman asking a child to act as her financial power of attorney. This can quickly progress to a sense of entitlement, particularly when adult children have mortgages or debts.

There is little reliable data on the extent of financial elder abuse. It is often a silent crime – unreported and unacknowledged. Although the banking industry has introduced initiatives to help prevent this silent crime, financial elder abuse remains difficult to police.

Published in Online Opinion

Good bloke or smug thug

The Human Rights Commission’s report The Forgotten Children: National Inquiry into Children in Immigration Detention was tabled in parliament two months ago. The 315-page report provided compelling first-hand evidence of the negative impact that prolonged immigration detention has on children’s mental and physical health. The report also made 16 recommendations.

Since the report was tabled, there has been no substantive discussion in parliament about the report or its recommendations. Our Prime Minister has used all-too-common techniques to stifle debate – attack, shoot the messenger and then ignore the message. These silencing techniques have been effective – they have taken the focus away from an important issue that reflects on Australia’s standing in the world community: children in detention and our obligations under international law.

Tony Abbott’s aggressive behaviour towards the President of the Australian Human Rights Commission, Professor Gillian Triggs, has been named for what it was: bullying.  No doubt, like me, other women have experienced this type of silencing behaviour. In response, Gillian Triggs remained composed and dignified. She is a role model for all of us at the receiving end of such attacks in both public and domestic places.

When Tony Abbott was accused of bullying Gillian Triggs, several colleagues defended him. They described him as a “good bloke”. I don’t know Tony Abbott but I know Tony Abbott Types (TATs). TATs are often described as “good blokes”.  They are men who attended an exclusive private boys’ school. After school, they studied at a sandstone university, lived at an exclusive college and did the ‘right’ courses – law, commerce and medicine. Although many men get over their privileged upbringing, TATs do not.

TATs are men whose sheltered lives as white, private school-educated, professional heterosexuals make them blind to their privilege. They form a network by surrounding themselves with others who share their worldview. They have a toxic sense of entitlement and often say that feminism has “gone too far”.

The upper end of town is filled with TATs. These men huddle together at exclusive clubs where their networking sustains their network. When they attend social functions, they often reminisce about their school and university days – a cricket game or a rowing regatta. The old school tie matters at the MCG’s Long Room.

They do not respond respectfully to 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 dissent. TATs perceive those who disagree with them as enemies who must be silenced.

They use a range of tactics to quell opposition. They will interrupt, talk loudly and mock. They jeer and insult. They blame others. Recently our Prime Minister described the Opposition Leader as an “arsonist” and “the Dr Goebbels of economic policy”. They dismiss alternate views by describing them as “offensive” and “ridiculous”. All these tactics are used to avoid negotiation and compromise.

They shoot the messenger rather than listen to the message. Personal attacks are common not only in parliament but also in the Australian media. In The Australian’s ‘Cut and Paste’ section and The Saturday Paper’s ‘Gadfly’, ‘argumentum ad hominem’ replaces reasoned arguments.

TATs do not substantiate their views. They don’t need to because they know they are right. They use rhetoric, slogans and dog whistles rather than evidence to support their views. The proposed government-funded ‘stop the boats’ telemovie has been described as “propaganda”. How can propaganda further informed debate?

If the evidence does not fit with their worldview, they will simply ignore the evidence. Statements such as “climate change is crap” and “coal is good for humanity” deny decades of academic research.

TATs do not apologise when they offend others – perhaps because they do not have the insight to know how offensive they can be. Scott Morrison refused to apologise to the Save the Children staff for besmirching their reputations. Instead, he brazenly attempted to justify his actions.

They are also vindictive. Cross a TAT and you will be punished.  Soon after the recent failed spill motion, an outspoken supporter of Tony Abbott, Scott Buchholz, replaced Philip Ruddock as party whip. Philip Ruddock went quietly. Not so Gillian Triggs. Professor Triggs refused to resign. She continues to speak about the plight of children in detention.

I call on all of us who are victims or witnesses of bullying to similarly take a firm stand. The next time our views are attacked, dismissed or ridiculed, we should stay put and stay on message.

A TAT recently told me to “shut up” before abruptly leaving the room and slamming the door. He told me that my views are “offensive”. When I later received a hurtful email, I was told that the email was “only factual and honest”.

The next time I am on the receiving end of a TAT attack, I will ask him to “settle down”. When he responds aggressively to my views, I will substantiate my views. If he treats me dismissively, or attributes malicious motives, I will name his behaviour for what it is: a technique to negate my views.

Now that the tantrum towards Gillian Triggs has passed, it is time for our government to provide a substantive response to the Human Rights Commission’s report and its recommendations.  If the issue of children in detention and Australia’s obligations under international law continue to be ignored, it will be at our peril.