What is the issue?
Photographer : Sandra
Every day a young Australian with high care needs is placed in an aged care nursing home. Across the nation, there are more then 6000 young people with disabilities that are forced to live in aged care homes. If this continues it is estimated that by 2007 the number of young people in nursing homes will have risen to 10,000!
So how do young Aussies end up in nursing homes?
The complex care needs of young people in care means that there is limited accommodation available that is designed to meet their specific needs. The type of care offered by the disability and acute care sectors is either unsuitable or places are limited. Very often young people’s families can’t look after them because the burden of care is too much to handle—both financially and emotionally. The combination of these factors often leaves young people with no other option than to live out their youth in the confines of nursing homes, alongside frail, aged and dying residents who have reached the final stages of their life.
Why is this a problem?
Nursing homes create huge lifestyle and care problems for younger residents.
First of all, aged care nursing homes are designed to manage the end stages of life and not the living life. This culture is very different to that which is needed for successful rehabilitation and does not provide younger residents with the kind of therapy and support that they require for recovery.
A further problem is that the needs of young people with disabilities require more funding and support than is provided by nursing homes. Without the specialist disability services they need, the overall health and well-being of young people in care can deteriorate over time.
Young people in nursing homes also suffer from social isolation. Nursing homes are not funded to provide elderly residents with access to the community, so there are very limited opportunities for young people to participate in the community or do social activities like shopping, eating out or visiting friends. A study has shown that 34% of young people in nursing homes almost never participated in community activities, and 21% went outside the nursing home less than once a month.
Furthermore, as you can probably imagine, visiting hours in aged care nursing homes do not feature highly on the weekend plans of friends! A study has found that nursing home environments tend to deter younger visitors, and that 44% of younger people received a visit from friends less than once a year.
Adding to this feeling of isolation is the exclusion young residents feel because of the huge generation gap between them and aged residents. In light of all this, it is not surprising that many young people in care suffer from depression and distress.
Who else is it affecting?
The negative effects of young people living in nursing homes not only affect young people and their families, but also the elderly and Australia's general population. The care facility places that young people occupy were not spare beds waiting to be filled. Quite the opposite is true. The reality is, that young people are taking up spaces in an already overstretched care system. So what’s the result? The overflow of elderly Australians that are unable to secure a place in these facilities, are forced into acute care hospital beds while they await a place in nursing homes. This use of hospital beds by the elderly is then felt by the general Australian population - as tax payer’s money is spent on their care and as hospital waiting lists grow longer!
Why is it happening?
So, how is it that young people remain stuck in aged care nursing homes with the wrong type of care?
The majority of the time it is because young people in nursing homes are caught in a funding trap that has left them in funding no mans land! The funding responsibility for aged care and disability services is split between the state and territory and Commonwealth governments.
The responsibility for providing disability services
is set out in the Commonwealth, State, Territory Disability Agreement [CSDA]
. It makes disability accommodation services, therapy, recreation and equipment the responsibility of the state and territory governments.
On the other hand aged care services are a Commonwealth responsibility. Aged care nursing homes do not come under the CSDA
, so young people end up getting ‘lost’ in the system and cannot access many of the services available to others with disabilities. This may be because they have not registered with state disability services or because since they have a roof over their heads, they are no longer considered a high priority for supported disability accommodation. To make the situation worse, because aged care beds are funded by the Commonwealth, there is little incentive for the states and territories to do anything to help the situation because then they would have to deal with the problem (and cost) themselves.
What is being done about it? What is happening now?
Good news. The government has finally started taking notice. In response to calls for the government to provide appropriate accommodation and support services they have taken the first steps in the right direction. At the Coalition of Australian Governments (COAG) meeting of 10 February 2006, the governments announced their commitment to start to reduce the number of young people with disabilities living in residential aged care services. $244 million will be provided over the next 5 years in order to fund: the provision of cost effective alternative residential care services for young people; the improvement of support services for those who continue to live in aged care; and finally to assist young people that are at risk of entering nursing homes. This final commitment, although stated last is very significant, as prevention is definitely the best cure.
Let’s hope they come through with the promised goods!
How do I know this?
Australian Government Department of Health and Ageing 2006, Reducing the number of younger people with disabilities living in nursing homes
Brain Injury Association of New South Wales http://www.biansw.org.au
Farnworth L, Winkler D, Sloan S 2006, 'People under 60 living in aged care facilities in Victoria' Australian Health Review
, Vol. 30, no. 1
O’Reilly K, Pryor J 2002, ‘Young people with brain injury in nursing homes: not the best option!’, Australian Health Review
, Vol. 25, No. 3
The National Alliance of Young People in Nursing Homes, http://www.ypinh.org.au