Aged Care with Home Care Packages

[Citroënbender]

I’ve been greatly underwhelmed by two recent articles making a glamorous look out of caring for elderly family at home. This report is more accurate per my experience.

https://www.abc.net.au/news/2020-09-...grade/12622558

While it is tangential, even intersecting to the CV thread, I felt it fairer not to try interrupting the general tendencies of dialogue flow there.

It comes, coincidentally, on the back of a recent story about an elderly woman seemingly abandoned at a public hospital with no ID. The disturbing takeaway from that article was this:

The head of Aged and Disability Advocacy Australia chief Geoff Rowe said while hospital abandonments were rare, it was not unusual for older Australians to be put into a respite care centre and never picked up.

He said it was important that anyone caring for an elderly person asked for help when they needed it.

"It's really important that people in a caring role reach out and seek support," he said.

I don’t dispute that one bit, but the first article outlines realistically how responding to the moral and physical challenges as a carer, actually removes much of the opportunity to balance the books in terms of advocating the carer’s welfare in concert with meeting the recipient’s needs.

It’s easy to see how an institution can suddenly become the chosen option, especially if not all family members are on the same page in terms of home care.

[.:4:.]

Home care is extremely difficult when it comes to kepping gainful employment. It can be like a full time job depending on the circumstance. My ex father in law got to a point where he needed 24/7 assistance. My ex mother in law couldnt keep up. She was on the pension too, but couldnt leave him alone for long enough to run up the shops, couldnt take him with due to the advanced dementia, it was too much. So govco nursing home.
My grandparents initially moved into assisted living. They had their own fully functional unit in a private facility. Once a day a nurse would visit to make sure they're alive. They did their own washing, cooking and cleaning, but had buttons on every other wall incase of a medical event. Plus remotes on neck lanyards just in case. My brother was their primary carer so got the minor carers goverment grant as his job wasnt a 40 hour week and was flexable so he could make daily visits and bring his cat and the now (due to old age) passed lap dog.
My grandparents are now in proper aged care. Its a nice private facility. They are passed the point of self sustainability. An hour or 2 every day from either my brother or my mum helping out just wasnt enough. So full time care was the only option.
Now understandibly, a lot of older people dont have the option of private aged care facilities. Mainly due to superanuation only becoming a mandatory thing in something like 1989. Hence my 75 year old ex father in law being in a public home. My mid 90 year old grandparents did volantary super their working lives. Grandma chose to be a stay at home mum, grandpa retired in 1986. But they still are self funded retirees. Yes visitation rights due to covid are non existant pretty much, but they're looked after, the staff and inhabitants are overly tested, so it not a desiesed rat of a place. As invasive as constant testing is, and the isolations and stuff, it keeps the olds getting older.

[FTE217]

My mother has a saying that my wife quotes to many friends when talking about "aging", getting old is not for wimps.
Man our aged care system/facilities stinks at Gov levels and the costs for Home Care is another hurdle.
I'm living through it, my wife's parents had to end up in aged care facility just 2yrs ago for a number of reasons, more so because it was too hard managing their daily needs and costs leaving them in their home, and for some siblings just can't agree on things as well.
I take my hat off to all family home carers - some have it much harder than others but overall what a strain in your life and well being.

[Polyal]

Originally Posted by FTE217

My mother has a saying that my wife quotes to many friends when talking about "aging", getting old is not for wimps.
Man our aged care system/facilities stinks at Gov levels and the costs for Home Care is another hurdle.
I'm living through it, my wife's parents had to end up in aged care facility just 2yrs ago for a number of reasons, more so because it was too hard managing their daily needs and costs leaving them in their home, and for some siblings just can't agree on things as well.
I take my hat off to all family home carers - some have it much harder than others but overall what a strain in your life and well being.

Ive got no idea what I am going to do when the time comes. Id like to think I will be able to assist them but what do I know other than basic care.

As above, depending no your situation your work would suffer, which in turn means your income does to sustain someone who is increasing your costs.

The Royal Commission is going to be ugly, but it needs to happen, the amount of cash we throw at other issues and we cant sort this out is crazy. We will all be there one day!

[falcon_bandit]

Having 3 family members working in public aged care facilities. It can only be described as a depressing place. There's simply not enough staff to give them a reason to wanna live a meaningful existance. Most care plans are setup by the families to help them die faster. Even with their dementia, they still have enough wits about them to constantly try to find the front door, as if they can, then they can leave.... But never do

[FTE217]

falcon bandit, hats off to your 3 family members in those friggin tuff jobs.
Sure would be depressing BUT I'm Thankful people take on these jobs most don't but all I'm seeing its harder and harder in those jobs.
The system red tape, lack of new workers coming in, our aging pop is putting a massive strain on an already strained broken system lacking funding.
The private ones are banks, yes they are far nicer premise's, similar to the ones my inlaws are in BUT the costs are massive ! but in the end I'd far prefer seeing the inlaws and my own (one day) in these compared to the Gov ones.
I'm so so sorry for those people, no one deserves going into a place that is not up to a standard of living they once were used to.
My wife is at wits end due to covid let alone all the hassles we've gone through with her siblings and her parents last 5yrs trying to keep them at home for as long as poss -
My wife one of 8 kids, she and the eldest sis have power of attorney.
For years they had rosters so as someone would turn up everyday with food,clean house take to doc appointments etcetc, the work is huge.
Mum inlaw dementia sufferer Dad so many aging ailments etc its a demoralising experience for them and for family.
Then trying to work with aged care arrange visits etc, its a friggin challenge.
One sibling expected they stay at home till the end of their lives and has caused so much pain and fall outs.
In the end it was agreed to sell their home to cover the costs going into a good nursing home.
OMG the costs - the red tape trying to retain the pension, 3/4 of that is pulled into paying weekly costs + add ons from the sale of the house.
Its a massive dogs breakfast.
Yes polyal, the time comes for us, lord help us its better.
I'm not looking forward to it one bit.
I watched my father inlaw deteriote and sadly pass away just 3mths ago.
His wife due to dementia couldn't even relate he was gone lying in his bed for some 5hrs till funeral company came to pick him up. :(
Can't complain a good 91yrs here BUT I ask myself why hang on for as long as you do, he could hardly walk, wipe your **** or shower without assistance.
Yes falcon bandit yet still they all want to find a way home no matter the condition they are in.
You felt like a heel when asked "we come home with you" like ffs how sad.
Whats the point living like this for x last years of your life.
Those poor aged care workers seeing this day in day out knowing such and such will go soon who's next.
Mum losing weight, we see it during facetiming her.
Depressing is depressing.

[falcon_bandit]

One poor lady had her foot accidently stomped on by another resident's walker. This turned into necrosis, and as the care plan stated nothing to be done, this poor lady died over a few weeks with a black rotten infected foot.

Alot of them develop pressure sores from lying in bed all day, which can be limited by frequent rotations (lack of staff doesn't, get done) and can lead to necrosis. My daughter spoke of cleaning one resident's "sores" where she could see their femur through the rotten hole.

There's a few In there that try maintain a positive vibe, some of the blokes being a little cheeky with their own version innocent way of flirting which brings a smile to the nurse, then they have to watch them deteriorate the next week & die. Dementia turns some of them into violent depraved individuals & and alot of care has to be taken around them

I hear all the stories every day, and I can't believe they don't get paid alot more as it's an emotional & physical Rollercoaster. Not for the faint hearted.

[BENT_8]

Originally Posted by falcon_bandit

I hear all the stories every day, and I can't believe they don't get paid alot more as it's an emotional & physical Rollercoaster. Not for the faint hearted.

Agreed, my Wife also works in aged care, she's the cook so no real direct contact but the kitchen tends to be the central hub so everything that happens passes through there, after 14yrs nothing surprises me anymore. I dont like hearing about it, its depressing but i listen because she gets it off her chest.
When she first considered the position i said to her, if youre going to cook in that environment youve got to consider that any meal could be a residents last so youve got to give it 100%.

[FTE217]

all to true mate.
Damn that poor women - imagine how the family felt let alone the resident feeling bad.
Yer those pressure sores are not good at all.
Without daily regular care its a quick decline.
Yes Mum inlaw can be a viscious women at times due to her dementia, having to keep re checking the dosage to counter the aggressive nature.
Between public hospital workers to aged care at private homes or facilities they are worth every cent and agree more.

[falcon_bandit]

The typical start to the morning shift... Try convince a resident to have a shower that really needs one as they've refused for the last 7 days (this is their right), then depending how mobile they are you may need the lifter, which there's a shortage of so u go for a hike to find one that's not being used, good luck. Get them in the lifter & cop a few blows to the face & skin ripped off your arm as your not allowed to cut their nails unless they let you, & alot of them have worked out they do more damage when they're long.

So now they're in the lifter & their bowels have let go emptied all through it. Gotta clean that. Get to the shower & it's more of the same resistance. All clean now, let's get them dressed..... Bowels let go again. Better sit them on the toilet for awhile to make sure there's no more..... OK.... No more ****, clean you up & let's get you dressed. Bit hard putting clothes on someone who has clenched up into a tight ball of rigamortis. All dressed now, great..... Oh, bowels let go again. Repeat steps again.

OK resident done, onto the next..... Oh wait, their emergency buzzer is going off, have to go back..... Old Bob just likes to press buttons, all good. After a few times we decide to take away his right to use the buzzer for awhile. Another 8 residents in the section to go. Get screamed at by the registered nurse asking why ur taking so long. Sometimes you come across a dead body, & get them cleaned up, dressed, ready to be viewed by the family & taken away. Might have to cover their face first as sometimes they die with a frozen look of horror..... Hard to see them like that when was only just had a friendly chat yesterday. So much more to say, but will leave it there. Tough emotionally draining job.

[Citroënbender]

On a practical level, home care has parallels in driving. If you don’t “scan” it will end up with tears.

The financials are another catch. For eligibility to receive assistance, people or their POA designate must complete a statement of income and assets. Stuff like property is still counted after divesting, for a number of years. This seems to trip up the people with not quite enough net assets/income to personally fund good care, yet too much apparent wealth to receive meaningful assistance.

[zilo]

The secret to a happy aged care experience is to have a good family support network.

If the good family bit can't be obtained then having plenty of money is also good.

If you ease off the smashed avocado early in life then you are on the right track to the plenty of money bit.

The prospect of a favorable mention in a will is also a known reliable contributor to a ""caring" family network....
(as long as the smashed avocado advice was taken.)

[Crazy Dazz]

It's sad that as a culture we don't want to have our oldfolks around.
I want to stay around my kids (and hopefully grandkids) provided I'm not too much of a burden. If, for whatever reason, I wind up physically incapacitated, then I'm not sure what I'll do. Maybe just sail off into the sunset.

I think part of the problem with aged care facilities, is that its a downward spiral. Residents become increasingly vegetative and immobile, so they lose muscle and bone-density, spend increasing time either in bed or their chairs, start to develop other problems such as pressure sores, and so on it goes.

Dementia of course is a whole other issue. I think that's the one I fear most, not being in control of my brain.

[Citroënbender]

Very good “plain English” summary of where Australia is perched with respect to supply of Home Care Packages vs actual demand (as assessed on a needs basis by Government staff).

https://www.abc.net.au/news/2020-10-...short/12736428

In short, despite the incumbents saying they’re doing something, they’re not really doing much and there’s a reasonable prospect care recipients may never effectively benefit from a package at the level they’re assessed as currently needing.

[Polyal]

Originally Posted by Crazy Dazz

It's sad that as a culture we don't want to have our oldfolks around.
I want to stay around my kids (and hopefully grandkids) provided I'm not too much of a burden. If, for whatever reason, I wind up physically incapacitated, then I'm not sure what I'll do. Maybe just sail off into the sunset.

I think part of the problem with aged care facilities, is that its a downward spiral. Residents become increasingly vegetative and immobile, so they lose muscle and bone-density, spend increasing time either in bed or their chairs, start to develop other problems such as pressure sores, and so on it goes.

Dementia of course is a whole other issue. I think that's the one I fear most, not being in control of my brain.

Its really hard depending on your situation.

While he drives me mad most days (we are just different people), we bought my old man a caravan so as we have moved over the past few years he can move with us.

Mutual benefit at the moment, his helping with the school pick ups etc, not sure what we would do without it at the moment. But as he starts to have health issues (already knees and eyes needing work) we will need to be a bit more flexible. He is 70ish so hopefully we have a few more years before we need to work out a longer term solution.

But I agree, if possible, having them around and active is not only useful for the economy but also better in general for our kids (as long as he stops regurgitating tabloid news to the kids) and helps with the career.

His on the pension a bit and struggling, so we help out, it would be good if he could somehow get some benefit from Govco as well. Doesnt have to be much but he would do 4 hours per day of care for the kids + transport so we recognize there are costs with that, most nights he has dinner with us too as its something we can offer that makes a little difference.

[Citroënbender]

You could be on a knife-edge already without knowing. Say the old fellow trips on his caravan steps, shatters a couple of bones because he has (previously undiagnosed) osteoporosis. Now he’s gone from helper to extra burden.

The packages can often take literally years to come in, that’s the problem. While waiting, who will be doing the personal care, taking him to the rehab sessions, cleaning his digs? If you can get him fully assessed even in his current state, he’s in the system and that may mean either some help now (typically CHSP) or a timeline to when it is available.

[Polyal]

Originally Posted by Citroënbender

You could be on a knife-edge already without knowing. Say the old fellow trips on his caravan steps, shatters a couple of bones because he has (previously undiagnosed) osteoporosis. Now he’s gone from helper to extra burden.

The packages can often take literally years to come in, that’s the problem. While waiting, who will be doing the personal care, taking him to the rehab sessions, cleaning his digs? If you can get him fully assessed even in his current state, he’s in the system and that may mean either some help now (typically CHSP) or a timeline to when it is available.

Yeap and we know it, myself or my wife will have to change hours to suit.

Its already in the plan for 2021 or 2022, both of us working 9-10hr days is nice from a financial POV but its not sustainable for the family.

Modern life huh, we both worked hard to get degrees etc, so one of us will have to choose. She has taken 8-10 years off/part time having kids....but there is a point where you have to do the hard yards. But how long for and to what end?

I think I am going through a pre mid life crisis, but CV19 has also given a reason to re-evaluate.

There is always before and after school care if required, but then who looks after the oldies as well.

Im yet to hear much more from the Royal Commission on Aged Care.

[Crazy Dazz]

Dad battled lymphoma for around a decade.
Stayed in his own place until a few days before he died. Apart from being a cantankerous old worry-wort, he wasn't a burden to anyone.

I'll tel you one thing I'm not doing, and that's moving into some ****ing retirement village. Apart from the fact that they a rip-off and flaming rort, last thing I want when I am old is to be surrounded by a bunch of other old farts.
Imagine, being packed in wall-to-wall like sardines, with nothing to do all day but whinge and moan about each other.

When Dad died, mum moved into one. On a few occasions I volunteered to smother her neighbours in their sleep.

Crazy thing is that at the time we were living in a huge house, and one that actually had a "Granny Suite" with its own ensuite. I would have loved to have Mum live with us, as would the grandkids, buts its like she was conditioned into thinking "this is what you do".

I have friends from foreign backgrounds, and the wouldn't dream of it.

Again, dementia is a ****er. My Nan was off her rocker for decades. If that does happen to me, then I don't expect my kids to look after me, but I will cross that bridge if the time comes.