The Future of Australia's Elderly - Literature review Example

Running head: The future of aging people in Australia Name: University/ College: Course: Lecturer: Date: A discussion and analysis of the future of Australia’s ageing population Abstract Every contemporary society is composed of people from all walks of life. Across the ages are the elderly who form a vital part of the population. In Australia, the population growth rate of the elderly is 3.0%, translating to 85, 800 elderly persons per year. This paper examines the place and future of the elderly in Australia. It elucidates key issues impacting the population and analyses the gravity of the confronting issues. Among others, the major challenges identified include: inaccessibility to affordable housing and homelessness, poor home based care, neglect and abuse and chronic illnesses. Finally, the paper discusses the initiatives instituted by key players including the government, local organizations and Registered Nurses to alleviate the problems they encounter and advocate for a better life for them, if the remaining years of the elderly are to be memorable. Issues impacting the aged in Australia Caring for the aged is one of the most fascinating challenges the world is facing today. The population of aged people in Australia is increasing with the increase in the general population. In Sydney for instance, statistics show that 23% of the population are aged 65 and above with a projection of 10% increase by the year 2021 (www.nrsdc.org.au). This observable significant elderly proportion is attributable to advanced technology and treatment (Dodds, 2005, 295-298). Nevertheless, it has been noted with a lot of concern that there is little focus toward the provision of sustainable socio-cultural and economic services to this important part of the Australian population (www.actnow.com.au). Furthermore, there are several pertinent and sensitive issues impacting the elderly in Australia at large which needs to be addressed. According to the Social Development Council (2010), it is emerging that most old people in the country lack proper affordable housing and medical care. These, as we all know, make the prototype of basic human needs without which life becomes improbable. It beats any reasonable logic to imagine a society where the old who are susceptible to chronic infection, are subjected to poor housing. This has compromised the immune system of the exposed adults of 65 years and above (Smith and Leggat, 2005: 71-76). Loneliness, anxiety and stress management have for a long period of time affected the elderly. There are also reported cases of abuse, neglect and malnutrition (McFadden, 2010a). Whereas the old are sedentary in most cases, the above attributes contributes generous risk factors to hypertension, heart failure and latent stroke (Smith and Leggat, 2005: 71-76). The enormity of this challenge cannot be overemphasized. Many have died of heart attack, diabetes and unexplained falls (ABS, 2009). Efforts made to reverse the trend have not been quite successful simply because the root cause of the problem has not been significantly addressed (O’Connor, 2006). In his literature, Daniel O’Connor reiterates that indeed Australian elderly have high rates of anxiety and depression. His conclusion contradicts the general belief that the aged in this county record low rates of anxiety and depression. On the other hand there are few nursing homes with specialized facilities for optimal elderly care. Nurses are inadequate and the workload is overwhelming hence the need for prompt intervention (www.agedcarecrisis.com, 2010). On the other hand, hospitals are not enough to adequately absorb people suffering from chronic illnesses. Reports show that only 2.8 doctors are available for every 1000 persons (Commonwealth Fund report, 2007). This has created a huge shortage of medics and paramedics reliable to address the needs of the old people in Australia. From a different perspective, most of the old people in Australia lack full time devoted caregivers. Some of the available ones are either part time employees or preoccupied family members. Consequently, the old thereof do not receive optimum recommended care (O’Connor, 2006). According to the National Age Research Institute, majority of the elderly in Australia are on low pension rates. They have no access to safe environment and customized transport facilities. This analogy renders the aged Australian temporarily under house arrest, bored and insecure. They cannot afford to travel alone without the help of close family members who are aware of their special needs. Where such family assistance is not available, the safety of the elderly in question is jeopardized (www.agedcarecrisis.com, 2010). Besides, many lack reliable caregivers especially in their homes due to financial constraints, and service shortage. As a result a number of them have developed depression and some committed suicide (www.nrsdc.org.au). Analysis of issues confronting the elderly First and foremost, healthcare for the elderly is an issue too expensive to be ignored, since a great majority largely depends on government pension, which by all standards is quite low. In 2008, an average poor elder of 65 years earned $280 per week, with a medical allowance of $2.9. In fact the Deputy Prime Minister, Julia Gillard and the Treasurer, Wayne Swan concluded that they cannot survive on a pensioner’s income especially at a time when cost of living had drastically risen (www.actnow.com.au). In light of this scenario, many cannot afford proper healthcare suitable for persons of their age. As a matter of fact, age is a risk factor to numerous health complications. The elderly are at high risk of coronary heart disorders (CHD), corpulence, osteoporosis, mental disorders and skin diseases (Smith and Leggat, 2005: 71-76). Schizophrenia, Alzheimer’s and depression are among the major mental health problems of the elderly in Australia. While these conditions have consequently resulted in suicide cases, there is insufficient emphasis to combat the predicament. According to the Australia healthcare facts report, there were a total of 38,974 per 100,000 deaths registered between 2006-2008 among the elderly of 65 years and above (ABS, 2009). The figure translates to 12,991.3 deaths per year. This is alarming. Going by the Commonwealth Fund report (2007) the Australian life expectancy is 81.4, while the distribution of doctors and nurses per 1000 persons is 2.8 and 9.7 respectively. Between June 2008 and June 2009, the population of citizens aged 65 and above increased by 85,800 from 11.0% to 13.3% (ABS, 2009). This imposes significant burden on healthcare and housing and the future is implausibly critical. With this in mind, there is need for considerable healthcare support for the elderly. Since these old people are prone to depression, neglect, loneliness, stroke, heart failure and terminal illness they require fanatical consideration in terms of therapeutic counseling, home based care and prompt medical attention (Ames and Flynn, 2009). There is need to increase the number of nursing homes equipped with proper technology and staff dedicated to the elderly (Barclay, 2010). In the article ‘Issues facing the elderly’ (2010), it was observed that the population growth rate of the elderly is not proportionate to the available healthcare resources. Therefore, it safely predictable that in the near future, it will be quite hard to see a doctor, have devoted nurses or access nursing homes customized for the elderly. The elderly also experience physical and emotional abuse at times. And to worsen the situation, many times their personal rights have been infringed. Moreover, when the old are abandoned and neglected in their homes, there is high risk of abuse by strangers or other family members (McFadden, 2010a). Due to ill health and age, they are too weak to defend themselves from such verbal or physical maltreatment. Some have suffered in silence and died in cold blood simply because there were no devoted caregivers to attend them in the homes. In addition, trying to absorb this population in the few nursing homes inflicts unwarranted pressure on medical resources and staff. The idea leaves us with the question of what we shall do with the old. (Dodds, 2005:295-298). The monetary resources given by the Australian government in support of the elderly is very scanty (www.agedcarecrisis.com, 2010). The caregivers can only manage to acquire the very basic human needs of the old people they are supposed to be taking care of. In this interest, the caregivers, who are mostly family members, lack the basic training on care for the elderly. Accordingly, these elderly persons are subjected to poor and unprofessional care. Due to the sensitivity and tiresome needs of the aged, the caregivers suffer prolonged fatigue, stress and burn out without any therapeutic counseling services. Per se, their credibility of service is frustrated and they withdraw or eschew affectionate moral support for the old members of the family (Ames and Flynn, 2009). Another major issue of concern is housing. Since most of the elderly are dependent on pension, they find it hard, if not impossible to afford and maintain proper housing. The pay is too little and sometimes the person does not have other sources to augment this income. As such they end up living in the shanties or neglected family homes. Notwithstanding, studies observes that some of the Australians age faster due to poverty. These people are observed to have experienced homelessness due to financial inadequacies or broken families (www.missionaustralia.com.au). It is however impressive that the country has taken initiative to help avert the menace of homelessness for the elderly Australians. Surprisingly, only a small proportion has come out to utilize this opportunity. What about the rest? Initiatives to address the identified issues We are the people of Australia and the old are our foundation, so be the stance of a passionate Australian benevolence. A philosopher would claim that history is the mother of all teachings without which human society barely exist. In light of this, organizations and the government has taken estimable initiatives to resolve these predicaments of the elderly. Policymakers have since recognized the need to focus on home based health care. This is deemed to reduce congestion on hospital- based care for the elderly. As a result, it has channeled resources towards the development of comprehensive home based care services (Haralambos et al, 2008). Currently, the government of Australia is campaigning for the optimization of home based care(Moore et al, 2009).On the other hand, it has, through the Aged Care Act of 1997, relaxed the regulations imposed on private health care facilities. This has encouraged the increase of private nursing homes. At the same time, this initiative has led to a paradigm shift of professional nurses from public hospitals to these private healthcare facilities favorable to the elderly. Another key initiative to support the elderly and ensure a favorable future for them is the introduction of a pensioner’s card. This was a government initiative that ensures the elderly enjoy half fares on public transport (www.actnow.com.au). The elderly in Australia are entitled to medical and pharmaceutical benefits. To this end, the government provides them with $2.90 weekly, money that helps them buy the medicine they need. In addition, they are entitled to subsidized medicine and pharmaceutical products that are below an accepted price range. This is determined to encourage community based healthcare and service provision (Moore et al, 2009). To reduce housing and the homelessness problem, the National System of Homeless services was introduced (www.missionaustralia.com.au). Between 2006 and 2007, about 9.4% of the elderly, aged 50 and above utilized this opportunity. This is a small number at best, and a lot of the homeless elderly loose their lives as a result of exposure, lack of proper nutritious food and neglect. One of the reasons given for the reluctance of the elders to make use of this free service was a fear of being victimized by their younger housemates. To combat this, homes catering for the needs of the elderly have been set up. An example is Mission Australia’s Charles Chambers Court in Sydney. In addition, the system developed the rent assistance and disability payment initiative. This initiative targets the elderly and the physically challenged that may not be in a position to access suitable housing. Today, the Australian insurance provider, Medicare takes care of hospice services extended to the elderly. In this way, many can now access and afford professional palliative care (McFadden, 2010b). ‘Meals on Wheels’ provides one meal per day for the nation’s poor, at a very subsidized rate. This is a good initiative and should be applauded for the good it does. However, it provides only one meal per day, and is unable to reach the rural population. This service should be extended to reach the rural elderly, and should also include all the meals as, as the elderly still have to get the two remaining meals. It is commendable that the Australian government has upheld its commitment to advance pension remunerations to the elderly on a weekly basis. Though little, the money is at least helpful in sustaining the basic needs of these people. Besides, the government now recognizes the vital role of the caregivers. From this viewpoint, it has passed a policy entitling the caregivers to the ‘carer’s pension’ as a sign of appreciation. It is a positive action, though it will do the caregivers a lot of good if the government decided to up this pension to something substantial enough to take care of their needs. On a lighter note, the Northern Rivers Social Development Council (NRSDC) is actively educating and encouraging the younger generation to live and harmoniously work with the old people (www.nrsdc.au). This undertaking has seen remarkable positive changes in attitude towards the aged in Australia. With this kind of advocacy, the country is headed for homogenous age- friendly and enabling environment for the aged. As such, elderly members of the Australian society feel appreciated, loved and important, contrary to the looming notion that old citizens are a burden in the contemporary society. This initiative also helps the young people learn from the elderly, who have a lot to offer, and they end up knowing they had made a difference in someone’s life. However, NRSDC would do well if they shifted their focus to other age groups. While working with young people is commendable, they are not the only ones living with the elderly. McFadden states that elders are abused by their grown up children, especially if they are the ones providing primary care (2010a). Getting the caregivers together and instructing them on what they can do when they feel frustrated with their relatives would be a big step in reducing the incidences of elderly abuse. They need to be taught about patience, and how not to despair when it seems as if the situation will never get better. This will enable the elderly have a smooth transition to the afterlife, instead of dying depressed, and lonely. The role of Registered Nurses as advocates in promoting health and empowerment among the elderly Nurses are the secondary care givers to the elderly. This is done in hospitals, nursing homes or in their own homes. As a result of this interaction, they are intimately aware of what the vulnerable elders go through. This places them in a better position to take care of them, thus helping them as their age advances. As nurses, they are able to provide care that is on point with their different needs. For example, a person that has osteoporosis has different requirements from one that has arthritis. The nurse in this case will know that calcium- rich foods will help in the alleviation of osteoporosis, while swimming greatly reduces arthritic pain. As a means of cutting costs however, the number of nurses stationed in the different nursing homes has greatly reduced. This means that patients do not have someone to take care of them when they fall ill, and will have to be taken to the nearest hospital (www.agedcarecrisis.com, 2010). This can be very distressing to relatives who may be present at the time, and might lead to a possible death, if the illness is really serious, for example a heart attack. Due to these factors that are beyond their control, nurses might not always be in a position to take personal care of the elderly. The Commonwealth Fund (2007) found out that the rate of nurses per 1000 people currently stands at 9.7. This means that there is only one nurse for over 103 people. It will be close to impossible to expect a nurse to give close and personal attention to all these people under her care. However, nurses are under the obligation to uphold an environment where the patient’s rights of freedom, values, customs and human beliefs are respected (ICN, 2005). This means that they should do their very best to ensure that all the patients under them receive the best possible care. Through the council, registered nurses should be in the forefront in advocacy for mindful consideration of the aged Australians. They can initiate dialogue forums with the government towards funding elderly oriented projects. Besides, nurses are known to be the ambassadors of change in the healthcare fraternity. Nurses in collaboration with the Australian Ministry of Health have the potential to facilitate and promote training of community health workers (CHWs). In lieu of building more healthcare facilities, the government would incur less cost in training these CHWs who can work closely with the family members to promote home based care for the elderly. In the same line, the RN council can persuade the ministry to advance some monthly financial motivation to the trained CHWs. The synergy herein indirectly reduces the workload on nurses and focuses assiduous care to the elderly. Another paramount role of the nursing community involves referral and follow-up, and it is to monitor the progress of the terminally ill elderly patients. Where home based care and the sanatorium services teams up with technical support of the nurses, the elderly can be assured of the best practice of Medicare. This system of networking, referral and follow-ups guarantees the checks and balance in creating enabling ambience for the old generation of Australian society. In this way, clients are protected from potential abuse, neglect and superfluous trepidation of rejection. Slight changes in health can be promptly noticed, reported, diagnosed and restored before deterioration. As a result the natural history and prognosis of disease among the elderly is brought under ascetic surveillance, prevention, control and management. Conclusion The elderly are an important aspect of every society. Before they became old, they were presidents, Kings and Prime Ministers. They were the scientists who discovered the award winning formula that lengthened the lives of people with various illnesses. Before a country started considering them as a burden, these were the people whose brilliance in economics brought back the country from recession. This consequently saved the jobs, and the very lives of people in the country. Any nation that recognizes the value its elderly had been, and can still be, will be wise to ensure that they receive the best care possible. While this is being done in Australia, more still needs to be done to ensure they are comfortable in their last days. With advanced technology and treatment alongside high expectancy, the population of the Australian elderly is likely to increase significantly. This trend substantiates the burden on medical and housing resources. If not handled with care, the situation might get out of hand. The result could render the old a national burden, nursing nightmare and societal obsoletes. If this happens, global intervention and humanitarian support might be needed. However, if taken care of well, Australia might set a precedent that other countries would envy and be willing to adapt to their own countries. References Aged care crisis .com (2010) More RN’s and less tinkering around the edges. http://www.agedcaresrisis.com/thecolumn/3all-more-rns-and-less-tinkering-around-the-edges Retrieved, May 2010. Ames D & Flynn E. 2009. Management of late-life depression around the world: summary of international commentaries (Australia). In: Chew-Graham C. Baldwin R and Burns A. (eds.) Integrated Management of Depression in the Elderly. Cambridge :Cambridge University Press, , pp 140-143. Australian Bureau of Statistics (2009). Deaths Australia (2008). Canberra. Retrieved, May 2010. Barclay, Laurie. (2010) Nurses should play a greater role in health policy, planning and management. http://www.medscape.com/viewarticle/716344. Retrieved, May 2010. Commonwealth Fund (2007)Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American (2007) http://www.commonwealthfund.org/Content/Publications/Fund Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx. Retrieved, May, 2010. Dodds, S. (2005) Gender, aging and injustices: Social and political contexts of bioethics. Journal of Medical Ethics 31: 295-298. Haralambous B, Vrantsidis F, Renehan E, Ledgerwood K, Hill K, Pinikahana J, Hendy S, Harper S & Penberthy M. Effects of a community based strength training program on functional status and quality of life in older adults. Report to the William Buckland Foundation, October 2008. International Council of Nurses (2006) The ICN code of ethics for nurses. Geneva. Issues facing the elderly (2008) Retrieved in May 2010 McFadden, Donna (2010a) Emotional abuse in the elderly. Retrieved, May 2010. McFadden, Donna. (2010b) Healthcare delivery to the elderly. Retrieved, May 2010. Mission Australia(2008) Homelessness among the elderly : the hidden face of homelessness in Australia. Retrieved, May 2010. Moore K, Borschmann K, Fenwick E, Lamoureux E, Hill K, Klaic M, Bingham A, Lin X & Batchelor F. Environment and Vision Optimisation in Residential Care (EnVORC). Report to the Australian Government Department of Health and Ageing, March 2009. O'Connor, D W (2006) Do older Australians truly have low rates of anxiety and depression? A critique of the 1997 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, Vol. 40, No. 8, P 623-631. Smith, D.R & Leggat, P.A (2005). Prevalence of skin disease among the elderly in different clinical environments. Australasian Journal on Ageing 24(2). Social Development Council (2010). Social priority issue: the Aged . Retrieved in May 2010. Read More

According to the National Age Research Institute, majority of the elderly in Australia are on low pension rates. They have no access to safe environment and customized transport facilities. This analogy renders the aged Australian temporarily under house arrest, bored and insecure. They cannot afford to travel alone without the help of close family members who are aware of their special needs. Where such family assistance is not available, the safety of the elderly in question is jeopardized (www.

agedcarecrisis.com, 2010). Besides, many lack reliable caregivers especially in their homes due to financial constraints, and service shortage. As a result a number of them have developed depression and some committed suicide (www.nrsdc.org.au). Analysis of issues confronting the elderly First and foremost, healthcare for the elderly is an issue too expensive to be ignored, since a great majority largely depends on government pension, which by all standards is quite low. In 2008, an average poor elder of 65 years earned $280 per week, with a medical allowance of $2.9. In fact the Deputy Prime Minister, Julia Gillard and the Treasurer, Wayne Swan concluded that they cannot survive on a pensioner’s income especially at a time when cost of living had drastically risen (www.actnow.com.au). In light of this scenario, many cannot afford proper healthcare suitable for persons of their age.

As a matter of fact, age is a risk factor to numerous health complications. The elderly are at high risk of coronary heart disorders (CHD), corpulence, osteoporosis, mental disorders and skin diseases (Smith and Leggat, 2005: 71-76). Schizophrenia, Alzheimer’s and depression are among the major mental health problems of the elderly in Australia. While these conditions have consequently resulted in suicide cases, there is insufficient emphasis to combat the predicament. According to the Australia healthcare facts report, there were a total of 38,974 per 100,000 deaths registered between 2006-2008 among the elderly of 65 years and above (ABS, 2009).

The figure translates to 12,991.3 deaths per year. This is alarming. Going by the Commonwealth Fund report (2007) the Australian life expectancy is 81.4, while the distribution of doctors and nurses per 1000 persons is 2.8 and 9.7 respectively. Between June 2008 and June 2009, the population of citizens aged 65 and above increased by 85,800 from 11.0% to 13.3% (ABS, 2009). This imposes significant burden on healthcare and housing and the future is implausibly critical. With this in mind, there is need for considerable healthcare support for the elderly.

Since these old people are prone to depression, neglect, loneliness, stroke, heart failure and terminal illness they require fanatical consideration in terms of therapeutic counseling, home based care and prompt medical attention (Ames and Flynn, 2009). There is need to increase the number of nursing homes equipped with proper technology and staff dedicated to the elderly (Barclay, 2010). In the article ‘Issues facing the elderly’ (2010), it was observed that the population growth rate of the elderly is not proportionate to the available healthcare resources.

Therefore, it safely predictable that in the near future, it will be quite hard to see a doctor, have devoted nurses or access nursing homes customized for the elderly. The elderly also experience physical and emotional abuse at times. And to worsen the situation, many times their personal rights have been infringed. Moreover, when the old are abandoned and neglected in their homes, there is high risk of abuse by strangers or other family members (McFadden, 2010a). Due to ill health and age, they are too weak to defend themselves from such verbal or physical maltreatment.

Some have suffered in silence and died in cold blood simply because there were no devoted caregivers to attend them in the homes. In addition, trying to absorb this population in the few nursing homes inflicts unwarranted pressure on medical resources and staff.

Read More