Our place, being a beautiful little town on the Limestone Coast, is a favoured location for retired people. Many of them are farmers who have moved in from their farms in the district. Others are people who have lived their lives and worked here, in fishing, construction, and now retail. Generally speaking their preference is to stay here as they move through the business of getting older; ageing in place, among friends, and in familiar surroundings, is now a well-recognised approach to supporting the ageing process.
However, our place is one of the few in the district that lacks aged care residential facilities, although there are aged care support workers doing a sterling job in some homes. Apart from a few older housing trust dwellings, left over from the rush to privatisation (deeply ill-advised, particularly in the social housing arena, we would argue) there are no dedicated facilities. Conversations around this gap seem to centre on the standard, three-tiered model of aged care: entry level support at home; more complex support for older people who are able to continue living independently in their own homes with assistance; and a range of care options and accommodation for older people who are unable to continue living independently in their own home.
The question is whether these are the best, or only, options. Increasingly there is a feeling that new approaches, more embedded in the local community, are needed.
We found a useful guide to these new approaches in a research paper that was developed for the recent Australian Royal Commission into Aged Care Quality and Safety. The title of the paper is: ‘Review of Innovative Models of Aged Care’ (available here).
This is a big topic and we’re not able to cover it all here. But the ideas underpinning new approaches centre on moving aged care from ‘institutional’ to ‘homelike’. They include ‘person-centred care’, which focuses on empowering each individual, and ‘relationship care’, which recognises the importance of key relationships for every person as they age.
New models of aged care are based on ‘ageing in place’. They include small-scale living, community-based shared housing arrangements, and intergenerational communities. For example, community-based models can take the form of groups of individual units with shared supporting services, with smart-home technology and onsite nursing care, giving a sense of community and enabling couples to remain together. Another innovative model is integrated or co-located housing within housing developments for the general public, using smart-home and communications technologies with on-call support, enabling community integration and connectedness.
We recognise that aged care is a highly regulated area and has to be done right. At the same time, it’s clear that new ways of providing support for our senior citizens are emerging and deserve to be looked it. These are the more natural, homelike ways of maintaining personal agency in ageing within one’s own community. Local communities, together with their councils, can take charge of it themselves. It can be done.