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Thursday, 17 November 1983
Page: 2923

Ms MAYER(9.36) —When we are discussing amendments to Bills which deal with the care of our aging, as we have been tonight and as I intend to do for the next few minutes, we tend to forget whom we are talking about. I would like to remind everybody here that we are talking about us as well as those people out there; that the quality of care for aging people is a matter of concern to each one of us. We anticipate living to a ripe old age and we hope that it will be a happy and comfortable one. We know, however, that it is probable that we will suffer some degree of physical impairment as we grow older and may suffer some degree of mental impairment also. It is important to realise that the things we are doing now we are doing not only for our constituents and for those people out there but also for our own benefit and that we need to be sensitive to some of the things that we say about that, I think.

Because of those considerations, provision for a comfortable and secure old age is something that concerns us all. We in Australia for many years have not followed a practice which remains in some areas of the world, whereby aging parents live with the family and contribute to its daily activities. We have tended to isolate the various age groups in society, giving each group considerable freedom to determine its life style but denying each age group the support that family members can give each other. Very often that is a matter of mutual choice. It is not a matter of families neglecting to look after their elderly, or the elderly finding that they cannot get on with their families. It is simply a mutual choice which is often made in society. But the consequence is that elderly people are often alone when they are finding increasing difficulty in coping with the problems of daily life. Too often they are women who, because their lives are centred on caring for others, have learnt too little about caring and managing for themselves. We are reminded of that today by some members of the Combined Pensioners Association with whom we were talking.

There is no doubt that many community organisations work very hard to alleviate these problems. Most are dependent upon voluntary assistance, which is given generously by many. The elderly citizens clubs, the Meals on Wheels programs, the day care centres attached to public hospitals and the large multi-level accommodation villages provide services of all kinds at varying levels. However for many elderly people the transition can be abruptly from home to nursing home , as suitable accommodation can be difficult to find and expensive to maintain. We do have an adequate number of nursing homes, not necessarily precisely where they are needed geographically, but adequate as to numbers of beds, particlarly if beds are not occupied by people who can remain in their own homes with adequate assistance. I know that many of the older people in my electorate would prefer to remain in their homes. Even if this presents a considerable degree of difficulty in managing their daily lives, they would prefer to stay where they have made their homes and they feel comfortable. It is important that there should not be an either-or choice. There is sufficient evidence already that elderly people who wish to remain independent can be helped to do that with adequate domiciliary care. This is a most important aspect of any coherent program for people and it is often forgotten because it has tended to lodge in the too-hard basket.

Two aspects of domiciliary care are important. One is the continuing independence that it can support and the other is the portability of this type of care. The small rural towns we have heard discussed tonight are often too small to support any kind of institution for the care of the aging. In some towns the local hospital has frequently been called on to deal with long term care or people needing support have had to go to institutions in larger towns. We all know about the devastating psychological effect on elderly people who have to leave their familiar surroundings and live the remainder of their lives in an unfamiliar environment. That should be a last resort.

The Bill amends the Act to provide for a restriction in the growth of nursing homes to provide funds for more varied and extensive care. In my electorate the eastern suburbs geriatric centre will operate as an assessment and day care centre to provide for the aging people of the eastern suburbs of Melbourne a more suitable range of choices for care and continuing independence. Such centres as these, funded with State and Federal moneys, have long been needed. I am pleased that it will be able to provide services for the aging people in my electorate as well as others quite soon. Centres which provide short stay programs with physiotherapy to assist movement, podiatry to improve walking ability, social activities to restore confidence and medical care where necessary, have a very important role to play in ensuring that aging people are not the forgotten ones. Too many elderly people in nursing homes in my electorate have no visitors from one end of the year to the other. Too many have no way to offer their very real wisdom and experience to the community and too many feel buried alive even though their physical health is cared for devotedly by the nursing home staff.

There are, of course, people for whom full nursing home care is necessary. It is important then that the nursing home care be of very high quality. There have been some nursing home proprietors whose practices have been far from acceptable ; we all know that. The amendments which change the conditions of approval to protect patients from possible malpractice should be welcomed. In that context I share another comment that was made by some of us today, and that is that the restrictions and rules which nursing homes and some hostels use are humiliating to their customers and are unnecessary. I would like the people who own nursing homes and hostels privately and those who operate them for the Government to think very hard about whether it is necessary to make the rules before they do so.

There have been sufficient examples of various kinds of malpractice over the years to indicate the necessity for the Government to take the greatest possible care with the ownership and practices of nursing homes. It is in the interests of everybody, especially those nursing home proprietors who observe the highest possible standards of responsibility and care, that clear and unequivocal conditions be imposed upon people who own or propose to own nursing homes. It seems reasonable to suppose that the combination of assessment teams, about which my colleague the honourable member for Grayndler (Mr Leo McLeay) has spoken, increased hospital accommodation, day and domiciliary care and short stay facilities for the restoration of social and physical skills is a more positive way of providing the necessary care for aging people than an ever expanding increase in the number of nursing homes. Age is not an illness, nor is it a reason to tuck people away from the wider community as if it were untidy and undesirable to be older. The achievement of independence is one of the most looked forward to and celebrated occasions in our lives. We should be very careful to ensure the continuation of that valued status for everyone as long as possible.