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How to talk to reluctant parents about aged care as industry enters 'critical' reform

· In short: Elderly Australians are entering aged care facilities later in life with higher assistance requirements. 

· More than 1.1 million Australians over 65 receive support and care in their own homes.

· A professor in ageing and health details four things to consider when talking about residential aged care.

Australia's population is rapidly ageing and putting increasing pressure on a care system that is yet to fully emerge from the impacts of a devastating royal commission. 

So when it comes to discussions about loved ones moving into aged care, it can be an understandably difficult subject to broach. 

Aged care experts say that discussion can often start when adult children begin noticing worrying signs of decline in elderly parents.

Sometimes it is unexplained weight loss or gain, a messier-than-usual house, or that they have started to cut back on social outings.

Associate professor Lee-Fay Low, a psychologist, epidemiologist, and researcher specialising in developing and evaluating interventions for older people, said the idea of parents refusing to enter aged care, or accept additional help, was nothing new.

However, it had certainly been brought to the fore over the past decade.

"Both the pandemic and the news around the royal commission and neglect in aged care has certainly increased our reluctance to go into residential aged care and increased the appetite for home-based care," Dr Low said. 

According to government figures, more than 1.1 million Australians over 65 engage in some level of professional care in their own home, compared to a little more than 250,000 in residential care.

And with Australia's rapidly ageing population of over 65s tipped to increase by 6.1 per cent to reach 23.4 per cent in the next 40 years, such difficult discussions are only going to become more prevalent.

How to approach aged care reluctance

Dr Low said there were four things to consider if older parents or loved ones were hesitant to enter aged care.

How to talk about aged care reluctance:

00001. 1.Start with more care at home

00002. 2.Be ready to have multiple conversations

00003. 3. Understand home care sometimes isn't enough

00004. 4.Know your options if loved ones can no longer make decisions

Source: Lee-Fay Low, The Conversation

"The first step is realising and accepting that, perhaps, a little bit more help and support is needed," she said. 

Dr Low said at-home services that help loved ones stay independent, such as cleaning or installing safety rails, were among common first steps.

Second, she said conversations about aged care often bore repeating.

"They're usually not one conversation, but multiple conversations," she said.

"The third step, if you really have to go into a nursing home, is to do your research on the nursing homes and take Mum and Dad to visit the home if it's possible.

"You can also book in for a try before you buy. It's called respite care, where the person can stay for two to four weeks sometimes."

The fourth thing Dr Low suggested considering was understanding power of attorney rights if your parent or loved one was no longer in a position to make appropriate decisions for themselves.

"We can't force Mum and Dad to go into a nursing home and we shouldn't. We should really care about their wishes," she said.

A difficult transition

Chris Potaris, the chief executive of Council on the Ageing (COTA) Victoria and Seniors Rights Victoria, said it was imperative that the autonomy of older Australians was respected at all stages.

"Aged care reform is entering a critical stage as we try to deliver on the findings and recommendations stemming from the Royal Commission into Aged Care Quality and Safety," he said.

"It is a long-established trend that older Australians want to live in their own homes and receive care there, which has always been the case for the vast majority of older Australians."

COTA Victoria is pushing for older people to be at the heart of the new Aged Care Act, which is yet to be finalised by parliament.  

Mr Potaris said appropriate funding for both at-home and residential care would pave the way for the industry to adequately support the increasing needs of the sector.

"It's been well established that the Royal Commission into Aged Care Quality and Safety had a negative impact on the perception of aged care facilities," he said.

"With future funding and a new Aged Care Act being discussed and created, it is vital that we ensure that this reform supports older Victorians."

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