Conversations About Aged Care Should Always Evolve, The Chronicle, 7 April 2015
Harry Truman lived on Spirit Lake, at the foot of Mount Saint Helens in the northwest of the United States. A former World War I pilot and bootlegger, he was 83 years old when the volcano began to rumble. Authorities tried to get him to move out, but he was worried his lodge would be vandalised. ‘If this place is gonna go’, he said, ‘I want to go with it.’ On 18 May 1980, the volcano blast covered his home beneath a massive lava flow.
In his book Being Mortal: Medicine and What Matters in the End, Atul Gawande tells the story of how modern medicine struggles to get aged care right. Nursing homes often place too much emphasis on safety and not enough on quality of life. Most people want to end their lives at home, but many end up dying in hospital. Two-thirds of doctors overestimate how long patients with terminal diseases will survive.
The status of age, Gawande points out, has changed over time. In the eighteenth century, survey respondents tended to shade their age upwards, desiring the dignity of old age. Now, the tendency is for people to understate their age. Modern society has less respect for those who are full of days.
Having seen my grandmother lose her self-esteem in a nursing home, I was struck to learn from Gawande that the model largely derives from the post-war era, as a means of reducing hospital overcrowding. At their worst, nursing homes suffer from the ‘three plagues’ of boredom, loneliness and helplessness.
But not all are like that. In one study, researchers found that nursing home residents who were given responsibility for watering a plant ended up living longer. Gawande describes radicals like Bill Thomas, who put a pet bird in every resident’s room. In some homes, local school students are regular visitors, supplementing their history lessons with real stories. One student developed such a strong bond with the Alzheimer’s patient he befriended that he ended up speaking at the man’s funeral.
In Canberra, we have some terrific aged care facilities. Last year, I joined ‘Play Up’, a humour therapy group that drops into Kangara Waters to put a smile on the residents’ faces. This not only helps address the ‘three plagues’, it also helps foster a sense of community and boosts the quality of life.
We can do better at end of life care too. Cancer patients who see a palliative care specialist not only experience a higher quality of life, but live 25 percent longer. When I jog past Clare Holland House, a hospice on the shores of Lake Burley Griffin, I’m reminded of how its staff allowed my friends Peter Veness and Liz Dawson to maintain dignity until their final curtains fell.
We need a deeper, richer and smarter conversation about aged care, and Gawande’s thought-provoking book isn’t a bad starting place.
Andrew Leigh is the Federal Member for Fraser and the Shadow Assistant Treasurer. His website is www.andrewleigh.com.