Smaller scale aged care homes the future, advocacy group says

Older Australians aren’t getting the support they need to live as they want, a new report warns. What can be done to shift the dial?

Older Persons Advocacy Network chief executive Craig Gear.

Smaller-scale aged-care facilities housing fewer than 20 people are preferred by older Australians but too few are being built, a leading advocacy group for older people warns.

And those heading into frail old age who don’t own their home are in a perilous position when it comes to finding appropriate accommodation options, the Older Persons Advocacy Network says.

OPAN’s new report, titled Deinstitutionalisation in Aged Care, states that developers must move away from the current focus on large nursing homes ­towards smaller facilities scattered throughout communities, as has happened in other settings such as disability care.

“Some older people need the sort of intensive support that is provided by residential aged care … but many residential aged-care environments resemble an institution rather than a home,” OPAN chief Craig Gear said.

“Let’s ensure any future builds adhere to the deinstitutionalised approach. When building new developments, we urge sector stakeholders to consider older people’s preference for smaller-scale facilities.

“There is nothing stopping current providers, as some are doing, investing in retrofits to ­remove some of the worst institutional aspects and to give residents greater choice and independence.”

The report notes that while most older people want to remain living independently in their own home, “one-fifth of Australians aged 80 or older live in residential aged care – one of the highest proportions in the world”.

The policy emphasis should therefore be on “ageing in place” by offering in-home care support, including for those who don’t own their own homes.

“A large proportion of existing rental and social housing does not meet the required ­accessibility standards to support ageing in place,” Mr Gear said. “Older people in the private rental sector face additional ­uncertainties including issues around security of tenure and rental increases.”

Some of the options to ­improve accessibility to aged care canvassed in OPAN’s paper include collaborative housing, rental retirement villages and home-share arrangements.

“An older person’s home and community can provide connection, security and familiarity, and a sense of identity and autonomy,” the report finds.

“Close to 80 per cent of (residential aged-care) places are ­located in facilities with over 61 (beds).

“Many of these larger facilities include locked dementia units, a feature considered … an added unjust and harmful form of institutional segregation.”