Victoria must act on gaps in residential care | The Age

The Age

July 28, 2011

Opinion

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We ignore a crisis that could affect any one of us as we age.

‘WILL you still feed me, when I’m 64?” Paul McCartney, who wrote these words, was unusual and not just because his band became the Beatles. He wrote the song about enduring love and care at the age of 16, long before most of us think about who will care for us at 64 and beyond. And when we do, a common wish is ”just don’t put me in a home”. The sad irony is that the term home refers to a place where residents depend on strangers, not family. And more than ever, the quality of care is a lottery.

The trends are almost all taking a troubling direction. There have never been more people with intellectual disabilities, mental illnesses and dementia. An ageing population points to a surge in the numbers requiring care because they don’t have families or their families are unable or unwilling to look after them.

Last financial year, the number of elderly Victorians placed under the care of the Public Advocate rose by almost 10 per cent. The incidence of dementia, the most common disability which affected a third of the 1574 guardianship orders in 2010 – up 45 per cent from 2005 – is predicted to jump by 230 per cent by 2030. Yet the system can’t cope now; these vulnerable people already face a growing waiting list.

Twenty-five years ago today, when guardianship by the Public Advocate was introduced as a protection of last resort, the focus was on people with intellectual disabilities. They still require active protection, too. The Public Advocate, Colleen Pearce, relies on a band of dedicated volunteers who visit residential facilities to ensure basic standards are met. As The Age reported yesterday, even standards at the better institutions are fairly basic.

These community visitors have exposed appalling cases where officialdom failed in its duty. The Public Advocate’s reports have shamed governments into action, leading to the closures of Aradale Mental Hospital, Janefield Training Centre and Kew Cottages. As recently as January, the Public Advocate reported that volunteers had lodged 86 reports of violence against people with cognitive impairments or mental illness in the past four years.

That makes another trend all the more alarming: community visitor numbers have fallen by more than a third, from 484 two years ago to 312. The result, Ms Pearce notes, is that institutions, private lodges, community residential units and psychiatric wards are inspected less frequently by the visitors, who are the independent ”safeguard in the system”.

The Law Reform Commission recommended that powers of investigation be extended to reported abuses of the disabled or elderly in private homes, but for this change to be effective the state must boost resources. Queensland and New South Wales pay community visitors, but Victoria covers only their basic expenses.

A systemic shake-up is needed to guarantee proper care for people under guardianship orders. Seven out of 10 are aged over 65 and about 50 are on the waiting list. More than 1300 disabled adults are also waiting for places in residential services as their parents grow old or die. To add to the challenges, more elderly Victorians require care not because they have no family, but as a result of family conflicts or inheritance disputes.

The problems are not new – Ms Pearce cites reports dating back to 1988 – but the scale of neglect and abuse and the lack of political and public response are an indictment of our society. We all hope that someone will look after us if we were to grow infirm, develop dementia or be disabled. None of us can say ”it won’t happen to me”. Yet the only way we can ensure there will be someone to care for and protect us is if we insist on the same guarantees of care for everyone.

People in care suffer the curse of being out of sight and out of mind. They depend on others to speak up for them. All Victorians are shamed if, by our silence, we leave the door open to abuse and neglect of anyone who needs care now or in the future.

 

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