The " Dementia " Crisis !

The spotlight has recently turned on aged care and how we deal with our elderly who have ever increasing years of life after they retire from the workforce.  Aged care is a rapidly growing industry and there seems to be a growing gap between the care envisaged by loved ones and the reality of creating a safe and comfortable environment for people who have lost the ability to be cooperative.

We now live in an age where dementia is common in people of advancing years and this is often the reason that loved ones seek to have the elderly confined in some form of aged care.   The onset of dementia is often characterised by memory loss, instability in making financial decisions and a tendency to wander beyond the regular confines of security.

Unfortunately, the characteristics of dementia vary greatly between individuals.  Some aged are easy to care for and very cooperative with aged care staff. A lot depends on the nature of the person and the type of relationship they have had with others over their lifetime.  Some tend to become very aggressive, both to other residents and staff and need a form of restraint.  This presents an acute area of conflict between care providers and the residents  loved ones.

There are two areas of control that are often the subject of conflict.   One is the use of restraints to keep a restless resident confined to a chair. This usually take the form of a seat belt similar to that used in an airplane and individual aged care facilities have different regulations on how long this may be used during the day.

The other is the use of anti-psychotic drugs to calm the resident.  These are given on the instruction of an attending doctor but they cause the resident to become uncommunicative with visitors and often appear to be sleeping.  Their need is often questioned by loved ones.

There is no doubt that both these methods provide a convenient option for aged care staff to maintain control and in some instances are resorted to far too frequently and for long periods of time.   The need to establish a reasonable time limit is something those tasked with regulating the aged industry are struggling to achieve.

Unfortunately, there are some people with dementia whose conduct makes them unsuitable for tenancy in which they share common space with others.   There have been instances where fires have been lit and combative attacks have resulted in the death of other residents.  Loss of inhibitions can cause obscene or insulting rantings and sometimes sexual intrusions that cause distress to others.  It is sometimes necessary to turn away such a resident from further accommodation.

In the past, the government maintained a separate aged care facility for such people, but it has long been closed.  It is not possible to house those with a tendency for violence in close proximity to more cooperative residents and the provision of a separate facility with added staff numbers to maintain control is an absolute necessity.

We are seeing an increasing incidence of dementia in the elderly and this clash of control measures will not be sorted successfully until we accept that extremes of dementia can not be shared with residents in all aged care facilities.   It requires the establishment of special facilities and this must be included in forward planning.