The 'Age' Old Question
Questions are being raised about the Government’s new aged care model that prioritises management over prevention.
The Australian government has released the details for the new 2025 Aged Care Bill. It calls for increased non-government funding to improve the standards of aged care facilities.
Whilst this may relieve the struggling aged care sector, some believe a better solution could be found elsewhere in embracing the 'prevention over cure' ethos. Implementing strategies to systematically reduce the number of elderly Australians entering aged care facilities requires an increased emphasis on the process of healthy ageing.
The Healthy Ageing Conundrum
As we know, Australia’s population is steadily ageing. New data reveals that by 2066, 21-23% of the population will be aged 65 and over. Despite this, the average time spent in ill health has also increased by an average of 1.3 years.
When we combine these figures, it is clear we are focusing on a substantive national health crisis. The Australian population is at the precipice of an ageing tragedy.
This is something that Pauline, aged 65, believes should be at the forefront of government policy and community initiatives.
After enjoying a fulfilled life decorated by various sporting and career accolades, Pauline was diagnosed with chronic osteoarthritis, a long-term degenerative joint condition.
The news came as an unwanted shock to the family. ‘When we were young, she could never sit still,’ sister Denise explains. ‘She was always on the go, running around a field here or doing an odd job there.’
After persistent knee pain and countless physio visits came up empty handed, Pauline sought expert advice. ‘When they told me, I was devastated.’ Pauline says.
‘Never, in a million years, would I have envisioned myself like this.’
Yet, this is the harsh reality for over 2.1 million Australians currently living with the condition. With the knowledge that the total health expenditure for chronic musculoskeletal conditions was over $4 billion, specialists believe there is an underlying trend: the issue of Australia’s under-funded ageing population.
Intermittency Solutions
Figure 1: OECD International Data on preventative care expenditure.
Figure 1: OECD International Data on preventative care expenditure.
Pictured: Physio Ben Klarich's physiotherapy business in Beecroft, NSW.
Pictured: Physio Ben Klarich's physiotherapy business in Beecroft, NSW.
General Practitioner Dr Stella Tang works amongst the elderly population of Beecroft. She expresses concerns for her patients, believing that the government does not realise the threat the ageing population will face in absence of appropriate policies.
‘On a health spectrum, I see countless elderly patients with chronic conditions that could have been easily prevented with proactive care,’ she says.
This comes as a 2018 report revealed nearly half (46%) of preventable hospitalizations occurred among individuals aged 65 and over.
Pauline says her prognosis could have been avoided with the right resources and information.
'I had no real way of knowing that the exercise I was doing was causing irreparable damage to my bones.'
‘Most of the information I read and received was to continue being active and look at what good that did me!’
It is hard to believe how common Pauline's story is. Yet, despite Australia's recent expenditures, data shows that we are being outperformed in preventative care internationally (Figure 1).
Instead, our ageing population now stares down the barrel of a retirement conundrum: to spend their savings on maintaining their health or do what they had hoped for in retirement.
The Mental Health Equation
To add to the burden, research suggests that chronic diseases are associated with a higher potential to develop mental health illnesses.
‘Receiving a diagnosis of a chronic illness can be life-altering. Emotional turmoil and isolation can be spurred by a diagnosis.’
A Cornell scale of depression tool estimated that 62.5% of elderly in aged care facilities had at least mild symptoms of depression. Questions are now being asked as to the intentions of the Australian government in their new measures that prioritise the management, opposed to prevention, of healthy ageing capabilities.
The importance of addressing mental health as a part of a holistic approach to healthy ageing schemes necessitates deeper investigation.
With increased care, comes increased cost. It is hardly surprising that the struggle of meeting health care bills within a cost-of-living crisis is challenging.
Physiotherapist Ben Klarich worries for the ability of his elderly patients to afford care amongst other necessities. ‘I’ve seen a few patients have to forfeit their appointments because of the costs,’ He explains.
‘It's upsetting when you think of how easily this could have been prevented.'
In addition to personal and community costs, chronic diseases result in a significant economic burden due to the combined effects of health-care costs and loss of productivity from illness.
‘I had stop working to reduce the stress on my bones. Now, my husband has had to increase his working hours to compensate for the loss of my income.’ Pauline explains.
According to research by the ABS on retirement intentions, 13% of people who retired in 2022-23 left their last job due to sickness, injury or disability. As more middle-aged people are forced to retire prematurely, workforce, production and economic growth levels shrink, leaving Australia’s economic landscape in turmoil.
What's Next?
With this in mind, we cant help but asking: where to next?
The government has assured citizens of the relieving impact the proposed measures will have on the aged care sector.
Not content to assume the government has it right, community leaders have taken it upon themselves to mobilise and attempt to alter the future of Australia’s healthy ageing.
Encouraging active and healthy participation amongst the ageing population is a way that Libby Teale, owner of independent Love Pilates brand, is doing her part.
‘We offer classes to people of all ages, irrespective of their movement ability.’ Libby explains. ‘We are in the process of introducing more Young at Heart classes, which are targeted towards maintaining strength and mobility amongst our older clientele.’
Libby tells us her elderly patrons gain mental stimulation and healthy community involvement during the classes. ‘Its like killing two birds with one stone!’ She explains.
‘We really encourage people to participate on the principle that it gets them out and about whilst also getting them moving, which releases the endorphins necessary for a healthy lifestyle.’
Whilst the Government’s efforts to address the immediate pressures of an ageing population through funding and policy reform are crucial, the real solution lies in a shift towards proactive, preventative healthcare.
Pauline accepts the reforms with cold comfort. ‘It marks a small step towards a viable solution,’ she says. However, it remains that unless underlying health issues are addressed, disparities and illness burdens will continue to grow, ‘and that is a terrifying thought.’
Written and photographed by Kate Law-Whitting
