Aged care refers to a person not a medical condition

Ageism is alive and well and the sometimes-patronising assumptions we make about aging can influence care for older Australians. KENDALL MORTON discusses the importance of keeping people at the forefront of care.

Aging and the Art of Living was written by Dutch philosopher Jan Baars. His ideas challenge us to reflect on how we care for older people in our communities.

He argues that science does not produce objective knowledge but serves to legitimise and regulate the social processes and forms of domination.

It helps us view aging as a medical condition. But – newsflash – aging is not a disease!

When we focus exclusively on the physical effects of aging, such as lower bone density and diminished sight and hearing, it’s easy to devalue and disempower seniors. It’s easy to bow to the medical descriptions of ourselves as frail, impaired … less than.

You may not think this matters to you now, but God willing, we will all be old one day. And ageism diminishes us all.

Baars says terms we use, such as “the aged” and “the elderly” are part of the problem. These terms allow us to think of older citizens as objects of special care, rather than people with ideas, histories and innate value.

He goes on to challenge the health sector to deliver care differently. In his words, care should be “embedded in the life of persons with dignity in their own right, not simply problematic beings needing care.” (The Aging and the Art of Living, 2012)

It’s common to reflect at the end of life. Did I matter? Did I love enough? These are questions about connections and purpose.

Baars has coined a new word. He says rather than being human we are “interhuman”. We are born, live and die in relation to others.

Taking on this interhuman concept lets us re-evaluate how we give home care. It’s not possible to be in someone’s home three or more mornings a week without becoming part of their lives. Love and connection happen.

It’s natural and it’s enriching for the home care worker and the person living at home.

However, the language we use such as “receiving care” is difficult. It paints the client with a home care package as a docile recipient of a service. We are alert to this language and the cultural tendencies to disempower older people.

As someone loses mobility or strength it’s easy to take decisions away from them, to infantilise them or see them as a collection of medical or nursing dilemmas to be managed. It’s faster to do things for them than let them stay in control.

Language is one way we give or take power from people. Have you heard a younger person address an older person with “Hello darling. How are we today?” in a sing-song voice. I cringe. I’m sure you do too.

Home care happens in a cultural context. We are all influenced by advertising and stories. Ageism is deeply embedded in our society. It’s not cool to have wrinkles. Our corporations can sell more potions and lotions when looking old is something to be avoided and ashamed of.

Let’s talk about power again. When care staff go into a client’s home we need to remember the client is the decision-maker. For example, they choose the time of day we arrive, the services we provide, what they wear each day and the outside activities they join. They choose what we call them, “Mrs Lee” or “Susan”.

Home care is often seen as transactional. We give someone a shower and we are paid by them or the government. The senior person gets to remain safely at home for another day. This is a very impoverished way of looking at things.

A better approach is person-centred not task-centred. Carers need to enter the home thinking about WHO rather than WHAT. It’s a challenge to create relationships in a short space of time. But staff do this again and again. They share jokes, they listen. They do their work in a warm human context.

And the service we provide is directed by the client. If there’s time to spare, they decide whether the carer makes them a cuppa or waters the patio plants. This may seem like a minor thing, but being an adult means making decisions.

If we take that away in the home care relationship, we turn private homes into mini-institutions. And we are all poorer for that.

Kendall Morton is the Director of Home Care Assistance.