whilst I am extraordinarily conscious of the amount of money being spent on aged care and not completely against the idea of an insurance scheme for when we are old, nothing changes the fact that we will get old, and we will die. That is what we call a fact of life.

What drives me berserk with anger is when supposedly "intelligent" experts spend any time at all on extending our lifespans, to the point where I have actually heard these experts talk about keeping somebody alive until they are 150. What planet are they from? WTF will feed these people? WTF will care for them? WTF will pay the bills?

We already have an ageing population which has 60% of the population paying the bills of the other 40%, in terms of pensions, allowances, the dole, and so on ad infinitum. Where will this need to extend people's lifetime to 150 years End?

It is high time that the money wasted on research into extending peoples lifetimes stop and that money directed towards something a little more useful among the thoughts could actually be aged care.

If we invested $15 billion a year in today's terms in National Aged Care Insurance - that would be only 1 per cent of GDP - and yet it would make a massive difference. The point is that with increased funding not only can we extend peoples' lifespans - but crucially we can maintain a better quality of life. This also applies to keeping people out of high intensity care until they really need it. (that means more low intensity care, support for Carers' etc) Read the article through and see the suggestions I make. If we can help the disabled, we can also improve the quality of life of our vulnerable aged. (unless you oppose the NDIS as well) As I argue, today the problem is so bad we have malnutrition on a massive scale; and people are denied what should be a human right for the best quality palliative care. If people think it will 'cost too much' we will see how they feel when it is their quality of life - of that of their loved ones - at stake.

Hi Tristan,

I take that on board and I hadn't actually discounted it as an issue. I think it would be a great idea if people could actually put together a process where their health insurance covered them into their old age, even if that means a publicly assisted insurance scheme such as you are suggesting.

That does not however we move the main point that I made, which was that if people spent a hell of a lot less money on finding ways to increase people's lifespans, and instead worked on the idea of management of Alzheimer's and other debilitating diseases of the elderly (and in some cases not so elderly), the whole process would be better off.

My biggest grief about the whole process is that I do not believe money should be spent on research into keeping people alive until they are 150 years old. far better to spend the money on research into management of current illnesses and diseases then run around trying to keep people alive who would have no quality of life.

Tristan,
I don't understand how insufficient funding, for there is currently some degree of state based funding of disability, outweights disgraceful policy that encourages people to undertake endeavours that result in 100's of innocent men, women and children to die at sea.

I think your prorities are a tad askew.

Well one thing we can be sure of, Tristan did not teach math. If he did he would know that there is no 15 Billion for anything. There is no 10 Billion for an NDIS, or a Gonski, or 100 Billion for a National Broadband Network.

For god sake mate, go get some year 12 math student to do some math for you, then write 100 times, We do not want to be another Grease. Then open your eyes & observe the world.

All these things would be lovely, particularly for someone like me who is near that part of their lives, but they just AINT on mate. The system won't allow any more money to be poured into taking in each others washing.

Yes you are right, it's the wrong system. Just like socialism which works until you run out of other peoples money, [about last decade for the western world], women in full time work is great, until you run out of old time grannies & mums who stayed at home, & did all the caring we now pay through the nose for for.

They were the ones who cared for the elderly, the disabled, & their kids, [no child care required thanks], in a system that worked. Sure we had less SUVs, pleasure boats, & overseas trips, but we all lived well, if less exciting lives.

Time we went back to the old way. Unfortunately I don't see any way back without a huge catastrophe first, thanks to ideas like this.

As for 10 Billion for the aged care we should be doing ourselves, forget it mate, we are going broke now, we don't need to hasten that any more, with hair brained feel good schemes.

Tristan,

Why not use the extra 3% that is going to be paid into superannuation when it rises to 12% for longevity/long-term care insurance? With longevity insurance, you would get nothing until you turn 85, for example, and would then get an annuity, reducing worries about outliving the money. A great many people are never going to need long-term care or will be cared for at home. From a US website

http://www.aaltci.org/long-term-care-insurance/learning-center/probability-long-term-care.php

"What percentage of people who purchase long-term care insurance will utilize their policy at some point before they die?. They need to know this in order to properly price the policies you buy.

"We asked them [actuaries] to provide data at various ages from 60 to 80. And, here is the answer.

"The lifetime chance someone who buys a policy at age 60 will use their policy before they die is 50%. So, 50% will use their policy and 50% won't. The actuaries did this based on a zero (0) day elimination period. Obviously it assumes you keep your policy in force by paying premiums.

"Most people today, however, purchase coverage with a 90-day Elimination Period (a 90-day deductible, or where you or someone else will pay for care for 90 days until the policy kicks in. That is a significant way to make coverage today affordable. So, I went back to the actuaries and asked them to take this into consideration. What happens if you purchase coverage with a 90-day deductible?

"For someone with a 90-day Elimination Period, the lifetime chance of someone buying coverage at age 60 and using policy benefits was 35%. So, 35% will use their coverage and 65% will not. As you might assume, the decline is because during those first 90 days, some people will recover and some will die."

They also have a table showing that 44% of the people who do enter a nursing home will have a stay of less than a year and 74% less than 3 years.

IJN - I have seen first hand what our aged citizens - who have paid their taxes all their working lives - are made to suffer in their final years. I dare say if you were in the position of not being able to afford quality care for you loved ones or yourself you would feel differently. Read the reports from Lateline from last night and the night before - and get your head around the issue before talking about 'priorities'.

Hasbeen: We have one of the smallest public sectors in the world, and small, very highly targeted social wage. We're WAY SHORT of Canada - let alone most of Europe. We CAN afford to do better. Even ONE PERCENT of GDP would make a massive difference. It is a matter of priorities. And if you watched the Lateline programs you may decide it makes more sense to tax the wealthy a bit more to prevent the horrific suffering that many of our loved one have/will go through. (not to mention the prospect of enduring such suffering ourselves) I've explained how it can be funded too - through reform of superannuation concessions, dividend imputation and/or reform of the Medicare Levy.

Divergence - you're right many people will die before needed high intensity care - but the numbers in care is currently over 200,000. And with the ageing population that's only going to grow. (exponentially) BTW The average stay in a nursing home is about 2 years. But for some it will be significantly more. And for many this will be two years of Hell. Compulsory Aged Care Insurance seems the answer - just like with the NDIS. Though I think paying for it through superannuation money would be regressive compared with more progressive funding mechanisms as I suggest. As Andrew Leigh has been arguing recently inequality is already way out of control in this country....

Dear Tristan,

I watched the aged care programs on television and
they were horrific. Nobody should have to suffer
under circumstances that were presented. Of course
not all aged care facilities are like that but there
were enough of them and made one wander - where were
the families of these elderly people and why did they
not know what was going on? How often did families
actually visit their relatives and check up on them?
That particular case of that elderly lady with
those bleeding sores - was a case in point.
How could family members not have seen those sores?
She was covered in them and they were bleeding and very
large - and the dead skin was simply falling off. The
stench must have been dreadful. The same goes for
urinary infections and other problems. Stench is a
give-away that something is wrong.

Yes, these facilities are often under-staffed, and
they do often have unqualified and untrained staff having
to deal with situations beyond their capabilities - but
my goodness - if you even suspect that a family member is
being mistreated - do something about it. Accept some
responsibility. Don't just dump your relative into a
nursing home and expect others to do all the caring.
Part of the responsibility as a family is also yours.
Check up on everything, and do something about it. Don't just
assume that "It'll be right." It may well not be.

Lexi; For my grandmother my mother and I were going in several times a week. But you cannot be there all the time.. Things would go missing from her room. (She had a private room which we managed to secure 0 the vast majority don't) She still did not eat enough, though, and lost weight... This was in the best facility we could find. We had to sell her house to secure the care.

Dear Tristan,

My mother-in-law and my stepfather were both in private
rooms with their own on-suites -
in the reputable - Blue-Cross facilities.
We also had to sell their
homes to get them into these facilities. However we visited
them regularly and I made sure that their Care-Co-Ordinators
immediately took care of anything that was not satisfactory.
From completely changing my mother-in-laws bed linen
(when her bed stank of urine). To seeing that stronger
incontinence pants were provided.
To making sure that doctors visited regularly.
They've both passed away. My mother-in-law was at the tail-end
of Alzheimers and my step-dad had suffered a series of strokes
and had lost his power of speech, and was partially paralysed
down one side. Of-course we couldn't be there for them all
the time - but I made darn sure that we visited at least several
times during the week (after hours if need be)
and on week-ends. Vigilance was important -
and of course as was the social contact with them .
Taking them out for coffee and cake and for a ride - made a
big difference to their lives, as well as making sure that
other family members visited regularly.

Tristan even if it was the only media on earth, I would not watch any of the garbage served up by the rabble that have gained control of their ABC. I am not interested in the tripe these activists produce.

I have had a couple of family through both the public hospital system, & private aged care facilities recently. Let me assure it was the hard & caring work of a nursing home that corrected the disastrous treatment my mother received in one of our larger public hospitals.

It was not cheap, but why should it be? When another group is bitching the sector workers are under paid it will probably only get more expensive. However, have you ever thought of paying you own, & your families way yourself? I think it would be a novel & equitable idea if we all started getting what we had earned

If a nursing home has mistreated a relative of yours badly, bring charges, & see them in court, otherwise keep it to your self. I am not interested in anyone running someone down, if they won't take action.

By the way, telling us we are better off than some disastrous countries does not help much. We are going down the gurgler right now, & if serious competition for our minerals develops in the near term, we will have no chance of maintaining services, let alone increasing them.

I was not impressed by this article. Whilst I don't condone the ill treatment of the elderly (or any one else for that matter) I also don't think we should be providing outstanding medical care for them either. I think that is part of the problem, not the solution. With an ageing population, there is a limit to what we can afford to spend.
Unfortunately, good medical care can delay for long periods of time people from dying of the natural consequences of ageing. If they are seeing a doctor every week and receiving top notch medical care, they may well live far beyond their natural life span, and in the process cost the country an absolute fortune. This money is being spent on people who are no longer contributing in a valuable way to society. It is money that could otherwise be spent on things such as education, infrastructure, health care (for other people in society) and all the other myriad of things we expect the government to provide. Every dollar spent on aged care is a dollar that is not spent else where. When people live in their own home, and are left to their own devices they may or may not see their doctor regularly. They may or may not take their medications regularly. In such cases they are far more likely to die naturally without costing the rest of society a fortune.
Also, the assertion that these people should retain their assets whilst riding on the taxpayers back is a disgrace. These assets of course will go in the end to those people who failed to look after their parents in their old age. Meanwhile, me as a taxpayer will be unable to afford to buy my own house or look after my family because all my money is going to people who already own their own homes.
Opportunity cost to the key to the provision of all government services. A dollar spent here is a dollar that can't be spent somewhere else.

Hasbeen;

The problems my grandmother suffered began in the late 1990s. It is too late to take action now; And my mother and I have other personal problems that are none of your business that make our lives very difficult just as it is. But when my grandmother was mistreated in a public hospital after a heart attack my mother intervened immediately, stopped the drugging and restraint; and we took her home as long as we could manage. they were about to put her in a home without any consultation with us as she was 'taking up a bed'.

But for poor and working class families there is only so much you can do. You simply cannot afford the 'top notch' places. When my grandma had to move from low intensity to high intensity care we were given about a week or two's notice.

The User Pays approach you suggest will mean poor quality care for poor and many working class families. It is a policy of selfishness, and is plainly inhumane.

I believe a massive difference could be made by directing 1% of GDP new social funding into Aged Care. Or do we have other priorities like Abbott's full-pay Parental Leave for women on $150,000 a year?

We have one of the smallest and narrow-focused welfare state and social wage in the world. Look to the Nordics, Holland, Denmark - We can do MUCH better. That is if we care enough.

Or do we think when we see someone suffering who's not family: "that's not my problem'.

Over-dependence on direct personal contributions means a flat, ultra-regressive tax on a masssive scale. Why would ordinary workers support this if they fully understood what it meant? Why not a compulsory national aged care insurance scheme to make certain no-one goes without -and everyone pays their way in proportion to what they can afford?

But improving the quality of care is the main issue - more so than the distributive justice issues even...

Hasbeen, I like your attitude. How about a bit of self reliance Tristan? If you don't like the way someone else looks after your mother, look after her yourself. People need to be providing for their own care in their old age. Not expecting the ever dwindling pool of taxpayers to do it for them.

I worked in the Aged Care industry for 10 years in WA up until a couple of years ago.
I agree that we should have a scheme to help provide more money for reidents in aged care facilities. We should use all medically trained staff instead of 'carers' who do a 6 week course at TAFE and are then let loose amongst our vulnerable aged residents.

The Government ensures each Nursing Home has a certain number of 'concessional beds', which are reserved for residents who were on an aged pension and did not have any assets like their own home. They paid 85% of their pension in fees.

The other residents needed to pay a bond that required them to sell their family home, as long as they had no spouse still living in it. When the resident passed away, their relatives got most of the bond back, depending on how long they were living there.

Nursing home medical staff were not in the business of 'prolonging' anyone's lives, unless they requested it. If some residents became ill with infections like pneumonia, their relatives often requested no treatment except for comfort reasons.
There are good and 'bad' nursing homes, but they must now have certain standards by law, and are regularly audited.

If some aged residents weren't visited by relatives or friends, it usually meant they had lost all those close to them over the years, or never had children. If they did have relatives, but no one visited, it was usually because the resident never treated them well over the years! People don't change their negative attitudes towards others simply because they are old and in care.

Rhys Jones -

You do not understand; many people reach the point where there is no choice but to go into high intensity care with 24 hour around the clock supervision. Many such aged Australians would rather not have to be washed by the closest loved ones every day either. And it takes qualified staff to know how to wash residents, and regularly turn and lift them to avoid bedsores. You are also neglecting the fact that the government is trying to extend the working age to 70 as well. So how can family thus effected provide care and work at the same time?

Finally I am arguing for a National Disability Insurance Scheme - where everyone pays on the basis of their CAPACITY TO PAY over their entire lives. Yes the money has to come from somewhere - but in the context of compulsory insurance payments levied in a progressive way. Even John Howard said he believed in progressive taxation... Yet nowadays it seems even many in the ALP are afraid to stand up for fear of the catchcry 'class warfare'. (which only seems to apply when the rich are asked to pay a fair share in solidarity with the poor and vulnerable; But it never used to described union-busting and austerity)

It appears there are some people here who lack in empathy and compassion, and have a warped sense of justice.

Hi Tristan. On the contrary I do understand. You want to provide nursing home residents with top quality care and you want it to be funded with a compulsory insurance, which of course is just another way of saying a tax. If you want to spend part of your income providing this top quality care then good for you. I, however, don't. I would rather choose how to spend the money I earn myself on the things that I prioritize. Imagine if you were forced to pay for the things that I place a high priority on.
You obviously agree with the recently introduced DIS. I'm sure all those suffering with disabilities will be very happy too. However, neither I nor any member of my family are in this category, yet my family will be $1,000 a year worse off because of it. That is a grand we cannot spend on the things we place a priority on. Now you suggest the government should take another $1,000 a year to provide top notch care to those who have had an entire life time in which to make provision for their old age.
I think the current system, though not perfect, is none the less perfectly adequate. Poor standards of care will be exception, not the rule. With our ageing population we need to find cheaper ways of looking after the elderly, not more expensive ones.

Obviously Tristan you expect to be a beneficiary under any increased age care spending. Your idea of each paying according to their means has been tried old mate. It was called Communism, & it failed dismally, killing millions along the way.

Equally you expect to be a beneficiary under a National Disability Insurance Scheme & sprout the same airy fairy tripe in favor of it. Do you know what is offering, & have you ever done the math on it.

A neighbor of mine has a mid 20 age son, with a mental age in single figures. I don't know what the politically correct name for him is. She has been told the NDIS will provide him with public housing, & 24/7 cares. There may even be his own car.

Can you imagine the cost of this? It would range between $400,0000 & $600,000 PA, just for this one bloke. That is the gross income of at least 8 checkout chicks. It is the tax take from 24 of them.

I would love you to justify how this is equitable, or possible. No welfare recipient should ever receive more than the lowest full time worker, more than that is just a rip off.

The welfare sector right now consumes almost the entire PAYE tax take of the government. Yes that's right, there is nothing left of all our taxes after paying for the dead weight this sector has grown to be. If this impost is increased, rather than reduced soon, expect a very serious backlash.

As things get tougher expect those under strain to get very resentful of keeping others in comfort as their own dreams & comfort go up in smoke. Time to get your demanding hand out of other peoples pocket, & start doing a bit more for your self. If you are too delicate to wash your loved ones, don't expect someone else's taxes to pay for your sensibilities. I admit to having the same problem originally myself, but I did it until my mother could no longer stand, then paid out of my savings.

Tristan,

The advantage of paying for long-term care out of superannuation, and only using tax money for the indigent, is that the individual or the family would have more leverage over the provider, as they could take their money elsewhere. The government would always be tempted to underfund the nursing homes and use the money for electoral bribes in marginal seats.

Rhys Jones,

You clearly don't understand the principle of insurance. Someone in your family could go under a bus tomorrow, and you would be very glad of NDIS. You would consider that premium of $1,000 a year well worth it. Similarly, you could develop a nasty disability in old age, and your family might not be able to care for you, for example, if you develop Alzheimers relatively early and become aggressive. You then leave your wife with the choice of consigning you to some understaffed, underfunded hellhole, or losing her home and spending all the family money on you to give you topnotch care, leaving her destitute in her own old age. If there is only about a 1 in 3 chance of needing extended care, then an insurance model would be quite doable, especially if the money is collected throughout your working life so that compound interest can help.

Thanks for the support, Divergence - even if we disagree slightly on the model.

Hasbeen - It seems you don't know the difference between Social Democracy and Stalinism. In my book Stalinist practices don't even stack up has being faithful to the (original) Marxist tradition.

Look at the Marxist Social Democrats Karl Kautksy, Julius Martov, Rosa Luxemburg and their criticisms of Lenin and later Stalin. (except for Luxemburg who was murdered in 1919) Do some research so you have a better idea what you're talking about. The most determined critics and opponents of Stalinism were Marxists who were true to the original spirit and traditions of Social Democracy. (though Lenin doesn't really deserve to be put in the same category of Stalin- though his desperate strategies helped create the fertile ground from which a Stalin could emerge.... In Lenin's favour he tried to give the RUssian people what they wanted - an end to war; On that them I don't think Kautsky appreciated the reality of collapse and war exhaustion in Russia) Have a look - if you can - at 'The Dictatorship of the Proletariat' by Karl Kautsky in 1919...

Amazing how we all recall the horrors of what's been called Communism; But few people know of the atrocities of World War One, and of the Cold War - including proxy wars in Central and South America...

Divergence, I do understand insurance. I insure myself for a variety of risks and choose not to insure myself for other risks. I fail to understand why people like yourself feel the government is in a better position than they are to decide what insurance they need or don't need. A compulsory insurance does not differ from a tax in anything but name. It is levied by the government to pay for services whether I want them or not.

We'll see if you still feel that way if it happens to you or one of your close family one day, Rhys.

Rhys,

Whether insurance should be compulsory or not depends on whether your misfortune impinges on other people or on society as a whole. You can make up your own mind about fire insurance if you are prepared to lose everything if your house burns down. Green slip insurance is compulsory because you can be at fault in an accident that maims someone. While he can sue you, even bankrupt you, there may well not be enough money to pay his bills. No one is going to let your mentally retarded son or your crippled elderly mother starve on the streets, even if you have other priorities that you put above paying insurance.

Divergence Tristan, we already take care of the disabled & the elderly, & I did mention my recent experience of this care, & my near approach to it.

However it is what is planned for the NDIS, carefully hidden from the general public, that is a major question.

Neither of you answered my post regarding expectations of the mentally incapable being given public housing & 24/7 in house support, costing around $500,000 PA. All I got was typical waffle. Do you have an answer? Do you wish to hide this fact, or do you wish to ignore it as it is not good for the cause?

Cat got your tongue folks?

Hasbeen; Many of those people would require the support of family; And support for Carers' would cost much less than $500,000 annually. But if these peoples' loved ones die the state needs to step in and provide the best quality care - even if indirectly through support for NGOs. What else would you suggest?

Divergence, You seem to suggest that we have two choices. Compulsory insurance or people starving on the street.
I don't have a mentally retarded son and if I did I would care for him myself, not leave him to starve on the streets or be cared for by other members of society. I also would not allow my mother to starve on the streets. I view it as my responsibility to care for my family. Not the responsibility of the rest of society. Under the current system I have not noticed any retarded or senile people starving on the street.
Tristan says "the state needs to step in and provide the best quality care". Why does it have to be the best quality care? Why not adequate and humane care that is within the means of the taxpayer to provide? Remember, there is no return on this investment. Unlike education and health care for relatively young folk, which enables them to contribute to society, aged care and disability care provides nothing in return to the society that pays for it. No matter how well you look after a person with Alzheimers, they are never going to be a productive member of society again. To the contrary, they are likely to live much longer, increasing the burden on the taxpayer still more.
Likewise with the mentally retarded.
The money would be better spent rehabilitating people with injuries so they can return to work, or on ex-prisoners so they may be transformed into productive citizens. On on better infrastructure so we can do business and thrive. The more we thrive the better able we will be to care for our elderly and disabled. Not the other way around.

Rhys; So human beings and humanity are not seen to be innately valuable in themselves - but only insofar as they "provide a return on investment". And they say there's nothing wrong with capitalism as we know it....

Family is an important societal support structure. But sometimes the majority of people are better off providing and consuming welfare and social services collectively. It's called 'social solidarity' and it is a sign of a civilized society. Call it socialism if you like - though social Christianity and liberalism have maintained the same principles. It's also sometimes more efficient in terms of the labour required. (eg: as in the case with child care)

The alternative to leaving all care to family neglects the fact that not all families have the wealth, spare time or financial security themselves to do a proper job. And some families simply neglect their dependent members.

And again most crucially: You have failed to address the fact that there are SKILLS involved in caring for the aged and the disabled. That in of itself means a need for socialisation of care - with minimum standards in terms of skills.

You say 'the best possible care' is not necessary. Well it depends on your standards. If at the moment up to 50% of high intensity residents are suffering malnutrition doesn't that suggest something is wrong? And if the problem is at least partly staffing - doesn't that suggest an increase in funding is needed to improve skills and staffing numbers? Ditto: provision of doctors and dentists visits, heating and cooling, standards for recreation and social interaction.

The point is that many of our aged are suffering so intensely that only a dramatic improvement in the standard of care is acceptable.

Rhys,

What happens to your relatives if you die and the money runs out? Not everyone is lavishly paid. No one is suggesting that elderly and disabled people be kept in luxury at the taxpayers expense, but it is clear that there have been horrific abuses, which may have been ignored by government because of what adequate, humane care would cost. Under my suggestion, most people would pay for their care themselves, unless they are extremely unlucky.

Look after your own aged people, why push everything on to welfare to come to the party. Every one is going to go through it. What i've seen of those places is it's not for me. Who wants to sit in a chair and rock back and forth all day. You are best to do that in familiar surroundings.

Tristan, I do believe that human beings are valuable in themselves. However, that does not mean we need to spend millions of dollars on keeping the the very old and frail in pristine conditions.
That is not capitalism. That is about opportunity cost. Obviously you value the health of those at the end of their life above the health of those at the beginning or middle of their life. I do not. I believe funds need to be spent in the manner which is most beneficial to the individual and to society as a whole. As far as tax payer dollars are concerned we need to get value for money.
That fact that half of high intensity residents have malnutrition says nothing about the care they receive. What it says is that these people are very old and very sick. Whilst we could perhaps relieve that malnutrition via nasogastric tubes or peg feeds, the likely result would be to simply extend that persons life and suffering still further at enormous cost to the tax payer and with little benefit to the individual concerned. I can think of many better ways for that money to be spent that would benefit individuals and society as a whole rather than simply act as a huge drain.
You say caring for the elderly requires special skills. Unless you are intent on extending their lives then it does not require special skills. We have been looking after our elderly, the same as we have been looking after our children ever since we became human and probably long before that time. Nothing has changed, except the expectation from people like yourself that dying of old age should somehow look pretty and be enjoyable for all concerned. I have worked in nursing homes and I can assure it is neither pretty, nor enjoyable. Not because of a lack of care, but because dying of old age is filled with pain and suffering, both mental and physical.

Rhys; The common malnutrition is largely because of insufficient staffing; Yes people are ill and sick; But that is WHY they need staff to ensure that they eat and do not get sicker. We can only do this is we have higher staffing levels. And that will cost money!

You obviously have a personal axe to grind Tristan, & it is getting boring. There is nothing worse than someone who applies their unhappiness with one institution to a whole sector, or expects their slightest desire to be funded by someone else.

My experience.

My mother was completely bedridden, & could not sit up without help after a procedure, that should not have happened to a 98 year old, in a Qld public hospital.

They failed to feed or water her for 30 hours, due to the total inefficiency of weekend nurses, & their management.

When the large hospital wanted rid of her, the small local public hospital refused to take her because of her platelet count. They couldn't manage that they said, so suggested a nursing home should, for gods sake.

She was never able to sit up unassisted again, or feed herself. However the nursing home brought her back to reasonable health, although their physiotherapist could not get her mobile again, despite valiant efforts.

Those country town girls & women, unqualified & low paid as they are, did a much better job of looking after & in fact caring for my mother, than the highly qualified & paid public hospital nurses.

I will be forever grateful to them. It was not the cheapest place, nor was it exorbitant. Perhaps you are not good at choosing the right places. From general discussion, I can't find a nursing home on our extended area that is not well thought of.

Oh that's right, "it's just me"; Which must be why Lateline devoted two nights in a row solely to the issue of Aged Care, including instances of abuse, neglect - or just plain incapability for workers to cope.

You say: "it's getting boring". I'm so sorry if I bore you. If you really don't care then just let the issue drop.

It sounds like the hospital gave your mother a raw deal; the same with my grandmother - We should have held those responsible accountable - but were so overwhelmed with finding her accommodation and rehabilitation with no notice.

Here's some of the transcripts from Lateline; Acquaint yourself with the material before taking me to task again:

See: http://www.abc.net.au/lateline/content/2013/s3803710.htm
and: http://www.abc.net.au/lateline/content/2013/s3803716.htm
and: http://www.abc.net.au/lateline/content/2013/s3804573.htm

You may have found a decent place for your loved one. But we found the best place we could after looking around a lot. There were kind people there - that made a big difference. But even still the facility was under-resourced. We had to visit personally to ensure my grandmother ate. And basically people were sat in a common room all today.

If the system is so good then what problem do you have with minimum standards? What problem do you have with ratios to ensure staff are not over-stretched - with the consequences I've already spoken of? What problem do you have with mandating the provision of heating and cooling; regular visits by doctors and dentists; planning provisions that ensure people can enjoy time in the sunlight when the weather is right?... What problem do you have with establishing standards so all who have the need get quality palliative care? What problem do you have with high intensity residents having access to information technology?

John Kelly - who represents the not-for-profit sector in aged care tried to stay clear of the word 'crisis' - but he conceded there was a "Chronic Under-Funding' problem. It will get worse with an ageing population.

I'm told there have been improvements since my grandmother's experience. Perhaps. But the Lateline programs suggest the problems have not gone away.

I'm sorry also if you think my 'slightest desire' for providing for the basic human rights of our aged citizens is 'boring' you as well; And that it 'is not your problem' (your apparent attitude) - given your apparent individualist philosophy which seems to have a problem with social solidarity 'in principle' no matter what the human cost...

The following remains true:

Broad standards exist and comprise an improvement from the time of my personal experience with the system from around 1995-2000.

But nonetheless there are problems with a 'revolving door' of staff - because it is a stressful job; there are insufficient pay scales and career paths; aged care nurses face effective discrimination; many facilities are under-staffed.

To really adequately meet standards of intellectual ,cultural, spiritual engagement - Again these standards and promises are empty without funding. Only funding means there will be books, information and communications technology etc.

We need ongoing independent studies funded for a variety of advocacy groups which establish the way in which standards are being met; and whether our interpretation of 'sufficient' standards is good enough.

There needs to be much more robust policing of standards - As the Lateline reports show these standards are often not met in practice regardless of aspirations. Again malnutrition is a big problem - and requires sufficient staffing levels. The same applies re: turning in beds, changing nappies and clothes and bathing whenever necessary. There is no getting around the fact this requires funding.

Again John Kelly concedes a "Chronic Funding Shortage" - How clear can you get?

Tristan you have to stop watching those W*s on the ABC. Too much will make you go blind, don't you know.

Tristan says "To really adequately meet standards of intellectual ,cultural, spiritual engagement - Again these standards and promises are empty without funding. Only funding means there will be books, information and communications technology etc."

Surely you must be joking. Since when did Australians become so incapable of meeting their own needs that it became the governments responsibility to provide for their "intellectual, spiritual and cultural engagement". What has happened to these people and their families that they are unable to provide their own books, communications technology and other pass times? Should the government also supply these things for me and my family too? Is no-one responsible for themselves and their families any more in your opinion?
You obviously will not be satisfied until the government (taxpayers) control, pay for and regulate absolutely every aspect of our lives.

The problem is not unlike the issue of paedophile priests, in that the overwhelming majority of priests were not paedophiles - but they turned their backs on victims and were more concerned to protect the industry. The aged care industry has to similarly acknowledge it has some bad apples, but it is because of subhuman attitudes (like some of the selfish and ignorant people - who have so appealingly responded to this article) that the baddies get away with it.

I don't believe that we should prolong death, but nor should defenceless victims be allowed to be mistreated. Elder abuse is not acceptable - full stop. The obsession with youth, and denial of ageing, is a media driven disgrace.

For those who think that money shouldn't be spent on the elderly, they need to bear in mind that it costs far more in intensive care for a premature baby. Today's young, who remain at home and sponge off their parents until their mid thirties, are far more of a drain on working families than the elderly.

Some respondents seem to be suggesting we opt for a eugenic society - as Hitler did - and euthanize all sick and disabled 'unproductive burdens'.

Ageism is a sick replacement for racism and sexism - and a royal commission is needed to bring it out into the open.

Dear Tristan,

Once again - Thank You for this article and I
fully support your insurance scheme for the elderly.
I think it's not only a great idea but a necessity.
If people live long enough, dependence becomes inevitable.

Extreme
old age, beginning around the eighties, is accompanied,
sooner or later, by a slowing or even crippling of mental
and physical processes. Unable or unwilling to take care
of an elderly relative, younger family members usually
arrange for the aged person to move to a nursing or
old-age home. This prospect is hardly an appealing one,
however, at best, it means living in an unfamiliar
environment where one relies for medical and other needs
on professional staff rather than on family or relatives.

Some homes offer superb facilities, but many are dreary,
shabby, and ill-equipped places, run by people whose
concern is not in the best interests of the elderly but rather
in whatever profit they can wring from the enterprise.

I'm not sure what the exact percentage of the elderly are in
nursing or old-age homes at any given time, but most do
conclude their lives in that kind of setting. Today, fewer
than one in five dies in that familiar context; most of the
rest meet death in a hospital or nursing home.