The disability, health, housing and aged care sectors must ensure young people with disabilities stay out of aged-care facilities.
This week, the community affairs committee started hearings for the Senate inquiry into the lives of some of the most vulnerable, disadvantaged and disabled people in Australia: young people in nursing homes. It has been 10 years since the initial Senate inquiry that brought the issue to the attention of our government.
The current Senate inquiry focuses on the adequacy of residential care for young people with disabilities, including young people in nursing homes.
In 2005, as part of the inquiry into aged care, senators were stunned to meet people like 34-year-old Vicky Smith. Smith was severely injured in a horrific car accident and was admitted to a nursing home at the age of 17. Smith told the committee, “I have been in a nursing home for a long time, and I have seen death after death. I do not have the willpower to put up with any more deaths.”
In 2006, governments jointly established and funded the national five-year $244 million younger people in residential aged care (YPIRAC) program. The program was implemented through disability services departments within each state and territory government. As a result of this program, 250 young people were able to move out of nursing homes and a further 244 young people avoided being admitted. Throughout Australia, 65 new services were created to provide housing and support for more than 322 people. Summer Foundation research found that moving out of nursing homes enriched the lives of young people with disability. They went outside more often, had more opportunities to make everyday choices and spent fewer hours in bed. After 23 long years in a nursing home Smith now lives in a community house with several other people with disabilities.
One of the key findings from the YPIRAC initiative is the importance of preventing new admissions to aged-care facilities. It is a much better use of resources to stop people from entering than letting them enter and then trying to move them out. Once in a nursing home, young people lose skills and their social networks diminish. Most (59 per cent) young people are admitted to an acute or rehabilitation hospital before their first admission to residential aged care. This suggests that disability services need to partner with health services to develop pathways to community living to prevent new admissions. The YPIRAC initiative made a significant difference to the lives of the people who received services but it did not create the systemic change needed to stem the flow of young people into nursing homes. Since the YPIRAC initiative ended, the system has largely reverted to the way things were in the past. The new housing and support options developed for this target group are full and vacancies are usually created only when a resident dies. More than 300 people under 50 are still admitted to nursing homes in Australia each year.
The disability sector is being transformed with the introduction of the National Disability Insurance Scheme (NDIS). People under 65 years of age living in residential aged care are eligible for funding through the NDIS. The NDIS is one part of the solution to the issue of young people being placed in nursing homes. The NDIS will provide the crucial funding for support that young people in aged care or at risk of entry need to live in the community.
Based on current research and experience with previous government programs, most young people in nursing homes will miss out on the NDIS. They are unable to initiate and complete the registration process due to their cognitive and communication difficulties. They often have no one to advocate on their behalf. There needs to be a national strategy to ensure that the most vulnerable and disadvantaged people with disabilities get equitable access to services funded through the NDIS.
The NDIS cannot on its own stop the inappropriate placement of young people in residential aged care. We need to change the system to prevent new admissions. More accessible and affordable housing also needs to be built.
The NDIS has limited funding for capital to support the development of new housing for young people in nursing homes. Due to the current overall shortage of accessible and affordable housing we do not expect many young people to move out of aged-care facilities as a result of the NDIS. A range of housing options including options for people to live with their partner and/or children is needed. Many (46 per cent) of young people in residential aged care are in partner relationships and 27 per cent are parents of school-age children. Australia desperately needs a long-term strategy to create more housing that is both accessible and affordable. Rather than continuing to build segregated specialist housing, the housing needs of people with disabilities need to be incorporated into mainstream housing strategy.
Solving the issue of young people in residential aged care on a sustainable basis requires strong government policy leadership and effective collaboration across many sectors. No single sector has the expertise or resources to prevent new admissions of young people to residential aged care or to develop the range and scale of housing, rehabilitation and ongoing support required for this target group. The complex needs of young people in residential aged care requires a more co-ordinated approach that involves health, housing and aged care rather than just looking to disability services to solve the issue alone as has happened in the past.
Di Winkler is chief executive and founder of the Summer Foundation.
Read the full story... (off-site)- Topics:
- Housing
- Author:
- Di Winkler
- Source:
- Sydney Morning Herald
- Date published:
- Thu 19th Feb, 2015