PAUL DALEY April 15, 2012
Illustration: David Rowe
I wonder when you last thought about where you'd like to spend your final years or months.
A grim subject for a Sunday morning, I know - but one we all should think about. We delight in the magic of birth. But in the West, we tend to put off planning for the end until … well, until it's too late.
Then our loved ones have to pick up the pieces and make all the decisions for us.
I'm not talking about those who are struck down tragically, too early. I'm talking about the elderly who need constant care and assistance to bathe, toilet and nourish themselves but who still have the right to experience joy, dignity and tranquillity.
Those of you who've ever had to find an aged care facility for a loved one in a hurry will know what I'm talking about.
My father, an independent and stubborn old bugger, refused to leave the double-storey, four-bedroom family home that was falling down around him even though he had early onset dementia and poor mobility. He kept falling down the stairs but couldn't live on the lower floor because there was no bathroom.
Eager to keep him out of a nursing home - the thought of which he dreaded (''All those annoying bloody old people!'') - we intervened, liquidated the house at a fire sale and moved him and my mother into a single-storey unit. We paid for someone to help him shower and shave. My mum, then also in her 80s, somehow managed the rest.
And then the wheels fell off. Dad was hospitalised with pneumonia and collapsed with exhaustion. Mum, exhausted, was hospitalised, too.
No matter how much support we bought in, home for my dad was no longer an option. He refused to live with his children.
A social worker gave us a list of nursing homes. I looked at them all. It was my first experience of Australia's three-tiered aged care system.
If you've got millions, then you can buy your loved one luxury. If you're moderately wealthy you can, with luck, provide them with some comfort and dignity - if you can find a place.
If you have little money then the reality is grim indeed: a bed in a dormitory-style room with little privacy, poor meals, endless daytime television and a bathroom down the hall, in a run-down building. It's a heart-breaking option for everybody but one that tens of thousands of Australians are forced into.
The choice (tier two) for us was easy. After the hasty sale of the family home, we could manage the $600,000 bond. This entitled him to a well-lit room with a private bathroom, good meals and constant nursing care.
He had privacy. The carers were compassionate and patient as he endured the cruel and harrowing symptoms of Parkinson's disease that ended his life a few months later.
The commitment of the staff (some of whom are paid as little as $16 an hour) was evident at all of the institutions we inspected, despite the wildly disparate quality of care that each place could offer.
It made me determined to plan for my own end (should I be so fortunate to live until my 70s or 80s). I'm determined not to hang on to the family home until I'm dragged out of it in an emergency. I want to plan, financially at least, for those final years elsewhere, either in my smaller place or an institution.
But it also made me absolutely certain that the federal government must play a far greater role in addressing the inequity of the current aged care system. The Gillard government effectively conceded last week that the system was in ''crisis''.
Finding the money will be just one of the great difficulties. Convincing some of the wealthy that they should not only provide for themselves in old age but also the less fortunate through the tax system, is another.
Meanwhile, any significant reform will have to take into account the workers who care for the elderly too.
Now, bring on the Health Services Union, the employee organisation that is supposed to be representing the interests of these forgotten workers.
So utterly repugnant has been the alleged behaviour of some current and former HSU executives that the Australian Council of Trade Unions has suspended the union.
The members must also look askance at the Gillard government, which reels under the moral weight of its continued reliance on MP Craig Thomson amid all the shameful allegations that haunt him.
Spare these workers a thought or two today.
Because the chances are we will be relying on them for our own dignity tomorrow.