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It was George Bernard Shaw who famously said, 鈥淲e don鈥檛 stop playing because we grow old. We grow old because we stop playing.鈥�

Although it may be a frivolous expression, Shaw鈥檚 quote is grounded in scientific truth. When our activity level or quality of life declines,聽often our health does too.

In fact, SA Health suggests that 鈥榝unctional decline鈥� 鈥� the decrement of physical or cognitive function in response to inactivity 鈥� is unrelated to the initial diagnosis for 30% of people; can begin as early as day two of a hospitalisation; and is non-recoverable for half of sufferers, three months post-discharge. 颅颅

With these statistics in mind, it is hard to accept that 鈥斅爋ften through no fault of any individual worker 鈥� the majority of aged-care residents may be spending their final years颅颅颅 (typically more than three) sedated in front of a television set, drowsy and unresponsive to visiting family, getting neither the levels of physical, cognitive nor social stimulation they need to stay healthy.

Yet this is the tableaux painted by nurses鈥� submissions to the ongoing .

In an interview with 黑料吃瓜群网 + Healthcare, Federal Secretary for the 聽Annie Butler聽said that virtually all instances of elder neglect point to one common denominator: unsafe nurse-to-resident ratios.

鈥淲hen you have one nurse for every 100鈥�190 residents, there simply isn鈥檛 scope to meet the psychosocial needs of residents; sometimes not even their basic physical needs 鈥� like staying hydrated, getting wounds redressed in a timely fashion, or undertaking exercises that may offset functional decline,鈥澛燘utler said.

鈥淐laims that providers have created 鈥榟omes鈥� for their residents are nonsense,鈥� she added.

鈥淎ged-care workers want to give residents a home-like environment. They want them to be as happy as they can be. But the governance structures aren鈥檛 allowing them to provide that.鈥�

Despite numerous inquiry-backed calls to instate a minimum staff-to-resident ratio 鈥� or at least make existing ratios public knowledge 鈥斅爐here is currently no legislation in place to deter the chronic understaffing of Australia鈥檚 aged-care workforce. In fact, a staff ratio disclosure bill was put forward in 2018 and sharply dropped. Butler attributes this to funding but says that, paradoxically 鈥� factoring in reductions in agency use, overtime, staff turnover and unwarranted hospital visits 鈥� implementing a minimum nurse-to-resident ratio policy would prove to be 鈥渃ost neutral鈥�.

鈥淥ur analysis shows that half a billion dollars would be saved if we were to raise the prevalence of nurses and care workers in aged care.

鈥淣urses often have no choice but to call an ambulance for simple medical interventions, which they may not need to if they had assistance from at least one other onsite medical expert.

鈥淎s a nation, we aren鈥檛 saving anything by underemploying nurses in aged care; we are simply palming the issue (and associated costs) off to other services.鈥�

Butler鈥檚 estimate 鈥� produced by economists at 鈥� is similar to that made by Aged Care Workforce Strategy Taskforce Chair聽Professor John Pollaers聽in 2018.

Professor Pollaers鈥� analysis showed that putting an additional hour of care into the system, and bringing wages in line with commensurate health-related professions, would improve employee recognition, capability and retention, and yield substantial holistic care benefits.

He advocates a living-well model of care encompassing clinical health, functional health, cognitive heath, living-well aspirations and cultural needs.

鈥淲e need a system that delivers fundamental clinical care and, at the same time, gives people the opportunity to self-determine and live the life they wish to live,鈥� he told 黑料吃瓜群网 + Healthcare.

鈥淲e all need to consider what it would take to keep people at home and independent for longer. For example, if given 12 weeks of rehabilitation post-hospital discharge, instead of the usual four, older patients could avoid ending up in residential care. But because our health and aged-care funding systems are siloed, the opportunity is missed. Instead, without the extended care they need, the patient often deteriorates, placing a greater longer-term strain on the sector.鈥�

An expert in functional decline, Professor Pollaers said the reports of oversedation were a 鈥渢ragic shame鈥� and would create a 鈥渟nowballing effect鈥� of suffering for aged-care residents.

鈥淚t鈥檚 well documented that visits from family members become fewer and further between if they don鈥檛 get a 鈥榬eturn鈥� on their time investment. If residents are overly medicated and unable to properly interact with their relatives, I fear they will become deprived of the social interaction they so critically need to stay cognitively healthy and, importantly, independent and happy.鈥�

Though 鈥榩laying鈥� may be too literal an interpretation of Shaw鈥檚 quote, perhaps its key takeaway 鈥� to keep young through physical and social stimulation 鈥� is one to keep in mind when driving aged-care policy.

Image credit: 漏蝉迟辞肠办.补诲辞产别.肠辞尘/补耻/驳辫辞颈苍迟蝉迟耻诲颈辞