When aged care becomes the only option

By 2021 one in three Victorians living in rural areas will be aged 60 and over, and the topic of how regional health and aged care services will cope has divided policy makers, politicians and the public alike.

For a generation of sons and daughters, the questions raised by an aging population reverberate on a more personal level.  For many, the problem is the question of who is going to care for their loved ones when and if they can’t.

It is a topic that Rhonda Nay, Professor of Interdisciplinary Aged Care at La Trobe University knows all too well.

‘Carers can feel helpless when it is time to ‘hand over’ responsibility to the aged care staff. Separation, after taking care of someone for years, can be an incredibly emotional process for both the carer and the person being admitted,’ she says.

‘Looking after a relative at home can lead to feelings of isolation, depression, and even illness for the carer, the realisation that they need to turn to residential care can often lead to guilt and a sense of failure on their behalf.’

Sometimes though, she insists, aged care is the best – and the only option for those no longer able to support those they care for.  

‘Being aware of how to manage that transition can be a really empowering tool, moving a loved one into aged care in the right circumstances and with the right advice can be a really beneficial move for both parties.’

Her advice is to start with three simple steps.


1.    Understanding carer stress and the causes of “elder abuse”

Ranging from neglect through to physical harm, ‘elder abuse’ is often a sign that the carer relationship is over stressed as Professor Nay explains.

‘Often ’elder abuse’ isn’t a result of deliberate actions or a desire to hurt, simply it can be the outcome of the carer no longer being able to fulfill the responsibilities they need to.’   

‘It’s really important to tell someone about any anger, frustration or stress you may be feeling towards your elderly relative.  Don’t be afraid of talking about emotions and realising you need help can be the first step to helping the situation,’ she says.

2.    Choosing an appropriate residential aged care facility

‘What to look for or ask when choosing the right facility is a really common question.  Start with a checklist for your meeting with residential staff and have some basic questions to ask such as:
•    are staff welcoming and friendly?
•    are they professional and courteous towards the residents?  
•    What is really important to you  - locality, meals, activities…
•    The Department of Health and Aged Care has a very helpful list of questions you should consult.

‘Another good tip is to speak to the local council, they will be able to give you some good feedback on the facilities in the area and give you an honest opinion on the facility.’

3.    Develop an advanced care plan (ACP)

An ‘ACP’ – is about life and death situations, Professor Nay believes family have an important role in assisting staff to fully understand the resident and what should be included in the general care plan. This can include details of how carers have ‘done things’ up until now, but it also needs a detailed life history – especially if dementia is making it hard for the resident to convey preferences.

Professor Nay suggests an ACP should be developed long before aged care is an issue,

‘Where possible a Medical Enduring Power of Attorney (MEPOA) should be appointed and a Statement of Choices completed. Information is available on the Vic Gov web site or families also have the option of discussing it with their GP.  The staff need to know what to do in a medical emergency.  For instance, if heroics are to be performed, or if they should insert PEG tubes, or if a palliative care approach is preferred and so on.’

‘Discussing the needs of the resident with staff will help foster a positive relationship between all parties, the main thing to remember is that because your older relative is in aged care it doesn’t mean you stop being an important part of their lives,’ she says.

Professor Rhonda Nay, La Trobe University academic and director of the Australian Centre for Evidence Based Aged Care (ACEBAC),

For more information visit the ACEBAC website:

https://www.latrobe.edu.au/acebac/ or to receive a free booklet on aged care call: 03 9495 3141.

For more information about regular health tips from La Trobe or to speak to Professor Rhonda Nay please contact:

Lisa Prowling
La Trobe University Media Officer on
T: 03 9479 5517 E: L.Prowling@latrobe.edu.au