Published in The Advertiser on May 10 2021

Ageism is pernicious and pervasive. It is the reason we needed a Royal Commission into aged care.

Ageism is at the heart of the low expectations we have about our ageing. It has resulted in an underinvestment in aged care and, as the Royal Commission sadly reported, a tolerance of too much substandard care. It is also the basis of elder abuse.

Ageing has become synonymous with low expectations – for care, for health services, for media images, for having dreams and for the respect of even fundamental human rights.

Ageism is so commonplace that most people don’t recognise it, don’t confront it, and don’t call it out as wrong. Some still laugh it off as harmless fun. But it is not.

A recent report by the World Health Organisation (WHO)1 found that ageism has serious and far-reaching consequences for health, for wellbeing and for human rights. It is associated with shorter lifespans, poorer physical and mental health, reduced quality of life, increased loneliness and poverty and financial insecurity.

The WHO report found that ageism has been shown to result in the loss of productivity, costing societies billions of dollars.

Old has become so undesirable that many of the words associated with it are infested with negativity and despair and many South Australians have an irrational fear and an instinctive dislike of old.

We see ageism play out every day in South Australia.

Ageism has so undervalued older people who need support that 10,000 older South Australians wait up to eighteen months for the level of home care package they have been assessed for and hundreds die waiting. This is demeaning and disrespectful. 30 days is a much more reasonable expectation.

Ageism, according to evidence and anecdotes, drives health service decision-making, resulting in both over treatment and undertreatment. The phrase “at your age” is so often attached to decisions to investigate symptoms or to explore treatment options.

Most South Australians were surprised when the Royal Commission uncovered that people living in aged care often do not get the level of health care they need, whether that is oral health care, allied or mental health services, or even access to a GP.

There is plenty of room to improve the relationships between hospital and aged care to prevent unnecessary hospitalisation and to stop what seems to be the disproportionate ramping of older people.

Underlying attitudes and perceptions of older people – ageism – causes us to look away or walk past the serious abuse of safety, rights, and freedoms.

COTA supports the Royal Commission’s call for a better resourced and independent regulator that investigates, enforces and prosecutes breaches of standards, and shuts down substandard operators. Good aged care providers and their outstanding staff – who are deserving of much better recognition and reward – want nothing more than to
lose those aged care providers which let older people down.

Ageism also means we fail to invest in and fund aged care careers adequately. Staff are underpaid, undertrained, and undervalued, and there simply aren’t enough of them. Improved training, pay and numbers of staff is one of the most important reform recommendations in the Royal Commission’s report. It will pay back the investment through improvements in retention, recruitment and quality of service. As the South Australian economy rebuilds from the COVID restrictions of 2020, it is also an important jobs strategy.

Ageing today bears little resemblance to the experience of our parents and grandparents and yet, as a community, we have done very little to re-route the road map we use to age.

Royal Commissions don’t automatically bring about change. Sometimes they do the opposite – they lance a wound, exhaust a community, quell a lobby and palliate bids for justice.

It’s important we don’t allow this to happen in aged care.

There will naturally be tension inside both state and federal governments, between doing the minimum necessary and doing what actually needs to be done.

In the meantime, we, the community of South Australia, can start by confronting our own ageism.

It’s time to take strident action, set high expectations, and use a very loud voice.