The topic of aged care is one that’s fraught with an array of differing emotions. For many of us, we first negotiate grandparents’ transition into care, then parents’, then face the sobering prospect of how we spend our own final years. Here in Australia, aged care has received significant amounts of scrutiny and attention over recent years. Exposés revealed a systemically flawed approach to aged care, and the subsequent Royal Commission into Aged Care Quality and Safety made 148 recommendations to improve the quality of care we provide to the elderly in this country.1 Of course, aged care doesn’t come cheaply. Aged care – both in-home and residential, cost the Australian Government $23.6bn in 2020/21,2 and by 2025/26 that figure is estimated to grow to $35.8bn.3
With baby boomers now entering their retirement years and the number of people over 70 projected to increase from 3.239m in 2023 to 4.473m in 20334, demand and cost for quality options are only going to rise. So, with aged care in the spotlight, we look at three different approaches from around the world to the care of elders. Italy: elderly stay at home In Italy, only two per cent of the country’s elderly population live in aged care facilities.5 Culturally, older family members are always looked after by their family, with authorities only intervening if an elderly person has no one to look after them. Germany: cohabitation and multigenerational facilities In Germany, an initiative introduced a decade ago enables the elderly to live together in community apartments, with kitchens and living rooms enabling people to live as normal, outside of institutional care. By cohabiting, the elderly benefit from the interaction and companionship needed to reduce the risk of loneliness, without placing them into full-time care.6
Multigenerational housing is also popular in Germany, often comprising kindergartens and social centres where the community can drop in, as well as housing for the elderly. Residents can volunteer to read, play and sing with children, helping provide purpose and meaning.7 Asia: societal changes force aged care shifts Traditionally, Asian cultures have placed great weight on children supporting their parents in old age – however, with smaller families, higher rates of divorce and fewer marriages, things are changing, forcing countries to explore new ways of caring for their elderly. In Singapore, for example, integrated health and social care systems are being developed to enable older people to ‘age in place’ – which lessens the required government spending on institutional facilities, and helps people enjoy a higher quality of life too.8 Creating the future of aged care Across the world, it’s clear that the demands on and for aged care are changing, and new thinking will help create the future gold standard. The care given to older people with dementia here in Australia was highlighted in the Royal Commission, with facilities being deemed ‘substandard’,9 while research in East and South-East Asia also found a lack of positive care environments for people living with dementia.10
In Tasmania, a new village for people living with dementia is leading the way – and could be the face of aged care to come. The village called Korongee in a suburb of Hobart, mirrors what is, for many, a typical experience of living in a community. Houses, in which eight people live, are situated at the end of quiet cul-de-sacs, while the surrounding gardens and village grounds all reflect dementia design principles. The village itself contains a cafe, a community centre, a salon, a wellness centre and a general store, all of which promote independence and authentic connection while ensuring the requisite care is on hand. ‘Lifestyle companions’ encourage and support the residents in daily tasks, promoting the independence that is so critical, and this could be the blueprint for a wider change in how we look after people as they age.