Before entering an aged-care facility, Terance Reeves could use the toilet by himself, talk to family, and walk without assistance. Two months later, he was unable to do any of those things, write Barbara Barbosa Neves and Narelle Warren.
Terance’s story of decline is one of several heard by the Royal Commission into Aged Care. That this could occur to Terance, and other older people, doesn’t just highlight the problems with the aged care sector — it also asks us to think about how society responds to ageing.
Living a retirement characterised by plenty of travel appeals to many of us. Terance had that dream, too. After a long working life, he retired to travel around Australia with his wife, Lillian. But not even a year later, he was diagnosed with Alzheimer’s disease. That didn’t stop them; Terance and Lillian travelled as much as possible before his condition deteriorated. Then Lillian became his carer, with full responsibility and limited support for her role.
To address her own needs for a short period of time, Lillian looked into residential respite care for Terance. An aged-care assessment team recorded that Terance was mobile and continent, although dependent on Lillian for activities of daily living due to cognitive decline. He was deemed eligible for high-level respite care. Lillian felt she could take comfort knowing that Terance would be cared for by a professional team in her absence.
Two months later, when she removed him from aged care, Terance was not the same. What happened to him?
Staff say Terance was “unsettled” and agitated. Risperidone — a medication with serious side-effects, such as drowsiness and a higher risk of falls — was administered without Lillian’s consent. Had they asked her, she would have told staff that risperidone didn’t sit well with her husband. The medication was increased as he continued to be “unsettled”.
As was later conceded, the staff could have tried to manage Terance’s behaviours differently; they could have sought advice from the Dementia Behaviour Management Advisory Service; they could have asked for an intervention by the Severe Behaviour Response teams. They didn’t.
As researchers have noted, and the Royal Commission makes clear, what can happen once we reach old age is deeply troubling, especially if our life circumstances make it difficult to keep living independently. A later life with dignity and respect was what Terance and Lillian desired, but this was what ageism ultimately denied them — that ageism cannot continue to exist in our policies, practices, and society.
The authors
Barbara Barbosa Neves is a Senior Lecturer in Sociology at Monash University.
Narelle Warren is a Senior Lecturer in Anthropology and Sociology at Monash University.
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