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Risk Vs Quality Of Life In Aged Care: What's Fair?

“What makes us so uncomfortable when someone wants to take a risk with their life?”

This is a question posed by Monash University aged care expert Professor Joseph Ibrahim.

According to ABC News , the Melbourne professor is pushing a new approach to aged care, in an effort to ignite discussion on ‘risky’ activities that can enrich the lives of seniors.

A specialist at the Victorian Institute of Forensic Medicine, Professor Ibrahim manages patients at an aged care ward in Ballarat.

The professor hopes to create a change in thinking regarding aged care, through a concept he has labelled Dignity of Risk.

He gave an example of Dignity of Risk being a nursing home resident who prefers to walk, in the evening, to a nearby store for an ice cream (rather than it coming to him).

The walk posed the risk of a fall, which is one of the greatest causes of death among nursing home residents, but the act itself greatly enriched the resident’s life.

Some aged care facilities are already embracing Dignity of Risk.

Starrett Lodge on the New South Wales Central Coast staff have introduced what they call resident-centred care – it’s a change from a time when families, doctors and nursing homes made minimising the risk the top priority for residents.

Uniting lodge operator Linda Wollard said that over time, it’s possible that people’s lives have been restricted.

“It really comes down to remembering that person is still a person, they are just older. And we need to be creative in the way that we manage those risks.”

An analysis is now underway into nursing home deaths using data from the National Coronial Information System (NCIS), based in Melbourne, making the element of risk a major facet of the project.

Researchers have embarked on a two-year study to look at all nursing home deaths reported to state and territory coroners since 2000.

The analysis will consider roughly 6,000 nursing home deaths over a 14-year time frame.

Professor Ibrahim said he believed it to be the first study of its kind in Australia, and maybe the world.

Researchers not only want to know more about how deaths could be prevented, but also hope for answers on how many fatalities involved residents taking a risk — and whether that risk could have been better managed.

He has also launched a website to discuss ageing issues using animated films, with topics such as “To Resuscitate Or Not?” and “Driving with Dementia”.

Aged care residents Patricia Allison and Marcia Bannister, aged 80 and 93 respectively, both have strong opinions on how they should live out their lives.

Having recently taken a helicopter flight, the aged care facility where they reside has a “bucket list” program which permits them to choose their activities.

“We are adults … And we have always been used to making our own decisions and things like that,” Ms Allison said.

“I think you have got every right to do what we want to do here,” Ms Bannister said. “And we do.”

Similarly, Starret Lodge resident Jack Wardrope, 71, took a trip to Sydney’s Luna Park, despite his degenerating sight.

“Some of these places, they mollycoddle [residents]. They put cotton ball around them, say you can’t do this, you can’t do that,” Mr Wardope said.

“It needs to be known older people, we are part of the society. We are not ready to die.”

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Alana Lowes

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