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Tuesday, May 17, 2022

COTA VIC policy objectives highlight glaring gaps in services for older Victorians

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It’s been all eyes of the stoush between the two major parties in the lead up to the federal election in May, but Victorian advocates are also keenly eyeing the state’s upcoming 2022/23 budget, ahead of the state election in November.

Just as aged care has taken centre-stage in the Federal Budget discourse, Council on the Ageing Victoria (COTA VIC) has produced a pre-budget submission listing their key requests to best support older Victorians at the state-level.

COTA Victoria’s six priorities featured in its pre-budget submission highlight the depth and breadth of the gaps in services older Victorians are experiencing relating to social wellbeing, expanding workforce opportunities, elder abuse, transport, digital inclusion and mobility – all fundamentals to living and ageing well, as well as to boost opportunities for older people to contribute to the community and economy.

COTA VIC policy officer Lauren Henley tells Aged Care News that COTA VIC developed its state-level policy objectives through a “nothing about us, without us” approach, ensuring older Victorians were at the centre of policy development.

“We are a community driven organisation, so we always do everything we can to make sure that our policy work is informed by the lived experiences of older Victorians,” she says.

Lauren Henley (right), with her guide dog Valentina and former COTA VIC senior policy officer Donna Swan.

The State of the (Older) Nation Survey 2021, which surveys older Australians every two years about their attitudes to their own health and wellbeing on a variety of metrics, was an invaluable source of information for COTA VIC’s policy development team.

Their work was also informed by a 2020 COTA VIC survey, which looked at elders experiences during the COVID-19 pandemic, as well as Ageing Well in a Changing World, a survey undertaken by the Commissioner for senior Victorians, Gerard Mansour.

“What we did was we tried to look at emerging trends or systemic issues [evident in the survey data] … and we tried to pull out those systemic trends and think ‘what are the key issues that we need to highlight leading up to the budget?’,” Henley notes.

“We then sent that discussion paper to a diverse group of older Victorians who we invited along to a focus group, and the idea of that focus group was really to road test what was in the discussion paper, to see if they thought we had the issues right.

“Had we forgotten anything? Was there anything that needed further clarification? Were the recommendations we were making actually the right ones, or were we not hitting the mark?  

“Then based on the feedback that came out of that focus group, we ended up with our pre-budget submission.”

Aged Care News spoke to Henley about three of the key budget requests detailed in COTA VIC’s submission.

Transport assistance services must be broadened

Firstly, transport has been a significant issue for older Victorians, with many finding public transport not suitable to their needs. 

COTA VIC is urging the State Government to fund a thoroughly costed community transport program to deliver improved and consistent access to older Victorians, as well as expanding the multipurpose taxi program to provide subsidised services to older people on low incomes who cannot drive.

“We know that there are also a lot of older people who don’t drive or who are required to give up their driver’s licence as they age because they might have deteriorated vision or other health problems that makes it unsafe for them to keep driving,” Henley says.

“Public transport around Melbourne and in regional areas is hit and miss.”

COTA VIC is requesting that the State Government expands the multi-purpose taxi program, which provides half-price fares for eligible participants.

At the moment it is only available through the NDIS for Victorians with a severe and permanent disability.

“To actually meet that threshold, and to prove that, is quite difficult,” Henley says.

“So, we’d really like to see that program expanded to cover Victorian seniors on low incomes who can no longer drive.”

Ruth Hosking OAM, a Bendigo based COTA VIC volunteer, knows firsthand the struggle of securing transport for elders living in regional areas.

“While my 97-year-old husband Bill can be transported comfortably in our own personal car, other older people in Bendigo do not have the same luxury,” the 89-year-old says.

“For many older people, conventional taxis and public transport are too difficult to enter and exit, and they often require wheelchair taxis. 

“The challenge with this mode of transport is you often must book well in advance as there are limited numbers in Bendigo. 

“And we have also seen popular bus routes cancelled, leaving some older locals having to walk to another bus stop which is a considerable distance away – a challenge for some with mobility limitations.

“There needs to be better access to door-to-door transport such as community transport and taxis to support older Victorians experiencing transport disadvantage so they can get to their medical and social appointments,” Hosking says.

Ruth Hosking OAM, who cares for her husband of 65 years Bill, says that more comprehensive transport assistance for older Victorians would improve wellbeing and allow greater connection with the wider community.

She adds that reduced transport accessibility has severe flow-on effects for elders’ community engagement opportunities.

“If some older people can’t get to their destination because of inappropriate or lack of transport, they may end up staying home, lonely and isolated,” Hosking says.

In fact, five senior citizens centres have shut down in Bendigo in recent times, due to lack of attendance, with Hosking pointing to lack of accessibility as a key driver of the closures.

Henley says that the State Government must take accountability for this lack of accessibility, which she concludes is a vital component of allowing elders to age in place longer.

“It’s really to keep people connected and give them the support they need to remain living at home, so they don’t have to move into care.

“But if that is that support is lacking in some areas, it’s going to force people into care sooner, because they’re not getting the help they need.”

Universal dental care and allied health support awareness

Elders are often neglecting their own dental care due to the exorbitant cost of check-ups and dental procedures.

Whilst COTA VIC supports the push for the Federal Government to expand Medicare coverage to basic dental care, Henley notes that the Victorian Government could do more in the meantime to reduce waiting times for its state-level public dental scheme.

“There is a Victorian scheme that can provide free or low cost dental care to people on low incomes, but right now, people can wait up to 30 months to access that support, which is just way too long.

“In that 30 months, an older person might have to put up with pain and discomfort, they might experience poor nutrition, or the onset of secondary health conditions, all of which have a really drastic impact on their quality of life.”

Reduced mobility during the COVID-19 pandemic has brought the necessity of allied health, especially physiotherapy and exercise physiology, into the spotlight.

“[Pandemic conditions, such as lockdowns, have] prevented a lot of older people from engaging in their usual physical activities and, as a result, people have told us that they’ve noticed a change in their balance and coordination and strength, as well as a deterioration in their confidence.

“So we need tailored support and advice to help them to re-engage in physical activities.”

For those who have organised a care plan with their general practitioner, Medicare subsidises up to five allied health appointments per calendar year, but Henley notes many older Australians are not aware of their rights to claim this benefit.  

“We’d really like to see the Government advertise that more broadly, just to make sure that people know about it.

Furthermore, COTA VIC is requesting that the Victorian Government establish free, community-based clinics to deliver information to elders about how to safely reengage with physical activity.

“So we envisage that those facilities would be staffed by exercise physiologists, physiotherapists and personal trainers who have experience working with older people,” Henley says.

It’s time to bridge the digital divide

“I think there’s a very common misconception that older people who aren’t digitally connected or digitally confident are just resistant to using technology or they’re being stubborn,” Henley says.

But this is a myth, with cost and other accessibility issues a far more likely reason for their lack of digital engagement.

“Just the cost of the internet or internet capable devices are still an issue for a number of older people on fixed or low incomes…

“And the standard internet capable device, whether it’s an iPad or a laptop, whatever it happens to be, that’s not always going to meet the needs of people with disability.

“So some people may need additional software or hardware to help them use a computer in the same way as anyone else.”

Hosking notes that a specialised video phone, with a screen size similar to that of a small computer, has made phone technology much more accessible for her husband, Bill.

“When not in use, its screen lists names of family and friends whom Bill can call by touching their name, including my mobile number when I am out.”

But such technology often comes with a hefty price-tag, notes Henley.

“That sort of technology is actually really expensive…. And there’s no funding available at the moment to cover the cost of that assistive technology.”

Whilst subsidies are available for those aged under 65 on the NDIS, older Australians are left to fork out for specialised technology out of their paltry pensions.

“That needs to change,” Henley says.

However, she says that use of digital technology should not be a prerequisite for receiving comprehensive information and support from government.

“The bottom line for us is that an older person really shouldn’t be required to use digital technology just to be able to access information and services, because a lot of them still can’t…

“There should always be low tech solutions available to meet people’s needs.

“For those who do not want to embrace the digital world, they can’t be forgotten,” Hosking adds.

“Telephone lines need to be maintained to allow older Victorians to get the information they need in a timely manner.”

Alexia Huxley, COTA VIC policy and advocacy manager, concludes that robust access to information through analogue and in-person means is essential for ensuring older Australians age with dignity and agency.

“Older people are constantly being forced to rely on friends and family to access information and services online because there are no low-tech solutions available; we know that dependency is one of the key risk factors for elder abuse,” she says.

“There needs to be a significant investment in a range of well-coordinated services to facilitate digital inclusion and alternative access to information for older Victorians including ongoing funding for a dedicated telephone line that provides information, support and referrals for older Victorians and to enable local libraries and neighbourhood centres to facilitate access to information and online services.”

To read COTA VIC’s full pre-budget submission paper, follow this link.

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