Working with older people

working with older peopleWorking with older people

It is important for anyone working with older people to understand their rights and how to ensure that their rights are respected. If you are working with older people, this guide will help you to understand the age, gender, culture and other aspects which will help you to work with them respectfully.

 

 

 

 

 

 

Photographer: Australia Post for Our Community

What should I know about working respectfully with older people?

In Australia, as in other parts of the world, perceptions of ageing can be based on negative stereotypes that lead to older people feeling isolated and powerless. Some common misconceptions about ageing include the belief that older people are all the same, that they are unable to make decisions for themselves, that they are likely to suffer ill health and that they are a burden for their families and the wider community.

It is important for those of us working with older people to challenge these misconceptions and to promote the rights of older people to independence, dignity and respect, as well as the right to fair access to services and community resources. When working with older people we need to respect these rights while being aware of some of the more common difficulties older people may experience so that we can adapt our work to meet their needs.

The process of ageing can result in physical and sensory changes as well as bringing an increased risk of conditions such as dementia, stroke, diabetes and heart disease. We need to be aware of how these issues may affect an older person’s access to and use of services and adapt our work to ensure that any barriers are addressed.

Older people have the right to privacy and confidentiality.

It is important to work in ways that respect the older person’s privacy and dignity. This includes talking to the person not their family members. Sometimes this means taking extra time and effort to ensure the person understands. If English is not the person’s first language it is important to use an interpreter.

Older people have the right to make their own decisions

The law says that we have the capacity to make our own decisions unless proven otherwise. This is called having ‘capacity’ or ‘competence’. A person’s capacity can be temporarily affected by stress, anxiety, medication, illness, infection or injury, and then regained after a temporary illness or stressful situation passes.

Lack of capacity is not necessarily an indicator of dementia. Decision making capacity can vary depending on the issue being decided. For example, it may be difficult for a person to understand complex banking arrangements, but they may be quite capable of deciding things such as medical treatment or where they want to live.

Encourage older people to make their own decisions by:

  • Choosing a time when they are less tired, such as earlier in the day
  • Choosing a place where they can relax and feel comfortable and safe
  • Taking time to give them the information they need to make an informed decision – this may involve explaining things in plain English or in their own language through an interpreter
  • Asking them what they want and don’t tell them what to do
  • Listening to them and respecting their choices even if you don’t agree.

If it seems that an older person is not able to make a particular decision it may be necessary to arrange a formal assessment to determine their capacity.  See ‘Supporting someone who may have decision making problems’ for more information.

Communicating with older people

Common age-related conditions that affect communication can include hearing difficulties and vision changes. When working with older people it is important to ensure that you can be heard and understood.

The following may help when communicating with an older person:

  • Ask the person how you can best communicate with them
  • Reduce background noise
  • Visit in person rather than speaking on the phone
  • Speak clearly and at a moderate pace
  • Avoid shouting
  • Use body language such as gestures
  • Take the time to ensure the person has heard and understood you
  • Ask them to repeat the information back to you so you can feel confident they have understood
  • Provide written information in large print if necessary and in the person’s own language where possible
  • Encourage the older person to obtain and use relevant aids, such as hearing aids
  • Consider purchasing a hearing amplifier for your organisation. For more information contact an Independent Living Centre.

Research by Seniors Rights Victoria (2013 p18) found the following practices had a positive impact for older people contacting the service:

  • Home visits
  • Warm referrals, meaning that the worker contacted services to introduce a client
  • Care coordination, assisting the client to navigate the service system.

What services may older people need and how can we get them?

There are a range of services available to help older people maintain their safety, dignity and independence.  These include help to stay living at home, such as help with housework, meals, personal care, transport and social activities. They also include help with nursing care, allied health such as physiotherapy or podiatry, home modifications and aids.  Support and assistance for carers is also available.

Older people who need more help with day-to-day tasks or health care may find the best way to receive the help and support they need is by living in an aged care home, either on a permanent basis or for a short stay (called ‘residential respite’).

Many services require an older person to undergo an assessment before they can access their services. Some assessments are conducted by the organisation providing the service. The Aged Care Assessment Service (ACAS) conduct holistic in-home assessments for older people to access community aged care packages and residential care. Waiting lists often apply after the assessment.

Find out more about aged care services at My Aged Care. The website provides up-to-date information about Australia’s aged care system and services. The National Contact Centre on1800 200 422 provides prompt, reliable and confidential services, information in other languages and other formats for those with hearing difficulties or a vision impairment and help to find Government-funded aged care services.

My Aged Care can help you:

  • Learn more about aged care assessment eligibility and processes
  • Understand the type of care available, how to get it and costs
  • Find services in a local area
  • Get information about a range of health conditions and healthy living
  • Access information in other languages

 

What should I know about working respectfully with older men

Abuse of older men tends to be a hidden problem, yet men make up a significant proportion of older people who are being abused. One in four callers to the Seniors Rights Victoria Helpline is male and in our experience, older men can suffer the same level of intensity of elder abuse as older women.

Heath researchers have found that older men (and men generally) are less likely to seek help for their problems and only do so when things become critical. This is borne out by our experiences at Seniors Rights Victoria, where older men tend to contact us only as a last resort.

Traditional beliefs about masculinity cause this reluctance and delay in men talking about elder abuse. Older men have lived through a period in which masculinity is strongly associated with strength, independence and being a provider. This has often set a benchmark of the “real man”. As a result older men will strive to live up to this benchmark by maintaining their sense of masculinity and their autonomy. This can lead to older men thinking they need to continue to be self-reliant, strong, a provider for the family and able to resolve their own and others’ problems.

Because society continues to reinforce what it is to be a “real man”, older men might think that they have to resolve any forms of abuse, unassisted and unsupported. Yet ageing may result in older men not being able to maintain these benchmarks. This may inhibit them from talking about elder abuse as it implies an admission that they are no longer ‘real men’.

Education targeting older men and breaking down these ideas of masculinity can assist older men to be more open about issues of concern. This should include print campaigns and resources as well as forums which look at the issue of elder abuse within the context of improving health. Some men’s health initiatives in Australia have been successful in delivering forums attracting hard-to-reach men by including a well-known male identity who promotes the importance of talking about concerns early. This can provide a model for similar activities in elder abuse.

In Australia there is very little discussion of elder abuse of men in men’s health programs and men’s health policy. For there to be real change in addressing the invisibility of men as victims of elder abuse, there needs to be a demonstration at the policy and program level that older men matter.

Suggestions for how service providers may engage with older men:

  • Identify the needs of older men in the local community by talking with them directly and including them in any community consultations
  • Develop positive strategies and approaches to addressing elder abuse of men. This can be done by raising awareness of elder abuse through activities, campaigns and events, which are combined with positive outcomes (e.g. men’s health week, men’s pride walk,etc.)
  • Create opportunities for men to socialise over tea/coffee in your service and combine this with talks on future planning for seniors
  • Review your own service to assess whether it’s inviting to older men. Are there positive images of older men in the service’s waiting areas, clinical rooms, meeting rooms and other areas?
  • Identify male staff members who will be the first point of contact for older men when they approach your service/agency
  • Think about outreaching some of your services/agencies activities and programs to where men get together such as sporting and service clubs, pubs, etc
  • Consider volunteer opportunities which can be specifically targeted at older men
  • Design and deliver activities and events that speak directly to older men and are held at times when they are most likely to attend.

More information

UK resource – Working With Older Men: Improving Aged Concern’s Responses (2006)

MensLine Australia is a 24 hour professional telephone and online support, information and referral service, helping men to deal with relationship problems in a practical and effective way.  Phone: 1300 78 99 78
The Shed Online: Like the original Men’s Sheds, The Shed Online is a place for men to socialise, network, make friends and share skills.

Housing and homelessness services are among the services that can assist older men. Contact:  Housing for the Aged Action Group or use the Dept of Human Services Homelessness Services directory.

What should I know about working respectfully with older women?

Older women have lived through times when things were very different from the way they are today. When they were younger there were clear social expectations and understandings of gender roles, in particular women’s responsibilities as wives and mothers. Historically, family matters were viewed as private matters. Violence and abuse within the family was seen as something to keep behind closed doors and not talked about.  Legislation and social policy reflected this perspective. With little protection against abuse and few options for women to live independently, many women felt they simply had to put up with it.

For many older women today, barriers to living free from abuse remain. Some older women fear that if they disclose their experience of abuse to health or welfare workers they may be institutionalised and this fear can keep women from seeking help. Others lack information about the options and choices that may be available to them.

When working with older women experiencing abuse, it’s important to let them know they don’t have to put up with it and help is available.

What should I know about working respectfully with older gay, lesbian, bisexual, transgender and intersex (GLBTI) people?

The growth in population ageing across Australia means that there are increasing  numbers of older people who are gay, lesbian, bisexual, transgender or intersex (GLBTI for short).  Up to 11% of Australians may be of diverse sexual orientation, sex or gender and GLBTI people come from all cultural backgrounds and walks of life.

The issues facing older GLBTI people are often the same as those facing all older Australians. Discrimination and invisibility are two key issues. It’s a mistake to see all  GLBTI people as being alike – they are as diverse as any other group in society. It’s also important to recognise that while some may be open about their orientation or identity, others may prefer to keep this part of their lives private and this can often be due to experiences of discrimination or stigma. Someone’s sexual orientation or gender identity may not always be clear, so it’s best not to make assumptions. Don’t assume all your clients are heterosexual or that they identify as one of two genders. Working in ways that are inclusive of gender and sexual diversity can help to ensure your GLBTI clients get the services they need.

Discrimination against GLBTI people is unlawful under the Victorian Equal Opportunity Act 1995, with some exceptions and exemptions. Legislation exists across Australia recognising some (but not all) of the rights and responsibilities of GLBTI people and same-sex couples in relation to tax, social security and family. Government services, including health care and community services are required to respect people’s basic rights and make sure that people are not treated unfairly under the Victorian Charter of Human Rights and Responsibilities Act

Negative attitudes towards GLBTI people may make them more vulnerable to abuse, particularly when combined with other factors such as poor health and ageing.

More information:

Val’s Café: Resources to support organisations to provide inclusive service to older LGBTI people.

GLBTI Retirement Association Incorporated (GRAI) Best Practice Guidelines for providers of retirement and residential aged care.

We live here too: A guide to lesbian inclusive practice in aged care. Matrix Guild Vic.

Beyond: ‘we treat everyone the same’. A report on the 2010– 2011 program: How2 create a gay, lesbian, bisexual, transgender and intersex inclusive service. Gay and Lesbian Health Victoria.

Acknowledgment

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