The palliative mode: Some explorations among the frail elderly

Chapter 1: Introduction

The majority of people over 75 years in Australia are women. Most maintain their own households, most maintain strong bonds with their children, and most turn to their children when they need assistance. Yet many women over 75 are in institutions in receipt of palliative care of some kind1, and it is about this group of people, ‘the frail aged’2 that the research in this dissertation is addressed.

The term ‘palliative mode’, within the context of this dissertation, is concerned with the type of care that is institutionally administered in circumstances where the personal wishes, aspirations, self-perceptions and social interaction of the resident is over-ruled by those who are trained to see it as their concern to make decisions concerning the lifestyle, care and decision-making process of individuals in residence.

OBJECTIVES

This dissertation explores demographic, theoretical and functional perspectives of the ‘frail elderly’, how they regard themselves and how they are regarded by society at large. The objective is to demonstrate that institutional care in the ‘palliative mode’ does not necessarily provide ‘total’ care of answer the ‘inner’ needs of these people. The objective is reached by theoretical research and by evaluating a nursing home and a day care centre. Research for this dissertation does not include psychiatric institutions, nor does it include different cultural values, or evaluate a range of socio-economic differences of palliative medical treatment. All these issues are possibilities for further research.

DEMOGRAPHY

The 1982 Bulletin of the Australian Bureau of Statistics shows that in 1980 there were 1.4 million people aged 65 years and over in Australia. They make up 9.6 per cent of the total population. When compared with the 604,900 aged who made up 8 per cent of the population in 1947, the ageing process in Australia is evident. It becomes even more significant when the estimated aged population in the year 2000 is 2.3 million; an approximate increase to 11.7 per cent. In 1980 the median age of the aged population was 72.2 years compared with 71.1 years in 1947, and it is estimated that by the year 2001, the median age could be as high as 74.1 years.

1. D.M Gibson & D.T Rowland, Community versus Institutional Care, The case of the Australian Aged, Ageing and the Family Project, Working Paper No 20, RSSS, ANU, Canberra, 1982m Page 46

2. "Frail aged" is taken to mean those people whose physical, mental and social deterioration means they need help in varying degrees." G. O’Toole, "Rapport from the Elderly Persons point of view", Geriaction, 5:3, June 1981, Page 19