I have a is a 70-year old neighbor who is a widow. She has two children. She has to go into hospital for surgery. She usually looks after her daughter's children as this is the custom and expectation in her ethnic background but she won’t be able to for a few months at least. Last time I saw her she was nervous about speaking to her daughter and her son-in-law about her need for care while she recovers and the fact she won’t be able to look after the grandchildren. After managing to talk to her children, she became really upset because they said that it was best if they sold her house and she moved into a residential aged care facility as they are not able to look after her. This has created so much stress and anxiety in her that she's unable to relax, can't sleep, stopped eating and has lost weight, and she feels helpless.

All families are faced with making major decisions as its members reach older age and their needs and circumstances begin to change. These decisions can be difficult and emotionally complex for the entire family. Due to many factors, older people can become sidelined in the very decisions that affect them the most. Is it ok to not include an older person in major decisions about their future? What about if major decisions being made that are not in the interest of the older person? Or when family is forcing or coercing an older person into residential aged care against their will? Is it ok if the family is making threats of residential care in response to the older person expressing their needs or concerns? Is it neglect if the family is failing to provide care where it could be reasonably expected? The sale of an older persons’ assets or possessions against their will?

How would you respond to this situation? How could you help this lady understand that there are choices and alternatives? Although I understand that being in such predicament can be daunting, I want to ensure her that there is help available for her and help her to understand her rights and make the best decision for herself. How would you empower older people to consider their rights and needs and actively participate in major decisions about their future? What are traditional ways families of your background would have managed this situation? What would you advise this person and her family to do? Where could she and her family get support in finding more information and making these decisions?

Hi Donte',

What a distressing story. I wish I had information in terms of her rights but I don't unfortunately. Just memories of the same thing happening all the time.

I hate nursing homes. Hate them. Yes they are an unfortunate necessity. But I remember as a child going to keep my Nan company as she volunteered in the nursing home and feeling so upset. I spose times have changed and this would be against the rules now. But I used to make cups of tea and watch my Nan make people feel human again. Even at that young age I promised myself I would never put my parents in a nursing home. Never.

Yes there are the usual arguments... Money. Privacy. Impact on relationships. Impact on other family members. But in my immediate family the rule has been care for them to live independently as long as possible (because they are adults entitled to their own life!) and then they live with you.

I would encourage your friend to speak to her doctor. Maybe there is a home care option she can pay for like the SilverChain. The hard thing is money. There is always help if you have finances. As to her rights I'm not sure. But BlondeGuy and Kanga may have some ideas. There is a thread about nursing homes I will have to find for you.

Hi Donte....I hope you can find some value in this thread

Thankyou Quercus for the link to the Nursing Home thread

It may start off somewhat political but the thread has been written to provide awareness on aged mental health

www.beyondblue.org.au/get-support/online-forums/long-term-support-over-the-journey/nursing-home-residents-mental-health

My Best

Paul

Thank you Quercus,

Great advice! Not sure if she's spoken to the GP about it. I'll check the links you suggested.

I think there are some underlying issues, attitudes or values that could influence the people involved in this situation. The family has a strong central role in many cultures. Often there is an implicit trust that the family will make decisions and act in the older persons best interests. However, major decisions are often made without any discussion of potential changes or problems that could arise, and each person’s expectations.

Due to migration intergenerational differences and conflict can be greater than usual, generations having grown up in different times, places and cultures. Traditional expectations of being cared for in old age by their children, especially their daughters, may clash with those of the younger generations who may have economic and time constraints and different practicalities. Many older parents may be expected to provide care for grandchildren.

Many culturally and linguistically diverse seniors have a lack of awareness of the options that are
available to them and may be dependent on information and advice provided by family members. Migration
created a dependence on children due to language and cultural differences. Older people may be
accustomed to relying on their children for information that inform decisions and they may be used to
signing forms they don’t understand. This heightened trust and dependence can make older people from
migrant backgrounds more vulnerable to abuse of their rights.

Older women may have low financial literacy and could have been dependent on their husband, then children for all financial matters. The transfer of assets to the next generation may be connected to the main reason to migrate (to create a better life for the children), or to balance a relationship where it is recognised there has been a strong dependence on the children (you supported me and you will receive my assets in return).

Many older people left their parents in their homeland and were not able to return and care for them as they got older. This may result in unresolved feelings of guilt or grief. They may feel that any lack of care from their own children is a retribution for past actions.

There can also be a strong fear and stigma around going into a residential aged care facility, as you pointed out.

Thank you blondguy,

I'll have a read. )

Hello Donte

Yes a nasty situation for your neighbour. I suppose it will not help her to understand she cannot be forced to sell her home if it is in her name. Check if she has an Enduring Power of Attorney, Health Directive or Advanced Health Directive. These documents set out who can do what. However, if there are none of these documents it may be better that she keeps it that way.

With the advent of the NDIS your neighbour may be eligible to have services to help her stay in her home. I think her GP should be best placed to put your neighbour in touch with a suitable agency or agencies to provide the level of assistance she needs. Perhaps you can approach one of your local services to ask for assistance. Try church organisations and other local charities. It's not charity your neighbour wants I know but these organisations can provide the services she needs.

If she meets the criteria she will be given a package of money to be paid to service providers. I don't mean literally given money, it's kept in NDIS hands, but she will be allocated a sum to be spent on what she wants. The first principal is that the client is the one who makes the decisions about what they want.

Not knowing where you live makes it difficult to suggest help agencies but I am sure you can find a suitable organisation or your neighbour's doctor can recommend one. You may want to search online for advocacy services for aged people.

I hope this helps.

Mary

Thanks Mary,

Great advice! I’ll find out. I was of the impression that the NDIS only covers disability. Not sure if she’s eligible for services like these. Like others have said the GP would be a good place to start the discussions. Was also thinking that the social workers in hospital should be doing an exit care plan to ensure her rehabilitation upon exiting the hospital and returning home. Seems terrible that her children have taken this opportunity to push their agenda by putting pressure on her to sell the house but I guess often self-interest prevails even in family-oriented communities.

It is very unlikely that there is a power of attorney or advance care plan in place as these are often very alien concepts to many culturally and linguistically diverse people but I could ask and find out. :)

Hello Donte

The hospital social worker would be a good place to start. Had a longer look on the net. I had forgotten about My Aged Care, no comments please. Look at this web site. https://www.myagedcare.gov.au/ This is a federal govt initiative and has been operating for a while. It provides services, or more accurately provides money, for house cleaning, nursing at home which may be necessary after leaving hospital, taking your neighbour shopping. It's also a good idea to contact local churches and other charities for someone to visit her at home. If your neighbour has an affiliation to one church then they would be best placed to offer home visits, someone to chat to about anything. This is usually a voluntary service.

I do congratulate you on wanting to help your neighbour and recognising what a bad place she is in at the moment. It is sad when families feel they cannot care for the various members. I understand the kind of pressure your neighbour is under to sell her home. My Aged Care can also help with preventing elder abuse.

Your hospital social worker can arrange for Meal on Wheels if she is not up to cooking. I know when I broke my leg it was so helpful to have a cooked meal delivered every day.

If there is any other way I can help please shout out.

Mary

Thank you Mary,

Yes was looking at MyAgedcare website today. I also talked to her about contacting the Russian Welfare and the Council. looked up Seniors Rights Victoria and they provide support in different languages via interpreters. They can assist with potential elder abuse issues (including financial) and can offer free, confidential counselling and practical support. My neighbor made an appointment to see her doctor this week. it's a good start. :)

Great stuff Donte

Free counselling and support sounds good. It always helps when you can recommend a help service in the language and culture of the person's birth. Sounds as though you have it all under control in terms of agency which can help. I hope your neighbour will take advantage of these services.

The issue that worries me most is if her children start to pressure her into moving into an aged care facility. It sounds as though she must be fairly able if she has been caring for her grandchildren. Not the easiest job to do.

I don't know if this is true, but it seems to me that children born in Australia to parents whose country of birth is not Australia have difficulty marrying the two cultures in terms of caring for their parents. I'm sure there are other areas of difficulty and contrast but your neighbour's dilemma is poignant. In many countries it is the custom to care for aged parents with parents moving into the same home as their children. The elderly have grown up expecting this. This attitude is not the norm in Australian families though they may offer support in different ways.

Caring for grandchildren is also an expectation which in this case has happened but without the reciprocal care for mom. This must be a difficult time for your neighbour who probably has great feelings of loss and betrayal. It is always sad when someone cares more about a neighbour than the family. I hope you can help her live a more secure life in her own home. I think she will feel more isolated in an aged care facility where there is no cultural familiarity.

Mary

Hello White Rose,

thank you for your kind words and sound advice. Indeed, the caring for grandchildren and being looked after by your own adult children when frail and unable to function by yourself is a common trend in multitudes of cultures across the globe and not uncommon even here in Australia.

In the absence of welfare and aged services, most people around the globe are forced to depend on family for support. We are very fortunate in Australia to have one of the World’s best health care, welfare, mental health and aged care systems in place - something others from various countries (including USA), wouldn’t even dream of.

In the midst of so many options in regards to care, it is indeed confusing and challenging for many families of migrants to ‘marry’ the traditional cultural expectations of their parents and the notions of a modern, independent generation being brought up here in Australia at an era where family values differ drastically from the previous generations.

The more affluent we become, the less depended on others we are. The more services and supports we have, the less we have to rely on family and friends for our needs. There are benefits in having all these options and supports as we can continue living independently but there are also disadvantages in terms of intergenerational abuse, social isolation, and offspring forcing older people to pursue age care residential services against their will.

It is something that each individual will have to plan and prepare prior to reaching that stage. Traditionally, in many migrant communities the notion of advanced care planning, powers of attorney, even making a will, is alien, particularly in the post-War generation.

Seniors Rights can help set a plan to prevent abuse and also Family Mediation can help families meet half way but it’s not easy and the person has to be willing to contact them.

It is very important I think to keep talking about these issues and particularly in the context of mental health, stress and conflict experienced by all sides - older person and family.

I’m meeting my neighbor this afternoon to see how her doctor appointment went and if there are any new developments. X

In my last trip to my homeland more than a decade ago I was surprised to see that all of my cousins who hadn’t migrated were living in the same block with their elderly parents. The parents have built an apartment above their house and the adult children live upstairs while the parents are on the ground floor. This may sound beautiful and caring and loving but it comes with a high cost! No privacy. Control over relationships and child rearing and often even friendships or finances. Of course in the absence of government and charity supports people have no alternatives but to stick together and support each other.

For someone who migrated to Australia at a young age with no extended family and having put my daughter in child care since she was 6 month old, I found this arrangement that my cousins and everyone else seems to have quiet bizarre. For me it’s something unknown. My experience here in Australia post migration is so different that I couldn’t relate. I find this reliance on each other a bit codependent and unhealthy. Everyone seemed to be in each other’s pockets. I believe when we grow up we must fend for ourselves. The umbilical cord needs to be cut once and for all.

But then again I’m a generation X who relies on welfare, supports and counseling etc for emergencies instead of family. And I have lived in Australia for three plus decades exploring different alternatives and options. I feel I’m too independent and a lot of water has gone under the bridge for me to even fathom living like my same-age cousins over in my country of birth.