02 October 2018

Aged Care Politics

'Conflicting Agendas: The Politics of Sex in Aged Care' by Alison Rahn, Tiffany Jones, Cary Bennett and Amy Lykins in (2016) 10 Elder Law Review 1-24 comments
Despite legal protections, couples in Australian residential aged care facilities experience institutional interference in their intimate and sexual relationships. Panoptic surveillance remains widespread in aged care. Little attention is given to privacy. Some residents’ doors are kept open at all times. Couples may be separated or provided with single beds only, unable to push them together. Staff frequently enter without knocking, commonly ignore ‘do not disturb signs’ and often gossip about residents. This culture has its origins in colonial institutions. Attempts at legislative reform to redress this situation have been met with mixed responses, with the most vociferous opposition coming from religious conservatives. A recurrent source of conflict is the tension between the ‘rights’ of religious and political institutions versus those of individuals. This article identifies systemic issues faced by partnered aged care residents, their historical origins, and the legislation that is designed to protect residents. Using a thematic analysis methodology, it reviews political debates in the past 40 years, in both federal Parliament and newspapers, and provides a critical analysis of recurrent themes and ideologies underpinning them. It concludes with recommendations for legislation that is consultative and ‘person-centred’ and recommends proscriptive privacy protections. Adoption of these ideas in future policy reforms has the potential to create more positive outcomes for partnered aged care residents.
 The Authors state
Sexuality in aged care environments is a fraught topic. Traditionally, aged care providers have determined moral standards and ‘acceptable’ behaviours in their facilities. However, some politicians and professionals have argued that aged care residents have the same civil rights as all citizens1 and have advocated for residents’ sexual relationships to be respected and accommodated.2 Some contend that cultural change is long overdue and will only happen if the Government legislates for providers to actively protect residents’ sexual relationships by training staff to respond appropriately and compassionately to residents’ sexual expressions.3 What prevents this from happening? xxx A review of the literature suggests entrenched cultural patterns in aged care practice have their roots in colonial institutions. This article begins by briefly reviewing current problems faced by partnered residents, followed by an historical overview of institutional aged care in Australia, tracing recurrent themes and persistent problems for couples. With this background, discussion turns to the history of attempted reforms to protect couples and the corresponding political debates in the period 1974 to 2015.