Several years ago, when my grandmother was living in an aged care facility, she went missing for about half a day. It was frightening for us, her family, who began to fear the worst when she could not be found. 

Though physically well, still tall and strong, my grandmother was living with dementia at the time. She had only recently moved to Sydney after living for half a century on a remote property in country New South Wales. She didn’t know the city well. 

The thought of her on the streets, alone, was deeply concerning.

The nursing home where she lived raised the alarm first, we were informed, and then the authorities were brought in. After scouring the area and finding nothing, all we could do was wait for news.

Eventually we received a call from the police, notifying us that a kind stranger had spotted my grandmother, obviously out of place and becoming distressing, on a train halfway across the city.

This caring soul struck up a conversation with my grandmother, and, realising she was lost, chaperoned her to the train guards. My grandmother was eventually returned home – to our great relief.

Always immaculate and proper, my gran arrived back at the nursing home with a hamburger and a bottle of beer in a plastic bag – untouched I’m please to report.

We were so lucky she was found; many who go missing from aged care facilities do not have such good fortune.

Here at HelloCare we hear many stories of older family members going missing, sometimes never to be found again, or their bodies found days later. When a frail and vulnerable older person goes missing from an aged care facility, we know the consequences can be catastrophic.

Childcare centre faces charges after toddlers escape

So I read with interest on the weekend that a childcare facility in Werribee, Victoria, faces charges after two of its students, both toddlers, escaped the confines of the preschool’s walls, and ran out onto a busy road.

The story got me thinking, why do the operators of childcare centres face charges when a person in their care goes missing, but aged care operators do not?

Still digesting the Royal Commission into Aged Care Quality and Safety’s interim report, I wondered could it be because our society has “drifted” into an “ageist mentality”, as the commissioners suggest?

Are we accepting a lower standard of safety for older adults than we do for children simply because we don’t value them so highly? Perhaps.

Or is the answer more nuanced?

Aged care is not a prison

Of course, there is a key difference between aged care and childcare: residential aged care provides a home for residents, whereas children only attend childcare during the day. When the place you receive care is also your home, we would probably accept there are fewer regulations about what you can and can’t do? It’s not a prison, after all. 

If an aged care resident wants to walk out of their home, surely they should they be able to?

The dignity of risk

The new Charter of Aged Care Rights states aged care residents have the right to “safe” care. Yet they also have the right to have “control over… choices (that) involve personal risk”.

Aged care residents should be given the ‘dignity of risk’. But when residents become cognitively impaired, such as if they are living with dementia, it can be difficult to determine the exact point at which they are no longer be able to accurately assess risk. 

The balance between providing safety and delivering dignity of risk at the same time is a complex area of aged care.

Of course, children have rights too. According to the Human Rights Commission, children have “special” rights because of their “vulnerability”. 

The United Nation’s Convention of the Rights of the Child states the “institutions, services and facilities responsible for the care or protection of children shall conform with the standards established… particularly in the areas of safety”.

Children inherently ‘take risks’ – climbing trees, rolling down hills, jumping off walls – in part because they don’t fully understand the consequences of their actions. Though we know this type of ‘play’ is good for children because it teaches them how to engage with the world, we also know children don’t fully understand the consequences of their decisions, and we often need to make decisions on their behalf to keep them safe.

We don’t always make the same assumption for older adults, though sometimes it might be the case.

Perhaps this is why we don’t see harsher penalties for aged care providers when residents ‘escape’.

Would harsher penalties when aged care operators ‘lost’ a resident mean residents are safer? Perhaps, but what would the cost be? The residents’ freedom?

After my grandmother returned to her aged care facility, she wore a bracelet that alerted staff when she approached the front door. The next time she left the nursing home was when she moved into a hospice. Some might say wearing a device was an infringement of my grandmother’s rights, but I was grateful it kept her safe.

What do you think: Should aged care operators face charges or penalties if a resident goes missing?

 

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