Dr Rodney Jilek has spent the past four years finding out what it is older men want from aged care facilities, and looking for the best ways to provide it. He tells Sue Cartledge that a female majority of both residents and staff numbers leaves male residents feeling disempowered and isolated.
Jilek is one of the Amity Group’s senior nursing managers, managing the Amity Grand at Dural aged care facility. He has balanced study and work commitments, undertaking research completing a Doctorate in Health Sciences.
The research, a phenomenological study into the experiences of men entering residential care examined both positive and negative aspects of their transition. He found that what men wanted most from life in an ACF was a sense of control and meaning. Lacking control over their person and their surroundings, the men described “a litany of environmental limitations and staff practices” that impaired their ability to maintain independence and control over their own lives.
They also spoke of their lives as “boring and meaningless.” They longed for positive social interaction and activity with other men, and, most importantly, children.
“Two major points came out of this research” Jilek says.
Firstly, men are an obvious minority in ACFs and there is a great need to plan and provide gender appropriate activity for these residents.
“The second point is that despite the many changes in residential aged care since 1997, many providers still struggle to provide an environment and level of service that meet residents’ physical and psychological needs and preferences.”
“Each of the survey participants articulated an overwhelming sense of institutionalisation and disempowerment, exacerbated by the physical environment of the facility and the policies and practices of staff.”
Jilek reminds us that men and women respond differently to these challenges. “Men of that generation often held strongly patriarchal positions within their households and are used to getting their own way. Men are more prone to displaying ‘cranky old man’ behaviour which may include levels of both verbal and physical aggression in response to stress and frustration.”
The study included 10 facilities, of which eight did not provide a single male specific activity. “Even in the two that did, it is questionable whether the activity was appropriate for the residents participating. In both facilities, the activity was limited to a single nondescript ‘men’s group’.”
Since women are dominant both as residents and staff in most ACFs, activities and social programs tend be developed predominantly for women.
“It is a pretty safe bet to assume that every facility in the country provides activities such as art and craft, sewing, knitting, cooking and bingo. It is far less likely that male residents would be provided with a range of gender-orientated activities such as tool sheds, gardening, business and social discussion groups, fishing trips, pub visits, trips to the hardware store or sporting activities.”
One way in which Amity at Dural responded to the men’s needs for social interaction was to begin building strong links with the local community. Community groups hold meetings in the facility, including members from Probus joining the men’s group. A number of residents were past businessmen in the local area, and they wanted to be able to continue with this group. Jilek stresses that women would also benefit from increased opportunities to socialise with their local community.
Another initiative suggested was a playground at the facility for children and grandchildren of staff and visitors. A cappuccino machine is also provided free of charge for visitors. This results in a higher frequency of visitors who stay for longer periods of time. Needless to say, it isn’t only the men who enjoy the sight and sound of children playing!
A computer with internet connection has been installed in the library, as a number of residents have family interstate and overseas and use email as a valuable means of communication.
Other structural and equipment provisions include improving the outdoor courtyard areas with BBQ facilities for residents, tables and seating and large shade sails.
In the main entertaining area, a large cinema style screen and projector have been installed and the area surrounded with heavy curtaining to provide a real cinema experience. A large marine aquarium is being installed, as are baby change facilities for the youngest visitors.
However, Jilek stresses change must be more than material.
“The largest change (which is continuously ongoing) is the change of staff attitude reinforced by policies and procedures that enhances the individuality of the resident. Our staff underwent hospitality style service training sessions in an effort to reinforce the expectations of the organisation in the area of a more hotel style service provision.”
Other Amity ACFs are exploring the results of this research.
Jilek plans to continue his research into older men’s needs. “There are more men than ever in ACFs, and with baby boomers ageing, this growth will continue,” he says. ” We need to look at providing specific social stimulation and activity for this group. The challenge for residential care providers is to keep pace with the changing levels of expectation and need.
“The importance of constantly surveying the needs, preferences and expectations of the ageing population cannot be underestimated. Providers who refuse to do this and continue to plan and provide aged care as it has historically been presented will surely find it difficult to survive into the future.”