Dr Kerryn Phelps, AMA President - Radio 3AK, with Derryn Hinch
HINCH: Now I heard the Breakfast program this morning. I disagreed with Cathy actually, Cathy Bedford, when she was … she made light of the fact that … she said, 'what's the big deal about wanting to have double beds in nursing homes, surely there are more important things about nursing home conditions than that?'. I'm paraphrasing her here, but she sort of said, well, people of that age, why do they need double beds anyway, they're too old for sex.
I thought to myself, haven't you ever heard of cuddling? It means for a couple in a nursing home … I think it's shocking the way in our nursing homes in this country, we put the husband, they've been together for 60 years, they put the husband in one nursing home and the wife in another one. Or they put … have to put the husband in a nursing home so far away from where the wife is living at home, she can't visit him. And if a couple want to have a double bed in a nursing home and they want to get together and they want to have their form of sex, what the hell is wrong with that? They've earned it, it's their right. It shouldn't even be … we shouldn't even be discussing it; but we are. On the line now, the President of the Australian Medical Association, Dr Kerryn Phelps. Good morning.
PHELPS: Good morning, Derryn.
HINCH: First of all, I want to thank you and congratulate you on the speech you made on behalf of the AMA at the Child Abuse Fundraiser we had in Sydney on Friday night.
PHELPS: Thank you, Derryn. I think it was a very important occasion. It was great to see you there. And I think it was an important event to raise community awareness of this particular issue.
HINCH: And when you see victims who have the guts and the courage to get up there and talk about themselves, that little boy who got up and read a poem, it brings a lump to your throat.
PHELPS: Oh, he brought me to tears, I have to say.
HINCH: It would indeed. Well, on this issue of double beds, I mean, it's been described as inhumane. I think it's inhumane. I didn't even … I must be naive, I didn't even realise it was an issue.
PHELPS: It is an issue and it's really part of the whole compassionate, or lack of compassion, I suppose, in a lot of provision of aged care services and that is that people who have particular lifestyle, or social context, in the relationship context, is completely ignored a lot of the time in aged care. And I think one of the really important things that we need to do in planning aged care for services into the future is to look at the whole person, the individual, with dignity and with all of their personality and to look at aged care services that are appropriate to them. And at the moment, aged care really is in a crisis situation, ask anyone who is trying to get an elderly relative into a facility.
HINCH: See, one of the problems here, too, is that it's very traumatic, if you've lived with your wife or husband, often in the same house for 60 years and suddenly you're not only leaving them, you're losing your surroundings, you're losing the things that are familiar to you, you're losing your possessions, you can take some with you, but not many. And so that in itself, apart from your deteriorating health, can be a major problem.
PHELPS: It can be an actual terror for elderly people facing the prospect of going into a facility when they're getting old, because for one thing, it's seen as a one way street, once you're in there, that's it, next stop, you know…
HINCH: Yeah. It's God's waiting room.
PHELPS: Yep. And I think that we need to develop some different concepts of ageing, where people can, who perhaps have been unwell, can go into a facility where they have some support, some assistance, to get better, rehabilitation. We seem to have lost the concept of rehabilitation in aged care. And one of the ways we can get this back is to develop what we call centres of excellence in aged care, where we can do research into the most positive ways of helping people to maintain their independence when they're ageing, the best ways of caring for them, the best ways of actually preventing the ageing process, if possible.
HINCH: I notice that from Geriaction, a great name for a group, that's Anne Patterson, has said that it's not just the act of sex of people of 70 and 80, it's the loss of physical closeness and intimacy.
PHELPS: Yes. And I think this is something that has been completely ignored for elderly people for far too long. And the reason I brought it up in my speech yesterday at the National Press Club was to raise this issue of intimacy, closeness and individuality for older people and to say, well, why can't we incorporate that into our aged care facilities as we're planning them for the future? We're going to see an enormous explosion in the number of people over the age of 85 between now and the next 50 years and in 50 years we're expecting to have between 1.1 and 1.2 million people over 85. So there is going to be an increased need for different concepts of aged care than we have now.
HINCH: Yeah.
HINCH: Now we had a bit of a wish list for the Government, whoever gets elected coming up to this federal election, about various health issues. The one that I mentioned on air yesterday - and we've talked about it before - is over the six weeks waiting list, the government enforced diets for people with high cholesterol and needing medication.
I suggested yesterday they should put a picture of an overweight Michael Wooldridge in every doctor's surgery.
PHELPS: That's very mischievous of you.
HINCH: Well, I mean, don't you think this is ludicrous?
PHELPS: Look, in a way, it's a bit like teaching grandma to suck eggs, you know. It's something that doctors do anyway. If we have patients who have a high cholesterol level and it's fairly apparent that lifestyle is a contributor, or even if it's not apparent, we say to them, 'okay, let's go through your diet with a fine tooth comb, let's see what you're eating, what you're not eating, cut out the high fat foods, make a food diary, exercise regularly and let's see if we can get your cholesterol level down by these lifestyle measures.' Now if that's not successful, then clearly there's a need for medication.
One of the problems is getting people to stay on medication if they don't have any symptoms of their high cholesterol and there's only so much … people can be a little bit frightened about a heart attack, if they have no signs of heart attack. Unless they've got a close relative, or … who has dropped dead at, you know, 45, or something and then they take it a bit more seriously. So the problem we have is not … the problem we actually have with cholesterol lowering drugs is getting people when they need them to stay on them to keep their cholesterol level down.
- So, yes to the diet and exercise advice; it's what we're doing already. But similarly, if somebody has had heart disease and has a high cholesterol level, you don't wait for six weeks because you could be losing precious time.
PHELPS: That's exactly right and that's certainly what we find in general practice and probably the reason why people sort of take their cholesterol lowering drugs for a while and then sort of stop it. And, in fact, if all of the people that were taking their medication took it and all of the people who were appropriate for statin therapy, which is the cholesterol lowering drugs we're talking about, were all of them, the Heart Foundation's estimated we'd see a tripling of the number of people on statin drugs. So I don't know how the government is coming up with their $104 million savings over four years, because I think we're going to see an increase in the number of people on statins.
HINCH: Yeah. The other point here and it's a larger moral issue, isn't it, if a government says, okay, go on a diet for six weeks and then you can have your pills, that's like because it's your own fault. It's like people saying, well, you can't have treatment for this smoking related disease because you smoke, or you can't have treatment for this for six weeks for this alcohol related disease because you brought it on yourself because you drink. It seems to me to be a government interference in a level which can be in the end dangerous.
PHELPS: I think we have to be careful about this and it's the form of managed care by a government. We've seen it in the MRI issue. We're seeing it in a number of areas now where the government is starting to interpose itself between doctor and patient and say, 'as the government, we say you can have this treatment', or 'you can't have this treatment'. I think that's a very scary prospect and I think that we need to guard against doctors' best clinical judgment being interfered with by government.
HINCH: Yeah, I agree with you. Dr Phelps, thank you for your time.
PHELPS: Thank you, Derryn.
HINCH: Bye, bye.
Ends