Behind Closed Doors: Exploring Ways to Support Partnered Baby Boomers' Coupledom in Residential Aged Care Settings

Abstract

A third of Australians living in residential aged care facilities are married or partnered, however, institutional interference in residents' relationships is not uncommon. Practices in some establishments include keeping residents' doors open; staff entering without knocking, ignoring 'do not disturb' signs, and gossiping about residents. Partners are variously accommodated in separate beds, separate rooms or separate wings of a facility. Many are not permitted to enter care together. Such conditions make it challenging for couples to maintain their relationships. To date, insufficient research has focused on supporting older couples’ relationships subsequent to one or both partners being admitted into care. From July 2018, a public policy of consumerdirected residential aged care will take effect, developed in anticipation of the postwar 'baby boom' cohort becoming aged care consumers. This thesis reports on a study that explored the needs of Baby Boomers as aged care consumers, given that they represent almost a quarter of Australia's population. The aims of this study were to identify (1) which aspects of Baby Boomers' intimate relationships they considered essential to their wellbeing; and (2) practical measures that need to be implemented to support those valued relationship elements in residential aged care settings. To address these aims, a predominantly qualitative, three-part mixed methods study was designed. It adopted an interpretivist-constructivist perspective, drawing on grounded theory and phenomenology. The findings indicated that, in practice, a broad policy focus on 'person-centred' aged care did not adequately address the needs of couples as they envisaged them. Instead, this thesis argues that, in the case of partnered residents, what is called for is an industry-wide 'couple-centred' model of aged care. Conclusions drawn were that: (1) ageist attitudes to older adults' intimate and/or sexual relationships are pervasive at every tier of the aged care system; (2) the sector is failing the needs of many older couples; (3) these issues are not unique to Australia; (4) partnered Baby Boomers' needs are unlikely to be met by current aged care policies and practices; and (5) Baby Boomers' are already exploring alternatives to current models of residential aged care. These issues have wide-reaching implications at a societal level, for public institutions, the aged care sector as a whole and Baby Boomers themselves.