The paradox of the Aged Care Act 1997: the marginalisation of nursing discourse.
This paper examines the marginalisation of nursing discourse, which followed the enactment of the Aged Care Act 1997. This neo-reform period in aged care, dominated by theories of economic rationalism, enshrined legislation based upon market principles and by implication, the provision of care at the cheapest possible price. This paper exposes some of the gaps in the neo-reform period and challenges the assertion that the amalgamation of nursing homes and hostels in such an environment can provide better quality of care and life for residents. It argues that this amalgamation entails a transformation towards a social model of care and fails to address the professional healthcare needs of the acutely sick and complex extreme old person and makes evident new gaps in the provision of aged care services. The paper proceeds to present strategies where the future for nursing practice in aged care necessarily involves a judicious balancing of individual cases alongside economic prescriptions of care and ever-changing public policy initiatives. It concludes that this can be achieved through a more interactive public, professional and advocacy discourse. The methodology involves extensive analysis of public documents including media, academic journals, government reports and interviews with recognised leaders in the field of aged care. The study utilises a critical interpretative framework consistent with the logic of Michel Foucault.
Angus
Jocelyn
J
Faculty of Human Development, Victoria University, Melbourne, Australia. jocelyn.angus@vu.edu.au
Nay
Rhonda
R
D000368:Aged; D001315:Australia; D003659:Decision Making, Organizational; D005851:Geriatric Nursing / Q000458:organization & administration*; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006299:Health Services for the Aged / Q000331:legislation & jurisprudence*; D006801:Humans; D040541:Marketing; D020380:Needs Assessment; D024802:Nurse's Role; D009735:Nursing Homes / Q000331:legislation & jurisprudence*; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D011057:Politics; D011209:Power, Psychological