From retirement dreams to corporate schemes: the business of ageing and public funding | Edgar Galea Curmi

Before delving into this brief discussion, I emphasise that none of the forthcoming remarks are intended as a judgment on any individuals associated with the topic at hand. Whether it be staff, management, businesspersons, consultants, decision makers, Franciscan friars, or any other involved party, I habitually presume that everyone’s intentions are virtuous; however, good intentions, time and again, pave the road to hell.

By the time this article is published, Malta will have “celebrated” yet another milestone in the development of services for older persons, a new residential facility that replaced a retreat home previously run by a religious order inspired by St. Francis. A new state-of-the-art investment that provides top quality services for older persons – the stuff of dreams for all of us who, after five or more decades of hard work, will be able to retire in the peace of a St Francis inspired retirement “home”.

But then, is it a “home”? Beyond the glossy headlines, what in developing a 400+ capacity residential facility has been driven by the best interests of older persons? To what extent does such a facility contribute to older persons’ sense of security, sense of purpose, sense of belonging, sense of competence, sense of identity, sense of self-actualisation?

Let’s start from some basics. The Constitution of Malta, in line with Universal Declaration of Human Rights, unequivocally protects any citizen’s right for respect of one’s private life. Yet, unless one is extremely privileged, either by virtue of one’s financial resources or by some special political patronage, no older person living in a publicly funded residential placement has this right guaranteed. Imagine being compelled to leave your own home for whatever reason, being admitted to a residential facility, and with all that you would have had to give up you are also forced to give up your privacy, placed with a roommate not of your choice. And only if you are lucky are you spared the trauma of being in a room with two or three other older persons. I’ve made this argument before and have often been given the flippant reply that older persons love company. Yes indeed, don’t we all... when it is actually us that choose whom to keep company with!

Privacy is not the only loss. Running a 400-person facility necessitates structure and procedures to keep the enterprise well-oiled and running smoothly.  The person can no longer function as an individual, but necessarily has to fall in line with ‘the system’. Even a simple choice like one’s wake-up time is taken away.

What is the reality of the publicly funded mass institutionalisation of older persons taking place under the guise of progress? I put this question to a professional colleague of mine who works in these homes. She mentioned high staff turnover and shortage of staff, language barriers leading to frequent misunderstandings and frustrations, sub-par variety and quality of food with limited choices and absence of fresh options, residents having no say in the choice of their roommates, residents’ lives predominantly consisting of passivity, and a prevailing culture of learned helplessness, leaning towards making residents dependent on the facility rather than fostering genuine independence.

So, coming back to the 400+ “home”, who are the likely main beneficiaries of this milestone development? No doubt, the religious order is guaranteed an income for 60 years so that its financial concerns taken care of, with the secured income expected to outlive the current generation of friars.

The “investors” have made careful calculations on the number of older persons they need financed by public funds for a guaranteed number of years, for a secure investment with minimal risks and a sound return on investment. Government will seek public recognition, boasting of the progress being registered in the services for older persons. Yet, to what extent can older persons be listed as beneficiaries?  Are those persons, in whose interest these services are being created, actual beneficiaries, or are they the ones losing out for others to benefit?

There’s an old joke that goes around the religious circles about this individual who went to seek the Rabbi’s advice, and the conversation goes as follows: “Rabbi, I have a strong desire to live forever. What can I do?” “Get married” replies the Rabbi. “And will I live forever?” “No, but the desire will disappear.” I wonder whether the Rabbi would now reply: “Get a publicly funded retirement home placement.” As one older person living in a residential home put it: “This is not the life I worked so hard for and not the life I want to be living. It is not a proper life. I get the feeling that I’m a burden and that it will be much better for everyone the quicker it is all over.”

On a national policy level, how does one reconcile a strong strategy for the deinstitutionalisation of disabled persons while on the other hand financing and implicitly promoting the mass institutionalisation of older persons? And how does the massive public funding going into the institutionalisation of older persons contribute to a national strategy for active ageing?

When older persons move out of their home, their neighbourhood and their community, they experience a terrible prolonged shock of loss, the loss of a way of life, their circles of support, and all they would have hoped for in the evening of their life journey.

And they find themselves becoming yet another number in the balance sheet of the profitable business of ageing, financed by public funds – their retirement dreams engulfed by the corporate schemes that not only replace one’s own home but also the hope of dignified twilight years.

Unity Gazzetta is a collaboration between MaltaToday and the Faculty for Social Wellbein