Long term care (LTC), is one term used to describe congregate living style settings including nursing homes and residential aged care institutions; most countries have their preferred term, as do academic journals.

As a humanitarian and campaigner for civil rights and social justice, I’m becoming increasingly aware, and more educated on why these locked assisted living settings are places of detention.

They may not have barbed wire fences, but they might as well…

I also believe the well marketed, and increasingly popular and profitable Dementia Villages are places of detention, but more on that for another day.

Having recently completed the Torture Prevention Village course, Introduction to the OPCAT, I’m also a little shocked and even disappointed with myself for not having thought about locked LTC settings as places of detention sooner. As a young nurse in the 1970’s, I didn’t think to question any form of care, including the care of people locked in nursing homes, and realise of course, that we all go to work, believing we are doing our best, and that in health care at least, clinical practice is aligned to best practice of the time.

My blog today has been inspired by the recent Australian Human Rights Commission article, The Use of Hotels as Alternative Places of Detention published on 21 June 2023, which included a list of human rights impacts of detention.

There are a few things missing in the list below, that people with dementia and others living in long term care experience, such as a lack of adequate oral health care and chemical restraint. But it is now well known that people with dementia and others in LTC, who are mostly coerced to live in these institutions, have their rights violated every day.

Worse, people with dementia are segregated within these ‘homes’, as if they are criminals. It really is time to stop locking people up, as if they are in jail. Oh, and I think the food is probably better in a prison, and at least, people in prison usually get to go outside every day.

The list below on just how bad hotel detention is, is almost identical to the negative impacts to people who are detained (living) in long term care settings. Have a read for yourself, and nd see what you think. If you disagree, please connect and explain to me why locked institutional care facilities are not places of detention, that should be subject to OPCAT monitoring.

The Commission’s report found serious human rights impacts on people being detained in hotel APODs (Alternative Places of Detention, commonly known as APODs) at the time of the inspection in 2022. These included:

• Serious negative mental health impacts, which progressively worsen over time and exacerbate pre-existing trauma experienced by some people being detained.
• People in hotel APODs were largely confined to their rooms with almost no freedom of movement. They experienced social isolation and entrenched loneliness.
• Many people did not have sufficient access to fresh air, exercise, or outdoor areas. There have also been reports of substandard food.
• Many people experienced a distressing lack of privacy, either because of intrusive monitoring by staff or because of their living arrangements.
• People in hotel APODs had very limited access to programs or activities, fuelling boredom, frustration, and apathy.
• Many people had insufficient access to private spaces for visits by family, friends, or legal assistance.
• Concerns about the use of physical restraints, (including handcuffs) on people when they were escorted outside of detention facilities.
• Many people had difficulties accessing appropriate and timely medical care, including access to specialist health care and mental health care.
• Concerns about both the way that releases from hotel APODs have been conducted and the provision of post-release support. [most people in long term care are never released, they die there]
   

We need to rethink aged and dementia care…