Methadone Maintenance Treatment: Disciplining the 'Addict'
This article examines key aims, objectives, technologies, strategies, and procedures utilised in Australian methadone maintenance programs over the past thirty years. An examination of the major policy documents reveal that, in addition to medico-health concerns, methadone programs have been strategically deployed to manage specific sociopolitical problems including illicit drug use, crime, and the spread of infectious diseases. The techniques, technologies, and procedures utilised in methadone programs and the 'disciplinary monotony' of the methadone regime itself aim to produce a more compliant, conforming, and self-regulating subject. It is argued that the promotion of methadone maintenance as a 'treatment' modality obscures these disciplinary objectives and the political goals that have fostered them.
Opening a Can of Worms: Consenting Partners in Aged Care
With Consumer Directed Care (CDC) on the horizon and a wave of baby boomers who are ageing, aged care providers need to be aware of and respect the desires and requirements of future 'consumers'. In contrast with current provider arrangements, funding is linked to the individual rather than the institution in a CDC model, with the likelihood that there will be greater demand for those facilities that meet emerging consumer expectations and offer couple-friendly environments. One group that has largely been ignored at all levels in residential care, from government policy to service provision, is couples, or partnered individuals. Situated within a broader study exploring the needs of partnered baby boomers, this paper investigates whether existing residential aged care facilities provide the conditions needed to facilitate the sexual and intimacy needs of partnered aged care residents. Such exploration is particularly pertinent at a time when the National Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Ageing and Aged Care Strategy is being implemented. In this presentation we report on early findings of a phenomenological study using semi-structured interviews conducted in 2015 with 29 key informants with expertise and experience in aged care law, policy, practice, health, education, research and related service areas. Early findings suggest that difficult though necessary conversations are being avoided by older people, by those representing them, and by service providers. Recommendations for aged care providers include the need for comprehensive education and training in the areas of sexuality and intimacy with the aim to facilitate communication around residents' sexual needs and the formulation of individually tailored care plans. We believe that such initiatives would have the potential to create more positive outcomes for partnered older persons and aged care staff.
Couples' Privacy in Residential Aged Care
Currently, a third of Australian aged care residents are partnered, with many experiencing institutional interference in their relationships. Staff duty of care usually takes precedence over privacy. Some institutions separate couples; residents' doors may be kept open; staff enter without knocking, ignore 'do not disturb' signs, or gossip about residents; all of which make privacy a challenge. This paper reports on findings from an online survey into the needs of partnered Baby Boomers (born 1946-65) and the levels of privacy that they anticipate they will require to maintain their primary relationships in residential aged care facilities. At a time marked by a policy shift towards consumer-directed residential aged care, it is pertinent to understand the needs of this subset of future consumers. Our research found that the majority of respondents expected to remain sexual indefinitely, considered physical intimacy with their partners essential to their wellbeing, and required a high degree of privacy to maintain their relationships. Respondents were asked to rate seven domains of privacy. Those considered most important were visual privacy, private space, and bodily privacy. This paper outlines various ways for service providers to prepare for the next generation of consumers, initiatives that would enable residents and their families to make informed decisions when choosing a facility, potentially improving the experiences of both residents and staff.