When Horsham Hospital was first built in 1875 it faced challenges almost immediately.
Staffing a hospital in a frontier town was difficult, as was dealing with epidemics that swept through the region, such as scarlet fever, diphtheria and typhoid.
Funding the hospital was a perennial issue, largely dealt with in the early years by willing volunteers and generous donations from the people.
The one challenge that was present from the hospital's earliest years was what to do with patients who were not technically sick but were simply too old or infirm to care for themselves.
Hospital care is expensive and many of these patients had no funds nor relatives.
The hospital's management committee sought help from the Victorian Government in 1888 and were told to transfer them to the government funded Benevolent Asylum at Stawell.
When approached, the Benevolent Asylum agreed to take such patients but only if Horsham paid them an annual fee of £20, rising to £25, per patient, equivalent to about $23,000 today.
In 1896 the management committee began setting aside funds to build their own 'Benevolent Wing' at the hospital.
It was to be another 65 years before this became a reality. During the intervening period, some patients were transferred to Stawell but many simply became permanent patients in the hospital's wards 6 and 8.
On 20 September 1961 the Chairman of the Hospitals and Charities Commission opened a 'Geriatric Unit'.
An indication of the government's thinking at the time is reflected in his words, "Medical science had conquered many diseases and because of this old people were becoming a problem".
The unit had two wings with 21 beds in total. Women were housed in the northern wing and men in the south.
It was built on the site of the recently demolished, old weatherboard nurses' residence on the corner of Robinson Street and O'Brien Lane.
Early managers were Sister J Morris and Sister Freeble.
They were followed by Sister Jan Curran and, from the late 1980s, Sister Dianne Johnson.
The Geriatric Unit was renamed Kurrajong Lodge in the mid-1990s.
Around 1994 a change in the funding model used for aged care by the State and Federal Governments effectively meant that any publicly-funded aged care facility with fewer than 30 beds would no longer be viable.
In April 1997 the present 36-bed Kurrajong Lodge residential care hostel opened at 2 Arnott Street. This $3 million hostel has three residential wings.
Each wing has 12 bedrooms with ensuite, a kitchen and dining area, a small sitting room and a private outdoor area.
There was one glaring omission: there was no activity room where larger groups of people could gather.
A support group, consisting of friends and relatives, raised money for one but it was never built.
In December 1976 a new purpose-built Day Centre, located just east of the old geriatric unit, was opened. Costing $38,000, it was built by local firm, P & A Coutts.
The southern end of the Day Centre contained administration, hairdresser, podiatry, physiotherapy, speech therapy and a visiting doctor's room.
The northern end consisted of the main activities area, dining area and kitchen.
The centre's aim was to provide day care for elderly or disabled people so that they could remain out of hospital and in their own homes.
In the 1980s and 1990s the Day Centre catered for up to 40 patients each day.
Services provided included meals, holistic nursing care, craft and woodwork sessions, entertainment activities, day trips and exercises.
Some special needs patients were bathed at the centre and had their laundry done.
About 2010 the Day Centre was scaled back with the southern portion of the building given over to continence services and district nursing.
Beginning in December 1978, high-care residents were housed in the newly built Sir Robert Menzies Nursing Home. Built on the site of the old hospital's ward 7, the 50 bed Menzies nursing home had rooms with 2, 3 or 4 beds.
Bathroom facilities were located at both ends of the corridor.
The air quality in Menzies was greatly improved when provision was eventually made for a separate area for soiled linen and medical waste.
First discussed in 1982, the urgent need for additional high-care accommodation resulted in the construction of the 30-bed Matron Arthur Manor nursing home.
It was built to the north of Menzies, on the site of the old hospital's Ward 5.
Opened in November 1987, it cost $1.4 million, $820,000 of which was raised locally.
The builders were Plazzer Brothers of Horsham.
The Manor was named for Matron Gil Arthur, who was a mainstay of the hospital from 1928 until her retirement in 1953.
In the mid-1990s these two nursing homes underwent a major refurbishment.
Now named the Wimmera Nursing Home, they were linked by a foyer and had ensuite bathrooms added.
One of the initiatives taken at the day centre and in the nursing homes was to produce a small booklet for each resident or patient.
The activity staff, consulting with the person and their relatives, assembled a personal booklet with a brief story of their life with photos etc.
In the nursing home the booklet was kept in the resident's drawer so new staff could access it.
This was especially important for dementia patients because they felt much more comfortable with staff who knew about them.
Unfortunately, aged care remains a low priority for government funding.
Local groups try their best to raise funds and provide support but, with successive governments still regarding aged care as a "problem", there is some way to go.
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