{"id":1896,"date":"2023-02-06T01:30:52","date_gmt":"2023-02-06T01:30:52","guid":{"rendered":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/?p=1896"},"modified":"2023-02-06T01:31:46","modified_gmt":"2023-02-06T01:31:46","slug":"aged-care-in-australia-can-be-tricky-to-navigate","status":"publish","type":"post","link":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/2023\/02\/06\/aged-care-in-australia-can-be-tricky-to-navigate\/","title":{"rendered":"Aged care in Australia can be tricky to navigate"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">As a registered nurse, Belinda Davis thought she was in a pretty good position to help find the best aged care options for her ageing parents.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But even with her background in healthcare, she found navigating the process challenging.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;I cannot imagine how elderly people without computer literacy and skills are expected to navigate the system\u201d, she said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ms Davis has battled her way through different parts of the aged care system for almost five years.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She placed her father in an aged care home and organised home care for her late mother who had Parkinson&#8217;s disease.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She said she spent hours on the phone to government portal My Aged Care<\/span><b>,<\/b><span style=\"font-weight: 400;\"> Centrelink, aged care homes and service providers, trying to get information.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;No one person actually understands all of it\u201d, she said. &#8220;Every single person knows their little tiny bit of it. Talking to financial advisers and even they couldn&#8217;t understand.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The ABC has heard\u00a0stories of<\/span> <span style=\"font-weight: 400;\">confusion, frustration and despair<\/span> <span style=\"font-weight: 400;\">from other people encountering the system or who are already enmeshed in it.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">So how do you ensure that you or your loved one avoids the worst of the system and finds the best possible care?<\/span><\/p>\n<p><b>Where do you start?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The first step is recognising when you, or your loved one, needs help and when living at home without support is no longer an option, according to Kyra-Bae Snell, the executive director of aged care consultancy group CareAbout.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She wishes she could tell every Australian one thing: &#8220;Things change very quickly.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;It&#8217;s important to be informed and know what&#8217;s available ahead of time,&#8221; she said. &#8220;Don&#8217;t put your head in the sand about the reality of ageing.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After that, the first port of call is My Aged Care, which is the gateway to the three main forms of aged care in Australia: the Commonwealth Home Support Programme (CHSP), Home Care Packages, and residential aged care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can access their website or call them on 1800 200 422.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The CHSP is an entry-level package for people who need very basic domestic help, like a couple of hours of cleaning per week.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Home care packages and residential aged care provide higher levels of support.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But to access either of these, you need to get assessed by an Aged Care Assessment Team (ACAT).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ACAT determines what sort of help is needed, how urgent it is, and whether it can be done in the home.<\/span><\/p>\n<p><b>Home care packages: what are they, and how do they work?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">This is for people who are able to remain at home but need a higher level of support than what the CHSP provides.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are four different types of home care packages depending on needs, and ACAT determines which one you&#8217;ll get.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Level 1<\/b><span style=\"font-weight: 400;\"> &#8211; Low needs (domestic help or meal prep)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Level 2<\/b><span style=\"font-weight: 400;\"> &#8211; Moderate needs (social support, transport and shopping)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Level 3<\/b><span style=\"font-weight: 400;\"> &#8211; Intermediate needs (personal care, medication help)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Level 4<\/b><span style=\"font-weight: 400;\"> &#8211; High needs (showering\/dressing help, nursing, memory help)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">People with moderate to severe cognitive impairment, like dementia, can qualify for extra services.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The packages are &#8220;consumer led&#8221; meaning\u00a0the individual<\/span> <a href=\"https:\/\/www.myagedcare.gov.au\/find-a-provider\/\"><span style=\"font-weight: 400;\">decides their own service provider<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Choosing a provider can be a job unto itself, but the best place to start is through My Aged Care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Once you&#8217;ve picked a provider, federal government pays the provider a subsidy to arrange a package of care services, based on what level ACAT has determined you need.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You may face some additional out-of-pocket costs, such as daily care fees, depending on your financial situation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">They can range from $10.50 a day for a Level 1 package or up to $11.70 a day for a Level 4.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is also an income-tested fee which generally only applies to part-pensioners or self-funded retirees; however there are annual and lifetime caps on these.<\/span><\/p>\n<p><b>How do you choose a home care package provider?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Specialist aged care financial advisor Kerry Darton said it&#8217;s important to do preliminary checks with service providers ahead of making your choice.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The key one, she said, is to really make sure the service provider can provide &#8220;all the services needed&#8221; and the &#8220;total number of hours of care&#8221; that the home care package specifies.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She recommends meeting\u00a0 with the service provider to write up a checklist of all the things you\u00a0or your loved one needs, so there&#8217;s accountability and something to refer back to in case of a disagreement.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is also the option of a &#8220;self-managed home care package\u201d. Self-managing a home care package means you organise care and hire staff, such as cleaners or nurses, instead of using a service provider to do it.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ms Davis said it took time, but the benefit was saving money in admin fees.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While experts like Ms Snell think home care packages are a better option than residential care, there are huge wait times &#8211; sometimes up to 12 months.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Earlier this year it was estimated that <\/span><a href=\"https:\/\/www.abc.net.au\/news\/2022-03-16\/staff-shortages-home-care-packages-up-to-nine-month-wait\/100902860\"><span style=\"font-weight: 400;\">more than 62,000 Australians were waiting on one<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Unfortunately \u2026 because of the wait times, [some] people end up in aged care homes who could be cared for in their own home\u201d, Ms Snell said.<\/span><\/p>\n<p><b>Residential aged care: who needs it, and how do you apply?\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400;\">If you or your loved one have complex needs or it would be unsafe to continue living independently, that&#8217;s when it is time to consider an aged care home.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">An ACAT assessment determines if residential aged care is needed. If it is, then the challenge is often finding the right home.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ms Snell said the selection should be based on the home&#8217;s location, so family and friends can easily visit,\u00a0services, costs and reputation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can suss out a home&#8217;s reputation by asking around, <\/span><a href=\"https:\/\/www.agedcarequality.gov.au\/reports\"><span style=\"font-weight: 400;\">checking its accreditation status and performance assessment<\/span><\/a><span style=\"font-weight: 400;\">, or seeing if there&#8217;s any <\/span><a href=\"https:\/\/www.myagedcare.gov.au\/non-compliance-checker\"><span style=\"font-weight: 400;\">non-compliance orders for the home<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Then, as Ms Snell pointed out, it&#8217;s essential to take a tour of the facilities you&#8217;re considering. &#8220;You need to take a checklist and you need to take notes\u201d, she said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You also need to consider the costs involved and whether you can afford it.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Once you&#8217;ve found a place that feels right, the next step is apply to the home; wait to be accepted; and then sign contracts, often a resident and accommodation agreement.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A solicitor is useful at this stage, or you can contact\u00a0<\/span><a href=\"https:\/\/www.health.gov.au\/initiatives-and-programs\/national-aged-care-advocacy-program-nacap\"><span style=\"font-weight: 400;\">the National Aged Care Advocacy Line<\/span><\/a><span style=\"font-weight: 400;\"> on 1800 700 600.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ms Snell said homes that are more expensive don&#8217;t necessarily have better care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Getting a sense of the home by spending time in the home is actually the key to understanding whether or not it&#8217;s going to feel right for you and your loved one\u201d, she said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That&#8217;s why a temporary period of &#8216;respite&#8217; care, which lets you &#8220;test out&#8221; a facility for up to 63 days,\u00a0is essential.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you will be acting as an advocate for someone in aged care, it&#8217;s helpful to get your documentation in place immediately.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This includes the Will; the enduring power of attorney; the guardianship; and an end of life care plan &#8211; all of which can differ according to each state and territory.<\/span><\/p>\n<p><b>How do residential aged care costs work?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Even before you start the process of finding the right aged care placement, experts advise it&#8217;s important to get financial advice, either through a specialist aged care financial advisor or via Centrelink for free.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That&#8217;s because the financial side of things is very complex, Kerry Darton explained, as aged care has four different sets of costs:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The <\/span><b>refundable accommodation deposit<\/b><span style=\"font-weight: 400;\"> (RAD), which is used to secure a room<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A <\/span><b>basic daily fee<\/b><span style=\"font-weight: 400;\">, which applies to everyone and covers day-to-day services such as meals and cleaning<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The <\/span><b>means-tested fee<\/b><span style=\"font-weight: 400;\"> is for those with assets, and covers personal and clinical care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some facilities charge <\/span><b>additional service fees<\/b><span style=\"font-weight: 400;\">, for hotel-type services like pay TV or hairdressers.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The first cost you&#8217;ll need to prepare for is the RAD, and it&#8217;s generally a big up-front cost to secure a room in aged care.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">RADs can range from $200,000\u00a0to $1.5 million depending on the facility, where it&#8217;s located and size of the room.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If the RAD is paid in full, then when the resident dies, the money is returned to the estate and &#8220;distributed as per the will\u201d, Ms Darton said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But if the resident can&#8217;t pay the RAD in full, there are other options.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;You can buy part of the room and rent part of the room\u201d, Ms Darton said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Or there is the option of just paying rental fees; however those aren&#8217;t ever returned.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you really can&#8217;t afford the RAD or rental fees, then you could be deemed a &#8220;low means resident\u201d, meaning &#8220;the government then tips in for accommodation costs\u201d, Ms Darton explained.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some people sell their home to pay the RAD, but Ms Darton said she advised \u201c95% of [her] clients to hold onto the home&#8221;, at least initially.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That&#8217;s because for the first two years of residential aged care, Centrelink doesn&#8217;t include the value of the home when calculating if someone can get the aged pension.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">So, as Ms Darton explained, some people are better off using their super or savings to pay for the RAD, because it reduces their asset pool and therefore gives them a greater chance of getting the pension.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She also advised that &#8220;holding onto the house can help reduce the aged care means tested fee&#8221;, which is one of the other four costs associated with residential aged care.<\/span><\/p>\n<p><b>What about short-term or more immediate care?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">If you or your loved one don&#8217;t need long-term care just yet, there are two options: respite care, and Transitional Aged Care Packages (TACP).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Respite care can\u00a0be in the home or outside the home.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But the most common type of respite is a &#8220;testing out&#8221; period for when someone first enters an aged care home, which can last for up to 63 days.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Do it like a try before you buy; make sure you&#8217;re comfortable\u201d, Ms Darton advised. &#8220;It&#8217;s seen as a short-term care solution.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are still some costs with respite, but according to Ms Darton it&#8217;s cheaper, &#8220;so a lot of people want to use up their respite for as long as possible&#8221;.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">TACPs are also available in the home or in an aged care facility and generally apply to people who need help after a fall, or time in hospital.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The idea is to regain functional independence to avoid long-term care, so services like nursing, physio, speech pathology and personal care are provided.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The package can last up to 12 weeks and the costs are up to the service provider or aged care home.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, the government has set a maximum amount: $11.70 per day if the care is at home; and $56.80 per day if in an aged care home.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Belinda Davis swears by TACP and said it really helped bridge that gap while her mother waited for a home care package.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;It gave her a lot more support, with occupational therapy, exercise physiology, speech therapy and resources for the home\u201d, she said.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Published by ABC News in November 2022<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As a registered nurse, Belinda Davis thought she was in a pretty good position to help find the best aged care options for her ageing parents.\u00a0 But even with her background in healthcare, she found navigating the process challenging. &#8220;I cannot imagine how elderly people without computer literacy and skills are expected to navigate the [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":333,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[32,1],"tags":[],"class_list":["post-1896","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-seniors","category-uncategorized"],"acf":[],"distributor_meta":false,"distributor_terms":false,"distributor_media":false,"distributor_original_site_name":"Kangaroo Valley Voice","distributor_original_site_url":"https:\/\/kangaroovalley.nsw.au\/valleyvoice","push-errors":false,"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/posts\/1896","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/comments?post=1896"}],"version-history":[{"count":1,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/posts\/1896\/revisions"}],"predecessor-version":[{"id":1897,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/posts\/1896\/revisions\/1897"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/media\/333"}],"wp:attachment":[{"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/media?parent=1896"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/categories?post=1896"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kangaroovalley.nsw.au\/valleyvoice\/wp-json\/wp\/v2\/tags?post=1896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}