Law Talks Episode: Starting conversations about aged care needs when visiting elderly relatives this Christmas

Robyn:  Good morning and welcome to another edition of 4CRB’s Law Talks. And today joining me in the studio is Attwood Marshall Lawyers Aged Care Paralegal, Bindy Marshall. Welcome back, Bindy.

Bindy: Merry Christmas, Robyn.

Robyn: Well, Bindy, with Christmas fast approaching, today we’re going to be talking about preparing for a Christmas visit with elderly parents. Now, this can be tricky when families come together at Christmas time and some from out of state or even from overseas, they may not have seen their parents for a number of years. Things may not be quite what they were expecting.

Bindy: Yes, some loved ones are shocked when they arrive to find their parent living in such disarray.

They don’t see the mess, what’s in the fridge or the unwashed person or the extreme lack of hygiene over the phone. 

Robyn: So, what do you do if you get to your loved one’s home and detect things aren’t quite right?

Bindy: Yes, it can be really confronting, Robyn. Finding the phone in the pot plant and the smell coming from the fridge that could make your hair curl and the stack of unopened mail on the dining room table can be really overwhelming.

I will never forget a phone call that I received from a distressed family member who hadn’t seen mum for about five years, and they came for a surprise visit one Christmas. She was shocked at having to navigate her way into the lounge room like an Olympic gymnast from the front door. It was even more confronting when she started to clean up and found mum’s beloved cat that had gone missing three years prior under a stack of magazines.

It took them nearly 8 weeks and nine 10 cubic metre skip bins to clean the home out when mum transitioned into care.

Robyn: Yeah, well Bindy, I think at that point you clearly know something is wrong. So, where do you start?

Bindy: If you discover your loved one’s health is deteriorating, then arrange a GP visit to start.

This may lead to a referral from the GP for a capacity assessment with a geriatrician or another specialist, which may prove to be a little challenging over Christmas. This may mean that you will need to be prepared to stay a little longer to help your loved one put the appropriate services in place.

Robyn: Do you have to wait for an ACAT assessment to have care in your home?

Bindy: No, you can actually organise this with your local home care provider as a private service. We have some really dedicated home care providers here on the Gold Coast and Northern Rivers.  Although its preferable to have a home care package to help subsidize costs, you really don’t need to have one to engage services. You just need to organize private services until your loved one can be ACAT assessed. It’s not as costly as you think. 

For those listeners who don’t know, an ACAT assessment is conducted by an ACAT nurse either in your home or in hospital and contains codes required for home care, respite care and residential aged care.

This is the key to subsidised care and accessing these services. The ACAT’s a really important document and is a health report on an individual and that outlines their diagnosis, their current treatment, family background, supports and approval codes.

Robyn: So, Bindy, who is eligible to apply for an ACAT assessment and when should they do that?

Bindy: So, it’s never a case of if, it’s always a case of when. And if you are starting to age in place and you’re thinking, gosh, I’m having trouble with the heavy laundry and you’re having trouble making the beds, getting those fitted sheets on, then it’s time. You can apply to My Aged Care at any time and request an ACAT assessment, whether they approve you for Commonwealth Support Program or whether they approve you for a home care package, that’s up to the ACAT nurse to decide.

So, I guess it’s whenever you’re starting to feel a decline, there’s no age bracket in place.

Robyn: And what happens in extreme cases?

Bindy: In extreme cases, the older person often ends up in hospital. The doctors may enact mum or dad’s or your loved one’s enduring power of attorney to enable them to assist you. If their hygiene’s been compromised with the lack of bathing, it’s really beneficial for your loved ones to have a complete health check to ensure there’s no underlying issues, such as UTIs, which can affect their cognitive ability.

The social workers are usually a wonderful support to those who have loved ones in hospital. They provide guidance and help with the next steps, which is essential.

This might be additional supports required at home, or in some cases, assisting with the transition into permanent residential aged care.

Robyn: So, what should people do to be a little more prepared?

Bindy: Understand your role as Enduring Power of Attorney. Check the Enduring Power of Attorney document has been signed and determine if your role as an Enduring Power of Attorney is immediate or upon loss of capacity.

You should also check to see if you’re the solely appointed Enduring Power of Attorney or if you’ve been appointed in a joint capacity with another person.

It’s really important to check the appointment to determine how you can assist. Is the appointment for both financial and health and lifestyle? 

If your loved one has a home care provider, contact them and discuss the issues surrounding your loved one. You may find that your loved one has declined services.

If your loved one is starting to require assistance, you may need to register your loved one with My Aged Care and they may be able to assist with facilitating an ACAT assessment. Unfortunately, there is a long wait list at the moment, to obtain an ACAT in your home.

Robyn: Are there services available to help people to understand their appointment as an EPOA and to assist with the next steps to help transition into care?

Bindy: Yes, of course. Experienced aged care lawyers can assist with this and offer help to them to understand what their role is and how to safeguard the older person that they are appointed to protect.

Things can move pretty quickly when a loved one needs to transition into care and this process alone can be overwhelming with all the mandatory paperwork for government departments, placement, admission forms, and understanding the complexity of the current aged care system and all the terminology that goes along with aged care.

Accredited aged care professionals can help you navigate the next steps with ease and assist you with all the paperwork required so that you can concentrate on looking after your loved one.

Robyn: Alright Bindy, so just to recap, what should people do if they visit elderly parents this Christmas and notice a decline?

Bindy: So, step one should be, if you arrive and find your loved one unwell or showing signs of confusion, seek medical attention. This may lead to a hospital admission.

Step two, be guided by the GP or medical professional, even if it’s hard to hear that your loved one can’t go home and needs to transition into a permanent residential aged care facility.

Number three, if you are an enduring power of attorney for a loved one, understand what your role is as attorney and how you can best support the older person you’re appointed to protect. 

And number four, put some sort of home care in place, even if it’s a private care arrangement, until the ACAT can be completed.

And obviously the most important, please don’t go home without doing anything. If you need assistance, engage a professional specialised in aged care to help you navigate the way forward.

Robyn: Yeah, it can be quite complex. And thank you, Bindy. I’m sure these tips will be useful for some of our listeners this Christmas.

Bindy: Thank you so much, Robyn. Merry Christmas to you all.

Robyn: Merry Christmas, Bindy. Thanks for joining us. You’ve been listening to Law Talks here on 4CRB, which you can hear every Friday morning from nine o’clock.