The potential need for aged care can be a difficult and emotionally charged topic to discuss with your loved ones. It’s always best to plan ahead, do your homework, and make an informed choice. Everyone’s circumstances and preferences are different as you get older. Attwood Marshall Lawyers Wills and Estates Senior Associate and Accredited Aged Care Professional, Debbie Sage, discusses what to consider when transitioning to aged care.
Aged Care is a topic that many people do not like to discuss, particularly the person who most needs it! Some people feel that it is simply too soon to think about it, or they do not intend on ever going into an aged care facility, however it is important for everyone to understand what options are available and consider their potential future care needs as they enter the latter years of their life.
It is also a difficult decision for family members, who only want to support and do the best thing for their parent, grandparent, or spouse. The thought of your loved one going into care creates all sorts of fears and guilt for not looking after them. However, when the health and safety of your family member or friend is in danger due to their physical and/or mental condition deteriorating, it’s time to accept the inevitable and investigate available options. Sometimes this can be very challenging due to the onset of dementia or a dramatic change in their physical capabilities due to an illness or injury.
There are many different options available today when transitioning to aged care, including the option to remain in your own home for as long as possible. There are some key things you can do to take a proactive approach to plan for your future needs so you can be better prepared when transitioning to aged care, or to assist a friend or loved one who may be going through this process.
What does it mean to “transition to aged care”?
Transitioning to aged care is about that next phase for older Australians when they require additional help to be able to stay in their home, or if they can no longer live independently.
When people hear the words “aged care”, they tend to automatically think about nursing homes or residential aged care facilities – however “aged care” encompasses both these types of services as well as ongoing support at home through government-subsidised programs.
The percent of Australians aged 65 and over in 2017-2018 who required aged care included:
- 7% who accessed residential aged care
- 22% who accessed some form of support or care at home
It is important to be proactive about the next phase of your life as you age, so that you have the opportunity to have your say about how you want to live your life and what services you want to take advantage of. This will give you the best possible outcome instead of leaving these decisions up to someone else if you become unwell or lose capacity to make your own decisions.
Home Care – staying in your own home longer
“Home Care”, as the name suggests, refers to services provided to you in your home.
Home Care is usually the first step in accessing aged care services. Most people prefer to remain at home for as long as possible. Sometimes, people just need a little extra help from time to time and the help may gradually increase over time.
There are two types of government-funded home care services available:
This program is the largest aged care program with approximately 783,000 clients enrolled during 2017-2018. This is an entry level support at home program, which also extends to respite care services to help provide relief for carers.
Services in this program include social support, transport, help with domestic chores, personal care, home maintenance, home modifications, nursing care, preparing meals and allied health services such as podiatry or physiotherapy.
Clients pay a contribution toward the cost of these services and the providers receive Australian Government funding through grant agreements.
The Commonwealth Home Support Programme is not means tested which means your income and assets will not affect your eligibility to access these services.
- The individual must be aged 65 years or older (50 years or older for Aboriginal or Torres Strait Islander people), or
- 50 years or older (45 years or older for Aboriginal or Torres Strait Islander people) and on a low income, homeless or at risk of being homeless.
To access this program, you need to contact MyAgedCare and they will walk you through the entire process.
- Home Care Packages Programme (HCP)
Home Care Packages are designed for those that need a coordinated approach to the delivery of help in their home. This is a more comprehensive service where the program offers care packages from an approved home care provider. This program is usually for people who need more than what the CHSP can offer by providing ongoing personal and support services as well as clinical care.
There are 4 different levels of Home Care Packages available to provide basic support through to high care. The required package will depend on the individual’s circumstances. The main service categories include:
- Services focussed on keeping you well and independent offering personal care, nursing and allied health.
- Services to help keep you safe including cleaning, home maintenance and modifications and assistive technology.
- Services to keep you connected to your community including transport and social support services.
Clients in this program are expected to contribute to the cost of their care. Anyone receiving a HCP can be asked by their provider to pay the basic daily fee, which works out to be approximately 17.5% of the single basic age pension.
This service is means tested. Pensioners, part pensioners and self-funded retirees can also be asked to pay what’s called an income-tested fee (depending on their level of income and assets) which is subject to annual and lifetime caps.
Which package level you receive will depend on what your eligibility is after undergoing an ACAT Assessment through the Aged Care Assessment Team with MyAgedCare.
How does an ACAT assessment work?
An ACAT Assessment is an at-home or in-hospital assessment arranged by the ACAT team. The assessment is designed to work out how much help you need and what types of care or other services you may be eligible for.
The process follows clear guidelines. You will be able to express your own views and thoughts during the assessment – you can be assured that you will be listened to as this is an important part of the process.
You won’t be forced to make any decisions at the time of the assessment and you can also choose to have a friend or relative with you when you take part in the ACAT assessment.
If you require an interpreter, you can request for one to attend the assessment with you.
In most instances, there is 1 member of the ACAT team that completes the assessment and it can take anywhere from 45-75 minutes to complete.
The ACAT team member will explain the different types of service options available, and they will be able to answer any questions you may have about the process and your options.
Calling My Aged Care is the first step. The friendly team will guide you through the process over the phone. Your doctor can also send through a referral for an assessment to be done if required.
Residential aged care – how does it work?
Residential aged care is the next option that you may need to consider if you can no longer live at home.
Entering a residential aged care facility can be a difficult decision. Each aged care home is different, so it is important to choose the one that best suits you.
Just like Home Care Packages, an ACAT assessment will be required before you can enter into an approved residential aged care facility.
Residential aged care is provided in aged care homes on either a permanent basis or respite (meaning short term) basis.
- personal care such as help with bathing, eating, taking medications, etc.
- nursing care;
- some allied health services.
The Australian Government pays subsidies and supplements to approved aged care providers for each resident. The resident also pays fees to contribute to the cost of their care and accommodation.
In order for aged care homes to obtain funding from the Australian Government, they must meet Aged Care Quality Standards, ensuring quality care and services are provided.
Each aged care home sets their own prices within a prescribed limit, so costs will vary depending on the home you choose and an assessment of your income and assets.
A proactive approach to transitioning to aged care
We believe in advocating for independence and the freedom to make your own decisions (as long as you are capable of doing so). At Attwood Marshall Lawyers we ensure our clients know as much information as possible to be able to make a choice they are comfortable with. It is all about making choices that are in your best interests.
Nobody should be making these important decisions for you, unless you are no longer able to make the decision for yourself. Preparation is key, and by preparing as early as possible, you can choose your own living arrangements and the care options available that align with your preferences and needs.
What to consider if you want to have control over your aged care preferences
If you want to remain at home for as long as possible and consider moving into an aged care facility as a last resort in the event you are no longer capable of living safely at home, there are some key steps you can take now.
- Review your Enduring Power of Attorney (Qld) and/or Appointment of Enduring Guardian (NSW) documents as soon as possible. This will help you ensure your preferences are clearly outlined in your document. Your attorney/guardian needs to be aware of this condition and be authorised to use your resources to keep you at home for as long as possible if that is what you would prefer. In some cases, your attorney/guardian may need to spend some of your money to renovate your home or engage further assistance at home through HCPs to ensure you are capable of living at home safely.
- Speak to your family and loved ones and make your preferences clear.
If you are considering moving into a residential aged care facility, you should consider:
- If you want to remain in your current area, or if you would like to move closer to family or friends;
- Adding instructions to your Enduring Power of Attorney or Appointment of Enduring Guardian to include your location preferences or specific facilities you would like to be considered. Many people choose to live closer to their children or relatives so that they can keep an eye on them, visit regularly and keep the facility accountable.
- You may choose to go into the same facility as a friend;
- Visit any facilities and inspect the premises – it is never too soon to do this! By inspecting a facility, you can get a feeling for what it may be like to live there.
- Try before you buy – get some respite if you need it! Your ACAT assessment will tell you whether you are eligible for respite which means you are entitled to 63 days of subsidised care in a facility if you need it. This is a great opportunity to get hands-on experience living in a facility for a short period of time to see if you would like to live there long-term.
Helping you through every stage of life
It can be overwhelming when navigating all the options available for your transition to aged care and knowing what is right for you; there is a lot to consider! It is important to discuss your preferences and needs and plan for the future. By speaking to an experienced and accredited aged care professional, you can gain valuable insight into the aged care industry, as well as the financial, legal and medical decisions you need to make.
As a leading elder law firm, Attwood Marshall Lawyers believe in supporting you through all stages of life. By obtaining the right advice, we can help you prepare for your future and have peace of mind in knowing that you can have your say about the care you may receive, and where you want to live. We can also help with your future medical treatment wishes.