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Transitioning to aged care in 2022 and understanding the services available for older Australians

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Attwood Marshall Lawyers Senior Associate and Accredited Aged Care Professional, Debbie Sage, recently joined Robyn Hyland on Radio 4CRB to discuss the important topic of transitioning into aged care and what you need to consider if you or a loved one will be making that move in 2022.

Introduction

Transitioning to aged care is all about that next phase for older Australians when they can no longer live independently or if they need some extra help to stay in their home comfortably and safely.  

As 2022 begins, the aged care industry will continue to experience increasing demand. With reforms underway off the back of the Royal Commission into Aged Care Quality and Safety, this year should hopefully see increasing quality requirements and a tighter workforce starting to take shape, although it is still in its infancy and there is the ongoing issue with Covid-19 related staff shortages. Although these changes are likely to increase the cost of care for those entering a residential aged care facility, it is expected that there will be a significant shift away from resource-intensive residential care towards home care as more Home Care Packages become available and a greater focus is put on redesigning a new Support at Home’ Program for the future.

What to consider when transitioning to aged care

Conversations about requiring additional support and transitioning to aged care can be a challenging and extremely sensitive issue to raise with a loved one.  It can also be just as hard for older people to let their family or friends know they aren’t coping as well at home anymore and to ask for support. Many older Australians have fears about being put into an aged care facility and avoid asking for more assistance for this reason, without exploring other aged care services such as Home Care Packages, which may be better suited for their needs and help them remain at home for longer. Maintaining good communicationwith your loved ones and having an open and honest discussion can make this process so much easier for everyone, particularly the person who is going through the transition.

There is a wide range of accommodation and care options in the aged care space, so planning early and getting the right advice is crucial. By planning, it can help you be clear about what you want and what is most important to you.  It also allows you to have the opportunity to have your say.  Whenever possible, you want to avoid making decisions about aged care at the last minute, which usually occurs due to an unexpected injury or illness. If you leave it too late, you may lose the opportunity to have a voice in the process.

Whether you are planning early or not, one of the first essential steps is to identify and understand the level of care that you currently need. The best way to identify this is to get an assessment with the Aged Care Assessment Team [JG2] (referred to as an ACAT assessment).  The ACAT assessment will determine your care needs and confirm what services you can utilise. If you have already had an assessment before, you may need to request another assessment if it has been over a year and/or you or your loved ones feel that your needs have changed.

ACAT assessments and how they work

An ACAT assessment is an at-home or in-hospital assessment arranged with the Aged Care Assessment Team through MyAgedCare.  This assessment will work out how much help you need, what types of care are available to you and other services that you may be eligible for.

The process follows clear guidelines. The person being assessed is given the opportunity to express their views and thoughts throughout the process.  No one is forced to make any decisions when the assessment is being made, and a friend or a relative can be present during the process. 

The assessment usually takes anywhere from 45-75 minutes to complete.  The assessor usually explains the different kinds of service options available, and they can help answer any questions the person might have about the process and those options.

It is a relatively straightforward process, however, it is important to be aware that it may take weeks, sometimes months, to get this assessment done during busy times.  So, to take the first step, call My Aged Care, and they will guide you through the process over the phone, or alternatively, your doctor can send through a referral for an assessment to be done if required on your behalf.

A helping hand at home – applying for home care services

As the name suggests, home care refers to services provided in your home.  Home care is usually the first step in accessing aged care services because most people prefer to remain living at home for as long as possible. As people age, they may need a little bit of help from time to time, and that help will gradually increase over time.

There are two types of government-funded home care services for people still living at home:  The first one is the Commonwealth Home Support Program, and it is commonly known as the entry-level home help. This service also provides respite services to relieve carers.

The services in this program include social support, transport, help with domestic chores, personal care, home maintenance, home modifications, nursing care, meals, and allied health services.  Clients contribute towards the cost of these services, and the providers will receive funding from the Australian Government through grant agreements.

This program is known for providing small amounts of support to many people and is not means-tested. That means your income and assets will not affect your eligibility to receive this type of home support service.  However, to access the program, you need to contact MyAgedCare, and they will step you through the process after the ACAT assessment.

The second type of government-funded home care service currently available is the Home Care Packages Program (HCP). HCP is a more comprehensive service offering coordinated packages of care from approved home care provider/s.  This program is often for people who need more than what the Commonwealth Home Support Program can offer by providing ongoing personal and support services and clinical care.

Each package is customised to meet the individual’s care needs.  However, clients in this program must contribute to the cost of their care.  Their provider can ask anyone receiving a Home Care Package to pay a basic daily fee which works out to be around 17.5% of the single basic age pension.  

This service is means-tested, so that means pensioners, part pensioners, self-funded retirees can also be asked to pay what’s called an income-tested fee.  The fee will depend on the individual’s income and assets and is subject to annual and lifetime caps.

There are four levels of Home Care Packages available, ranging from level 1 (which supports people with basic or low care needs) to level 4 (which supports people with very high care needs).

What level package you receive will depend on what you are eligible for after you complete the ACAT Assessment process. Many people think these home care services are just to access services, however you can also access funding for equipment aids, home modifications, respite services, home and garden maintenance, and social activities through the Home Care Package.

Home care can also be accessed through private care services, which means you do not necessarily have to go through the ACAT assessment process. If an individual wishes to take responsibility for the total costs of the care services they receive, they can choose to receive home care services through a private care provider.  

In response to the final report of the Royal Commission into Aged Care Quality and Safety, the Australian Government is working on creating a single “Support at Home” Program to replace the Commonwealth Home Support Programme (CHSP), the Home Care Packages (HCP) Program, Short-Term Restorative Care Programme (STRC), and residential respite programs which is expected to come into place in July 2023.

Home care waitlist

Unfortunately, there’s a growing waitlist for home care packages.  Some reports say that up to 130,000 people are on the national queue waiting for a home care package or an upgrade to a higher-level package to be allocated to them.

MyAgedCare is currently stating that the wait times, based on people with a medium priority, are estimated to be 3-6 months for a Level 1 and 6-9 months for Level 2 to Level 4.  The Australian Government has acknowledged how this waitlist is impacting the elderly and to respond to the growing demand for home care and unacceptable wait times, the Government has pledged that 80,000 new packages will be issued by 2023, including 12,000 level 4 high care packages.  This forms part of the government’s $18 billion response to the aged care royal commission.

Despite that extra budget boost, there is still concern that this will not be enough to clear the current backlog.  We are hopeful that the Government continues to honour its commitment to reform the aged care sector because this will allow more Australians to access home care packages sooner rather than later.  It remains to be seen whether this will happen, with a federal election looming in the first half of 2022 and Covid-19 cases exploding with the ‘opening up’ of the country.

Transitioning to residential aged care

Making the move into residential aged care can be an extremely difficult decision and a daunting process. Every aged care facility is different, so it is essential to do your homework.  Before making the move into an approved residential aged care, an ACAT assessment will be required.

The main things to consider when choosing an aged care facility are the costs involved and what you can afford.  Each aged care facility sets its own prices for the room (accommodation costs) within a prescribed limit (currently up to $550,000 or the equivalent daily amount unless itis otherwise approved by the Minister for Health & Aged Care).  In addition to accommodation costs, you must also pay for the cost of your care (care fees).

Residential aged care is funded by the Australian Government and contributions from their residents.  The Australian Government pays subsidies and supplements to approved providers for each resident,  however the resident must also contribute to the cost of their care and accommodation if they can afford to, so it is essential to get proper advice from an aged care accredited professional, to determine your affordability and what options are best for your circumstances.

Tips to determining the best aged care solution for you

Tip 1: Ensure that your legal documents are updated (i.e. your Will, Enduring Power of Attorney and Advance Health Directive) well before going into a residential aged care facility and make sure this is done with lawyers who are experienced in this complex area.  It is usually a requirement for aged care facilities to obtain a copy of your Enduring Power of Attorney and Advance Health Directive before you enter. Many people have not done a Will or updated it for a long time – it is very important to get these estate planning issues sorted so that your family and loved ones know your wishes. If you lose mental capacity or suffer a stroke, it is important that you have trusted attorneys to step into your shoes and handle your affairs. Likewise, if you die, you need to know your Executors will take care of your estate and carry out your wishes.

Tip 2: Have an open and honest discussion with your loved ones.  Make your preferences loud and clear. Discuss your preferences about the type of care you would want to receive, if you want to remain in your home for as long as possible, and if you do have to make the move to a residential aged care facility, which location you would like to live in. Some people may prefer to move to a facility closer to their loved ones so that they can visit more easily and keep the facility accountable. Alternatively, others may choose to move to a facility where they already have friends or family who reside there. It is important to have confidence in the people who may have to make aged care decisions for you in the event you cannot make these decisions for yourself in the future. Communication is key.

Tip 3:  Do your homework.  Take the time to visit the local aged care facilities or other aged care facilities you may wish to consider moving into.  Take a tour, ask lots of questions, find out everything you need to know to make an informed decision. Make a list of your top five facilities so if somebody else must make this decision for you down the track, it gives them a starting point, and they can see what kind of facilities you like and where they are located.

Tip 4: Get trusted legal and financial advice from experienced aged care professionals who practice in this complex area.  You want to make sure that your estate plan supports your aged care objective and that you can plan for your future and have peace of mind in knowing that your affairs are in order and everything is going to go smoothly.

Attwood Marshall Lawyers – helping you through every stage of life

It can be overwhelming navigating all the options available for your transition to aged care and knowing what is suitable for you; there is a lot to consider!  Therefore, it is essential to discuss your preferences and needs and prepare for the future if you can.  By obtaining advice from an experienced and accredited aged care professional, you can make an informed decision and obtain valuable information about the aged care industry, and the financial, legal, and medical decisions you may need to make.

Attwood Marshall Lawyers have helped their clients navigate the complex aged care industry for many years and our team is passionate about ensuring people make an informed choice about the care they receive and the living arrangements they want for themselves as they get older.   

For enquiries regarding transitioning to aged care, service agreements, or estate planning advice, please contact Wills and Estates Department Manager, Donna Tolley, on direct line: 07 5506 8241 | email: dtolley@attwoodmarshall.com.au | free call: 1800 621 071.  In addition, we provide a free initial telephone consultation.  Call our office today!

Read more:

Part 1: Transitioning to aged care – it’s important to plan for the future

Part 2: Transitioning to aged care – what to expect when entering a residential aged care facility

Aged care sector receives good budget news

Planning for the future as you get older – Retirement Villages and Aged Care

 

 

 

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Debbie Sage - Wills and Estates Senior Associate

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