Transitioning from home care to Residential Aged Care—Part 1
This is the first of a two-part series on Residential Aged Care in Australia and takes an overview of the situation. The second looks at costs.
Most people prefer to stay in their family home as they age and more are accessing home-care packages to help them achieve this. Over time though, a person’s health may decline to where they need greater care. In some cases, people can access respite care, which is a short-term solution offering support to the person and, possibly, their carer or carers.
This post focuses on the considerations in play when making the decision to move someone into Residential Aged Care. There are two issues to be aware of when entering the aged-care arena for the first time.
- Changes are taking place at a rapid rate and change is built into the way a person’s income and assets are assessed every six months. There are groups of people caught under ‘old rules’ and a very different set of ‘new rules’.
- The costs associated with Residential Aged Care are high and rising. Prices are going up mainly because supply isn’t keeping up with demand.
The decision to seek care is a complex one and can involve various people including the individual concerned, a spouse or de-facto spouse, one or more children, a person holding a Power of Attorney and, possibly, a relative living nearby.
Many families aren’t prepared to move a loved one into a Residential Aged Care home. Families and individuals that have given it serious consideration may give one or more people Powers of Attorney, special provisions in their will(s) and specific instruction about how they should be cared for, by completing a document known as an Advanced Care Directive.
It is better to arrange these matters when the person concerned is fit, well, and rational.
A lot of emotion can be involved in these decisions, and time may be of the essence. It’s always advisable to speak to people who have been through a similar experience, and to people living in a Residential Aged Care facility.
It’s also advisable to seek advice from the doctor who has been treating the person concerned and to ask about their knowledge of the services and facilities available in the local area.
Care considerations can be listed in three major categories:
- Issues peculiar to the individual, their physical and mental health, their existing levels of support and the potential for changes in the future.
- The availability of Residential Aged Care facilities in the immediate area or in areas close to family and friends.
- Questions of how the person will arrange their financial and legal affairs to cover daily care and accommodation fees, and who they will turn to for advice on legal contracts involved.
The mental and physical health of the individual
As people age, they may accumulate disabilities—physical or mental, or a combination of both. Unfortunately, as Karen Hitchcock points out in Dear Life—On Caring for The Elderly, hospitals aren’t for the elderly. She quotes a Melbourne geriatrician who states that the elderly are ‘unwanted, unwelcome and undeserving’ in emergency departments of a hospital.
There are ethical, fiscal and humanitarian reasons why a hospital is no place to care for the elderly. Some doctors seem to view old patients as a different species of human, unrelated to their young selves.
There comes a time when some will need an extra level of care that family and friends are unable to provide on a consistent basis. This could be due to failing eyesight, falls, repeated bouts of illness, loss of memory, dementia, slurred speech, and other problems. Sometimes these problems aren’t noticeable or even purposely concealed.
Everyone entering a Residential Aged Care home must have an ACAS (Aged Care Assessment Services) assessment. This can be organised by calling My Aged Care on 1800 200 422. Additional information is also available on the My Aged Care website. The logical starting point is the doctor who knows the person involved.
Searching for a suitable Residential Aged Care home
Across Australia, Residential Aged Care availability is patchy, and the number of rooms available may be limited. Capital cities have the largest number of Residential Aged Care homes but most are close to, or at, capacity.
Rural Residential Aged Care homes may be an option for some, especially those close to transport and within a one- to two-hour drive from family and friends. Anecdotal evidence suggests that some rural facilities have a more homely-feel and the staff tend to live locally and know the area.
In most cases, the facility is run as a profit-making concern with tight controls on costs and staff levels. Inside these facilities, residents are placed in ‘communities’ based on their medical and mental condition. Groupings might include those who are high functioning; those who have low mobility; and those suffering from dementia. Big operators can have more than 60 homes spread across Australia.
One of the big challenges faced by those who move into a Residential Aged Care home is loneliness. Some will mingle easily with others, but others don’t. Some families do a great job of visiting their loved ones and keeping in touch by phone or social media. Others can’t or won’t.
Unfortunately, many are left alone and can be surrounded by people who do have close family connections, which can make them feel left out. Some facilities do allow pets, which can make a difference to those feeling isolated.
Those who have lived in an area for many years will be aware of the location of existing Residential Aged Care facilities, and may already have friends living in them. An internet search can be a useful way of finding existing or planned facilities.
After locating possible Residential Aged Care facilities, it’s important to visit them and talk to the manager, the staff and, if possible, residents. Decisions about a home will come down to an assessment of the facilities, the staff, the location, the range of services available, and the cost.
The following contain useful information:
Five Steps to Entry into an Aged Care Home is a publication available on the Department of Human Services website.
Retirement and Aged Care Planning is a book published by Thomson Reuters.
Part two of this post looks at the cost of Residential Aged Care homes. It can be found here.
Owen Weeks is director and authorised representative of Lifestyle Matters Pty Ltd and a Registered Tax Agent. He is a Fellow of the Financial Planning Association, a Fellow of the Institute of Professional Accountants, and an Honorary Fellow of the Association of Superannuation Funds of Australia. He is also the co-author of Retire Bizzi.