Understanding aged care delivered at home
Ageing in Place is a term used to describe what is arguably the first stage of supported Age Care Services for those beginning to need support to maintain a reasonable lifestyle.
Living at home while ageing has many advantages. A home is full of history and memories, it is close to familiar people—including neighbours and friends. It is often in reasonable proximity to shops and services and, in many cases, it may be the cheapest option regardless of levels of income.
Homes and units can be modified to make them age-care friendly by adding hand rails, ramps and stair lifts, if required. As people age they can be assisted by a range of mobility aids such as walker frames, electric scooters, modified motor vehicles and so on that allows them to stay at home.
The first call for help often comes from family members who notice a decline in health, a loss of memory and deteriorating attention to such things as personal appearance, house cleaning and gardening. In some cases, the person concerned may still be driving and be involved in minor car park or more serious accident.
Where do you start looking for assistance?
There are at least four potential starting points when looking for assistance.
- Healthcare professionals should be able to direct you to the most appropriate local advice and services. The best starting point is usually a doctor who knows the medical and, possibly, the family history. Doctors are in touch with the support services available in the community.
- Local Councils and Shires generally have a Health Care department that provides a range of services including some Aged Care services. The staff in these departments may help you commence stage one of implementing basic support services.
- The Federal Government has a useful website known as My Aged Care which is a good starting point with a huge range of information available.
- Private consultants.
Step one in the process of getting financial support for home care services
The first step involves getting an ACAT assessment. ACAT means an Aged Care Assessment Team (in Victoria it is ACAS—Aged Care Assessment Services). This is a free health assessment by a local ACAT health care worker who may be a nurse, social worker, or other healthcare professional. They visit the person concerned—in their home or unit—and ask questions designed to assess how well they manage their day-to-day lives.
This process results in an ACAT assessment that details the level of care deemed necessary. The assessment may recommend a home-care package, respite care, or permanent residential care. This post focuses on residential care packages only.
Residential Home Care packages are grouped into four levels, with each level providing additional services (and costs). In simple terms the levels are:
- Level 1 – Basic Care Needs
- Level 2 – Low-Level Care Needs
- Level 3 – Intermediate Care Needs
- Level 4 – High-Level Care Needs
The Australian User Rights Principles, 2014, provides a full list of the care, support, and clinical services available on a Home Care Package. The levels become important when determining how much government financial assistance will be available.
Finding a government subsidised residential care service
As noted, there are at least four pathways to getting in touch with Aged Care service providers (health professionals, Council Health Care services, the My Aged Care website, and private consultants).
The services vary from place to place and, as you would expect, the largest range of services are available in capital cities and larger rural towns. The My Aged Care website is a valuable tool that identifies the types of services a person can access in various locations across Australia. Other possible sources of information include: ACAT representatives; advocacy groups such as Older Persons Advocacy Network (OPAN); and Aged Care Placement specialists.
A big challenge is this: how do you assess the quality of services on offer? The best way is to speak with people already receiving residential aged care services about their experience. Also, talk to the professionals who engage with the service providers on a regular basis. Some organisations promise a lot, but, for a variety of reasons do not meet the aged person’s needs.
Understanding the financial implications
The following provides a basic introduction to how a person pays for Residential Aged Care Services. The figures quoted are current at the time of writing and are indexed twice a year (in March and September).
There are two major components to the Daily Care fees, namely:
- The Government Home Care Subsidy (and possible supplements)
- The Recipient’s Contribution
The Government contribution includes various payment rates and subsidies. Special supplements apply to dementia sufferers and some war veterans. The home care subsidy rates are:
|Home Care Package Level||Subsidy Rate Per Day|
The Recipient’s Contribution is made up of two components. The first is a daily-care fee that is calculated at 17.5 per cent of the basic Age Pension rate for a single person (regardless of whether the recipient is an Age pensioner or not). This amount is currently $10.10 per day. The second component is a means-tested daily-care fee, which is calculated by the Department of Human Services (DHS) and based on the recipient’s level of assessable income. Depending on the level of assessable income, the amount of the income-tested care fee may reduce the level of government subsidy and primary supplements provided by the government.
This subject is complex and it may require professional advice including advice from a financial advisor.
This is the second of a series looking at Aged Care in Australia. The next post in this series will focus on the transition to permanent residential aged care in an Aged Care Home.
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.