Aged Care is a complex area and has been a changing landscape over the last few years due to several governmental reforms. Therefore, it is important to be aware of the main concepts of aged care when planning for the future, whether this be for yourself or your loved ones.
As we reach our elderly years there may come a time when we need to consider the prospect of asking for help with regards to looking after ourselves. The help may come from family members and friends as well as through the delivery of aged care services by an aged care service provider.
Aged care services are designed with the aim of meeting your changing needs as you get older and can range from assistance with daily tasks to nursing care whilst still residing in your own home or alternatively in a residential aged care facility.
Care at Home
Being able to live independently in your home as you age may be your preferred choice; however, the reality is that at some point in your life you may need help with things such as personal care, transport, domestic care, meal preparation and nursing care.
When it comes to organising services to help at home, there are several things you will need to consider. For example, the type of service and your eligibility, as well as the cost to you and how to organise the services.
If you require entry-level care to stay living independently in your home for longer, the Australian Government funded Commonwealth Home Support Programme (CHSP) may be able to help.
The aim of the Commonwealth Home Support Programme is to help older people live as independently as possible.
To be deemed eligible for the Commonwealth Home Support Programme, a person will need to:
- Experience trouble doing everyday activities without help; and,
- Need support to live independently in the community.
The person will also need to have a home support assessment. This assessment is conducted by the Regional Assessment Service (RAS) in your home.
The RAS assessor determines whether you meet the relevant eligibility criteria for the Commonwealth Home Support Programme. The criteria is based on minimum age requirements, still living at home and your capacity to perform basic activities in your daily living without the need for extra help.
Minimum age requirements typically require individuals to be either: 65 years and over; 50 years and older, and on a low income, homeless or at risk of homelessness; or, 50 years and over, and identified as an Aboriginal and Torres Strait Islander.
Types of Support
The Commonwealth Home Support Programme can provide services either within the home setting, assisting with social activities within your community, or a combination of both. For example:
Whilst residing at home
- Nursing care – a qualified nurse comes to your home to help, for example, with checking aspects of your health (such as your blood pressure and heart rate), treatments (such as changing wound dressings), and managing your medicines.
- Personal care – help with moving about the house, eating, dressing, bathing and toileting.
- Domestic assistance – help with household jobs like cleaning, dishwashing, clothes washing, ironing and shopping.
- Home maintenance – help with home repairs and garden maintenance.
- Home modification – help with the installation of minor safety aids (such as support rails in your home, as well as ramps).
Social support within the community
- Transport – help with transportation to and from your place of residence for your shopping or appointments with either a transport service, or receipt of vouchers/subsidies for taxi services.
- Social support – help with accessing support groups and social/recreational activities.
- Home or community
- Allied Health support services – help with particular health problems by health professionals such as physiotherapists, podiatrists, speech pathologists, occupational therapists, exercise physiologists and dieticians.
- Food services – help with meals and shopping for food.
Upon being deemed eligible for the Commonwealth Home Support Programme, the RAS assessor will work with you to decide which aged care service providers may suit your relevant needs.
The Government allocates funding to the Commonwealth Home Support Programme; however, you may need to contribute towards the cost of your relevant package if it is deemed that you can afford to do so.
The fees payable for the relevant aged care service (and, your potential eligibility for Government subsidy) are discussed and then agreed upon between you and the aged care service provider; this process is completed prior to the receipt of your aged care services.
An income assessment isn’t required to access the Commonwealth Home Support Programme and the Government’s contributions to the cost of your aged care services will not affect your existing Age Pension entitlements.
Aged Care Services – Residential Aged Care
As you age, you may find that you are unable to continue residing at home due to a variety of reasons. For example, an illness, a disability, an emergency, or because of the needs of your family, friends or carer.
If this situation presents itself, you may still find that you need assistance with personal care, transport, domestic care, meal preparation and nursing care. In this instance, a residential aged care facility may assist you to receive the support that you need to continue living as independently as possible.
The first step when considering moving into a residential aged care facility is to undergo an assessment with an Aged Care Assessment Team (ACAT) or an Aged Care Assessment Service (ACAS) if you reside in Victoria.
An ACAT (or ACAS) assessor can determine and approve your eligibility for a residential aged care facility.
In addition, if you are not deemed eligible for entrance to a residential aged care facility, an ACAT (or ACAS) assessor may be able to suggest other options. For example, you may instead be eligible to receive care at home via either a Commonwealth Home Support Programme or Home Care Package.
Types of Support
When considering residential aged care, there are two types of service offerings, namely, permanent or short-term care (residential respite care). Depending on your needs, staff at a residential aged care facility can help you with:
- Day-to-day tasks, such as cleaning, cooking, dishwashing, clothes washing, ironing.
- Activities of daily living (personal care), such as eating, dressing, bathing, toileting (and, continence), and mobility.
- 24-hour nursing care, such as wound care, monitoring of vitals, administration of medication and catheter care.
- Allied health support service, such as physiotherapists, podiatrists, speech pathologists, occupational therapists, exercise physiologists and dietitians.
Upon the completion of your assessment with ACAT (or ACAS), you will receive a letter detailing whether you have been approved for Government subsidised aged care services; and, what types of services you are eligible for and approved to receive.
As you will be leaving your place of residence and entering a residential aged care facility, it is important to find a place that you are comfortable with.
It may be helpful to organise a visit to several residential aged care facilities so that you are able to gain an understanding of what the accommodation is like as well as the services that each offer.
An ACAT/ACAS assessor will also provide you with information regarding residential aged care facilities (and, the services available in your relevant area), as well as, provide you with assistance in accessing the services you need.
Costs (1 July 2014 Onwards)
The Government subsidises a range of aged care services in Australia, inclusive of residential aged care. However, in much the same way as the Commonwealth Home Support Programme and Home Care Package, you may need to contribute towards the cost of your residential aged care if it is deemed that you can afford to do so.
To determine your aged care service costs you will need to undergo an income and assets assessment conducted by the Department of Human Services.
In addition, before you enter a residential aged care facility, you will need to negotiate an agreement with your relevant aged care service provider. This agreement will outline the services offered by the aged care service provider, the fees payable for the services, as well as your rights and responsibilities as a resident.
When entering a residential aged care facility, there are several fees that you may be asked to pay:
- A basic daily care fee of up to 85% of the single person rate of the Age Pension. This fee applies to each individual entering a residential aged care facility, regardless of whether you are a member of a couple or not. From 1 January 2019, the basic daily care fee is $50.66 per day (residents in designated remote areas may be asked to pay an additional $1.06 per day).
- A means-tested care fee. This is an additional fee payable dependent upon an assessment of your existing income and assets. There are annual and lifetime limits, indexed each year, on the amount of means-tested care fee you may be asked to pay; upon reaching these caps you cannot be asked to pay any additional amount. The limits are as follows:
- The annual cap on the means-tested care fee is $27,232.33 (as at 1 January 2019).
- The lifetime cap on the means-tested care fee is $65,357.65 (as at 1 January 2019).
- An accommodation fee. This is another fee that helps to take care of the costs associated with having you stay within a residential aged care facility. Again, the amount you can be asked to pay will be dependent upon an assessment of your income and assets. You can choose to pay your accommodation fee by one of the following three options: lump-sum style ‘refundable accommodation deposit’ (RAD); rental-type payments called a ‘daily accommodation payment’ (DAP); or, a combination of both.
- Fees for extra or other additional care and services may apply if you choose a higher standard of accommodation or additional services.
The Department of Human Services will inform you of your maximum basic daily fee, as well as your means-tested care fee and accommodation fee.
If you entered into a residential aged care facility prior to 1 July 2014, the new fee arrangements will not apply to you. However, if you leave your residential aged care facility for more than 28 days, the new fee arrangement will apply if re-enter a residential aged care facility.
Furthermore, the new fee arrangements will also apply if you change the type of care you receive, for example, if you cease a Home Care Package and enter into a residential aged care facility.
Residential Aged Care Agreements
Before entering a residential aged care facility, you may need to formalise your relationship with your aged care service provider. Depending on the residential aged care facility, you may be presented with the following:
- Two individual agreement documents – Residential Agreement (every residential aged care service recipient) and Accommodation Agreement (in the event you are required to contribute to the cost of your accommodation).
- One agreement document that incorporates the Residential Agreement and Accommodation Agreement.
The Residential Agreement is a legal document between you and the aged care service provider that outlines the following:
- The name of the residential aged care facility providing the aged care services.
- The costs that you will be required to pay and how these have been calculated according to the aged care service providers policies and procedures.
- The services that will be provided, as well as any extra services agreed upon (and, their relevant costs).
- Rights and responsibilities – as governed under the Charter of Care Recipients’ Rights and Responsibilities – Residential Care.
- Your rights and responsibilities as a resident of the residential aged care facility. In addition to this, are circumstances in which you make be asked to leave the residential aged care facility e.g. non-payment of your relevant costs.
- The aged care service provider’s rights and responsibilities.
- Any other agreements that have been made between you and the aged care service provider that are pursuant to the Aged Care Act 1997.
There is no time limit or requirement to sign the Residential Agreement; however, it may be important to consider having the abovementioned points formalised in a signed legal document.
It is important to seek professional advice to understand both the contents and implications of signing any legal document.