Change and Choice: Navigating the aged care phase
Beginning the transition
Beginning a new phase of life will come with new challenges, navigating the new complexity then become a key priority is managing ones affairs.
On embarking the assisted living journey, those who seek aged care living arrangements need to sit with a member from the Aged Care Assessment team (ACAT). A referral to an ACAT is required to adequately assess the health assistance provisions necessary for the next step into assisted living.
Any related party to the applicant may lodge an assessment on their behalf so long as long as they have a legitimate interest in the provision of care. The assessment is free and will provide information relating to an individual’s choices for aged care living, usually detailed in the post assessment letter. This will determine the eligibility for government subsidised aged care.
Types of Aged Care
The Governments Department of Social Services website, myaged care, is a good resource that explores the functions of aged care. Myaged care can shed light on the following areas:
- The types of aged care services,
- Eligibility for the services,
- Unique needs of residents,
- Connections with local services that can meet specific needs; and
- Understanding the costs associated with aged care.
The different types of Aged care are:
- Staying in your home,
- Care in an aged home,
- After hospital care (transition-care); and
- Taking a break from care (respite care).
The following will detail the entry points and features of each unique level of aged care service. Fee subsidies are provided by the commonwealth for all aside respite care, however there are Consumer Directed Respite Care (CDRC) sponsored by the Commonwealth Home Support Programme.
There are services that allow for elderly people to reside in their own home. There are many services available and not limited to, help with housework, maintenance/modifications to your home and nursing care. There are four levels of care needs from basic to high level care. The government provides for many recipients via the Commonwealth Home Support Programme, with over 500,000 recipients.
Residence in an aged care home is another option for those who may require 24 hour access to care professionals. Some of these services include building and ground maintenance, cleaning services and day to day living activities. Aids are also provided to residence such as oxygen tanks and walking frames. This is a different form of facility from private retirement villages. Given the array of care facilities, it is very important that individuals match themselves well with an aged care facility that accommodates their needs.
After-hospital care (transition care) is essentially a short term, post hospital recuperation service. This service may be provided in a ‘live-in’ setting or at their own home. The features of such accommodation are, having access to a social worker, nursing support for wound care and low intensity therapy such as physiotherapy. The individual receiving care will be expected to contribute to the cost. However, if you are an old age pensioner receiving residential care services and paying the maximum daily fee, you cannot be charged the same amount for the transition care service. The maximum period of service is 12 weeks, unless additional care is assessed as necessary, in which case an extension of six weeks may be granted.
Respite care is the support mechanism for carers. This facility allows carers to enjoy time off from their care duties and enjoy everyday activities and holidays not viable when in their care giving capacity. This is enabled by the recipient of care being provided for in their usual carers’ absence. Respite care can be given informally by familiar connections or formally by respite care services. The length of time for the support varies according to the need; however, respite care exists for as little as a few hours. These services may help a carer enter/re-enter the workforce. Some of the Commonwealth supported respite services are, in-home respite, overnight or weekend respite and community access respite.
Commonwealth Home Support Program
The Commonwealth Home Support Program (CHSP) amalgamates the Commonwealth Home and Community Care (HACC) Programme, National Respite for Carers Programme, Day Therapy centres and Assistance with Care and Housing for the Aged.
The programme is catered for those who require some level of care but not totally reliant on other for their primary needs. For those who require support in their home a home support assessment is required to be conducted by the Regional assessment Service (RAS). Carers are also provided some respite care by the Commonwealth home support program.
The CHSP offers a range of services such as community based services for transport and social support. While in home services include domestic assistance, home maintenance and nursing care.
The three qualifiers to the CHSP are listed below; if all of these criteria are met my aged care contact centre should be engaged:
- 65 years or older (50 for Aboriginal and/or Torres Strait Islander)
- Living at home
- Help required to live independently
Costs
There are different types of costs and subsidy rates associated with aged care services. The two costs are for home support services & home care packages
For those who receive the CHSP there will be a requirement to contribute a portion of the cost of the service which varies depending on the service provided.
Home care package service providers may ask for a basic daily fee and/or an income-tested fee. The maximum basic daily fee is up to 17.5% of the single basic aged pension which (as at September 2015) is $137.76 per person per fortnight. The aged pension is indexed on the 20th of March and 20th of September every year to take inflation into consideration.
The income-tested care fee is the assessment of contributions to care services relative to income, in a couple scenario, the total income is split in half regardless of which person is the breadwinner. The assessment does not consider the value of the home. The thresholds for the income-tested fee are:
Financial Tools
There are a number of resources available to help decide which aged care option is best suited in a particular financial circumstance. The Department of Human Services offers a free Financial Information Services to help manage one’s personal finances. The Australian Securities and Investments Commission also offer tips and tools through their MoneySmart website. MoneySmart features over 55s considerations, budget tools, retirement planning and reverse mortgages included in a large base of information for people to better understand financial products and strategies to manage personal financial affairs.
Financial counsellors offer free services to individuals who are under financial strain, able to negotiate with creditors, organise finances and create a budget.
Financial advisors can provide a tailored outcome to retirement planning. Adviser’s qualifications and experience can be searched on ASICs MoneySmart website on the financial advisers register. One strategy that may be recommended is a home equity release. This strategy allows for the utilisation of the equity in the home to fund residential care. The two different forms of home equity releases are reverse mortgage and home reversion schemes. Again, ASICs MoneySmart website provides the information to enable a better understanding of these strategies.
Avoiding trial and error
Unfortunately there are cost in identifying the most suitable aged care service including time, effort and commitment. Thus, one cannot take a spoonful from each bowl and is essentially flying blind. This is a view well understood by the government and the reason for the ACAT assessment. The ACAT assessment is a vital component in matching the service offering to the needs of the individual, avoiding the incursion of the costs mentioned above through a trial and error experimentation process.