Guide to aged care at home

As we get older, most of us want to remain independent and in our own home for as long as possible, but this can be challenging without some help with household tasks and personal care.

Recognising this, the government runs a Home Care Packages program where approved aged care service providers work with individuals to deliver co-ordinated services at home.

Approval for a Home Care Package starts with an assessment by the Aged Care Assessment Team (ACAT). Eligibility for a Home Care Package, or other government subsidised help at home, is based on your care needs as determined through the assessment. You must also be an older person who needs co-ordinated services to help them stay at home or a younger person with a disability, dementia, or other care needs not met through other specialist services.

You can make your own referral via the government’s My Aged Care website or by calling 1800 200 422 and answering some questions.

Financial eligibility

Your financial situation won’t affect your eligibility. But once you have been assigned a package, you will need a financial assessment to work out exactly how much you may be asked to contribute.

There are four levels of Home Care Packages – from Level 1 for basic care needs to Level 4 for high care needs.

The annual budgets for the packages are (in round figures) $9,000 for a Level 1, $16,000 for a Level 2, $35,000 for a Level 3 and $53,000 for a Level 4. The government contribution changes on 1 July each year.

The idea is that a person, using a consumer directed care approach, can decide how they would like to use that money for help which may include equipment such as a walker or services such as household tasks, personal care, or allied health.

Your contribution could be a basic daily fee up to $11.26 a day, as well as an income tested fee up to $32.30 a day or $11,759.74 a year.i These fees are adjusted in March and September each year.

Expect a wait

Demand for packages is high, with a wait of 3-6 months for a low-level package and 6-9 months for a higher level package. It’s not unusual to be approved for a high-level package but be offered or ‘assigned’ a lower level package as an interim measure.

Once approved for a Home Care Package, you must appoint a provider approved by the government, whose role is to administer, and manage the package for you.

The provider will charge a fee for their services which is deducted from the Home Care Package. This essentially reduces the amount of money from the package that can be spent on services. Administration costs can be 10-15 per cent of the package and case management another 10 per cent, or thereabouts.

The services offered and the way they are delivered can vary between providers, so comparing offers is important.

How much help you get from a package will depend on your care needs and fees, but generally a Level 1 package might provide two or three hours of help a week, a Level 2 about four hours, a Level 3 package about 8 hours and a Level 4 about 12 hours.

A recent Fair Work Commission ruling mandating minimum two-hour shifts for casual home care workers, while improving conditions for low-paid workers, is also expected to lead to increased costs for providers and ultimately Home Care Package recipients.

Self-managed home care

One way to get more hours of help and have a greater say in who delivers it, is to self-manage your Home Care Package. As well as saving the case management fee you can generally negotiate directly with workers the hours worked and the rate of pay.

You still need an approved provider to administer the package, with the fee being about 10-15 per cent.

There are currently five providers offering a self-managed option. One way to find support workers to assist with your care needs is through one of several online platforms where carers register their willingness to help, along with their hourly rates.

If you are weighing up your aged care options for yourself or a loved one, and would like to discuss financing arrangements, please get in touch.

i https://www.myagedcare.gov.au/home-care-package-costs-and-fees

When do I start the aged care conversation?

No-one likes to talk about getting old. But at what age should you start thinking about your aged care needs? The answer is simple - any age is a good time. This is regardless of whether you are in your early retirement years or well into retirement.

 

If you are lucky enough to still have your parents, starting the conversation with them while they are still healthy is also sensible. They might not be thrilled that you’re raising the subject but it gives your parents an opportunity to think about what is important to them and give you some instructions, so you have something to guide you if you need to make choices for them in the future.

Don’t accidentally fall into either of these traps:

  1. Leaving it too late to have the conversation - once Mum or Dad can’t return home from the hospital, you’re in crisis mode. This is not the best time to be making life-changing decisions for anyone.
  2. Thinking it will never happen - unfortunately the statistics say otherwise. On average, we can expect to live 17-25% of our retirement with a profound disability that may threaten our ability to live independently without care support. With those odds, you at least want to have a quality conversation about the options for aged care and importantly, how you would pay for it.

 

How to find some help

Making an informed decision about aged care is incredibly important. Making the wrong decision can have far-reaching consequences for the whole family. When aged care decisions go badly, the stress can lead to family conflicts.

However, not all advice is good advice. Aged care financial advice is a specialist area. The rules change constantly, as do the available strategies. You don’t need extra stress wondering if you’ve received quality advice.

 

At PRP Advisers we specialise in aged care advice and have the experience to help you to plan for current or future needs. Call us today on 02 4266 1233.

Retirement Villages vs. Residential Care

Why retirement villages and aged care are not substitutes

As adults we make choices about where we want to live, with decisions driven by lifestyle, work or family. However, as we get older these choices start to be impacted by health or increasing levels of frailty. And this may necessitate a change.

In our frailty years, where we live is not just a decision about physical location, it needs to give consideration to the access of care and support.

Homes come in a variety of shapes, styles, and legal structures. Planning ahead of time and researching the options are both critical to making a well-informed decision. It is important to understand what is affordable as well as how your daily routine can be managed.

 

Accommodation versus care

Older people needing access to greater levels of support may compare retirement villages against residential aged care services and view them as substitutes. While both provide supportive environments for older people, it is incorrect to view them as substitutes.

The error comes from using the normal property comparisons of price and size. For example, people may see that in a retirement village they have access to a whole unit or villa while for a similar price in a residential aged care service, they have only a single room.

When looking at accommodation options to support an increasing level of frailty, you should separately consider:

 

Retirement villages versus residential care

Retirement villages offer the opportunity to live in a community of older people. Maintenance of the external building and community garden areas is provided by the village operator. But it is still independent living.

In a retirement village you may be able to choose to access support and assistance inside the home, but at an additional cost. The services available vary from one retirement village to the next. You need to have the financial capacity to meet the costs as these care services are not subsidised by government. You may, however, qualify for government subsidised home care packages.

Residential aged care services bundle together fully supported living and care supports with accommodation. This care is provided 24/7 and is very heavily subsidised by the government. You need to have an assessment by an Aged Care Assessment Team/Service to access the government subsidies.

The table below provides a basic summary of some of the key comparisons:

 

Retirement village

Residential care

Entry (accommodation) cost

Set by the operator and specified in the residential contract. Usually a lump sum “purchase” but some options may allow a rental arrangement. A published price which you can choose to pay as a fully refundable lump sum or a daily “rental” amount.

Tenancy right

Occupancy usually under a lease or licence arrangement. Permanent tenancy for life, with any rules for moving specified in the agreement.

Centrelink /DVA means-test impact

Homeowner status depends on the amount paid. If determined to be a homeowner, the entry amount paid is exempt. If a homeowner before moving, this status continues while a spouse continues to live there, or otherwise for the first two years only (or until home is sold).

Options when leave

Depends on contract. If the unit is sold you may or may not share in any capital gains. A deferred management fee and refurbishment expenses are generally deducted from the refunded amount. Refundable accommodation deposit (less any fees deducted) is refunded. All other rights terminate.

Cost of care

Optional services provided at the operator’s discretion – with commercial and non-subsidised pricing. Rules for calculating fees are set by the government based on means-testing, with minimum and maximum annual fees.

 

The value of advice

Pulling together the information you need to understand to make choices can be difficult and stressful for you and your family.

Emotions can run high when families are facing issues with frailty. Aged Care Steps has coined the phrase – The Three G’s of Aged Care®, as emotions of guilt, grief and greed can impact how family members react and behave.

Giving yourself time by starting your research early can reduce stress levels and ensure your voice is heard more clearly. And you don’t have to make these decisions alone. Professional advice can guide you through the process to create effective solutions for you and your family.

 

Want more information?

Contact us today or ask us about Aged Care in your next review.