At some point in our lives, most of us will need some form of aged care or disability care, yet the care system is vast, complex, and constantly changing.
Here are answers to some of the most common questions we are asked.
> Why is care planning so important?
Births, deaths and marriages are considered the three most important “life events”. People happily plan for many years for births and marriages – but do not plan for their end-of-life. This is surprising when you consider that it is the last opportunity to make the most out of the time remaining.
A care plan clearly outlines how you wish to be cared for as you age. We know that most Australians wish to remain at home as they age, and our services have a strong focus on the provision of in-home care. In-home care is such a blessing as it allows you to remain at home for as long as you want. You receive all of the support and services to live independently, healthily and safely, in the comfort of your own home.
Whether or not you have access to some government funding for the provision of care, we can generally find a way for you to remain living in the comfort of your own home with an accredited care service within your financial means.
While you may be getting older and frailer, we aim to wring every drop of enjoyment, comfort and humour out of the remaining years. So like births and marriages, to receive in-home care that gives you exactly what you want within your budget - you must simply plan for it.
> Can end-of-life care be provided in the home?
Given the choice, most people prefer to pass away in their own home instead of being admitted to a palliative care facility or hospital. While it is possible and commonplace, we advise you to plan for palliative care in the home well in advance.
If left unplanned and requested in the final week of life, many people find it is not possible as they have run out of time to make the necessary family decisions and put in place the required palliative care equipment. The urgency of it all also involves significant costs. In our experience, it can become all too difficult for families if left to the last minute. We recommend that end-of-life care be organised well in advance.
> How likely is it that you'll need care or assistance in the future?
Inevitably, everyone will need some sort of care or assistance as they age. With one million Australians already being cared for in 2021, the figure will only increase as our population aged 'over 65 years' burgeons. Being prepared and having an awareness of what options are available to you before a life event occurs is important. It ensures your wishes are respected.
In the absence of planning, what tends to happen is that when the ‘life event’ occurs there is a last minute ‘mad dash’ to find care at home or a room in residential care. Unfortunately, your expectations may not be fulfilled. Also, if you run out of time to properly investigate all the options to find the most suitable and affordable care, it can be costly.
Plan ahead, have family discussions and gain knowledge of the care options. Start discussions now and plan your chosen care preferences so that when (not if – but when) the time comes, the plan can be rolled out professionally, smoothly and with minimal stress for all involved. Call a family meeting and bring in professional assistance to discuss the options.
> How do you select the appropriate care for your needs?
A care needs assessment can be undertaken by the Aged Care Assessment Team (ACAT) and organised via the My Aged Care website. This assessment is funded by the Australian Government and often has a wait list.
Alternatively, an assessment can be undertaken by a private assessor, such as DR Care Solutions, who charges a fee for the service. A private assessor offers prompt service in ensuring that your care needs are met and, through their, holistic approach, that your wants and wishes are respected and delivered by an appropriate care services provider.
> What is a home care package? How do I secure one?
After your assessment, ACAT will determine whether you require in-home care support, and at what level. They will assess whether you are eligible for a home care package.
A home care package sets out the recommended in-home care for your circumstances and the government subsidy available for that care. There are four levels of home care package, with Level 4 providing the most extensive amount of care and corresponding government subsidy.
Your level of care, eligibility, the area you reside in and the care service provider you select influences whether you are able to obtain a home care package. Some home care providers have waitlists for home care packages, and please be aware that service providers are not allowed to charge you if you are added to their waitlist.
Essentially the support the government offers is minimal. Depending on the care provider you select, even the highest level of funding - a level 4 home care package) only allows for around 10 to 20 hours a week of assistance, depending on the charges of the service provider.
If you want or need additional care, you will need to finance it yourself through drawing on your cash reserves, assets, superannuation, investments or family funding. It is common to see family members come to the rescue and provide ‘hands on’ supplementary care themselves.
> When and how do I access care?
If you are having trouble keeping up with cleaning the house, preparing meals, shopping, laundry, gardening, home maintenance, and getting to medical appointments and social activities, speak with your GP about whether you should apply for a My Aged Care assessment.
It is advisable to engage care early on rather than wear yourself down and leave it all too late - to a point that you may jeopardise your independence and ability to remain in your own home.
> Should I move into a retirement home or stay in my own home?
This is a personal decision where many factors need weighing up, such as:
The impact of leaving the family home and your neighbourhood;
The proximity to family and friends;
The burden of maintaining the home and the benefits of downsizing;
The suitability of your home as you age;
The option of moving into an apartment rather than a retirement home; and
Access to in-home care.
It is a discussion worth drawing out with an objective and experienced adviser such as DR Care Solutions.
> What are the pros and cons of retirement living vs remaining in your own home?
If you plan to move to a retirement village, it is important to consider that when you move out of the retirement village, you will need to pay a Deferred Management Fee (DMF). The fee ranges between 18% and 30% of the value of the property. It is paid to the village operators on exit. Additionally, there are monthly or quarterly maintenance fees similar to body corporate charges.
If you decide to downsize and move to a standard apartment (not for over 55 year olds), you will have your council rates, water rates, maintenance and strata levies to pay.
It’s a good idea to have your financial adviser or accountant assist you with comparing the costs for each option. Also obtain good legal advice when buying into a retirement village to understand your obligations now and into the future.
Residential care (nursing home care) is mainly for people with high care needs or at end of life. Previously, residential care encouraged low level care as well as high-level admissions into their facilities. This has altered with the Australian Government and residential care providers encouraging people to remain at home for as long as possible to ensure there are places available to those who really need it.
> Is in-home care right for me?
As the government care subsidies are quite minimal, if you want to remain at home for as long as possible, you may like to consider organising some 'top up' care provided by paid external carers and unpaid care from family or friends.
If you have adequate cash flow, you can manage to pay for extra in home care. Whether you have a small amount of cash flow of $10,000 to $25,000 or larger amounts to spend annually, you can tailor your care needs to suit your financial means. It is helpful to also have the additional unpaid support of family or friends.
Before in-home carers are engaged, a risk assessment of the home will be undertaken to ensure your safety as well as your carers' safety. Safety issues to consider include whether you have a lot of stairs or whether the bathroom is inadequate for showering you. Other options can be investigated if problems are identified.
The alternative of residential care involves some costs. Many residential care facilities require a Refundable Accommodation Deposit (RAD) of around $400,000 but can be as high as a $1 million to secure your place. There are daily care fees on top of that. If you don't have the means to pay for a RAD, you can pay a Daily Accommodation Payment (DAP) instead of paying a lump sum up front.
Some places accept some RAD and some DAP payments. Speak with your trusted aged care financial adviser as to what is the best way to manage residential care payments. They understand all the Centrelink requirements and the most economical way of obtaining care.
> How do I find quality home care?
Commencing the process of looking for in-home care providers can be daunting. You can feel overwhelmed and anxious about the choices and decisions to be made.
Where do you start?
You can be guided by a private assessor like DR Care Solutions or you can navigate the process yourself.
When choosing your in-home care provider, we recommend the following checks:
Check the care provider's website and read their testimonials.
Find out how long they’ve been operating in business.
Do they have commercial premises or do they work from home on a mobile phone?
What geographical areas to they cover?
Are they accredited?
Do they provide home care packages in your area?
Do they offer registered nursing care and end of life care?
Do they have qualified and experienced carers?
Can they assist with complex care needs?
Do they offer emergency replacement carers if the carer is absent or ill?
Can they provide care hourly through to 24 hours a day, 7 days a week?
Do they employ their carers or do they use contractors?
Do they answer their phone professionally and call back when they say they will?
Have you heard good reports about the provider from other people?
If you are from a culturally and linguistically diverse background, do they work with similar clients?
If you are from the LGBTQIA+ community, do they work with similar clients?
> Why is a Will, Power of Attorney or Enduring Guardian required?
When considering in-home care, it is also a good idea to get your legal documentation in order. Review your will and ensure you have appointed a Power of Attorney and Enduring Guardian.
If your physical health or mental capacity deteriorates, you will need a designated representative (Attorney and Guardian) to speak on your behalf, from a health care perspective as well as a financial perspective. It is wise to have all the loose ends tied up should the need arise.
> How can I learn more?
Staying in your own home may be easier than you think and working with your trusted advisers and your family means that together we can make a plan to make your wishes happen.
We can help by explaining the options for care, attending family meetings, conducting a care needs assessment, introducing you to trusted providers and advisers if need be.
As a specialist care consultant, we have more than 35 years' experience in the aged care and disability care sectors.
Contact us for a tailored aged care or disability care solutions to assist you and your family obtain the best outcome possible within your financial means, your wants and wishes and your care requirements.
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