12 most asked questions ‘answered’ about Aged Care in the home to give you and your family peace of mind!
WHY IN-HOME CARE AND IS STAYING AT HOME RIGHT FOR YOU?
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 end-of-life. This is indeed a shame when you consider that end-of-life is truly the last opportunity to make the most out of the time remaining.
This is why in-home care becomes such a blessing. In home care 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 there is generally a way to live in the comfort of your own home with an accredited care service.
So even though we may be getting older and frailer, we can still wring every drop of enjoyment, comfort and humour out of our lives. So like births and marriages, to get a fully financed in-home care that gives you exactly what you want in - you must simply plan for it.
HOW END-OF-LIFE CARE BE PROVIDED IN THE HOME?
Given the choice, most people prefer to remain in their own homes instead of going into palliative care facility or hospital. When planned for, in-home care can be almost a seamless transition as there are still all of the familiar comforts and support within the home.
Although if left unplanned, many people find that it is not possible due to financial constraints, physical limitations or the family decides it’s too difficult to make this happen.
HOW LIKELY ARE YOU GOING TO 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, this is only going to 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 essential.
Plan ahead and have family discussions and gain knowledge of care options. Otherwise what tends to happen is that when the ‘life event’ occurs there is a last minute ‘mad dash’ to find care at home or be placed into residential care. Unfortunately this can end up being both most a hugely unfulfilling and very expensive experience.
When left to the last minute families have been unable to properly investigate all the options to find the most suitable and affordable outcomes. Start discussions now and plan care options so that when (not if – but when) the time comes, the plan can be rolled out professionally, succinctly 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 ACAT (Aged Care Assessment Team) organized via the My Aged Care website. This is Government funded and often has a wait list.
Alternatively, an assessment can be undertaken by a Private Assessor who charges a fee for service. A private assessor will ensure that not only your care needs are met but take a holistic approach to your wants and wishes and can match you with an appropriate provider based on the information you’ve provided.
Either way, once you’ve been assessed, you need to think about what sort of care you want in conjunction with what sort of care you need and what sort of care you can afford.
HOW TO SECURE A HOME CARE PACKAGE?
After you’ve been assessed, there are various considerations as to whether you are entitled to a home care package. Your level of care, eligibility, the area you reside in and the service provider you select, determines if you are able to obtain a Government Funded package. Some providers have waitlists. Service providers are not allowed to charge you if you are added to a waitlist.
Essentially the support the Government offers is minimal. Depending on the provider you select, case management and admin fees, even the highest level of funding (ie: ‘level 4’) for in home care only allows for approximately between 10 – 20 hours a week of assistance (depending on the charges by service provider).
If you want or need additional care, it is likely that you will need to finance that yourself. Usually this is achieved via cash reserves, assets, superannuation, investments or family funding. Although it is not uncommon for the family provide ‘hands on’ supplementary care themselves.
Your care needs might be minimal at this time. But whatever you are thinking, there is someone out there who can assist you with; domestic cleaning, meal preparation, shopping, laundry, ironing, gardening or home maintenance, social outings and companionship or transportation to medical appointments.
As you age there is a likelihood that your care needs will increase and reassessment at regular intervals is recommended. Full personal care and hygiene tasks may be needed (bathing, dressing, undressing, toileting, wound care, oral hygiene, transfers from bed, chair & toilet) in addition to psychological and emotional support.
Your local GP or family members may notice that your needs are changing and recommend reassessment to increase care hours.
RETIREMENT HOME OR STAY IN YOUR OWN HOME?
Although most people prefer the benefits of being close the familiarity of friends and family, everyone need to think about whether they would like to remain in their home with external care being provided on an “as needed” basis.
Possibly considering downsizing from the large family home. Consider the possibility of moving into an apartment (with external care being provided over time) or moving into a retirement village (also with external care bought in as you need it).
PROS & CONS: RETIREMENT LIVING vs REMAINING IN YOUR OWN HOME.
If moving into retirement villages you must consider that when you purchase your apartment you will pay a DMF exit fee (Deferred Management Fee). This 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 (like body corporate charges).
If you reside in 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 the comparative costs for each option. Ensure you receive good legal advice when buying into a retirement village to ensure you 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 as well as high-level admissions into their facilities. This has altered and the Government and Residential Care providers are encouraging people to remain at home for as long as possible to ensure that there are places available to those who really need it.
IS IN-HOME CARE RIGHT FOR YOU?
As the Government subsidies are quite minimal, if you want to remain at home for as long as possible, it might suit you if you have some family or friends to provide ‘top up’ care in addition to paid external carers. This would reduce the cost of care and enable you to have care in the home for a longer period of time.
If you have adequate cash flow, you can manage to pay for in home care. No matter if you have a small amount of cash flow of $10k, $25k or a large amount of cashflow $100k - $300k a year to spend, you can tailor your care needs to suit your financial constraints (as long as there is additional family or friends support).
Depending on the set up of the home (rooms, bathroom, living areas, stairs and /or inclines) you may be able to remain there. 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, whether the bathroom is inadequate for showering you, or whether the home has additional accommodation for carers. Other options can be investigated if problems are identified.
Many residential care facilities require a RAD (Refundable Accommodation Deposit) of around $400k but can be as high as a $1million to secure your place. There are daily care fees on top of that. If you haven’t got the means to pay for a RAD, you can pay a DAP (Daily Accommodation Payment) 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 what’s the most economical way of obtaining care in this way.
HOW TO FIND QUALITY HEALTHCARE?
Commencing the process to look for Aged Care in the home can be daunting. There is fear, uncertainty and doubt. It tends to bring on feelings of being overwhelmed and anxious. Where do you start?
You can be guided by a private assessor, placement consultant or if you wish to navigate the process yourself, undertake the following:
• Check the care providers 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 have Home Care packages in your area?
• Do they work with Culturally and linguistically diverse clients?
• Do they work with the LGBTI community (Lesbian, Gay, Bisexual, Transgender and Intersex)?
• 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 from 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?
WHY A WILL, POWER of ATTORNEY or ENDURING GUARDIAN IS REQUIRED.
When considering in-home care obtaining legal advice essential. It is a good idea to 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 who can 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 DO WE 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.
DR Care Solutions 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 aged care consultant, DR Care Solutions has more than 30 years experience in the Aged Care and Disability care industries.
Contact DR Care Solutions for a tailored aged care solutions and can assist you and your family to obtain the best outcome possible within your financial means, your wants and wishes and your care requirements.