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How to prepare for assessments
Episode 8 • 11th June 2024 • Your Aged Care Compass • Coral Wilkinson & Michelle Brown
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Before having an assessment for in-home aged care services, take the time to reflect on the amount of support you or an older loved one needs on a daily or weekly basis. Any support, formal or informal, paid or free, is important to note.

Preparation is key to getting the level of support you or an older loved one needs. Having a list of all the support the older person gets gives a very complete picture of their situation.

Understand who the assessment teams are and what support programs each assessment team can approve for.

In this episode:

  • Does My Aged Care Assess?
  • What are the assessment teams looking for?
  • Who are the assessment teams?
  • What are the different programs of support?
  • How do you prepare for an assessment?
  • Can others offer input during the assessment?

  

Resources Mentioned

Related Episodes


Connect with Coral Wilkinson: 

  

More about Your Aged Care Compass podcast: 

Are you supporting an older loved one at home and ready to give up because it’s just too hard? Your Aged Care Compass is aimed at anyone who is caring for an older loved one who still lives at home and is wondering what support is available to them.


We're Coral and Michelle, the sisters behind our business, See Me Aged Care Navigators.


Coral is a registered nurse with over 30 years’ experience in both health and aged care. A former assessor with the aged care assessment team, an advocate and author, there’s not much Coral doesn’t know about Australia’s aged care system.


Michelle is a former pharmacist with over 30 years in the public health and private sectors of pharmacy. Michelle is now client care manager for our business. 


Our story started as one of supporting our parents to remain in their own home, to be as independent as possible and remain connected to their community. We reached a point however, of needing extra support and we achieved this because we know Australia’s aged care system so well, we knew what programs could assist us and our parents.


This podcast, Your Aged Care Compass, brings together not only our personal experience in supporting our own ageing parents but also our vast professional experience in supporting other families to keep their loved ones at home. 


We will help you makes sense of Australia’s aged care system, from your first contact with My Aged Care through to the different funding streams and assessment workforces, management options for home care packages and extra funding that people might be eligible for.


There's so much more. Topics relating to dementia and legal and financial considerations will be covered, as well as real life stories of where it went wrong for people and how we guided them to get it right.

 

Your Aged Care Compass will guide you clearly and compassionately to the right support at the right time for your ageing parents and loved ones. 

Transcripts

Michelle:

Welcome to Episode 8 of your Aged Care Compass podcast.

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Today, we'll be talking about

how to prepare for assessments.

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It doesn't matter which team you are

being assessed by, it is still important

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that you understand what information you

need to get across to be approved for

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the level of care that is appropriate

for your or your loved one's needs.

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Coral, what are the key points

we'll be discussing today?

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Coral: Shell, we'll be discussing,

, screening versus assessment.

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We'll be talking about what assessors

are actually looking for when they're

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doing their assessments and we'll

be also including your ability to

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offer input during an assessment.

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Michelle: Okay, now I know we

say this in almost every podcast,

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but I'm going to ask you again.

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Does my aged care assess?

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Coral: Note, My Aged Care, the

gateway to all these government

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subsidised services, does not assess.

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My Aged Care screens people and then

My Aged Care On completion of that

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screening, they decide where your referral

will go to, to which assessment team.

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It might be the entry level team,

the regional assessment service,

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or it might be the aged care

assessment team or the ACAT.

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It's really important for people to

understand the difference between

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the screening and assessment.

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, if people ring up My Aged Care thinking

that their loved one's needs are better.

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Potentially sitting at an ACAT

level, they can't ask My Aged Care

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to give them an ACAT assessment.

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, during that screening process,

depending on how detailed and

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compelling the information is that

you get across to My Aged Care, they

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then determine whether your referral

will go to The RAS or the ACAT.

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, but , if you do get enough information

across at that point reflecting

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those, the needs of your older

loved one, , it is possible to sort

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of bypass that entry level and go

straight to the ACAT for an assessment.

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But it does come back to you providing as

much detail to My Aged Care so that Whilst

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they're screening, they then form a very

clear picture of what your loved ones

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needs are and which is the appropriate

team to refer your loved one to.

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Michelle: And so when it comes

to the assessment, what are the

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assessment teams looking for

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Coral: So assessors are looking at a

complete picture of the older person.

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They're looking at what they can and

can't do for themselves, how much

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family support is being provided, what

health conditions are impacting on the

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older person being able to complete

their daily tasks independently.

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Is the support that carers are

providing so high that it's taking

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a toll on the carer, making that

caring situation unsustainable?

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So specifically assessors are looking

at like a functional profile of people,

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which is Reflects the person's ability

to complete what we call the activities

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of daily living with some support or

a lot of support or no support and

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this also includes mobility and falls.

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Assessors are also looking

at cognitive presentation.

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So if the older person is beginning

to experience some issues with

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their memory, Or perhaps they do

have a diagnosis , of dementia.

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They'll be looking at how significant

that cognitive impairment is.

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They'll also be looking at impaired

mood, notably, , depression at

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this point, because if an older

person looks like they have some

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emerging cognitive or memory issues.

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At those early stages, it can

actually look like, you know, a mood

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disorder like depression as well.

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So assessors, particularly the ACATs,

because their clinicians will be

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teasing this out a little bit more.

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And, the other thing they will be

looking for is carer sustainability, which

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reflects what I just touched on about that

level of carer burden or carer stress.

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So a very important point to get across.

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When you're being assessed by the RAS

or the ACAT, is all that support that

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you're providing as a carer, , is

it starting to take a toll on you?

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And sometimes, particularly at

entry level, this discussion

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doesn't always and that's why

people need to go on the front foot.

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That's what we always say.

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Give as much information as possible

and talk about the toll that it's taking

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you, because this is really important

, as you progress through the aged care

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system is your ability to continue that

ongoing care of your older loved one.

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Now, if you're able to get any clinical

assessments along the way, , if

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there's currently a physiotherapist

or an occupational therapist or speech

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pathology, nursing, any kind of clinical

assessments that may have been done

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already, it's really beneficial RAS.

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And the ACAT assessors because that adds

weight to the information that you're

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imparting during that assessment process.

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Michelle: and who are the

assessment teams, Coral?

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Coral: So at entry level the

regional assessment service are

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typically a non clinical workforce.

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Now there are some RAS assessors around

the country Who do have clinicians on

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their teams, but on the whole, they

tend to be non clinicians, so more

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like administrative kind of staff.

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They, these RAS assessors work for

a number of large organizations

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across the country, and it

varies from state to state.

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The RAS approve the services and

support at entry level and these.

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services that they're approving

for are being funded under the

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Commonwealth Home Support Program.

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Then there's the ACATs, the Aged

Care Assessment Teams, or if you're

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living in Victoria, these will

be the Aged Care the Aged Care

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Assessment Service, or the ACATs.

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So ACATs are all clinicians right across

the country, and typically they consist

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of nurses, physiotherapists, occupational

therapists and social workers.

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When you get your ACAT assessment,

it makes no difference as to which

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discipline that clinician aligns

with, whether it's a social worker

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or, or a nurse or a physiotherapist,

the ACATs all assess the same way.

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So there's no advantage or

disadvantage, whether you get an ACAT

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social worker or an ACAT nurse, the

assessment is going to be the same.

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Michelle: What are the different

programs of support that come

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as the result of an assessment?

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Coral: So coming down from that screening

from My Aged Care, who then determine

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which assessment team or assessment

workforce you go to, only being the two,

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the Regional Assessment Service and the

ACAT, there are two funding buckets.

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there are three, but there

are two main funding buckets.

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So, at entry level, if you are

assessed by the Regional Assessment

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Service, you will get approvals

that are called referral codes.

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So, these referral codes are individual

codes or approvals that allow you

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to receive subsidised services from

providers who are approved to deliver

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those kind of services at entry level.

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The funding that's aligned with entry

level is called the Commonwealth Home

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Support Program or CHISP is the acronym.

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The Commonwealth Government allocates

this bucket of funding to approved

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CHISP providers and then it's

up to the providers to make that

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funding stretch as far as possible.

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CHISP services, entry level services, I

call these services fragmented because

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there could be any number of CHISP

providers involved at entry level.

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There's not one overarching provider.

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So there could be two or three or

four, sometimes even more providers.

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So I refer to this as fragmented because

there's not that sort of consolidated

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coordination that's happening.

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The ACATs.

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Aged care assessment team or services.

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They're assessing people for the home

care package program, which has its

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own funding stream and then they're

also assessing people for short term

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restore the flexible care options,

which are short term restorative

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care and the transition care program.

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The ACATs are also approving

people for respite and entry

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into residential accommodation.

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Michelle: Okay.

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So knowing all of this now, how do

people best prepare for an assessment?

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Coral: Look, people need to take

the time to do this because, you

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know, one of the things , we always

say, Shell, is preparation is key.

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The more you prepare, the better your

outcomes are going to be as you enter

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and move through our aged care system.

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So you would take some time to think about

all the help that you currently need.

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Now, for the older person

themselves, , this can be a challenge.

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So we always encourage.

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Family members, carers, those that are

involved with the older person to do this

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themselves or to sit down with the older

person , and talk about it together.

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So you would be reflecting on

how much help the older person

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is receiving from family.

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Or friends or neighbors, perhaps,

and are they paying privately

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for any help at the moment?

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Are they paying for someone to come in

and mow the lawn or to do some cleaning?

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You need to write down all the

support that you're receiving.

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You know, noting how many times the older

person perhaps is calling family for

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reminders about appointments , or perhaps

their medication, how many days family

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members are visiting the older person.

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Are family members taking you to

appointments or doing your grocery

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shopping or paying your bills for you?

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So these are typically tasks

that, as the adult children of

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older people, we just do this.

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We do this every day and we don't

really give it a second thought.

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But by reflecting upon this kind of

support and writing it all down, starts

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to form a picture of the level of care

that the older person would be sitting at.

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And this is all really

important information.

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, some people actually can struggle

with this a little bit because

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even though it's support, they

don't, don't see it as support.

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So the easiest way I say to people is if

you're , the adult child or the spouse

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of the older person, remove yourself from

the picture and then think about, can

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your older loved one get by without you?

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Could they actually manage

day to day, week to week?

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without you being around.

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And that often is a great way

for people , to sort of take a

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pause and realize actually how

much support they're providing.

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Another really important point

in preparing for assessments

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is acknowledging the toll that

it's taking on you as the carer.

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Now, sometimes this conversation may

not come up in assessments, but it's

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essential That it's discussed and often

it will be you driving this conversation.

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So we never want this conversation to be

left until the carer is at breaking point.

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Because then, people's

options are limited.

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If you're providing Even a low

level of support, , certainly

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moderate level of support.

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You need to be talking about that and

you need to be telling the assessor,

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that might be really hard for you,

that, you're raising your own kids,

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you're running your own business or

you're working full time and you just

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cannot continue to support perhaps

mum or dad as much as you'd like to.

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It's just not possible Two topics

that, again, sometimes don't come

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up, , they will more typically come

up in an ACAT assessment, but again,

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if people are entering the system at

entry level, it's really important to

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get this information across as well,

is incontinence, and as we've already

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touched on, cognitive impairment.

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So.

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, quite uncomfortable topics to

talk about, but again, reflecting

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the level of care or the level of

need that the older person has.

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So essential to getting

this information across.

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Don't rely on the assessor to prompt you.

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You need to have written this down

on that list and then you need

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to bring it up with the assessor.

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Michelle: And I guess given that,

Coral obviously the assessment's

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being done for the older person,

but can someone else offer input?

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Coral: Absolutely.

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And we always encourage this, you

want to get a whole, a complete, a very

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detailed picture of what's going on in

the older person's home and in their life.

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So during every discussion, as you

enter and move through the aged care

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system, it's essential that you

provide as much information as possible.

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So at initial contact with My

Aged Care who was screening you.

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You have to expand on the answers that

My Aged Carer is asking you because

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they do ask a lot of questions.

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But if you're unaware that you need to

give as much information as possible,

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you will miss a lot of detail.

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And potentially, if your loved one is

sitting at ACAT level and you haven't

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conveyed that information, your loved one

might be assessed at entry level and they

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may not get the support that they need.

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With RAS and ACAT assessments, when they

contact you to arrange an assessment date,

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you can actually offer information then.

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So, particularly, again with

the ACAT, they will call you.

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It will be the ACAT triage person that

will call you first, and they'll do

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their own brief screening with you.

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They will have read all All the

notes that are in My Aged Care from

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your previous discussion with the

My Aged Care call centre staff.

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And then the ACAT triage, in that

discussion where you're giving

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them all that information, they

will establish how urgently they

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need to respond to that referral.

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So take this chance to tell them if they

If it is urgent, the ACAT triage person

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will note that down and what they do

then is they assign that referral, your

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older loved one's referral to one of

their assessors and it will be determined

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that does this older person need an ACAT

assessment sooner rather than later?

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Is there more of an urgency

for this person than there

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is for perhaps other people?

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Both the RAS and the ACATs are so busy

that they are expected to complete

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their assessments very quickly.

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So we're hearing presently that if

people try to follow up a day or two

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later after having an assessment, trying

to offer more information that they'd

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perhaps forgotten during the assessment,

that it's actually too late because

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the approvals have already been given.

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Now you can certainly go back and ask

for a reassessment if you think that

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something's being missed, but it will

take many weeks, if not months to get

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either the RAS or the ACAT to review

their approvals that they've given you.

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So the key point here is to get it right.

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In the first instance,

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Michelle: And Coral, it's, actually

quite okay to have a list, isn't it?

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, when you go into that assessment , to

make sure that everything you

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want to discuss is covered off.

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Coral: it's essential, it's

essential Shell to have a list.

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Having a list means that you are prepared

and you definitely need to prepare, be

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prepared as you enter and then as you

move through the system at every stage at

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RAS assessment, at ACAT assessment , like

I've already said, , the outcomes that

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you get really reflect , on how much

detail you've gotten across at every step.

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So, if our aged care system did what

it should do and , was able to establish

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people's needs quite accurately, then

we wouldn't be here speaking about this,

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but the system just, it just doesn't.

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And so.

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, it really comes back to you as the

individual taking the reins and driving

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these conversations and getting all

that really important information

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across at every conversation.

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And you do that because you

have your list next to you.

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And so when you get that phone call from

the RAS or the ACAT, you're ready to go.

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You know exactly what you need to say.

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Michelle: Excellent.

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Oh, great information there, Coral.

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I think that that will do for today's

podcast and looking forward to speaking

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with all of you again next week.

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