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Our comments on Nine News's article about Home Care
Episode 23 • 24th September 2024 • Your Aged Care Compass • Coral Wilkinson & Michelle Brown
00:00:00 00:16:09

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The wait times to receive some home care packages (HCP) have tipped out to around 12 months. This has increased significantly in the past year, from about six months in September 2023.

This article described the frustration of the adult daughter in not only having to wait such a long time for her mum’s home care package (HCP) to be assigned, but her belief that the providers couldn’t offer services under the home care package anyway due to a lack of staff.

We discuss the important points from this article and address some of the confusion around accessing in-home help.

In this episode:

  • The confusion about what aged care is and what it looks like
  • How the wait time for HCPs is determined and by whom
  • Priority levels for HCPs and how they work
  • Asking for a support plan review/priority review
  • Extended wait times force people out of their own homes
  • The risk of carer burnout
  • Meeting the needs of clients is difficult when there are limits on the number of high priority approvals that assessors can give
  • Significant wait times just to get an assessment are not often mentioned
  • The financial and emotional toll of waiting for in-home support is huge
  • There are problems with having enough workers across the aged care system
  • One provider is not the same as the next. Do your research
  • Assuming other options are available while waiting for HCPs is not realistic.

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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. 


Like what you hear? Please leave us a Rating and Review. We’d love you to share this podcast with any friends or family who have older loved ones.

Transcripts

Michelle:

Welcome back for our next episode of Your Aged Care Compass.

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We were just about to begin

recording today's episode and Coral

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messaged me about an article she

just read about home care packages.

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So we've decided to discuss

this article as today's episode.

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Coral, tell our listeners

why we changed tack today and

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are discussing this article.

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Coral: Shell, I'm always watching

commentary in the media because I'm

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always interested to see what's being

reported about our aged care sector.

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Predominantly articles tend

to focus on residential care.

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So when I see an article about

home care, it grabs my attention.

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The article by Nine News reports on

the wait times to receive an approved

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home care package and the lack of

services available to the recipient of

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the package, an older lady living with

her daughter in Sydney's Inner West.

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The daughter reported in this article

that when her 91 year old mum was

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approved for the package in September

last year, the wait time until assignment

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of that package was three to six months.

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What we know is that over the next

six months, the wait time blew out

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to be nine to 12 months to receive

that level three home care package.

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And this is what the daughter was

highlighting in the article that over

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that period of time from approval.

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To assignment, the time her mum had to

wait tipped out to almost 12 months.

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So Barbara, the daughter, then

goes on to say that even though

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her mum has been assigned her home

care package, she's not getting any

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services due to the provider not having

any staff to provide the services.

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This point really got my attention

because a home care package can

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virtually guarantee service provision.

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So today I want to comment on this article

and unpack what has occurred here with

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Barbara and her mum and address Barbara's

dismay at considering changing providers

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because she thinks there's no point,

that the next provider will probably

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be the same as the current provider.

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Michelle: Yeah, I'm so glad we're

discussing this article, Coral.

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I must say it's timely and reflects the

frustration we hear about every week.

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Looking at the article, the

headline draws the reader in with

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home care lags behind high demand.

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But then there's a video clip of people

and staff from an aged care facility

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Before the article goes on to discuss

the wait times for home care packages.

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I know you have a comment you

want to raise here, so please

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tell our listeners why the video

and written article bother you.

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Coral: So the aged care system

is confusing enough as it is.

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People get so confused about entry

level services under the Commonwealth

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Home Support Program or CHISP program

and they think these fragmented entry

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level services are a home care package.

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They get confused about being approved

for a home care package, thinking

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that the approval documentation,

which is the summarised written

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account of the ACAT assessment, is the

assignment of their home care package.

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And then they get confused about

in home, centre based or cottage

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respite and residential respite.

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And then there's confusion about keeping

a home care package when a person

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enters residential care permanently.

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So, Nine News, I think being considerate

to people reading this article, it might

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have been prudent to have a video clip of

someone receiving support at home instead.

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Michelle: So Barbara, the daughter,

talks about how long it took for her mum

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to be assigned the home care package.

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Can you explain to our listeners how

the wait time is decided and by whom?

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Coral: When the ACAT completes

their assessment, they have a

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pretty good idea of what level of

home care package they're going to

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approve for, for the older person.

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It might be a level one, two,

three, or four home care package.

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The ACAT also determines, based

on the urgency for support, if

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they'll approve a person as a

medium priority or a high priority.

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What this means is where the

person's approval enters the queue.

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So the wait times as described by

Barbara reflect a medium priority

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approval for her mum's home care package.

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If Barbara's mum's needs changed

significantly, and perhaps they did,

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while she was waiting for her home

care package to be assigned, Barbara

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could have asked for a priority review.

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Also known as a support plan review

and had her mum's priority change from

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medium to high, effectively pushing

her mum to the front of the queue and

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decreasing the wait time to be assigned

that home care package by many months.

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Michelle: Coral, do you think

people are aware of that option?

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Coral: Uh, no, they're not Cheryl.

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, I see this all the time in

social media support groups.

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You know, I see people complaining

carers, adult children, we hear it

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ourselves about carers being completely

exhausted and having to just hang

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in there for another three weeks.

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four, five, six months until

their older loved one gets

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assigned a home care package.

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And the older loved one may have

had, you know, there may have been

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a significant change, a critical

incident that absolutely, absolutely

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validates that person needing to move

for the, to the front of the queue and,

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and get that priority level changed.

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People just don't know.

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Michelle: Yeah.

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So these increased waiting times are

pushing people into crisis situations.

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The whole idea of in home care is

to keep people in their own homes

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and out of residential aged care.

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But because of these extended wait times,

older people may decline to a point

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where they can't stay in their own home

because they need that support to do so.

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Effectively, the choice

is taken away from them.

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Coral: You're absolutely right, Chelle.

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As I've just mentioned, people can

ask for a priority review so their

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loved one can move to the front of the

queue, but people just don't know this.

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And you know, it's not as simple

as calling My Aged Care and

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asking for a priority review.

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You have to gather all your evidence

to convince the Aged Care Assessment

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Team Assessor that there's an urgent

need to receive formal support.

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What happens when carers have to

keep providing such high levels of

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support while waiting for their older

loved ones package to be assigned

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is that they burn out and then they

themselves end up in hospital because

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stress has taken such a toll on them.

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Or, you know, their older loved ones

end up in hospital, as well because

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the carer is completely exhausted

and can't continue to provide care.

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Michelle: Yeah, absolutely true.

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And Coral, the support plan review

you've just described, are there

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limits on how many people can be

given a high priority package?

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Coral: I don't have any exact figures,

Shell, but aged care assessment teams

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that, you know, we're privileged

enough to chat with from time to time,

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suggest that the Department of Health

and Aged Care encourages them to keep

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high priority approvals to around

10 percent of their total approvals.

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And I've heard from different ACAT

assessors that they get reprimanded by the

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department if they are deemed to exceed

the number of high priority approvals

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that they're supposed to be maintaining.

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Michelle: Wow, that's

a bit of an eye opener.

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Coral: So, having been a former ACAT

assessor, and a clinician, we're all

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about meeting the needs of the client

and the consumer should be sitting, front

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and centre of the care that we deliver.

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So it's very, very difficult for ACAT

assessors to go out and see people

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in such need, but walk away knowing

that Wow, I've already done X amount

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of high priority approvals this week.

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I can see that this person really

needs a high priority as well.

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And then having that dilemma of,

will I give them a high priority

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and, I might get in trouble for that

or giving them a medium priority.

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That that's, probably going to push

that carer into some kind of crisis

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because they have to wait so many

more months than for their older loved

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one to receive the home care package.

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Michelle: And I noticed this article talks

about the time taken to actually get an

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assessment, which can also be many months.

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So that's before a person even enters

the national queue to wait for their

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home care package to be assigned.

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These times aren't mentioned

in official documentation.

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Do you think this needs to change?

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Is it giving people false expectations?

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I

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Coral: It absolutely needs to change.

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When you add in the wait time to

be assessed, then the wait time

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to actually receive a home care

package, this time frame could

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add up to be 18 months or more.

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People just don't realise how long

it takes to get through the system

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to get the help that they need.

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And the comment that I hear too

frequently from older people in

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particular is, I don't need the help now.

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I'll wait until I do.

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And if they do that, it will be too late.

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Their options will be very limited.

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Michelle: think we also need to highlight

that in Barbara and her mother's

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case, Barbara is providing care and

assistance to her mother, as well as

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paying privately for support services.

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This will be taking both an emotional

and a financial toll on Barbara.

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And in the case where older people

don't have a loved one to help

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them, they may have to pay for their

own support services privately.

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And again, this is not

necessarily sustainable.

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These increasing wait times are placing

a lot of burden on a lot of people,

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not just the older person themselves.

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Coral: This is right, Shell.

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Family members are dipping into their own

pockets to source private care for older

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loved ones, and they're giving up work to

stay home and care for older loved ones

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because there is no other option for them.

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Michelle: Coral, do you think the

workforce problems that the aged

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care industry has are contributing

to the lack of support that

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older people are able to access?

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As Barbara highlighted in the article, the

provider not having any support workers

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or carers to meet Barbara's mum's needs.

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Coral: It's true, Shell.

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The workforce across the sector is

an issue, but believing one provider

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is just like the next is misinformed.

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When you're assigned a home care

package, you have 56 days to choose

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a provider and enter into a service

agreement with your chosen provider.

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During these 56 days, and preferably

even before this time frame, you

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should be doing your research.

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Choosing a provider for a home care

package is a very considered decision.

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You need to ask around in your local

community and see what other people

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are saying about their providers.

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You need to research and shortlist

providers who appear to be

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attractive and then call them to

discuss the older person's needs.

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And you can even ask other people

in the many social media support

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groups about providers as well.

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But one provider is not like the next.

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There are many good providers who have

loyal staff and can provide services.

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If a person like Barbara is not

satisfied with the service provision

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of their provider, they really should

think about moving to another provider.

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Michelle: Coral, a real sticking point for

me is the statement from the spokesperson

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from the Department of Health and Aged

Care, where they said there are other

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options available to older Australians who

are waiting for their home care package.

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And the statement was, they may

access aged care services through

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Commonwealth Home Support Program,

state or privately funded services.

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I wonder if this spokesperson

actually has any idea of how

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much private services cost.

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And you're asking aged

pensioners to pay for this.

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I saw a provider yesterday

advertising a starting price of 82

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per hour, plus travel costs, with

a minimum two hour place placement.

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That's for basic domestic

support, nothing else.

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I also wonder if this spokesperson

has any idea of how oversubscribed the

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Commonwealth Home Support Program is.

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Coral: I feel pretty confident in saying

that the department representative has

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no idea how much private services cost,

how challenging it is in some areas to

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get any CHISP services, and state funded

older person services are likely to be

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very short term and not funded at the

level of the higher home care packages.

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Michelle: So in a perfect

world, how do you think this

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situation could be improved?

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Coral: Well, I think the department

needs to allocate more funding

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to the home care package program.

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But I don't think the

department will agree with me.

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Michelle: Hmm.

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I hope you've found our commentary on the

Nine News article enlightening listeners,

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particularly if you've read the article.

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Understanding how the aged care system

works does place you in a stronger

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position to advocate for yourself.

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or older loved one, and it does help

to get the in home support you or

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your loved one needs in a timely

manner, should that be your situation.

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We have the link to the Nine News article

included in the show notes, as well

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as a couple of our blogs that explain

how to get aged care in home support.

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Thanks for joining us today.

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We'll chat with you again next Tuesday.

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