Most of us don't want to think about aged care while we're still relatively healthy and independent; we tend to leave it until an emergency forces us – or our family – to face the issue unprepared. But planning ahead for the later years means you and your loved ones won't have to make important decisions in a hurry.
Start by talking things over with your family about your needs. Involve yourself in the decision about where and how you'd like to live if you can no longer look after yourself. Visit a number of different types of aged care centres: some are church or community-based, others are operated for profit. Or discuss with your family how it might work if you decide to stay in your home for as long as possible. Whatever option you're leaning towards, an ACAT (Aged Care Assessment Team) assessment is the best place to start.
An ACAT – or in Victoria, ACAS (Aged Care Assessment Service) – assessment is funded by the government and it's valid for 12 months. It's your guide to the level of care you or your loved one needs, and is the starting point for moving into a residential aged care centre. The ACAT can also help identify what care you need if you want to stay in your own home, such as help with meals, showering or modifications to assist your mobility.
The different kinds of aged care
Your options for aged care are in- home support, low-level residential care or high-level residential care. Again, the ACAT assessment will be the best guide to the amount of care you'll require and the type of centre you'll need.
If you want to live at home for as long as possible, you'll need to look at what types of home care assistance are available in your area and if it's suitable for your situation. The government has a home care service for people aged over 65 at risk of ending up in aged care centres too early.
The Commonwealth Respite and Carelink Centre Program also provides information on the range of services available to support older people wanting to live at home.
Low-level residential care
Low-care centres provide extra help with meals, cleaning and laundry when these have become too difficult to manage in your own home. They also provide short-term or respite care if you or your carer need a break or if you'd had an accident or operation and need support for a little while before you go back home.
Low-level care centres provide:
- personal care such as showering, toileting and dressing
- nursing care for illness or ongoing aged-related problems
- rehabilitation and/or physiotherapy help after a fall or stay in hospital
- on-site doctors and nurses
- access to other health and therapy services such as scans.
They may also provide facilities and additional services such as internet and pay TV, on-site movies, gyms and therapies such as massage or entertainment. These have an additional cost beyond the government-mandated standard daily cost.
High-level residential care
High-care centres provide around-the-clock supervision and nursing care for almost all your needs. This type of nursing home care can be permanent and on-going, orshort-term respite care after an illness or accident.
High-level care centres provide:
- personal care such as dressing, bathing and toileting
- individual assistance with meals and eating
- nursing care for illnesses, pain management and age-related problems
- recreational therapy such as exercise or physiotherapy
- recreational activities and entertainment
- aids such as walking frames and other medical supplies
- basic toiletries and pharmacy supplies.
How much do aged care centres cost?
The government covers most of the cost of aged care and someone with little or no extra money will never be without care. But, like many services today, there is also a user-pays portion. The asset assessment will help work out what you may need to contribute to the cost of your care.
The basic daily fee covers meals, laundry and other day-to-day living costs. It does not exceed the pension but people with higher incomes will have a higher rate. There is also an accommodation charge that may be payable as a bond or an additional daily payment depending on your circumstances.
A schedule of daily fee and accommodation charges is available on the Department of Health website.
What is the resident agreement?
The resident agreement outlines the costs for aged care and is a legal agreement you sign when you enter a residential centre. It's important that you and your family fully understand the costs and care arrangements, so you may want to consult a financial adviser, lawyer and family before you sign. You can change the terms of the agreement if both parties are in agreement. If you are unable to sign or understand the agreement, you'll need a family member with power of attorney to sign on your behalf.
- the accommodation bond or charge depending on your circumstances
- interest for ongoing bond payment not paid as a lump sum
- monthly retention amount and maximum retention for bond
- dates for short-term or respite care
- your rights and responsibilities.
Accreditation and standards
Aged care homes must be accredited by the Australian Aged Care Quality Agency (ACQA) to receive federal government subsidies. Homes that fail to meet standards are put on a 'timetable for improvement', their progress is monitored and, if warranted, their accreditation shortened or revoked. The latest accreditation reports are published on the AACQA website.
The Commonwealth Department of Health is responsible for imposing sanctions if the non-compliance is considered serious, has occurred before or threatens the health, welfare or interests of residents. Information about sanctions (current and archived) imposed on aged care centres is published on its website (type sanctions in the search box) if you want to do background checks.
Steps to entering aged care
Here's how the process works when it's time to think about your needs for aged care:
Step 1: Assess eligibility with an Aged Care Assessment Team (ACAT) assessment, usually through a hospital, that confirms your eligibility for residential aged care.
Step 2: Research suitable centres, put your name down on waiting lists or apply to your preferred place if there's a vacancy.
Step 3: Complete an asset assessment through the Department of Human Services or the Department of Veterans' Affairs to understand the cost of care.
Step 4: Check and sign the Residential Agreement for fees, services and rights and responsibilities and sign when you and your family are clear about what it entails.
Step 5: Prepare to move and organise financial, legal, health, government, utilities and other organisations as well as family and friends. If you can't manage this on your own, consider appointing a nominee to deal with the government on your behalf.
If you need to move into an aged care home right away, you'll need to look for vacancies in the centres you like. If one's available, you can go ahead and organise the paperwork and move in.
The Australian Government aged care website has information about aged care services, the quality assessment agency, payments and community care programs.