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How can you go about finding the right residential aged care for yourself or a family member?
Published 06/08/2009
The decision to move into residential aged care is rarely an easy one. Loss of autonomy, and often of the family home, can leave many old people grieving. Family members too may struggle with feelings of sadness or guilt.
Add in high-profile scandals about abuse and neglect of elderly people in some homes and it's understandable that people feel worried and uncertain about the process.
So, when it becomes clear that an elderly person can no longer stay in their own home, how do they and their family go about finding the right alternative accommodation?
This guide provides an overview of government-funded aged care and suggests key things to look for and ask about when you are evaluating a home.
The Federal Government funds and accredits most of Australia's aged care homes. Government-funded homes may be run by religious and community organisations, private enterprise and state or local government.
These types of home provide two levels of care high-level care (these are nursing homes) and low-level care (these are hostels).
High-level care is for people who need 24-hour nursing care, perhaps because they are physically unable to care for themselves or because they have advanced dementia.
Low-level care is for people who need some help with daily living. Although they may need assistance with dressing, eating or washing, most will be able to move about on their own.
If you do not need either of these levels of care, other options to consider are an independent living unit or retirement village. Information on these types of alternative accomodation is available from Commonwealth Carelink Centres.
Before you can apply to enter a government-funded aged care home, you will need to be assessed and have your application approved by your local Aged Care Assessment Team (ACAT). (In Victoria, the teams are known as Aged Care Assessment Services (ACAS).)
A member of the team will visit you to conduct the free assessment and may also speak to your doctor, if you give permission.
The team will then recommend the appropriate level of care for you. Possible recommendations include:
The team can also give you information on homes in your local area and the services they offer. Your doctor can put you in touch with the assessment team or you can contact them directly (see useful numbers box below).
Once your application for residential care has been approved by the team, you can start applying to homes. It's a good idea to apply to several homes as popular ones won't always have a vacancy.
Choosing a place to live is always an important decision so it's worth asking around to get information about the homes in your area. Friends, social workers and your doctor may be able to help.
The Department of Health's Aged Care Home Finder can help you find homes in your area that provide the services you need.
You'll want to visit several facilities to get an idea of what's on offer . Location, atmosphere, cost and the services each home provides are all important. Some things to look out for include:
A useful basic quality check is to ask for a copy of the home's most recent accreditation report. These reports are also available from the Aged Care Standards and Accreditation Agency.
Homes subject to current or past sanctions for not meeting standards are also listed on the Department of Health website.
It's a good idea to prepare a list of the things you want to ask before you visit the home. Everybody will have their own questions but you might want to consider the following points:
If you have any special needs or concerns, ask the home how they will be accomodated.
Health conditions – if you have a particular health condition, mention this when you contact the home and ask how they can help you to manage it and what services will be available. Some homes specialise in particular conditions, such as dementia, and your aged care assessment will determine whether you need this kind of care.
Indigenous people – all aged care homes are expected to provide culturally appropriate care, but there are homes specifically for Aboriginal and Torres Strait Islander people. For more information, contact your local state or territory office of the Department of Health and Ageing.
Cultural and religious needs – ask the home how they will meet your cultural or religious needs. For those not fluent in English, it is wise to check the availability of interpreters. Homes are increasingly being set up to cater for elderly people from specific ethnic communities. You can search for homes where a particular language is spoken using the Aged Care Home Finder.
Dietary needs – ask the home how they will cater for any special dietary needs. You can also ask to see sample menus.
Couples – if you are entering a home as a couple, you will want to make sure the accomodation is suitable and provides adequate privacy. One member of a relationship entering a home may wish to check that their partner will be able to join them there if that becomes necessary.
The Federal Government subsidises the cost of residential aged care, but residents also pay some fees and charges, depending on their income and assets.
To access subsidised care, you must have an assets assessment done by Centrelink or the Department of Veterans' Affairs. Even if you are not eligible for a subsidy, you may choose to have the assessment as it could help you to negotiate costs with the home.
From 1 July 2009, same-sex couples are assessed in the same way as opposite-sex couples when determining their level of income and assets.
Your costs may include daily fees (based on your income) and an accommodation bond or charge (depending on your assets). You will need to negotiate the amounts you pay directly with the provider of care, although the government sets maximum basic charges for pensioners and non-pensioners.
The aged care home is entitled to keep a certain proportion of any bond you pay, depending on the length of your stay, with the balance repaid to you or your estate when you leave.
Information about charges and assistance for people facing financial hardship is available from the government's Aged and Community Care Information Line (see useful numbers box below).
Government-funded homes are required to provide certain services at no additional cost, including furniture, meals, laundry and assistance with daily tasks. Some aged care homes offer extra services, such as larger rooms or wine with meals, for an additional fee.
It is worth getting professional financial advice on costs and any impact on your pension or tax status.
Centrelink's financial information service provides free advice on the rules related to aged care fees and charges and the interaction with pension payments or superannuation. You can call Centrelink or Department of Veterans Affairs to make an appointment with their financial advisers. (See useful numbers box below).
Although the move into residential aged care is often associated with feelings of sadness and loss, there are things friends and family can do to smooth the transition. By far the most important is keeping up regular visits or outings to ensure the elderly person continues to feel valued and important, health professionals say. Visitors can also try to encourage the person to participate in the home's activities so they can start building relationships with other residents and staff.
Having personal belongings, such as family photographs, will help many older people to feel at home in their new environment. They may like to take along a favourite chair, a painting, perhaps some of their own cups or glasses.
If possible, help them to maintain some of the interests they had before entering the home. Would they like to have a radio or music player with headphones? Are there some favourite books they could take with them?
Building a positive relationship with key staff will also help to ensure family members know what is going on when they are not there and who to talk to if they have any concerns.
Residents of an aged care home have the same personal, civil and consumer rights as any other member of the community. The government has established a charter of residents' rights and responsibilities and this should be on display in all homes.
Your rights as a resident
As a resident of an aged care home you have the right to:
If you have a complaint about your care and are unable to resolve it with management, you can contact the Aged Care Complaints Investigation Scheme, run by the Department of Health and Ageing. The Aged Care Rights Service provides free and confidential advocacy services providing support to aged care residents.
Useful numbers
Aged Care Assessment Team – 1800 052 222
Aged and Community Care Information Line – 1800 500 853
Centrelink number for aged care related matters – 12 2300
Department of Veterans Affairs – 13 3254
The Aged Care Rights service 1800 700 600
Department of Health and Ageing's Aged Care Complaints Investigation Scheme – 1800 550 552.