Aged Care

Aged Care is an industry to which there are many aspects. From this page you can go to the YOURLifeChoices Aged Care A to Z guide which will help you understand all the industry terminology. Plus there’s a section updating you on the latest news and information on the difficult issue of Elder Abuse. If you’re looking for aged care accommodation, you’ll find our housing options page useful. The Aids and Equipment section offers a practical resource guide for all your household and personal needs. And last but not least, go to the Carers’ Connections page, and you’ll find informative resources and articles about these important and often undervalued community members.

Support for aged care residents

The elderly and infirm are some of the most vulnerable people within our communities and are often the target of those less scrupulous.

Physical, psychological, financial or sexual neglect or violence, which takes advantage of this vulnerability, are all forms of elder abuse. Many find it hard to admit that the perpetrators of elderly abuse can be, and often are, those closest to the person, whether their professional or personal carer, their family or trusted friend. Elderly people may also feel isolated from society or live alone, making them easy prey for perpetrators.

Elder abuse is a social problem, the reality of which many find difficult to accept. The forms which elder abuse can take are many:

· physical abuse, which may range from pushing and kicking to biting and burning.
· emotional or psychological abuse, in which the victim is treated with aggression, or bullied, coerced or forced into a fearful or distressed state of mind.
· financial abuse, which includes misuse of funds, forgery of documents, embezzlement, stealing, denial of access to funds, forced changes to financial arrangements and the use of the elderly person’s money to purchase items without their knowledge.
· sexual abuse, which may range from forced, inappropriate nudity, touching and other sexual behaviour to rape.

There are other forms of elder abuse such as general neglect of the elderly person’s basic needs, especially when left in care. The degree of neglect can be subtle but if left to compound over time, can be considered an abuse of fundamental human rights, such as respect, equality and freedom of choice.

The issue of elder abuse concerns all levels of society: individuals, families, communities, the police and legal fraternity, public and private aged care providers, including retirement villages, and State and Federal Governments. Below are details of state based organisations that offer support, advise and information for the elderly.

New South Wales - The Aged-care Rights Service
www.tars.com.au

Victoria - Elder Rights Advocacy
www.era.asn.au

Queensland - Queensland Aged and Disability Advocacy Inc.
www.qada.org.au

South Australia - Aged Rights Advocacy Service Inc.
www.sa.agedrights.asn.au

Western Australia - The Alliance for the Prevention of Elder Abuse
apeawa.advocare.org.au/

Tasmania - Advocacy Tasmania Inc
www.advocacytasmania.org.au

NT - Darwin - Darwin Community Legal Service

NT - Alice Springs - CatholicCare NT
www.catholiccarent.org.au

Australian Capital Territory - ACT Disability, Aged and Carer Advocacy Service
www.adacas.org.au

Is aged-care for me?

The decision to enter aged-care is not one to be taken lightly and there is assistance to help ease the burden.

For many, aged care conjures up images of cold, lonely facilities with row of beds, filled by residents who have no-one to care for them.  The reality is often far from this image and aged care can be provided through different means.  Anyone who considers that they, or someone they care for is in need of additional care, should discuss their circumstances with their own doctor, who will be able to advise if an assessment by an Aged Care Assessment Team (ACAT) is required.

ACATs are usually based with a hospital or community centre and consist of qualified individuals who can assess the level of care required. Aged care can often be provided at home, even for complex cases. ACATs will assess if this is possible and can arrange a Home and Community Care Package (HCCP), a Community Aged Care Package (CACP) or an Extended Aged Care at Home Package (EACH) for more complex cases. It is also possible to arrange an EACH Dementia Package for Dementia sufferers who are best served by staying at home but need additional care. These packages are subsidised by the Australian Government. 

If it is deemed that residential care best suits your needs, the ACAT can approve high-level care in a nursing home or low-level care in a hostel. Depending on your needs, the ACAT can assist with finding you a suitable aged care facility in your region.

To make an appointment with an ACAT, you can do so via your own doctor or contact a Commonwealth Respite and Carelink Centre by calling 1800 052 222 or click on YOURLifeChoices simple shortcut.

Planning for aged care

Accommodation bonds can be the equivalent of a blank cheque to some aged care facilities but what can you do to ensure you’re being treated fairly?

Aged care facilities charge potential residents an accommodation bond which can vary from $130,000 to almost $1,000,000 if you wish to reside in Melbourne or Sydney.  Few facilities offer set fees and the amount you pay is generally equal to the amount you have available, minus the government mandated $37,500 that a resident must be left with. High-care facilities are not at present able to charge such a bond although this may change.

So what happens to all this cash that the facility management takes from its resident?  It does earn interest but the facility management is allowed to retain an amount each month, which is currently capped at $299 and this can be taken for a maximum of five years.  Are you beginning to understand why so much is taken as an initial bond?  Now, of course there are liabilities involved with running an aged care facility and the management has to ensure that it will not be left out of pocket but this does not mean a set scale of accommodation bonds would not be a fairer method.

Until this changes potential residents are left with the task of finding the money required before they can access the care they need.  For many this may mean liquidating assets such as selling the family home, which has consequences:
· there may be a remaining spouse that needs somewhere to live
· proceeds from the sale of a family home are exempt from the Centrelink asset test for up to two years; this will not apply to the amount used as an accommodation bond, which may in turn mean a lower Age Pension.
Some facilities will accept the bond in partial payment but interest will accrue on the part unpaid.  The upside of this is that by paying your bond in this manner, any income received from renting out the family home is not assessed by Centrelink.

Another option may be getting an adult child to pay the bond but there may be knock on effects in terms of the distribution of the estate. Reverse mortgages are often used to finance this kind of bond but it needs to be borne in mind that interest on the loan is capitalised and will therefore increase the amount owed.  Many lenders will guarantee that you will not go into negative equity, this is an extremely important aspect of the loan to be determined before signing on the bottom line.

On top of the bond, there are also ongoing daily fees that cover extras not included in the standard fee structure.  Daily fees are income-tested and are currently capped at $60 per day, a substantial amount over the course of a stay.  Actions can be taken to reduce your assessable income which can reduce your income-tested fee.

So before you sell up the family home and knock on the door of your nearest aged-care facility looking for a bed, seek independent financial advice from a planner that specialises in managing aged-care funding.  Such a plan can cost between $500 and $2000 depending on the complexity but it can save you a small fortune in the long term.

To find an independent financial planner in your area, click YOURLifeChoices simple shortcut to the Financial Planning Association

Simplifying aged care fees

Fees and charges applied by aged care facilities are asset and income tested, making it difficult to understand what you will be liable to pay.

Firstly, if you are entering a low care facility, you may have to pay an accommodation bond.  If your assets are between $37,500 and $93,410.40, you may be asked to pay a small accommodation bond and you will be considered a partially subsidised resident. If your assets are over $93,410.40 then you will be asked to pay a bond, on which there is no limit but you must be left with assets of $37,500.

If you are entering a high care facility, you may be asked to pay an accommodation charge.  With assets below $37,500, you will have no charge to pay, assets between $37,500 and $93,410.40 you will pay between $1 and $26.88 daily, based on a sliding scale and with assets over $93.410.40, you will pay $26.88 daily.  High level care facilities can only enforce an accommodation charge if they have received Government certification.

Once you have entered a care facility, whether low or high care, you may be required to pay a basic daily fee and an income-tested fee.

Basic daily fee
You will be required to pay a daily fee at one of the following rates:
· a standard rate of $38.65 per day will apply to most aged care residents.
· a protected rate of $35.29 per day will apply to people in care on 19 September 2009 who did not get the benefit of a pension increase.
· a phased rate of $35.89 per day will apply to people who enter care on or after 20 September 2009 who did not get the benefit of a pension increase. This rate will increase to 78% of the basic age pension on 20 March 2010.
· a non-standard rate of $43.95 per day will apply to certain people who entered care prior to 20 March 2008.

Income-tested fee
Residents with a total assessable income above the maximum income of a full pensioner are required to pay an income-tested fee. This is based on total income and is currently capped at $62.11. It is reviewed four times every year.

For a full schedule of fees and charges, click on YOURLifeChoices simple shortcut.

Entering aged-care

YOURLifeChoices subscriber, Heidi, has recently moved her mother into an aged-care facility.  What is Centrelink’s two year ruling on the sale of her mother’s home.

Q. Heidi
My mother has just entered residential high level care in an aged-care facility. There is no accommodation bond just an accommodation charge and the daily basic care fee payable but I believe there is some kind of “two year ruling” regarding Centrelink and the sale of her home. Can you please explain this to me her daughter?

A. If a pensioner vacates their principal home to enter a care situation, their home continues to be an exempt asset under the assets test for a two year period and the person continues to be assessed as a homeowner. This provision applies irrespective of whether the person intends to return their principal home or not.
A care situation includes:
· community based care - where care is provided in a private home for 14 consecutive days or more
· nursing homes
· long term hospital stay
· hostels - approved aged care homes that receive subsidies under the Aged Care Act 1997.

If, after two years, the person has not returned to their principal home:
· the pensioner is treated as a non-homeowner and the higher asset limits are apply, and
· the person’s principal home is counted an assessable asset

Please also note that the principal home can be exempted indefinitely under the assets test if:
· the pensioner entered a care situation on or after 1 July 2004, and
· the resident is accruing a liability to pay an accommodation charge, and
· their principal home is rented.
(The rent received is also exempt from the income test for the period that the principal home is exempt under the income test.)

For more information, call Centrelink’s Financial Information Service on 13 2300.

Aged care complaints review

There have been many questions raised about the process of dealing with complaints made against aged care facilities.  This has lead to a review of the process and offers you the chance to have your say.

Public input is being sought on the operation of the Aged Care Complaints Investigation Scheme (CIS) which was introduced in May 2007.  The aim of the scheme is to address concerns about the service or quality of care being provided to elderly Australians receiving Commonwealth funded aged care services.

The review is considering aspects of the CIS including:

· processes, practices and timelines of responses to complaints
· communication between CIS and stakeholders
· training provided to investigators
· framework used for escalation of complaints
· relationship between the CIS, Aged Care Commissioner, Aged Care Standards and Accreditation Agency Ltd and other relevant bodies.

Public submissions close on Friday 28 August 2009 and can be made via the Department of Health and Ageing website.

Carer Programs

A carer is a person who, through family relationship or friendship, looks after a frail older person or someone with a disability or chronic illness. Caring can be demanding so that carers themselves can need support. The Australian Government has a range of programs and initiatives which support carers.