This could be the most important thing to consider before you downsize

Feb 22, 2020
For many people, the decision to downsize and maintain as much independence as possible is often a pre-emptive strike against moving into a nursing home. Source: Getty

When you start thinking about downsizing, it seems like there is a never-ending list of things you need to do, from decluttering to understanding the terms and conditions of your contract, right through to working out the implications for your pension. So thinking about care, especially if you don’t need it now, can seem like a ‘bridge to cross when we get to it’ … in other words something that can be put off until after you have downsized.

But the reality is that at some point most of us are going to need some sort of care. By that, I don’t mean that you are going to have to move into a nursing home, but there will likely come a time when you need some short-term help to recover from an illness or an operation, or you may need ongoing support to enable you to stay at home and of course, for some, there will be a need to move into residential aged care. So thinking about it now is a good idea, especially if you are one of those people who vow that this is the last time you are moving homes.

When you look at many newer homes and apartments, it may not be obvious but they often have what I call ‘care infrastructure’ in their design. By this, I mean the nice wide passages and doorways which give your new home that open, airy feeling may be part of the care infrastructure as the width may be based on accessibility for people using a walking frame or wheelchair. Similarly, a bathroom with a big walk-in shower with no steps, recess or door may actually be more about enabling you to get assistance should you need it than the luxury hotel vibe you’re feeling. Other care infrastructure can be impossible to see with the naked eye because they’re literally built into the walls and floors – things like the anchors for grab rails in the walls and sensors to detect falls in the floors which can be installed or activated if needed.

In most retirement villages you will find a string of call bells in the apartments or homes as well as in the community facilities. These call bells often create a sense of security, that in the event of an emergency help is close at hand and can be summoned quickly. But you really need to ask the question, who does the emergency call go to? There may be a person onsite 24/7 or during particular hours on certain days of the week, for example between 8.30am and 5pm Monday to Friday but in other cases, the call may simply be directed to emergency services. It’s not necessarily a problem — let’s face it, the onsite person may need to contact emergency services in certain circumstances anyway, but it’s more just about understanding who the call goes to and what that means for you in an emergency.

While many people downsize when they don’t need any care, for others the need to access care and support is a driving force in their decision. For these people, the decision to downsize and maintain as much independence as possible is often a pre-emptive strike against moving into a nursing home. There are a growing number of retirement communities which have been purpose-built to provide this balance of independent living with care and support, they often refer to themselves as care communities. In these communities, just like any other retirement community, you will find apartments or homes with communal facilities such as a community centre, swimming pool and library, but you will also typically find a central dining room (meals are often included in the weekly or monthly fee residents pay) and consulting rooms for a doctor, nurse or allied health professionals.

It is not uncommon in a care community for the manager or the person responsible for care to seek some sort of medical evaluation of you and your care needs before you move in. After all, they need to know that they’re going to be able to deliver the care and support you need. From your point of view this is important and so is understanding the cost. In some of the villages, it is an extra fixed weekly fee while in others it is a menu of services that you choose from and pay for what you use. In general, the first one can mean that you are paying for more than the care you are receiving early on with the expectation that when you need more care the extra you have paid now will cover it, while doing it strictly on a user pays basis may be fairer (especially if you don’t stay as long as you expect or your care needs don’t increase very much) either way it is important to understand at what point you would need to leave, either because your care needs cannot be met or you cannot afford that much care.

Care in a retirement community can be in the form of government-funded care such as the Commonwealth Home Support Programme (HSP) or Home Care Packages (HCP), or through private carers or a combination of both.

The amount you will pay for HSP services and for private care varies from one provider to another. It’s important to find out the cost as well as any related fees such as travel expenses before you agree to the service.

When it comes to HCP’s there are two components to the cost: a basic daily fee (based on the level of your package) and an income-tested care fee, which is means-tested by the government through Centrelink or Department of Veterans’ Affairs. The means assessment for people who already receive a means-tested pension, such as the age pension, is very simple in fact you do not need to complete a form as Centrelink or Department of Veterans Affairs already have your income information.

If you receive a pension which is not means-tested, such as the blind pension or the war widow pension or you are a self-funded retiree then to calculate your income-tested care fee you will need to complete the form. You should know that the assessment is not compulsory and there may be no benefit to you in completing the form. The income-tested care fee is capped at $15/day for part pensioners and $30/day for self-funded retirees – people who receive the full age pension don’t pay an income-tested care fee. Using the government’s fee estimator tool before you complete the form is a good idea.

Deciding to downsize is a big decision, financially and emotionally. For many people, it is something they only want to do once but the longevity of your downsizing decision may depend on your ability to get care, so it’s important to ask the question.

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