Is the home care system too confusing? Absolutely!
When an ageing relative needs care, many of us try to find out if home care is an option. Home care allows up to around 20 hours of assistance per week (depending on the package level) and provides help at home such as personal and nursing care, domestic assistance, help with getting to and from appointments, gardening and maintenance.
Aged care service is an essential service, with about 120,000 Australians on the waiting list for a government funded home care package (HCP). This doesn’t include services provided by the private sector funded by the individual and families.
Throughout my career, I have seen literally thousands of people go through this with their loved ones. And the reality is that due to the complexity and the delays in the system, many never receive the services they need until it’s too late. I find I see the same issues occur again and again, and I believe there are many problems which need to be addressed with the current home care system.
When Pat* applied for a HCP for her ageing father, she was very happy to let me know she had been approved for a Level 2 package. She contacted me to get help with contacting home care providers to see what was available in her area.
I asked if it was approved or allocated and she told me it was approved – I had to be the bearer of bad news and let her know that she didn’t have a HCP for her dad, instead he had been placed on the national waiting list. Approved simply means the government agrees the applicant is entitled to a specific HCP. It doesn’t mean you have been allocated one and until you’re allocated it, you can’t access the funds. Remember – there are 120,000 Australians on the waiting list.
I then worked with Pat to explain to her how the system works. I explained that private home care was an option and that even if she did engage a home care provider privately, her dad would not lose his place in the queue. Once the HCP was allocated to him, they could drop the private home care. This meant privately funding the care for 12 months and after that, her dad had his government funded package.
On top of that, many people simply don’t know how to access a provider or understand the different services and fee structures that are offered. When you’re allocated a package, you’ll be given a referral code. Then it’s simply a matter of going out and finding a provider. But what if you’re completely unaware of what’s available in your area? Or if you don’t know what a package will include?
There are four levels in home care, with Level 1 providing the lowest number of hours and more basic care needs and Level 4 the highest for more complex care needs. But what does Level 2 or 3 mean? Does that mean cooking meals? Case management? Transport? Different providers may offer different services even for the same package level, which brings me to my next point.
There are thousands of home care providers in Australia and they’re all different. There are private providers, government providers and not-for-profits. I will often meet clients when they have been allocated a package, but the one provider they contacted won’t offer all of the services they’re looking for. I then point out that there are sometimes up to a dozen other home care providers in the area and they all offer different services.
Remember each provider is an individual organisation and is not the entire industry. When a provider says, ‘we can’t do that,’ often it means ‘we won’t do that’. Everyone must follow the guidelines however, interpretation is varied. It’s very important that the provider keeps the client as the centre of the discussion and if the client needs care or services to keep them safe and well at home, then there should be a way to fit it in the guidelines.
My clients often don’t understand there is room for negotiation, particularly when it comes to maximising the funding allocated per hour of your home care package.
For example, you may find that a neighbour is happy to do the cleaning for you for $20 per hour, so why would you engage an approved homecare provider at $53 per hour to do the same job? Ideally, the provider should support you to access appropriate services from any provider that you feel will best meet the needs of the person receiving care. You can take the cost of cleaning out of the home care package and replace that with other types of assistance you need.
How many of you are reading this because you either currently have an ageing relative who needs home care or has needed it recently? I’m betting most of you. As a culture, we tend to want to educate ourselves about things ahead of when we need them, such as how to get a home loan. However, this isn’t the case when it comes to aged care.
More education or government regulation is not going to help when people don’t want to access that information ahead of when there is an immediate need. If you find you are one of those people – and it’s very common, please don’t try to navigate this on your own. It would be like purchasing a property when you haven’t taken the time to be educated about stamp duty, government benefits or find out what a conveyancer does. It would be too overwhelming. My advice is to contact an independent consultant, use all of the government resources available to you, and don’t be afraid to build the support you need so your loved one gets the care they need as soon as possible.
*Names have been changed to protect privacy