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  • Writer's pictureKate Bradshaw

Considering Home Care

If you are considering in-home support for you or a loved one, it can be a confusing and difficult decision.

Older people needing extra help to live at home, whether that’s help with bathing, gardening, transport or physiotherapy, now have greater choice when it comes to the types of subsidised government care they receive.

In this blog we provide some tips and information on what to consider, what questions to ask and more importantly what to avoid.

Nita Hedrick was 85 years old when she slipped at home and broke her hip. Reluctant to move into residential aged care, Nita had been living alone.

After the fall, Nita lay on the floor for six hours until, luckily, a relative dropped by. Later in hospital, Nita conceded it was time to consider residential care. It took 15 weeks to find her a bed.

If you're in the process of weighing up options, Nita's story might resonate. Fear of moving to unknown surroundings, painful accidents, hospital visits and long waiting lists are just some of the issues faced daily by elderly Australians.

Step 1: ACAT assessment

Whether you're looking for in-home support or residential aged care, the first step is to contact the Aged Care Assessment Team (ACAT). ACAT will visit your home to review your needs and may approve eligibility for either community care (services delivered to you at home) or entry into a residential aged-care home.

Step 2: Understanding key issues and insights

Lack of consumer knowledge is perhaps the biggest issue when researching services. The sector can be confusing to navigate as there are a great many providers all offering slightly different service options. When selecting a provider, it is worthwhile talking to other people about their experiences and having a checklist that includes:

  • Does the provider include you in decisions about your support-How

  • How are staff selected and what can you do if you are uncomfortable with the person supporting you

  • Is the provider reliable and will you receive consistent support staff

  • How involved can relatives and friends be in your support

  • How can you complain if you need to

So how do people choose the right package for them or a family member? And what are the barriers to getting the right services?

What is a home care package?

A home care package is a tailored suite of services, subsidised to a set amount by federal funding, to help older people live in the community. Home care packages are consumer directed. This means people choose the services that make up their package rather than being told what services they are going to be given. Some people may prioritise having a clean home or taking their medication, others want help to exercise and socialise. Some may have special language or cultural needs.

Consumer direction means much more than just choosing from a list of services; people can ask for services not on the list, as long as they would help them live independently, safely and well. Before now, the government allocated home care packages to service providers. Once signed up, it was difficult to change providers if the person moved or if the provider wasn’t meeting their needs (such as not having staff that spoke their language) because most providers’ packages were filled and had waiting lists. So, how do you choose a new provider? Here are seven points to consider when making the switch.

1. Beware exit fees

Check your existing home care agreement so you understand any exit fees your current provider may charge.

2. List what you need

List the things you are looking for in your new service. These may relate to staff (gender, language, culture, consistency), availability (day, weekend or evening service), or range of service provided (physiotherapy, occupational therapy, gardening). Some providers provide certain services more flexibly and cheaply than others.

3. Find out what’s available nearby

Identify alternative providers in your area by calling myagedcare on 1800 200 422 or by using the improved search function on its website.

4. Do your homework

When interviewing and comparing providers, ask about:

  • fees: how much the provider charges for administration and case management fees (these can vary widely from 15-45%); the hourly rates for cleaning, personal care, allied health visits etc; average percentage of government subsidy available for clients to spend; ask for an example of a monthly statement to see how clear it is and how it shows accrual of unspent funds

  • staff: whether service providers employ their own staff or use agency staff; the level of training of their care coordinators (some have university degrees, others might have minimal training); the level of training of their care staff (some require certificate III or certificate IV, others might have speciality training in dementia)

  • communication and relationships: how often care coordinators visit and speak with clients; how regularly care plans are reviewed; how service providers ensure you will get consistent care workers.

5. Negotiate, negotiate

When you’ve chosen a new provider, or if you’re going to stay with your existing provider, negotiate a home care agreement. You can also negotiate your daily fee contribution (some providers charge less than the maximum allowable amount). Decide what you will use your package for and what you may pay for privately. For instance, it’s often cheaper to pay for cleaning and gardening privately.

6. Set a date to switch

Agree on a date to switch to your new provider and notify your old provider the date from which you will no longer be using its services. Make sure your current provider tells you how much unspent home care you have, and make sure this is transferred to your new care provider.

7. Use your referral code

Give a referral code to your new provider. This is on a letter sent to you by the Department of Health at the end of 2016. Your new provider needs this code to make sure the subsidy is paid to them; you can’t switch providers without this. If you don’t know your referral code, call myagedcare on 1800 200 422.

Giving consumers choice is meant to create market forces that drive innovation and enhance service quality. However, until older people become aware that they have choice, are given information to help make choices, and start acting on their choices, we might not see much change in the standard of home care.

Want to find out more? Visit our home care page to see what's available.

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