Home care gives the elderly freedom

Sydney Morning Herald. Money Matters Pages 4 & 5
December 8, 2015

Bina Brown
Personal Finance Writer

Lisa Slater helps Jack Moulos get ready for an outing. Photo: Peter Rae

Every Monday, Better Caring careworker Lisa Slater collects Jack Moulos, 91, from his home in Sydney's eastern suburbs. Together with Jack's sister, Nell, 93, they head off to an art gallery, the Botanic Gardens and somewhere for lunch. For three hours, Jack's 89-year-old wife, Doreen, gets to do her own thing.

"Lisa is amazing with Dad and Aunty Nell. She throws herself into it and she is always taking them to interesting places, making it lively and extending their social contacts. Importantly, we know he is being looked after," says the daughter of Jack and Doreen, Carolyn Cox.

Lisa came to the Moulos family after an extensive search of the different caring options available for someone suffering dementia.

"The free services with Department of Veterans Affairs are fantastic but there were certain things like taking people out just for fun that they were not able to do. We wanted Dad to be engaged and Mum to have a break," Carolyn says.
Better Caring is an online platform where care workers and community members are matched according to their skills and needs. They negotiate their own hours and charges to suit each other.

Lisa, a former registered nurse, was recognised by the extended Moulos family as having the personality and credentials that would work for Jack, who is one of a handful of clients that Lisa cares for each week in some capacity.

"Better Caring allows me to be in control of who I care for and when. Jack and his sister Nell and I have a lot of fun finding new things to do each week," Lisa says.

Jack and Doreen are also on a government-subsidised home care package which gives them about seven hours a week of subsidised personal care services, including showering, shaving, help with physio exercises, cleaning and household chores and gardening.
The carers providing this assistance also serve as companions around the house and can take Jack for a short walk to the beach if the weather's right.

According to the government there are more than 350,000 people employed in the aged care sector, working in residential and community settings. By 2050 an estimated 827,100 people will be required to deliver a range of services to the 3.5 million elderly people expected to need them, the majority of them in their own home.

Given the choice, most older Australians would prefer to stay in their own home.

One way of making this happen is through an income-tested government subsidised home care package, delivered by approved providers to members of the community. There is also the Commonwealth home support program service as well as numerous providers offering a range of services on a privately funded basis.

To receive a home care package a person must first be assessed by health professionals within the Aged Care Assessment Team (ACAT) or the Aged Care Assessment Service (ACAS) in Victoria, who will then determine the appropriate level of support. (ACATs are arranged through myagedcare.gov.au).

There are four levels of home care package, ranging from low-level care (levels one and two) up to high-level care (levels three and four).

Customers can choose from a range of products, services and care solutions including domestic and shopping services, personal care, social activities, transport, home and garden maintenance, clinical and allied health services and the buying of equipment such as a walking frame.

The government provides a base level of funding, starting at $7822 a year for a level one package up to $47,567 for a level four.

For this everyone is asked to pay a basic care fee of $137.76 a fortnight (17.5 per cent of the single person rate of the basic Age Pension). Depending on your income you may be asked to contribute to your package but no one will be asked to pay more than $10,211.48 a year or $61,268 over a lifetime.

Once assessed as being eligible for a package it is up to the individual to find a provider in their area who has that package and can provide the services required. The number of hours of help provided depends on the type of service, but a level two package generally equates to about five hours and a level four between 10 and 15 hours.

Older Australians choosing to delay a transition to residential aged care and stay at home for longer means demand for three and four packages is high, says IRT Group chief executive Nieves Murray, whose organisation has about 700 Home Care Packages. Last year IRT provided in-home care to more than 2000 customers.

It is not unusual to be put on a wait list and customers can apply free of charge to be added to an unlimited number of provider wait lists, Murray says.

If you can afford it, you can bypass the government home care packages and secure any services you need privately with a home-care provider.

It is also possible to get a government package and top it up with privately funded care.

Since July 1, 2015, providers have been required to deliver all home care packages on a consumer-directed care basis, which gives customers greater control and choice over the type of care and services they receive, how and when they are delivered and who delivers them.

From February 2017, the funding package will be allocated directly to the consumer, further empowering them to choose any provider able to deliver their support and care services.
Bina Brown is a director of Third Age Matters, which organises aged care placement but not home care.