In our series about aged care, we’ve been exploring some different and important ways of thinking about growing older and potential care and support needs, how we need to start normalising our conversations about it, and how women shouldn’t need to carry the full burden.
If it’s become evident that an older relative in your life might benefit from some extra support at home, exploring an in-home aged care package could be worthwhile.
When it’s time to get down to the real options available for getting support at home, delving into this space can feel like a minefield. Questions regarding the different types of in-home services and packages available and knowing when and how to apply, can confound even the most dedicated researcher. Moreover, this process often exacerbates the stress many families are already experiencing.
Through this piece, we’ve endeavoured to untangle some of the knots and empower you and your loved ones to take the next step in this journey with greater confidence.
Remember, accessing in-home support is a smart thing.
As we’ve acknowledged previously, confronting the reality that a parent, or older relative needs support to remain at home can be uncomfortable for many families.
Not surprisingly, most people hate the idea of losing their independence and some people have real concerns about having strangers enter their home. For many people and their family members, there’s often uncertainty about what a home care package involves and whether it’s going to be the right fit.
Professor Lee-Fay Low, an expert in ageing and health at the University of Sydney, told Women’s Agenda that as soon as an older person or their family notices they are having trouble with basic tasks around the house, or in the community, it’s the right time to start thinking about in-home care options.
“If you don’t get in early, by the time you really, really need the service and you can’t manage without it, you’ll still have to wait,” Professor Low said.
Professor Low emphasises the importance of seeing in-home aged care, as taking proactive steps to stay in control and live safely in your own home, not as ‘giving in’ to a loss of independence. She says it’s important to reframe the picture so we view accessing help – with house cleaning, meal preparation, gardening, washing and personal care, transportation, shopping, and even social support- as the individual taking action to make sure they can maintain their lifestyle at home for as long as possible.
“The ‘reablement’ framework is meant to support the person to regain function or to do things themselves as much as possible and have control and say in how those services are delivered,” Professor Low says.
Acting early and not waiting for an accident or crisis to strike is important because it can prevent or at least delay possible health crises or accidents and avoid hospital admissions – something we all should try to do. It also means the individual gets the chance to ease into having more support at home, which can take some adjustment.
There are lots of options, but first check in with My Aged Care
There is no getting around it, to access government subsidised in-home care and find out what’s available, you need to get in touch with My Aged Care, the federal government’s aged care portal.
The My Aged Care website (or phone 1800 200 422) is your starting point. It’s where you get your assessment – the vital first step – to find out what kind of care you are eligible for, what services are available, and what you might need to pay for these services. As Professor Low advises, there can be lengthy wait times for Home Care Packages, up to a year, so it’s best to get an assessment as soon as possible.
There are two steps involved in getting assessed. The first step is where you provide some basic information to My Aged Care, either online or over the phone, about why you are there and some of the things you’ve noticed you need some help with. The second step is a face-to-face assessment that happens in your home.
The type of support needed varies for different people. For some, it might mean help to get to the shops or appointments, for others it could be more personal care like having a shower and getting dressed for the day.
Some people may need modifications to their home to improve movement and access – like having a ramp installed or a bathroom redesigned- while other families might need respite care so a regular carer can take a break.
Within a week or so of the face to face assessment, you receive a letter from My Aged Care telling you what level of support you have been approved for. If you are eligible for a Home Care Package, you will be told if it is Level 1, 2, 3 or 4, each offering a different amount of funds. Unfortunately being ‘approved’ is not the same as actually receiving the funding and getting started with your support. This is where the waiting time comes in.
In the meantime, now that you know what level of support you are eligible for, you can do your research, to get a good understanding of what you can and can’t use your home care funding for, and you should start looking at and comparing providers. This way, when your package comes through, you’ll be ready to get started right away.
What to look for in a service provider
Choosing a service provider can be daunting. There are lots of options, and providers can deliver services differently, so it’s important to consider your unique needs.
The My Aged Care website allows you to search providers by location, the services they offer and special criteria that might be important to you. For example, you need to consider if the provider’s location is close enough, and whether they can provide the services you need. Make sure the carers can speak your language or understand any special needs you might have. If you’re in a regional area, look into providers that know your area and aren’t coming in from a big distance. If an older person has dementia, find out how much dementia expertise the provider offers.
It’s important to establish that the care provided is high quality and that the provider is meeting compliance checks – you can do this by looking at the compliance section of their profile on the provider section of the My Aged Care website.
Costs are also important and can vary enormously. Professor Low advises examining how much each provider charges in admin costs. How much you’re expected to contribute personally to a government subsidised package will vary based on the type of care you’re approved for, the provider you choose, and your personal financial circumstances.
Tips for managing in-home care
When you are advised that you have been allocated your Home Care Package, you’ll get a unique code that you will give to the provider you have chosen, enabling them to receive and hold your funding. And you’re ready to go.
According to Professor Low, you should meet your case manager or care coordinator before starting your services, as often the person who does the first assessment isn’t the person coordinating the care you’ll receive.
“You want to make sure you meet the person that you’re going to be dealing with day-to-day, preferably with a home visit,” she says.
There are a few different ways you and your family can opt to manage your Home Care Package, and it’s worth remembering that in Australia, all in-home care is meant to be delivered in a way that gives a person choice and control over their lives. The amount of choice and control you have is up to each person.
For some people, having someone else make all the decisions is just fine. For others, who want to have more control over the exact services they receive, who comes to deliver them and when, ‘self-management’ might be a better option. This way, you employ your own support workers and manage the schedule yourself. Professor Low says self-management is a good option for some families, as long as they have good organisational and management skills.
“It’s unusual for the older person to self-manage, it usually falls to the family,” she says.
“You need to be English literate, you need access to technology, be organised, and have time to be able to do it. You also need some level of ability to be assertive and know what you want and be able to negotiate to get what you want. You have to be prepared to stand up for yourself, and advocate for what you’re after.”
You can also negotiate a combined approach where you might self-manage some things and have other things managed for you. Many people choose to manage some things themselves to save on administration fees and get more support hours from their package. If you’re using a platform like Mable to connect with support people, the platform helps with administration and can simplify the process while you feel more in control.
“You’re essentially hiring your own care support staff and you will know exactly who’s coming into your house and you have a say in that, and when they come,” adds Professor Low. “And a much bigger say in what they do, because you’re dealing directly with that person, not through the care coordinator or the case manager.”
Not all Home Care Package providers let you self-manage your services so that’s another important question to ask when you’re deciding on a package provider. There are also some service providers – like Home Made and Let’s Get Care – that specialise in self-management.
Changing providers and opting to manage things differently
If you’re not happy with your Home Care ackage provider, it’s never too late to change providers, or perhaps opt to manage things differently by trying self-management.
If you want to explore that option, COTA Australia has some great information available on self-management. Professor Low suggests also finding a way to connect with other families who are self-managing their care – perhaps through a closed Facebook group – as it may be helpful learning from other people’s experiences before taking the plunge.