Home Care vs Residential Aged Care

It is totally understandable that most older people wish to stay at home for as long as they can. Many have lived in their homes for decades and raised families there. Homes, and the comfort and independence that they bring, hold deep emotional attachments for many older people.

As Australia’s population ages, the trend is that people are remaining at home longer. Some are not moving into aged care until their late 80s or even 90s, if at all. The demand for home care and aged care will continue to increase; by 2050 the number of Australians aged 85 and over is expected to more than triple, to 1.8 million.

The government has seen the sense in people staying at home as long as possible. It costs on average of $400 a day for each resident in residential aged care, and many Australians only pay $63.82 per day of that (85 per cent of the daily full pension). Governments must make up the shortfall. For governments, home care packages are much less expensive.

When it comes to home care, people can choose a service provider that is right for them. The government then pays the provider a subsidy to arrange a package of care services to meet the needs of a patient.

Government-funded home-care packages come in four different care levels. My Aged Care organises assessments of a person’s needs, which is carried out by an aged care assessment service (ACAS) nurse, who visits them at home. This assessment determines what sort of home care package a person is eligible for. The waiting period for a home-care package can vary greatly, sometimes up to 12 months.

Self-funded retirees or part-pensioners will be asked to contribute some of the value of their home-care packages. The government pays the rest. This is called an income tested fee and is determined by the Department of Health and Human Services. Full pensioners are not asked to pay this contribution. Barbara Ould, CEO of care and support provider Absolute Care and Health – which administers home care packages – says it is important to understand what is provided under each level of care.

“A level 1 package covers basic things like assistance with cleaning and gardening; a level 2 package is for people who are still independent, and also covers shopping, assistance with attending appointments, and assistance with cooking; a level 3 package also includes cleaning, cooking, gardening, and some nursing assistance if required; a level 4 package is for people who are no longer independent and also includes regular nursing services.

It’s important to understand that home-care packages do not cover food, accommodation, entertainment, full-time nursing, security or access to transport.” Despite the excellent care that people can receive at home, eventually the practicalities of remaining at home can outweigh the emotions. Often children are the ones who must make the decision to move a parent into a form of residential aged-care, which ranges from retirement villages, to independent living in a community, to high-care residences.

Reasons why older people could consider a transition into aged-care include:

• Cost: As people age, the level of help required at home will generally increase. Some older people are happy getting, say, assistance for four or five hours a day, generally in the morning or getting help with evening meals. However, when help is required 24 hours a day, home care becomes hugely expensive and a home-care package will only cover a small portion of this. Often there is little change from $5,000 per week or $260,000 per annum for full-time care. By contrast, aged care can cost less than $65 a day for many Australians, which equates to around $24,000 per annum. There can be other incidental fees, such as the extra services fee and a Centrelink means-tested fee. The refundable accommodation deposit (RAD, formerly known as a bond) must be paid, but that is fully refundable.
  
  
• Difficulty of finding/managing quality carers: Finding carers who genuinely care for older people for a lengthy time can be a challenge. When more than one carer is needed (24-hour-a day care requires four or five carers), the problem becomes even greater. Managing multiple carers can be a difficult juggling act, and removing a sub-standard carer can sometimes be difficult.
  
  
• Loneliness: As much as older people value the independence of remaining at home, an empty house can be a lonely place, despite carers visiting during the day, particularly if a husband/wife has died. By contrast, modern aged-care residences have good and varied social calendars and try hard to include new residents. Security, too, is often better in aged-care residences.
  
  
• Strain and stress on family:  Managing home-care rosters can be time-consuming and can, in some instances, breed resentment among family members who end up doing most of the work. When parents transfer into aged care, their children and grandchildren can spend quality time with them without having to play the roles of principal carers at home.
  
  
• New modern aged-care residences: Modern aged-care residences are often bright, clean and vibrant, often far more modern and pleasant than a tired family home. Many have libraries and meeting areas, restaurants and cinemas, even swimming pools.
  
  
• Medical staff and facilities: Quality aged-care residences all have medical staff and medical facilities available either within the premises, or on call in retirement villages. As people age their reliance on medical services generally increases. Having medically trained people on hand leads to great peace of mind.

Our experienced Melbourne aged care advisors can help simplify this complex journey. Contact us today to learn more about how we can assist you in making informed decisions for your loved one’s aged care needs.

Note: Figures are accurate as of the publication date