Aged Care Assessment Service (ACAS)
For most people the first step to be taken when considering the move into a residential aged care facility is to have an ACAS assessment. There are official ACAS teams who provide the assessment, however there are a mix of other health care and allied healthcare professionals who are involved. These include:
• Doctors
• Nurses
• Social workers
• Physiotherapists
• Occupational therapists
• Psychologists
This assessment identifies a person’s needs and care requirements. This could include home care or respite care or even full-time permanent care in a residential aged care facility.
A formal assessment is required before even considering a move into a residential aged care facility.
ACAS assessments can be arranged via a doctor, social worker or healthcare centre. People under 65 generally have an assessment via disability services. For more information, please see
• the Victorian Government’s information on Aged Care Assessment Services or
• the Australian Government’s Myagedcare information on Aged Care Assessment
The time between an ACAS assessment and entering an aged care facility varies. Some people have to go directly from a stay in hospital after an injury or illness. Many have some time in respite care, either to try a place out, or while they wait for a permanent place.
Waiting lists and transition times
The waiting time and transition time into Residential Aged Care varies widely, depending on the institution and an individual’s circumstances. Popular facilities are generally 100% full all the time, with beds filled from a waiting list as they become available. Other places may regularly have spare places.
Even where there is a waiting list, the length of waiting time is only one factor that a facility or service provider takes into consideration.
Many facilities:
• favour high care residents over low care
• give preference to people who come from or have close family members close by and
• give priority to people who immediately have to live in a residential aged care facility as they are in hospital or respite care.
90% of people assessed as needing residential aged care in 2013/14 were in a residential aged care facility after 9 months. Generally, people assessed as needing high level of care due to dementia took a little longer. This is probably because of the high demand on places in suitable facilities.
Respite care
People can access respite care in an aged care facility for a few days or weeks at a time. For some, this is to give their usual carer a needed break. For others it’s a great way to see if a place is suitable. 46% of admissions to aged care facilities in 2013/14 were for respite care.
Sometimes people can get stuck in respite care while they wait for a permanent place. Respite care is only for a few weeks in any one place, and then a person has to move on. Moving can be unsettling and exhausting for a frail or sick person and can have a considerable impact on their well-being.
High and Low Care
Aged care facilities receive funding according to the level of care a person needs. Until recently people in aged care were assessed as either needing high or low care. People needing higher care received higher level of funding for their care.
Now the distinction between low and high care is less distinct. This recognises different people need a wide range of levels of care. Many facilities prefer to take people with higher needs as this gives them better funding.
Lower level care provides help with meals, laundry and cleaning. It includes some respite care if recovering from an injury or illness. It can also provide some help with showering, toileting and dressing.
Higher level care includes the same support, plus extra help with
• Mobility
• Meals and eating and
• Nursing care.
Due to budgetary reasons, and the increasing number of people needing care, the Australian Government has made it more difficult to be assessed as needing higher levels of care in the 2016/2017 budget.
Fees
The financial side of transitioning to residential aged care can be a minefield, and it’s one that most people navigate in the dark. It’s complex and it can be easy to lose a lot of money or assets simply by not having the right information to avoid the risks.
Fees for an aged care facility include:
• A daily fee for meals, laundry and day-to-day costs. This is usually slightly less than an average pension. The actual cost will depend on a person’s income. The basic daily fee in 2016 is $42.25 per day. This figure changes slightly each March and September in line with the aged pension. There is also a means tested care fee for people on higher incomes than an average pension. The Australian Government’s Department of Human Services lets people know how much to pay after a means test.
• An accommodation payment – The amount to be paid depends on a person’s income and assets, as assessed by the Australian Government’s Department of Human Services.
• Fees for extra services – Some places charge extra for added services or a higher standard of accommodation.
Some places ask for a Refundable Accommodation Deposit or RAD. A RAD is a lump sum bond. They will return some or all of the amount when a person leaves. RADs can be really complex. It is certainly worth getting some expert advice.
The actual amount a person has to pay depends on their circumstances. While all aged care facilities have set fees, the Australian Government does provide significant contributions. The actual amount that the government will contribute depends on a person’s state of heath, assets and other issues. The government’s means test can be arduous even in the most straightforward cases. If a person’s income comes partially from overseas or they have a range of assets, it can get really complicated.
The MyAgedCare website has a fee estimator but for many this is largely unhelpful due to the many variables that are involved.
Residential Agreement
The Residential Agreement is a legal agreement when entering a residential aged care facility. You can sometimes negotiate some of the conditions, however it is certainly worth getting assistance and advice from a lawyer and/or financial advisor. There are lots of details to consider.
There’s no way around it: getting in to a residential aged care facility in Australia is complex. It’s time-consuming, daunting, and a steep learning curve with plenty of potential pitfalls.
Make sure to get the help you need to ensure best outcomes.