While we all hope navigating and accessing the aged care system will be a problem-free experience, like all good things, it does come with some pitfalls. These issues can be serious and may result in seeking outside support such as an aged care advocate.
In Australia, the Older Persons Advocacy Network (OPAN) is a national network of nine state and territory organisations that help support older people by providing advocacy, information and education services.
These member organisations work alongside older people, their families, friends, carers or aged care staff to help resolve a variety of aged care issues.
Member organisations include Queensland’s Aged and Disability Advocacy Australia (ADA Australia).
Every year, OPAN publishes a report called Presenting Issues. This document highlights the top issues older people face when accessing home care or residential care.
The 2023-24 edition features information sourced from over 44,000 calls for support, a 20% increase in the number of calls they received in 2022-23. Unfortunately, many stubborn systemic issues in aged care have not been addressed in the past year.
So what exactly are those issues? We’re looking at the top five reasons why older people need advocacy and support while using aged care.
Communication is a recurring theme throughout OPAN’s report. OPAN’s Chief Executive Officer Craig Gear shared that it topped the list as the biggest problem for older people for the second consecutive year.
“When providers fail to communicate with older people, when they fail to support older people to exercise their basic human right to make decisions about the way they live their life, older people feel disregarded, disrespected and devalued,” he said.
Communication issues were often linked to a lack of information and support, another issue advocates regularly deal with. Older people stated they felt like they were not being listened to, kept in the dark about service changes or ignored when raising a complaint.
A case example shared by OPAN detailed how aged care advocates can help when poor communication occurs. In this instance, a home care client was being charged for personal care but only receiving domestic assistance like cleaning. Their service provider was not returning any phone calls.
The advocate visited the older person to view their statement and discuss the details. They then contacted the service provider and requested a review of charges, a care plan review, and more regular communication with the older person.
After reviewing the plan, the care coordinator reimbursed $1,000 to the client. An official care plan review was also booked to resolve the issue in the long term.
Recurring problems with equipment and assistive technology left many older people facing lengthy delays for essential equipment or repairs. Poor communication and contradictory advice were also co-contributing factors.
Long wait times and poor communication can easily lead to negative health and well-being if someone can’t do everyday tasks without necessary assistive technology.
Some problems can even appear easy to solve yet prove burdensome. After experiencing countless delays in repairing an electric bed, an older person’s carer (also their partner) contacted an advocate for help.
The bed, organised through a home care provider, arrived in February 2023 and stopped working one month later. Their service provider had organised repairs which were delayed due to an additional part not being in stock.
By November 2023 the bed had still not been fixed. No one had communicated with the older person about when it could be repaired.
The advocate contacted the case manager and equipment provider. They discovered the equipment provider had ongoing issues with their supplier, and ultimately, a communication breakdown stalled progress. With the advocate’s support and insistence, the bed was fixed within three weeks.
Aged care financial policies, invoices and statements can be a minefield to navigate. Older people are often confused over their fees and charges due to financial complexities, inconsistencies and lack of coordination between providers and services.
The lack of transparency and clarity in provider invoices, statements and agreements is another reason people seek advocacy services. As seen in the first example where an individual was being charged for services they were not receiving, poor communication plays a role.
Some situations involve older people receiving statements that do not specify what the charges are for or when they received the service mentioned. Therefore, individuals were often worried about overcharges or financial errors, yet their service provider provided no clarification.
Confusion is also common when older people have to navigate Services Australia because they receive an aged pension. Understanding means-testing and whether someone has to pay more for their aged care services is essential but often not explained well.
Advocates are regularly called in to provide clarity. OPAN’s report highlighted instances where they explained fee structures, provided financial information and successfully engaged with service providers.
Many examples saw older people reimbursed after being overcharged by their provider, including situations where this was unintentional due to circumstance changes.
Overall, service access and delivery issues accounted for a whopping 74% of calls to advocacy services across 2023-24.
These issues, like many others, are often related and are linked to problems with:
OPAN said older people often contacted advocates because they needed help understanding the range of aged care programs available and the processes for accessing them.
Examples included people seeking information about the aged care gateway, My Aged Care. Many felt frustrated or confused by the depth of information on the website or issues with navigation and internet connectivity.
People were even frustrated after calling My Aged Care staff. Several instances saw older people redirected to a local aged care assessment team only to be told they should speak to My Aged Care.
Poor communication again plays a part here as service providers were at fault for not explaining why an approved service could not be delivered.
One example was an older person approved for Commonwealth Home Support Program (CHSP) gardening services. They had been assigned a referral code from their aged care assessment team that was sent to and approved by a CHSP service provider.
However, the service provider never contacted the person and the gardening never began. The person was still charged for the service and only after 14 months of waiting did they contact an advocate because they didn’t even know who the service provider was and why the service was not being delivered.
The advocate helped uncover that the service provider could not provide gardening services in the location. The provider had released the referral code, which meant another provider could have stepped in, but this was never communicated to the older person. The advocate supplied a list of other local providers and the older person followed up with them directly.
Complaints support is often linked to poor communication, plus other essential rights such as supported decision-making.
Many advocates observed that callers felt their needs, preferences and concerns were unmet. While this directly impacts the support older people receive, it also forces many to go through a stressful formal complaint process when simple communication and understanding could help.
Advocates were involved in several cases where they provided critical mediation and support. They helped when aged care recipient and staff relationships had broken down, the quality and suitability of food were below par, or the complaint process escalated to involve the Aged Care Quality and Safety Commission.
Advocates offered insight, resources and access to extensive professional networks designed to help people facing issues big or small. Regardless of the impact, there are many examples in OPAN’s report of older people’s rights being eroded.
The new Aged Care Act that will come into force in 2025 will place the rights that older people have at the heart of aged care. It will also present its own challenges as service providers navigate how to implement its framework across new features like the new home care program, Support at Home, and the new-look co-contribution requirements.
Communication, information provision and transparency will be essential here. But if there are any issues, advocates will continue to provide crucial support. Importantly, that support and advice will remain free.
Aged care advocacy services are independent, free of charge and available across Australia. Call the Aged Care Advocacy Line 1800 700 600 to talk to ADA Australia or an aged care advocacy service in your State or Territory. You can find more information about ADA Australia at adaaustralia.com.au.
