Jan 31, 2020

“Broken” home care system leaving older Australians abandoned and confused

Many older Australians are falling through the cracks when it comes to home care as they struggle to use an ill-conceived system and are simply unaware of the options available to them.

New research from the Consumer Policy Research Centre undertaken in partnership with the University of South Australia has found that complexity and a lack of transparency is a “major barrier” to older people obtaining the support they need.

“Older Australians are being abandoned by the system, often unable to access the necessary support to live happier, healthier lives at home,” said CPRC CEO, Lauren Solomon.

“What we have here is a system that has not been built for the people trying to access it. 

“That burden is simply being shifted to family, friends and healthcare professionals as people try to navigate this bewildering and broken system,” she said.

Many older people without support networks may simply be left behind.

“For those older people without adequate family or healthcare support, it’s unclear whether they would even be aware of the available Home Care Package support, let alone be able to access the system,” Ms Solomon said.

What is home care?

Home Care Packages were designed to provide older Australians with services that allowed them to keep living at home for longer, for example with help for cleaning, gardening, transport, and nursing. 

Many studies have shown that the majority of people would prefer to stay in their own homes rather than move into residential care. 

Burden of finding home care is falling on friends and family

The researchers surveyed 502 home care package recipients from across metropolitan Australia in June and July 2019.

The study found that 60 per cent of older people surveyed required help to find and choose a HCP provider. 

This “hidden burden” most commonly fell to already busy healthcare professionals (40 per cent) or family and friends (35 per cent).

Nearly one-third of HCP recipients (32 per cent) didn’t know what level of package funding they received.

More than one-third of recipients (36 per cent) reported difficulties understanding fees and charges.

It was “concerning” that nearly four in ten (39 per cent) said they had not received a care plan. Care plans are supposed to describe each care recipient’s assessed needs, state the services the individual will receive, who will provide those services, and when they will be provided. They are intended to help older people hold their providers to account.

The large majority, 80 per cent, said they wanted information about the quality of different providers, but that data is not available.

A shockingly small proportion – 6.8 per cent – said they used information on My Aged Care. Even fewer, 5.8 per cent, said they went online to find and compare information about Home Care Packages.

Almost half, 44 per cent, said they weren’t confident using the internet.

More money not the answer

Around 112,000 older Australians are still waiting to receive their correct level of home care. In November 2019, the Royal Commission into Aged Care Quality and Safety’s Interim Report called on the government to take “immediate action” to release more funding for more home care packages.

But Ms Solomon warned “pouring more packages into a broken system” will not improve outcomes.

“We need to fix the way older people and their carers are accessing the system. It needs to be easier, fairer and a lot more transparent,” she said.

Consumers making decisions in the dark

Council on the Ageing Australia Chief Executive, Ian Yates, said the survey is “further evidence” the home care system needs more support for consumers.

“People need access to simple, useful, comparable information about providers so they can make the best decisions about their care, especially when it comes to fees, charges and quality of service,” he said.

“Importantly, this study also proves that price is not always the most important consideration for consumers. Referral from trusted individuals like healthcare professionals, friends or family were much more important, as well as quality and reputation.”

Mr Yates said older Australians are being forced to make decisions about home care in the dark.

“What this tells us is that older Australians are sick of an aged care lottery where they are forced to choose a provider without the right information and chance determines the quality of the service they receive. This is simply not good enough,” he said.

Recommendations to emerge from the study

CPRC made several recommendations in its report, ‘Choosing care: the difficulties in navigating the Home Care Package market’.

  • Fees, prices and service information should be standardised and simplified so that people can compare their home care options. (Most – 88 per cent – of resondents supported simpler, clearer information and 82 per cent supported fees and charges simplification.)
  • Better support for healthcare professionals and carers.
  • Systems that make it easier for older Australians to connect with the appropriate home care providers
  • More transparency on the quality of different providers. (Of the respondents, 80 per cent said they wanted transparent information about provider quality.)

My Aged Care not delivering

CPRC also said the My Aged Care website is not delivering the Productivity Commission’s original vision, a view also stated in the royal commission’s Interim Report. The original visision was for older Australians to navigate the aged care system with the support of a person-centred navigator. 

“There is still no substitute for local knowledge and face-to-face interactions,” a statement from the CPRC said.

“We must design markets with people at the centre. Too often, older people and their experience of the market is just an afterthought,” Ms Solomon said.

Click here to read the CPRC’s report ‘Choosing care: the difficulties in navigating the Home Care Package market’.

Have you had problems accessing home care services for yourself or a loved one? Tell us about your experiences [email protected]

Image: LPETTET, iStock. Model is posed, stock image.


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