Jun 14, 2016

Home Care – What Are My Options?

When the time comes and your ageing parent requires additional support to remain safely in their own home, knowing what your options are when you have had little or no prior knowledge can be time consuming and stressful.

Unless you have friends or family that have accessed home care services previously then getting your head around what your options are will take time, so we have created this blog highlighting the pro’s and con’s for the 5 most common Home Care Options available for you to choose from, which are:

  1. Local council supports
  2. Home Care Packages
  3. Private home care Services
  4. Online platform connecting care seekers with carers and nurses
  5. Employ your own carer – advertise yourself

Over the past few years we have observed families trying a number of different ways of finding the flexible care that actually delivers what they really need. The summary of the options below are based on our experience and feedback from people in the community. Work out which one or more may work for your parent.

old mans hand

Council Supports

Local Council supports are generally limited to a few hours per week – either home help, shopping assistance, shower assistance or in home respite (this means a personal carer will come to the house, whilst you can go out).

If you are on a part or full pension – receiving council supports is the most cost effective. See the ACRC help sheet for estimated costs. If you are not on a pension, then the pricing for Council supports is means tested. If you are at the highest income threshold the hourly rate is somewhere similar to a private agency, therefore given they are often more flexible you may be best choosing a private agency.

Council supports and home care packages to an extent are more structured services, in that they are less flexible with the time of day they can visit and whilst they make every effort to send the same person, they have lesser capacity than private services. Some council supports are restricted in their ability to clean under rugs or up high on shelves – therefore some people may not find this adequate for what they needs. In terms of shopping assistance, some councils offer escorted shopping, whilst others may not be able to take the client with them.

There maybe up to a three week waiting period and can only provide a limited number of hours per week. Some families may opt to use council supports and arrange additional supports through a private agency.

old lady flowers

Home Care Packages

Home Care Packages since 1 July, 2015 are provided on a Consumer Directed Care (CDC) basis, which is suppose to provide consumers with greater choice, transparency and control. In the first stage, from 27 February 2017, funding for a home care package will follow the consumer. This will allow a consumer to choose a provider that is suited to them and to direct the funding to that provider. Allowing them the ability to shop around with different providers if you are not happy with the service you are getting.

Partially government funded packages available to eligible families. Depending on which package you receive this maybe enough to support you or your loved one for the time being at home.

There can be up to 6 months to 18 months wait list depending on which area you live in. So we suggest putting your name on the waiting list earlier rather than later.
You require an aged care assessment before you can start receiving a package and the assessor will determine which package you are eligible for.
If you needs are beyond what the package will offer, then you will need to either seek support from friends/family or pay privately to continue staying at home safely.

Make sure you read between the lines of your agreement. Find out how much of your package goes on administration costs (including case management fees). Also find out what happens to the money at the end of the financial year if the package funds have not all been spent.

Home Care Packages are government funded packages, as mentioned above you will require a Community Aged Care Assessment before being considering, simply phone MyAgedCare 1800 200 422.

old lady helping man

Private Home Care Service

Generally speaking private home care services are more flexible than Council supports and generally can assist with most types of support services and errands. Which makes it a great option for seniors to remain independently at home, however for some people a private agency maybe too expensive for their personal financial situation and will need to rely on council supports or a home care package.

Generally more flexible with their availability and the time of day they can visit and no waiting lists unlike Council supports. Often have a greater focus on ensuring continuity of care – this means sending the same person each day where possible. More flexible with the types of services they offer such as cooking assistance, companionship, shopping assistance that is escorted (this means they can take the person shopping).

For some people the cost of a private agency is more than what their budget allows for. For example an hourly weekday rate for a personal care attendant could be anywhere from $38 up to $50 per hour.
To find a private agency in your area simply “google” private home care services and [Name of your suburb]. Or ask around your friends or GP if they have any recommendations.

finding home care

Online Marketplace connecting care workers directly with consumers

An online marketplace is a site that allows consumers the ability to directly connect with professionals in their community.

As mentioned the site allow care seekers (seniors & their families) to connect directly with aged care workers (personal carers and nurses), which effectively cuts out most of the third party (or agency fee). As it’s all online, the aged care workers profile is listed on the directory of carers. All you have to do is search your local community and see which aged care workers show up as a match. You can then read what their skill levels and qualifications are, along with ratings and reviews giving you an idea of what others have said about them.

There are two main sites we have come across are “Better Caring” and “Find a Carer”. As the home care market opens up as a direct result of the changes seen with Consumer Directed Care, greater competition and no doubt more of these disruptive types of sites will continue to enter the market.

If managed well these types of sites have the capability of offering care seekers greater flexibility, choice and transparency at a fraction of the price. Whilst in Australia it’s a relatively new concept, it has been implemented in the United States and other countries effectively for some time.

Aged care workers on the platform are independent contractors and therefore set their own hourly rates (around $25 to $30 per hour). You can discuss and agree the rate and schedule with each individual care worker before engaging them.

As published on Better Caring’s site “we charge clients an additional 5% as a service fee, and deducts a 10% care worker service fee on the payment received by care workers”.

A cheaper option than some private home care agencies. The ability to read reviews of personal carers before they start caring for you.
You can use your government funding (including Consumer Directed Care packages and the NDIS) to select a particular individual or service provider to deliver your care or support. Allowing your government funding to go a lot further if you hire care and support workers directly, compared to engaging workers through third party agencies.

Not all of these platforms pre-vet the care workers on their platform. Check this out before hand to ensure yours or your loved ones safety.

It’s unclear how much or if any education or training staff are provided with. It appears that any education or training is up to the individual to ensure they keep up to date. Although having said that you can read ratings and reviews for some carers on the site from real people that have booked them – this is probably the best way to quality control, but asking consumers how their care was that they received.
It’s up to the care seeker/consumer to “case manage” your own needs. Which is ok if you have have someone capable of assisting with this.

caring old person

5. Employ your own carer – advertise yourself

This is a common scenario for families that want 24 hour support or a live in carer. Which whilst a cheaper option, it’s advisable to make sure you do thorough research and background checks to avoid being taken advantage of and minimise any potential safety issues that may arise if not carefully planned out. If you can find someone through a recommendation from a friend-of-a-friend then that’s always the best way.

A more cost effective and sustainable option financially, especially if you need 24 hour support.

Knowing what to ask for, especially if it’s your first time hiring a care worker can be stressful. Whilst it’s not something we would recommend unless you have support from family or are capable in finding this yourself. Things you should definitely check for with the potential person you employee:

  1. Proof of Qualifications (if they are a personal care worker (ask for a certified copy of Certificate IV Aged Care certificate) or if they are an enrolled nurse or registered nurse ask for their proof from Nursing Board’s website or you can do a search on their website.
  2. Current Police Check,
  3. Curriculum Vitae (CV)
  4. References for at least 2 -3 people they have worked with
  5. It’s advisable to consider insurance, in case the the care worker injures themselves during their shift, you would not want to be liable for any injuries sustained and caught in a difficult position.

You also should find out what ongoing training they have attended throughout the years. As they are working for themselves, it is up to the individual to ensure they continue to attend education and training sessions.

Tip: Considerations for Hospital Discharge

If you are parents are currently in hospital, then check with the discharge planner or social worker as they may be eligible for post discharge support services covered by their private health fund (if in a private hospital) or post acute care (if in a public hospital).

See our help sheet summarising Seniors Health Insurance via ACRC’s Help Sheets.

Do you have any experiences with home care services that you could share with the community to help make a difficult decision a little easier? Then be sure to write a comment.

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