The Australian government’s proposed caps on domestic assistance services like gardening and cleaning as part of its new Support at Home Program have sparked significant concern among seniors and aged care advocates.
These proposed changes, which aim to streamline resources into clinical services, could have unintended consequences for elderly Australians, particularly those living in larger homes or with more complex needs.
Paul Sadler, an aged care expert with decades of experience, spoke candidly about the challenges these caps could create.
He noted that when the Home Care Packages and the Commonwealth Home Support Programme (CHSP) were first considered for integration in 2015-2016, there were concerns that too many resources were being allocated to services like cleaning and gardening, at the expense of clinical support.
“The concern was realistic,” Sadler explained, referring to a shift in focus towards increasing clinical services in the Support at Home Program.
The government’s intention is clear: they want to prioritise clinical care by removing co-contributions for clinical services, a shift that Sadler described as a “big message.” However, this shift comes at a cost, as these same reforms introduce caps on domestic assistance services, which have long been considered vital for older people living at home.
The proposed caps are stark—just 18 hours of gardening per year and one hour of cleaning per week—restrictions that Sadler believes fail to recognise the unique needs of many older Australians.
“Gardening and cleaning are services that older people need but also have difficulty accessing on the open market, especially if they are on a full pension,” he stated. While many may view gardening and cleaning as optional services, for some seniors, they are essential to maintaining a safe and liveable home environment.
Sadler recalls the many cases he encountered during his career as a community social worker, where older people struggled to maintain their gardens and homes.
“Thirty-five years ago, a major reason people were moving to residential care was because they couldn’t manage their gardens anymore,” he said. “It’s still a real issue for people today, particularly for those with larger homes or gardens.”
He highlighted that, although managing a garden may have been a personal responsibility throughout someone’s life, the need for help with these tasks increases significantly as people age.
Gardening, in particular, holds a sentimental value for many older people. “A lot of elderly people take great pride in their gardens,” Sadler explained. “For them, it’s a form of self-expression and often their only remaining link to the outside world.
“For those with larger gardens, the proposed 18-hour cap could severely limit their ability to maintain this important aspect of their lives.
Claire, the owner of Valley Care Gardening Services, which regularly organises gardening services for seniors as part of their home care packages, also voiced strong concerns about the proposed caps. “It’s crazy. It’s crazy the idea of only having 18 hours of gardening per year,” Claire said.
“Often, their gardens are their pride and joy. It’s also a safety issue if the lawns are so long that they can’t get out and enjoy that space or walk down a pathway because that work hasn’t been done. I think it’s disastrous.”
She went on to explain the practical implications of these caps. “Even a small back and front yard takes an hour, and you would need that done twice a month to keep things safe. That’s 24 hours of gardening for the year at a minimum,” Claire said.
“And places with bigger gardens could be upwards of 50 hours a year quite easily.” For many seniors, this level of care is essential not only to maintain the aesthetic and emotional value of their gardens but also to ensure their safety.
The implications of these caps are far-reaching. As Sadler highlighted, even current recipients of aged care services could find themselves facing reduced support. “The government intends for this cap to apply to everybody after 1 July, including those already receiving a greater level of domestic assistance,” he said.
This means many elderly Australians will be required to adjust to reduced service levels, despite having relied on more extensive support in the past.
While the government has stated that clinical services will not attract co-contributions, Sadler expressed concern over the broader impact on service recipients.
“The problem is, you’re effectively asking people to pay more for less,” he said, referring to the reality that seniors may need to cover the costs of services that were previously provided under their care packages. “It’s going to create a lot of difficult conversations between providers and clients.”
Interestingly, the government has not applied the same caps to the CHSP, which provides low-level support services. Sadler found this disparity baffling, noting that if the government is intent on capping services for Support at Home recipients, there should at least be consistency across all programs.
“It seems contradictory that you would apply a cap to Support at Home but not to CHSP,” he said. “CHSP funding is relatively modest, averaging around $3,500 per person annually, so it seems there’s less concern about its impact.”
The push to prioritise clinical services, while important, could leave vulnerable seniors without the necessary support to live independently. Sadler warned that, in the rush to refocus resources, the government might be overlooking the practical realities that many older Australians face.
“There’s a real contest between setting a cap that is realistic and its impact on older people,” he said. “Services like cleaning and gardening, although often overlooked, are fundamental to maintaining a dignified life at home.”
Thank you Paul for being able to speak out for our elderly. Cleaning and Gardening services are paramount in keeping consumers in their own homes for as long as possible, these are tasks that they could once do themselves, but as age catches up with them, they need assistance to continue to enable them to access their gardens safety and provide a clean and hygienic living space.
As a Home Care Provider I have several massive concerns about the new Support At Home system as presented.
The problem raised by Paul Sadler is Number 1 on my list of disasters about to happen with Support At Home:
The Government is making it mandatory for ordinary people to pay much more for their Home Care services out of their own pocket. The new “user pays” system will disproportionately and gravely hurt low income Clients.
Like Paul Sadler, I am particularly concerned for full Pensioners. Full Pensioners will now pay 5% of costs for services such as showering and personal care. They will also be forced to pay 17.5% of the costs of cleaning and gardening, and subsidised cleaning and gardening is capped at 1 hour per week for cleaning and 18 hours per year for gardening.
Even a 5% charge – let alone 17.5% – will be a SEVERE burden for anyone trying to live with dignity (or to live at all!) on a full Pension – and simply impossible for any full Pensioner who does not own a home and is trying to pay rent.
Most full Pensioners are struggling to pay their power bills. Pensioners who are renting are having to choose between food and rent – every week.
Even part-Pensioners will suffer. The co-payment increases with income – going as high as 80% of the cost for a fully self funded retiree. Yes – there are wealthy self funded retirees who don’t need any subsidy at all – but nearly all my Clients are either full or part Pensioners. Most of them cannot afford this. (We service rural areas of NSW).
As Paul Sadler says – an hour of cleaning per week and 18 hrs of garden help a year will be woefully inadequate anyway. That is certainly true for the majority of homes in rural areas.
The result: many full and part Pensioners will be forced to cancel cleaning and gardening services entirely because of the cost, and some will even have to cancel help with showering.
They will either live in increasing squalor with massive health risks or some will attempt physical work they are no longer safe to perform, resulting in falls, injury, hospitalisations and for some a premature death.
Pensioners in a home where 1 hour of cleaning per week and 18 of gardening per year is inadequate will also be forced to “do it themselves” unless they have a family member close who can do it for them.
The Support At Home program will cause increased mortality and force many more Pensioners into residential care which they do not want, and at far higher cost to the Government. This will be a truly perverse and insane outcome for what we are told is an Aged Care “reform.”
I am on a full pension with no other income (no shares, pots of hidden cash, super or savings on high interest. Cleaning and gardening are essential to me. I can’t stand on one leg, bend down safely without support or walk on uneven ground safely. I have had falls and am a ‘falls risk’. I live alone and have no family or community support for these tasks. I have unsuccessfully sought volunteer gardening in the past.
At this stage I need carer support at times as I have various surgeries and treatments that affect my independence in personal care, however, there are long periods in between where I require none of that.
I require gardening and cleaning at all times for which I have received at no cost. The proposed reduction in hours and imposition of a cost will mean I have to find not only funds from the pension for the fees but also extra funds for additional private hours. I don’t drink, smoke, eat out, go to movies, have holidays, buy expensive clothes or even have haircuts.
I am extremely grateful to have had this support as it has kept me independent in my own home. I know I am not alone in this situation as I cared for my mother for many years and managing the garden, cleaning and maintenance was the first and persistent limitation for her as she aged. Fortunately, she had me and me who was fit and able at that time.
I did try renting a room for extra income and help. He didn’t pay rent and robbed me of anything worth selling.
I hope this aspect of the HCP reform can be removed. Sitting in my maintained garden, seeing the flowers and birds at the birdbath, sipping a cuppa, is an absolute joy to me.
The government is attempting to support more people to live outside a residential aged care facility, but then stopping them from maintaining the environment that they live in. Having a clean environment directly affects a person’s health. Very near sighted strategy.
Thanks Jakob,
The Support at Home Handbook published 3 October points out that cleaning and gardening are “everyday living” category and full pensioners who previously paid zero will now pay 17.5% of the rate charged by the provider.
Also, from the Handbook –
Under Support at Home, providers will invoice the Australian Government for services delivered against each participant’s budget. The government will set price caps for each service type. Providers cannot charge unit prices that exceed these caps.
Price caps will be informed by advice from the Independent Health and Aged Care Pricing Authority (IHACPA) to ensure an equitable, fair and transparent approach to pricing of services. The price caps will include the full cost of service delivery, including administration costs.
Regards
Brian
The government needs to stop cutting services to the people that need them most! It is already overwhelming and stressful living on a pension that sometimes barely covers the basic needs. To remove or decrease anything is ridiculous! This includes anyone on jobseeker or any centrelink payment as well. These people need bloody increases not decreases!! Shame on the Australian government to send more money overseas than they use to help their own people. One last thing and my rant is over…who’s brilliant idea was it to make the poorest people in Australia to pay tax on their government payments? Do you realise all this does is cause people already in financial hardship to have a tax debt! Ridiculous to make people pay tax on any government payment!! We can do better!! We need to do better for the Australian people.
Why would these caps be called a ‘challenge’ in this article.
‘Challenge’ implies that there is an onus of obligation on the aged to work out how to make the caps effective. This is ridiculous. There is no challenge involved. The use of the word challenge to over ride ‘problem’ is to artificially minimise the situation. Why would you want to do that?