Aug 27, 2020

What’s involved in taking a loved one out of aged care?

The Covid-19 disaster sweeping through aged care has no doubt prompted plenty of family and friends to plan a ‘rescue’ mission for their loved one from a facility.

Even before an alarming number of elderly Australians started contracting and or dying from the disease, families were starting to work through the process that could be involved.

Aged care is not a prison, so the reality is you can take someone home anytime – forever – provided you had what you needed to look after them.

Residents have always been entitled to 52 annual social leave days; meaning they can spend nights away with family or friends while still keeping their subsidised place in aged care.

In the current environment that ability to move freely between a facility and a family home is more complicated due to strict isolation requirements in many jurisdictions.

In July the Government introduced a new temporary emergency leave provision which allows permanent aged care residents to take up to eight weeks leave, in addition to their social leave, from an aged care facility during an emergency situation. 

Clearly the pandemic is such a situation – as are natural or other disasters and epidemics.

Emergency leave is available from   April 1, 2020 to  September 30, 2020.

According to the Department of Health, as at August 24, 16 residential aged care clients have taken emergency leave and referred for services within the community.

The decision about whether to move someone out of aged care home is never an easy one and there are a couple of key things to consider under the new provisions.

There is the cost of care. As well as the ongoing fees currently being charged by the facility, there are potentially additional ones for care at home.

Whatever fees you are currently paying in aged care will continue to be charged whether you are on emergency or social leave. 

These include the basic daily fee (currently $52.25 a day), the means tested care fee (dependent on your income and assets but capped at about $28,000 a year) and if applicable, the daily accommodation payment and extra services fee.

If you were quick to move and take social leave when the pandemic struck in March, then any leave taken after April 1 could be counted as emergency leave and the facility should make the necessary adjustments.

The emergency leave period ends on  September 30 2020. After this date, all residents will have a full 52 day social leave balance for the 2020-21 financial year.

The emergency also opened the door to extra financial support for residents going to live with family to get help – the highest amount being the equivalent to a level four home care package or about $52,000 a year before costs  – with no further assessments needed. 

This top level or Tier 1 support is available to residents in a facility impacted by an outbreak of Covid-19 who take emergency leave either voluntarily or out of necessity. 

Older Persons Advocacy Network is assisting people with any temporary shift home, including pulling together a specialist team to support people with such a transition.

So far eight residential care clients have been referred through OPAN for Tier 1 services.

Assuming a provider can be found to deliver the services, they may include personal care, clinical care provided by a registered or enrolled nurse, meals, transport to medical appointments and allied health such as physiotherapy.

The next level, Tier 2, is for entry level services for clients who voluntarily decide to temporarily re-locate from an aged care home to stay with a family member if you are not eligible for the complex clinical support available under tier one.

It is through the existing Commonwealth Home Support Package and could include meals, transport to medical appointments, social support, personal care.  Eight clients have been referred by the government’s aged care portal, My Aged Care, for Tier 2 services to date.

It’s important to get as many ducks lined up as possible before you make a move.

In addition to the costs is the reality and practicality of caring for someone – who must have gone to residential care for good reason – at home. 

Considerations include the safety and suitability of the environment they are moving to, including room to move equipment such as wheel chairs, the right equipment, what level of care they need and who will provide the care and what is the plan if they get sick.

Where facilities are quickly getting on top of infection control procedures, it would be important to know that home care providers and carers coming into your home (possibly straight from someone else’s home) are taking similar precautions.

In the current environment quarantine requirements may be relevant.  You must be tested  and be found negative before you leave a facility. Anyone coming from a facility with Covid-19 means everyone in the house must quarantine for 14 days.  It is expected that families use appropriate personal protective equipment (consisting of a full body gown, gloves, face mask and eye protection) when providing direct care during the 14-day quarantine.

If you decide to move back to the facility, whether or not you have to isolate in your own room on return will depend on the rules at the time.

If a permanent move out of care is on the cards, you may be up for a refund of any lump sum amounts paid to the facility.

It depends on whether you give notice as to how quick the refund should be but generally it will be within 14 days of leaving a facility – otherwise the facility has to pay the basic interest rate of 2.25 per cent of the outstanding amount until it’s paid.

With occupancy levels in residential aged care on the decline, any initial move into aged care in the current environment is also clearly on people’s minds.

Anyone putting off a move into residential care is probably thinking through a lot of the same issues, including what is involved in staying home and can I get the support I need.

The whole industry is in need of rescue to ensure elderly Australians can be confident no matter where they choose to live.

This article originally appeared in the Australian Financial Review ($).

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