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Dying at home study backs case for Level 5 HCP


A study has found that introducing a Level 5 home care package would allow more people to remain at home where they could have a “good and respectful” death if that was their choice, an aged care conference heard.

David Panter

David Panter

ECH conducted a small-scale study over the last 12 months to see what was possible in terms of enabling this to occur  and investigate how much it would cost.

Presenting the results at LASA’s national congress in Adelaide this week, ECH CEO Dr David Panter said the additional cost involved in allowing people to die at home was “well within” the subsidy range for a potential Level 5 home care package proposed by David Tune in his 2017 review.

“It found that it’s relatively straightforward to be able to provide that service and our evidence suggests that it is less expensive than residential age care,” Panter said.

“I think it absolutely lays the groundwork for why we need a Level 5.”

The Tune Review recommended the introduction of a Level 5 home care package for people with high care needs equivalent to the average cost of residential care, which was around $63,000 at the time.

However, a commitment to introduce a Level 5 HCP was absent from the federal budget when it was handed down in May.

What does it take to die at home?

The Enabling Responsive and Individual Care at Home (EnRICH) study looked at 12 people aged over 70 who were not dealing with a complex terminal condition but were already on a home care package and were considered likely candidates for entry into a care facility.

The study found that by providing appropriate home support, 10 of the 12 managed to avoid permanent admission to residential care.

The additional cost of doing so came to a maximum of $11,000 additional to their HCP subsidy.

“The cost was very illuminating,” Panter said “We had people on a mixture of level 2 packages and level 4 packages and the additional subsidy required above their package varied between zero and $11,000. So we’re not talking about huge amounts of dollars, and those combined figures are less than the cost of residential aged care in many cases.

“Equally it plays into the discussions around the future of the replacement for ACFI, and whether the care component should be transportable … so the individual can take that and have the accommodation of their choice, be it in their own home or in residential aged care,” he added.

Too many going into aged care too soon

Panter said while residential care formed an important part of the aged care spectrum, too many people were being forced into care facilities by lack of choice.

“We have a system which has been designed to encourage far too many people to go to residential care before they need to if indeed they need to at all,” he said.

He said research by ECH suggested about 90 per cent of people wanted to die at home, but only 10 per cent of Australians aged over 70 managed to achieve this.

He said ECH was also looking at option to create a “funeral bond” that could be paid into over a period of time to provide for a death at home.

ECH is finalising the results of the EnRICH study and intends to submit it for publication.

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