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‘Try before you buy’ crowding out respite, report says


A report has recommended reducing the number of respite days that aged care facilities are allowed to offer amid concerns that some people are using respite as a “try before you buy” system and crowding out those in genuine need.

The Aged Care Financing Authority report on respite care says about 100,000 people a year take advantage of respite services, including 40,000 who access CHSP home or centre-based services and 60,000 who enter residential respite.

The government funds a combined $560 million a year for both avenues, including $248 million in CHSP grants and $312 million in subsidies for residential providers.

‘Try before you buy’ a concern

ACFA said it had identified a “noticeable uptake” in the use of residential respite for reasons other than giving carers and care recipients a break, in accordance with its definition under the Aged Care Act.

“This includes the use of respite as a ‘try before you buy’ model before a person enters permanent residential care,” ACFA said.

The agency says this is an appropriate market response to other service demands, like the need for potential long-term residents to try out a permanent spot, but it “needs to be balanced against ensuring that the availability of short-term respite to support those wishing to remain living at home for as long as possible and their carers is not compromised.”

The October 31 report also says the current time frame of 63 respite days a year that aged care facilities can offer is imposing administrative burdens on providers, consumers and the government.

“ACFA recommends keeping a cap on respite care, but suggests that consideration be given to whether it be less than 63 days and to introducing some form of means testing after a specified period of respite use,” the report recommends.

“The latter would address concerns that other uses of respite care may crowd out respite for supporting people wishing to live at home for as long as possible (and their carers).”

It also recommends there should be an expectation that all providers be prepared to provide respite and that the purchasing of respite care should remain an appropriate use of home care packages.

Need for improvement in community based care

ACFA says several issues were identified regarding access to community-based respite care under the CHSP and the HCP programs.

The most common issues were:

  • Insufficient supply of community-based respite care
  • Disparity in costs and access between CHSP and home care packages
  • Difficulty accessing community-based respite for home care package consumers
  • Lack of suitable care for people with dementia and other special needs groups.

ACFA says respite can provide a necessary break for carers, which supports them in their role and can consequently keep older people out of residential care, and it should be recognised as a vital component of aged care services.

ACFA said had it received 71 submissions as part of the review into respite services which identified a range of issues and areas for improvement around access, funding, fees, administrative processes and availability.

“Many of these issues would be best addressed as part of broader consideration of reforms in other parts of the aged care system,” the report says.

“This appropriately reflects that respite care is an important and integral part of the aged care system and should move in line and be consistent with the direction of broader reform.”

You can read the full report here.

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6 Responses to ‘Try before you buy’ crowding out respite, report says

  1. Kylie Hardy December 5, 2018 at 11:16 am #

    The practice to “try before you buy” is a common and accepted part of the placement process. It would be interesting to know who in the industry agrees that this use of respite is a concern and why reducing the overall amount respite days would be beneficial. Anyone who understand a consumer and their journey through Aged care into residential care would see the import place “try before you buy” respite plays in the bigger picture.

    The sooner Aged Care is viewed as one industry, rather than different funding types (HCP, CHSP, ACFI, CCRC etc) the better the outcome for all consumers and their families.

    There is no crowding of respite in Metropolitan areas if you understand how the Aged Care system works. Like most industries, Aged care now requires specialized professional expert to navigate what used to be a fairly simple process.

  2. Jason Burton December 5, 2018 at 12:38 pm #

    Such a shame the report was so focussed on residential home respite and just skirts over community respite and cottage respite. There’s a very telling stat in the report – 75% of people only use residential respite once in a year, makes you wonder why, maybe because it doesn’t suit them? We need more cottage respite environments.

  3. Paula Tolhurst December 5, 2018 at 12:55 pm #

    I fully agree with Kylie Hardy. The process has become so hard and so complicated that no one understands it. Our facility encourages people to “try before you buy” as sometimes it is the only way the consumer will look at coming into a facility, and when you see carers and family members at their wits end, trying to look after their family member, but can’t get them to agree to go into care, the respite pathway provides a way for them to see what being in a facility is like and allow them to see what care they will be given. Reducing respite care, will also impact on Home Care, where those who are choosing to stay at home, because this is what has been encouraged, means that those carers will not be able to easily assess respite care. I say don’t play with something that is not broken.

  4. Mary Bloggs December 5, 2018 at 2:32 pm #

    What about facilities that tell carers that their loved ones cant have respite unless they “buy” after respite?

    Their are 2 sides to this story

  5. Val Fell December 5, 2018 at 11:14 pm #

    Respite is an important part of the journey for both carer and the person living with dementia. Currently there is not enough available respite -cottage respite does not exist in the illawarra and there are problems in arranging respite in residential facilities.. More attention needs to be placed on the provision of respite. people waiting for packages need respite so they can carry on the informal caring of theirpartners..

  6. Anonymous December 6, 2018 at 12:57 pm #

    Respite IS a broken system (in residential care).

    There are problems on both sides of the coin:

    1. people and their carers have difficulty accessing it due to a lack of ‘respite only’ beds – let alone dementia specific respite only beds.
    2. providers have difficulty providing the service due to its high level of workload intensity, lack of parity of funding as opposed to a permanent bed, empty bed days between bookings and high level of cancellation rates
    3. Permanent customers-to-be are using it primarily as a means of avoiding permanent care costs due to the disparity between respite fees and means testing for permanent fees, subsequently eating up all the facilities respite days leaving scarce provision for the respite-only cohort.

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