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Home care wait forces move to residential care, inquiry hears


The long wait for home care packages is forcing some older people to enter residential care prematurely because of carer burn-out and lack of reablement support, the aged care royal commission has heard.

Craig Gear gives evidence at the royal commission

CEO of the Older Person’s Advocacy Network (OPAN) Craig Gear made the comments while giving evidence to the Royal Commission into Aged Care Quality and Safety in Adelaide on Tuesday.

“Our services are hearing cases of that,” he said when questioned by Commissioner Lynelle Briggs.

“It might be about carer burden, and caring for someone for that length of time without the right level of support.

“It may also be that the right level of reablement focus is not there … and that means that the level of function of that person deteriorates quicker than it needs to, and residential care becomes the next option.”

Greater investment in and earlier access to home care would help prevent this occurring, Mr Gear told the commission.

Concerns about home care, access

Mr Gear said OPAN received between 230 and 240 calls a week relating to home care, including waiting times, fees and charges, and choice of care.

“What they’re telling us is the wait times are just too long and the level of support that they are getting is not meeting their needs … supply is not meeting demand in Australia at the moment,” he said.

He said the current waiting time of 18 to 20 months was not acceptable and OPAN wanted to see this reduced to three months.

Mr Gear also said MyAgedCare had failed to resolve access issues, especially for vulnerable and marginalised groups such as those in remote indigenous communities or with mental health issues.

He said whiled the portal had helped by bringing information into one area, it only worked for people with IT infrastructure or who could use the telephone system, or wait on the phone.

Another difficulty was around the nature of the correspondence that was being sent to users about home care.

“Often when someone is allocated a package or is getting an update it’s sent out in a letter. Sometimes those letters don’t arrive, or the telephone calls that might accompany them don’t get answered,” he said.

“Current practice is when a person hasn’t answered three times it is considered  that they don’t want their package, and that typically is not the case.”

A ‘running sore’

During Monday’s evidence, National Seniors CEO Professor John McCallum described the home care waiting list as a “running sore” and “a really, profoundly critical failure”.

“We know that home care … is preventative for death and preventative for hospital admission. We haven’t really dealt with that and really dealt with the fact that people then have to go into residential care, into hospitals, which are much more expensive.

“It’s economically irrational, but we haven’t dealt with it. We haven’t dealt with it, because it is hard … it’s the most difficult immediate issue we have to confront.”

To stay up to date on the latest about the Royal Commission into Aged Care and Quality go to our special coverage. We will also be issuing regular Royal Commission Roundup reports which you’ll receive in addition to your weekly e-newsletters.

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6 Responses to Home care wait forces move to residential care, inquiry hears

  1. Josie February 14, 2019 at 2:34 pm #

    Mr Gear states that “Current practice is when a person hasn’t answered three times it is considered that they don’t want their package, and that typically is not the case.”. I am not sure what practice Mr Gear is referring to, but consumers are contacted in writing when they have been assigned a home care package and have 56 days to respond; are sent a reminder letter and have the option of extending the take up deadline by another 28 days. If assessed as vulnerable the ACAT have the option to also receive notification of the assignment and to support the client with the process of connecting to a suitable provider. Though we agree that the wait time for the assignment is not acceptable, even as a High priority, complex clients are waiting too long.

  2. Country carer February 14, 2019 at 3:26 pm #

    Professor McCallum needs to realise that death cannot be prevented. The facts need to be presented to people regarding costs involved in home care v residential care. Who has made residential care expensive? The same people that assess what people pay for residential care by changing the goal posts every 12 months! It also needs to be pointed out that home care is not 24/7 like residential care, and if you have a deposit with a residential facility, it is repaid when you leave. Paying for 24 hr home care is not in the least bit more affordable for our elderly. You can’t compare the two options as they are very different. Applying for anything thru government departments is onerous, lengthy and unnecessarily stressful. Fix some of that first.

  3. Narelle Morrow February 14, 2019 at 3:45 pm #

    1) I have found and my clients when they initially register with My Aged Care for services if contacted 3 times with no reply they are not processed onto the RAS Team for assessment and approval of services. There has been times when the clients have an answering machine and no message has been left for them to ring back. I find clients because of frequency of scams in our area will not pick up unless they recognise the number.
    2) In response to packages in our rural area I find the client does not understand the process and the letter can be put to 1 side.

  4. Carer and Aged Care Nurse February 15, 2019 at 8:31 am #

    What people need is access to services. A Home Care Package is not some cure all, give the client the services they need.

    Someone on a level 4 package cannot afford a nurse to administer insulin twice a day so it is into a Nursing Home you go.

    Need more than basic services then you must have Home Care Package why?

    My mother has Social Support twice a week and some Domestic Assistance and was harassed to have a Home Care Package level 2 when I asked the questions it was rapidly evident that the Home Care Package would not cover her current level of service especially her Social Support which is full cost recovery once you accept any level of package, why is this information not provided as part of the ACAS assessment?

    Why are people having to wait months for a Home Care Package when there are Service Provides who could provide the services the person needs tomorrow?

  5. Will Sullivan March 25, 2019 at 3:54 pm #

    I note that the “number of days queued since initial approval” has been removed from the latest release of the mobile version of MyAgedCare. When will the Department an Minister be honest and courageous enough to publish aggregated statistics of “actual” current wait times instead of the vague “notional” wait times like “12+ months”. It is cowardly and deliberately deceptive to keep this important information secret. And now even individual clients can’t see how long they have been in the queue. The person I care for is getting very close to 1000 days (so far).

  6. Will Sullivan March 26, 2019 at 10:22 am #

    In her evidence at the Aged Care Royal Commission last Friday, Ms Buffinton provided a document containing a table of carefully selected wait times in months by Level 1-4. Why quartiles? Why not deciles? Where is the minimum and maximum? Perhaps we are not so stupid as she thinks. If the wait time for a level 4 at the 75th percentile is 50 months, perhaps the 90th percentile was 60 months? When we can only see half the picture we can only speculate. I hope that the Commissioners and Counsel are able to see through this sleight of hand.

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