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Royal Commission considers home care best practice from overseas


Australia can learn a lot about providing better home care by looking at overseas examples such as Denmark and Sweden which have invested in providing care for people in their homes, a researcher says.

Dr Suzanne Dyer

Two research papers presented to the Royal Commission into Aged Care Quality and Safety this month look at approaches to aged care around the world.

Authors Dr Suzanne Dyer and Professor Maria Crotty from Flinders University say Denmark and Sweden, for example both spend more than 4 per cent of GDP on long term care for older people. Australia, in comparison, spends just over one per cent (1.2 per cent).

A global perspective

Dr Dyer says the papers, which focus on international systems of long-term care across 22 countries, and review innovative models of care aim to put Australia in a global context.

Denmark and Sweden both prioritise provision of care in the home, localised rather than centralised approaches to aged care provision, and support for carers, she says.

“It’s the inverse of relying on residential aged care but importantly they also have involvement of regional and local authorities in delivery of long-term care,” she told Australian Ageing Agenda.

The Danes also tend to integrate rehabilitation into home help, with an emphasis on maximising capability and increasing balance, strength and general health.

“There’s greater emphasis on active ageing, providing a wider variety of housing options and integration of that kind of rehabilitation approach into home help,” she says.

Enabling carers

The overseas analysis also found an emphasis on providing more flexible support for more families and informal carers, Dr Dyer says.

Germany, for example, provides cash benefits, so an older person can use it to pay family members for services.

Other countries like Denmark, allow family members to be registered as care workers so they can receive a salary.

“Quite a few countries provide much more generous leave provisions for families to allow them to provide care for older people, including paid leave.

“These are all ways you can help support people to live in the community, rather than relying on institutional care.”

Dementia support

There are also learnings about providing better dementia support for people living in the community.

The report notes that education and support programs for people caring for a loved one with dementia are available in Australia, however, some overseas countries offer other examples.

For example, the US Community Aging in Place, Advancing Better Living for Elders (CAPABLE) initiative provides support workers, system navigators or care coordinators who facilitate a streamlined approach to care for people with dementia.

In Scotland, the government guarantees a minimum of one year post-diagnostic support for people with dementia .

“Also internationally, there is an emphasis on age and dementia friendly communities and smart homes, telehealth and remote monitoring that can assist people to stay living in the community,” Dr Dyer says.

“In terms of home care, we think a key thing is providing a lot of support for informal care givers … and that’s something that’s done a lot internationally, increasing funding for informal care givers to help allow people to remain living at home,” Dr Dyer says.

Royal Commission

The Royal commission says the research identifies many opportunities for improvement of  long term care, including a focus on better home care, in Australia.

“The report notes the need to think of a care system from the social rather than just economic perspective and highlights some key areas where the authors consider that care for older Australians can be improved,” the commission said, including:

  • more support for home care and informal carers
  • more involvement from local authorities
  • professionalism of the workforce
  • more focus on rehab and maintaining function
  • support for carers of people with dementia at home
  • more use of smart home technology to support independent living

Read what the industry has to say about the research here.

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