How, when and why do you need care?
A new AIHW report shows that older people who access aged care choose services they want, according to what they need, are able to afford and can access.
By Yasmin Noone
If one of the latest reports hailing from the Australian Institute of Health and Welfare (AIHW) is anything to go by, the Productivity Commission’s recent draft report about the aged care sector could be spot on when it comes to its suggestions about caring for the varied and subjective needs of older Australians.
After analysing changes in the use of care programs over time and the concurrent use of programs, AIHW researchers have found that older Australians make care choices according to what they can both afford and access, and on the basis of what suits them.
The report, Pathways in Aged Care: program use after assessment, examined older people’s use of aged care programs by analysing the Aged Care Assessment Team (ACAT) assessments of a group of 105,000 people from 2003 to 2004.
The results showed that one third of the group had not previously used aged care services and most people’s first contact with the aged care system came through an ACAT assessment.
“We know that people are going to move between programs and we thought it was important to see the relationships between programs,” AIHW senior research analyst, Rosemary Karmel, said.
“That is, what programs people are using, the timing of changes in care arrangements and whether the people who are assessed actually take up any care.
“I was surprised by the variety [of people’s care pathways]. I was expecting to see a simple progression from limited service use in the community to residential care, but what we found was that there was great variety in the programs that people used and the timing of this use.”
The report stated that care programs were being accessed simultaneously and for those without previous contact with the aged care system, this usually occurred around six months after assessment.
“Although approval for program use from an ACAT assessment is valid for 12 months, re-assessment within that period is common: 30 per cent of the no previous care cohort had a re-assessment within 12 months, and two-fifths of these had no intervening program use,” the report stated.
The study also highlighted the fact that assessments do not necessarily result in program use. Around 25 per cent of those without previous aged care contact had not accessed any care program within two years after their initial assessment.
Among people who had a re-assessment within 12 months, the re-assessment was commonly the first event in their care pathway after the reference assessment.
“I think it’s interesting,” Ms Karmel said. “One reason for this could be that the older person thought they needed assistance but their assessors didn’t have the same opinion.
“Or that the services they needed to access maybe weren’t available in their area.
“Maybe they had the resources to arrange the services for themselves or the carers felt that they could take still manage on their own.
“There are a range of reasons. I don’t think it is that simple.”
The report also said that “…this suggests either a change in circumstances or a change in attitude since their earlier assessment, as clients must agree to a type of care before it can be approved by an ACAT.”
The recent Productivity Commission’s draft report from its inquiry into aged care recommended that the sector of the future offer a range of flexible care and support services to meet the individual needs that emphasise, where possible, restorative care and rehabilitation.
“The focus is on enhancing the wellbeing of older Australians — promoting independence, connectedness and choice,” the commission’s draft report said.
It also suggests that older people be able to “choose whether they would like to purchase additional services or a higher quality of accommodation if that is what they want and can afford to do.”
