Seamless Transitions: Aged Care Placement Services

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We provide information to support people moving into aged care    

Frequently Asked Questions

How important are leisure activities to quality residential aged care?

When selecting the best residential aged care for someone it is easy to look at the location, meals, surrounds and medical care, without paying enough attention to the leisure activities offered.   Leisure activities are often the conduit to develop social relationships, which in turn are associated with better physical, emotional, social and mental wellbeing in older age (Chang et al, 2014). And, vice versa, the stronger the social relationships, the more likely a person is to participate in leisure activities. 

Older people are twice as likely to experience depression, increasing to 35% of people in living residential aged care (National Ageing Research Institute, 2009).  The indicators for quality aged care are based on performance measures, rather than Quality of Life indicators.  Health Ageing maximises opportunities for people to have both choice and control over their lives and social connectedness (Browning and Thomas, 2013).  Perhaps more weight should be paid to satisfaction levels with leisure activities.

Leisure includes physical, mental and social activities; whatever a person chooses to do in their spare time.  The key to leisure is that it is a choice – what a person actually wants to do, not just what people think they might want to do (Browning and Thomas, 2013).  At Seamless Transitions, one of the first questions we ask people in ‘What is important to you?’  We then look for places that provide the activities that meet a person’s needs.  Consider the following two examples:

Staff in one residential aged care home identified that very few men were attending leisure activities.  It was decided, without consultation, to start a men’s group, so a notice was put out inviting men to an afternoon tea.  About 10 men attended, with food organised but no staff present.  The men’s group was then listed as an activity on the monthly program, but the next month only one gentleman showed up, no staff, and there were no activities or afternoon tea organised.  The next month there was no one.  The conclusion was that men just weren’t interested in leisure activities.

Another residential aged care home also identified that very few men were attending leisure activities.  In contrast to the above example, the staff in this home consulted residents and a men’s shed was organised where men could brew their own beer and garden in raised garden beds.  Staff supported the residents to organise a tour of local cottage breweries, and took them on monthly excursions to different pubs in the area.  This men’s group grew, and participants reported high satisfaction levels.

The importance of leisure activities designed to meet the interests of residents cannot be under estimated.  Looking at the recreation activities on offer is important, but also asking how responsive the Leisure and Lifestyle Coordinators are to suggestions of new activities indicates whether a home is flexible enough to meet an individual’s needs.

References

Browning, C and Thomas S. ‘Enhancing Quality of Life in Older People’, 2014

https://www.psychology.org.au/publications/inpsych/2013/february/browning/

Chang, P. and Wray, L. ‘Social Relationships, Leisure Activities and Health in Older Adults’, 2014

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467537/

National Ageing Research Institute, ‘Depression in Older Age: A scoping study’, 2009

https://www.beyondblue.org.au/docs/default-source/research-project-files/bw0143---nari-2009-full-report---minus-appendices.pdf?sfvrsn=4

 

When is it time to move into residential aged care?

Sometimes people have a sudden decline in health or capacity to care for themselves which makes the decision to move into residential aged care more straightforward.  However, in most cases the decision to place someone in aged care is the culmination of a number of different things, rather than a sudden decision.  

The primary caregiver may no longer be able to look after the person adequately because of their own health needs. They may be finding it difficult to care for the person or be always tired and emotionally drained.  Moving someone into aged care may be the best decision for all involved.  The following prompts may help your decision-making process. 

Is the person having difficulties with any of the following?

1.   Moving around their home safely and independently

2.   Poor balance, falls or other accidents

3.   Forgetting to turn off appliances etc.

4.   Changed or challenging behaviour

5.   Communication

6.   Memory loss

7.   Difficulty managing medications

8.   Depression or anxiety

9.   Feeling isolated or alone

10.  Difficulty sleeping

11.   Eating poorly or unexplained weight loss

12.  Poor personal hygiene or continence

If any of these areas are impacting on a person’s ability to remain safely and independently at home, it may be time to consider residential aged care.

Contact Seamless Transitions for support to take the next steps.  

 

How do you access Aged Care?

The transition into aged care, whether it be bringing in more supports at home or moving into residential care, involves an income assessment.  People moving into residential care will also need to provide an assets assessment.

Once you and your family decide that you require aged care, you need to request an assessment from the Aged Care Assessment Team (ACAT).  They will assess the level of care you require, whether is be services in your own home or residential care.

Seamless Transitions can help you to organise an ACAT assessment and the care you require.  

How do you choose the right residential aged care for you?

Finding the right aged care, that meets your needs is daunting when the aged care system is new to you.  Visiting residential aged care homes can be confusing because they offer similar services. Working out what you can afford may rule out some places. Then you need to decide what is most important to you.

For example: 
1. Do you need your own room and en-suite, or are you prepared to share? 
2. Do you need to be near family or friends?
3. What activities suit you?
4. What medical/rehabilitation services do you need?

The staff at Seamless Transitions can help you work out what is most important to you, both now and in the future. We short-list the residential aged care homes that best meet your needs, and have tools to help you compare homes.

For more information, please contact Seamless Transitions.

What are Home Care Packages?

Home Care Packages are designed to support people to remain in their own home.  There are four types of Home Care Packages:

  1. Basic care needs

  2. Low level care needs

  3. Intermediate care needs

  4. High level care needs

Level 3 and 4 are for people who are assessed as having complex needs.  

The range of care and services that may be provided includes, but is not limited to, the following:

  • Personal Care (showering, bathing, dressing, mobility, meals etc)

  •  Support Services (house cleaning, washing, gardening, basic home maintenance, transport, clinical care, nursing, health support etc)

 

What is the cost of Home Care (based on figures from September 2015)?

Your service provider may ask you to pay:

  • a basic daily fee of up to 17.5% of the single basic Age Pension (up to $137.76 per person per fortnight)
  • an income-tested care fee if your income is over a certain amount (individual person – $25,487.80, member of a couple – $39,561.60)

There are annual and lifetime caps that apply to the income-tested care fee. Once these caps are reached, you cannot be asked to pay any more income-tested care fees.

If a person believes they cannot meet the home care fees they can apply for a ‘Financial Hardship Assessment’ and the Department of Social Security (DSS).

 

What does Residential Aged Care include?

  • Accommodation, ground care, personal care, laundry, social activities, cleaning etc.

  • Additional or optional services may  include internet, pay TV in room, hair dressing, podiatry etc.

 

What is the cost of Residential Aged Care (based on figures from September 2014)?

There are three main types of fees associated with Residential Care:

  1. Refundable Accommodation Deposit (RAD): If you choose to make your payment as a lump sum, this is called a ‘refundable accommodation deposit’. A refundable accommodation deposit works like an interest-free loan to an aged care home. The balance of the deposit is refunded when you leave the aged care home less any amounts you have agreed to have deducted.  All residential care facilities advertise their fees on the 'My Aged Care' website.  

  2. Daily Accommodation Payment (DAP): Instead of paying for your accommodation as a lump sum (RAD) you can choose to pay as periodic payments. The amount you pay is based on a daily rate which is why this type of payment is called a daily accommodation payment. However, you will pay in instalments up to a month in advance, as agreed with your service provider. Daily accommodation payments, unless you have paid in advance, are not refundable if you leave the aged care home.  The DAP is calculated by multiplying the RAD by a Maximum Permissible Interest Rate (MPIR) and dividing it by 365 (the number of days in the year).  You may also choose to pay the accommodation fees in a combination of a RAD and DAP.

  3. Basic Daily Care Fees: A basic daily fee is payable by all residents, which is 85% of the aged pension.  A means-tested care fee may also be payable if an income and asset test is over a set amount.  Means-tested care fees are calculated by Centrelink.  Some residential care facilities also provide 'Extra Services', such as a choice of meals and larger rooms, and will charge an extra fee, which will be clearly stated.

Seamless Transitions can help you to understand the different types of care and help you to negotiate the fees and charges.  We recommend that you consult your Accountant or Financial Adviser.  

 

What is Consumer Directed Care?

From 2015, all government-funded home care providers funded were required to work under the Consumer Directed Care (CDC) model.

CDC is based on the premise that people have the right to manage their own lives, and reaching old age is no reason why this should not continue. Consumers are provided with all the information they need about types of care, services available and service providers so they can build a home care package that supports them to live the life they choose.  They can choose who delivers the services, and where and when they are delivered.  People may have more than one service provider.  

Providers working under CDC model listen to consumers, and support them to identify their goals and the supports they need.  It is strengths based, starting with identifying barriers and issues that interfere with them reaching their goals.  The consumer identifies what is important to them.

The consumer can manage their own home care plan, or appoint someone to assist them.  It is their choice.

From the end of February 2017 the funding for home care packages will follow the consumer, even if they relocate to another area or change to another service provider.  Currently the funding is allocated to service providers. 

There will be a consistent national approach to prioritising access to home care through the My Aged Care gateway. This will be a fairer and more flexible way of distributing packages to consumers based on their individual needs and circumstances, wherever they live.

The Aged Care Assessment Team will assess a person to determine their eligibility for a Care Package (Level 1, 2, 3 or 4).  Once a consumer has been assigned a package, they have 56 days to begin care.  Seamless Transitions can help you choose the service provider that best meets your needs.

 

What is the importance of nutrition for older people?

While it has long been recognised that children have different nutritional needs from adults due to the fact that they are growing and developing both mentally and physically, these days there is now also a growing understanding of the fact that older adults likewise have different nutritional needs from their younger counterparts. Those who care for the elderly have a duty to ensure that they are provided with appropriate food and that they are able to eat it comfortably.

Malnutrition and obesity in older adults

As we get older we may find ourselves with less appetite than in our younger days and/or we may find it becomes physically more difficult to eat, either in general or with regards to certain, specific types of food. The most obvious example of this is when people have false teeth, but people with conditions such as rheumatism and arthritis may also find it difficult to hold cutlery with enough grip to cut food into bite-sized pieces. At the same time, we often become less active and our metabolisms may slow. This means that while we still require nourishment, our calorie intake needs to be reduced to reflect the change in our lifestyles. We may also need to look at the practicalities of how we eat food, for example switching to softer foods, which need less cutting, biting and chewing and using sporks rather than the standard fork, knife and spoon.

Calcium-rich foods are crucial

Older people need plenty of calcium for the same reason that children do - to maintain the health of bones and teeth. As we age, our bones naturally become more brittle and our teeth often fall out. Calcium can help to counteract this. While the most obvious source of calcium is dairy products, there are actually plenty of alternative sources for those who can't or don't want to eat dairy, for example green, leafy vegetables and some fruit juices both contain calcium as does a lot of canned fish where the bones are left in, e.g. sardines. Even when an individual is happy to eat dairy foods, some caution is still required as these can be very high in fat and hence contribute to obesity in a person who leads a sedentary lifestyle and some dairy foods, such as blue and/or soft cheeses, also have specific health hazards. They may be low-risk to adults in their prime, but high risk to older people.

Vitamin D is vital

Vitamin D is needed to regulate the amount of calcium and phosphate in our bodies. Hence vitamin D deficiency can lead to serious problems with bones and teeth, such as rickets or osteomalacia. The main source of vitamin D is sunlight, but as we age, our ability to create vitamin D from sunlight decreases and also, we may spend less time out in the sun. Red meat is a good alternative source of vitamin D, but, of course, can trigger other health issues. Therefore for many older people, the best sources of vitamin D are: oily fish, liver, egg yolks and products fortified with vitamin D. There is also the option of using a specific, vitamin D supplements, although it is recommended to speak to a doctor before going down this route.

We are grateful to Gillian Douglas, Medical Writer for Oxley Home Care(http://oxleyhomecare.com.au/) for providing this article.

 

Contact the helpful staff at Seamless Transitions for further information