Older people living well with in-home support, or not so well?
A REPORT called Older people living well with in-home support tells the stories of forty people who receive aged care at home. The Report was prepared by consultancy Research Matters through an Australian Government grant.
While most of the people taking part in the study acknowledged that without in-home support they would not be able to continue living at home, or only with the greatest difficulty, their comments demonstrated that in-home support as a care system needs a lot of work.
People complained about being unable to access reliable information from MyAgedCare, the Aged Care Complaints Commissioner and the aged care regulators. Each time they phoned MyAgedCare, for example, they would speak to a different member of staff. Some were knowledgeable; others less so.
People said it was reasonable for providers to charge fees to cover overheads and operational costs, such as insurance, workers compensation, care co-ordination and travel costs, but the wide gap between service providers was a concern. Admin and case management fees ranged from 9 per cent to 53 per cent of home care packages.
People noted significant differences in hourly rates for support workers, ranging from $39 to $61 per hour for a support worker on a weekday. One provider charged $136 per hour on a public holiday.
As a result of unreasonable charging, some participants received less than 10 hours of support on the (highest) level 4 Home Care Package.
Some people were charged the pro rata basic daily fee of 17.5 per cent of the pension every day in spite of not receiving a service every day.
Getting services out of their provider was described by some as though they were “pulling teeth”. They said “fighting” for their entitlements was “exhausting”.
Some people asked support workers about their qualifications and were shocked that not all support workers were qualified. People were annoyed when young, inexperienced and untrained support workers came to their home. Three participants described the older person’s family having to train a support worker to use equipment safely.
People were upset when a stranger turned up at their door. Some felt unsafe inviting strangers into their home. They were also dissatisfied when support workers did not arrive on time or, in some cases, did not turn up at all. High staff turnover disrupts continuity of care.
The policy of full cost recovery for those who have a level 3 or 4 Home Care Package has the effect of limiting social engagement. Before receiving a home care package, an activity such as a bus trip or attending a Men’s Shed cost around $10. With a Home Care Package, participants said the cost increased to $100. Some participants who required nursing services were advised to remain on a level 2 Home Care Package, because they would need to pay full price for nursing services on the higher-level Home Care Packages.