How minimum staffing levels will improve aged care

nurse thinking about minimum staffing levels

The Aged Care Royal Commission and COVID-19 have revealed some glaring gaps in the aged care system, a major one of which is the lack of consistency across facilities when it comes to minimum staffing levels. In Australia, there is no legislated, mandated staff ratio – most facilities operate on a consumer-directed care model, meaning that they have enough staff to care for individual people. It is becoming evident that many people have very complex care needs and require more care than is currently being provided to meet their clinical and everyday living care needs.

 

As is recommended by the counsel assisting the Royal Commission into Aged Care, minimum staffing should be legislated to ensure that all residents receive the care they need. Rather than a concrete number of staff, it is recommended that the minimum staffing levels are essentially just that and these staffing levels should increase as the complexity of resident’s care needs change over time.

 

Having a Division 1 registered nurse on site 24 hours a day, and appropriate staffing of enrolled nurses would be an appropriate resourcing minimum. We also recommend the upskilling of PCA nurses and increased training across the board. It is not enough to only have minimum staffing levels – staff should also be appropriately trained, with a minimum of a Certificate III or IV. Training should be continuous, with supplementary engagement, opportunities to upskill and clear pathways for career progression. Increased training around common conditions such as dementia is necessary to ensure care staff are equipped with the appropriate knowledge to care for residents. Overall, we need more staff in aged care facilities and continual training to ensure the staff have the appropriate skills to look after our most vulnerable residents.

 

All caregivers need to be diligent, skilful and insightful, engaging with residents on a personal basis and fostering ongoing caring relationships. Having minimum staffing levels at facilities will mean that staff have the time and skills required to invest in creating these caring relationships to ensure residents receive the quality of care they deserve.

 

Recent studies show that over half of Australian aged care residents are in homes that have unacceptable staffing levels and that to raise the standards for all residents to receive a good level of staffing, an increase of 37.2% in staffing will be required. There are also further considerations when it comes to the needs of culturally and linguistically diverse residents, and staffing levels in regional and rural facilities.

 

We support the introduction of legislated minimum staff ratios, but this will only be effective if combined with enhanced training to give residents access to the highest quality care in line with requirements.

 

Do you or someone you know require an aged care solution? Contact us today and make an inquiry.

How My Care Path takes the stress out of aged care

couple discussing aged care

Making decisions around aged care is emotional, stressful and confusing. This is the first time I have had to navigate the aged care system, and I had no idea where to start. I tried Centrelink, but soon realised I may need another degree to understand the system. I have a young family, work full-time and my Dad has an aggressive form of dementia. While he is still largely independent, my mum is now his full-time carer. This process is overwhelming, as is the pressure to make the right decision for the person who has spent most of his life helping me make life’s big decisions. Fortunately for my mum and me, we were introduced to Dana and Jayne at My Care Path – a game-changer.

For my family, guidance from My Care Path has helped us navigate the aged care system. Their experience and expertise as aged care coordinators has significantly eased our stress, which has been compounded by Covid-19 and media attention surrounding the aged care system.

At our first meeting with My Care Path, we talked in detail about my dad: who he is, his likes and dislikes, his interests and hobbies, and of course his form of dementia. We were genuinely surprised by how much they knew and understood the disease, specifically his rare form of dementia. From there, they guided us through the financial side, including Centrelink, payment options and putting us in touch with a financial planner who specialises in aged care. They also processed forms for us, taking much of the logistical load off so we could focus on choosing a facility and caring for Dad.

The financial planner went through the finer details with us, including an audit of assets and a consideration of our circumstances. This meant that we could work out quickly what the financial situation would be for our family with the help of an expert. They took everything into account, including things we hadn’t considered, such as whether my mum should continue working, and how the financial side of aged care might impact other members of the family, such as my sister, who my mum also cares for. It moved beyond just the finances – My Care Path took a holistic approach, showing us what this decision would mean for the lifestyle and care arrangements of everyone involved.

My Care Path shortlisted facilities and accompanied us on-site tours. As a part of the initial briefing they spent a lot of time understanding who Dad is, so they knew it was important for him to feel at home, have access to a garden and the internet, space to walk and a place to have a red wine and watch sport. At each facility, we assessed whether there were other residents who were like him – many people, including me before this, assume that aged care is full of old, frail people, but my dad is very independent and young at heart, and we needed to make sure the place that becomes his home not only has the things he needs but also has neighbours he can form connections and become friends with.  My Care Path took all of this into account.

With My Care Path’s help, we have found a facility that we believe will suit my dad and his care requirements. There is a garden for him to maintain and space for family dinners with his kids and grandkids, and it’s close to my mum’s home. Continued family contact and connections are very important to us, and this facility ticks all the boxes for what Dad will need.

The next step will be the transition from our family home of 35 years to his new home. I am not sure I am ready for the next step, and we are not sure when it will be, but we do know it is inevitable, and we are now prepared.

Looking for an aged care facility for my dad has been an emotional and overwhelming experience. Having My Care Path to guide my family through the process has been a blessing. They have gone beyond just the logistics and finances, and have reassured us that if at any point we need to change the plan we can.  This is not set and forget – this is about giving my Dad the best life possible. My Care Path is flexible, honest and accommodating, and they have advocated for my dad and my family every step of the way, making sure that we find a solution that is in everyone’s best interest.

Knowing what I know now, I would never go through this process without an aged care coordinator like My Care Path. We seek experts in so many areas of our lives – surely how we see out the end of our lives is as important as all the other steps along the way.

Respite care: A practical solution over the holiday period?

carers enjoying respite care

Over the holiday period, some families may need to go away and leave an elderly person behind, or a carer may need to take a break. The options are either to get respite care at home or at a facility.

Respite residential aged care is a good way to ensure that an elderly person gets the care they need while their family is away. It also presents an opportunity to trial longer term aged care, so it’s important, even if you’re using it for a short period, to put the effort in to ensure the facility will be able to meet your family member’s care needs long-term.

It should not be viewed as a quick fix – if your family member has a bad experience, it may put them off the idea of entering care long-term. Make sure you talk to the facility about your family member’s routine, likes and dislikes, preferred food, hobbies and interests – that way, even with short-term care they will be looked after well.

It is also important to consider that changes can be difficult for people with cognitive difficulties, so you should only put your family member into respite care if you feel they will be able to cope with these changes. Respite residential aged care can work well as a way to slowly transition someone into full-time care by introducing them to a new routine.

If you have government approval, you are entitled to 63 days of respite aged care per year. Most facilities offer short-term stays of two to four weeks, depending on availability, but you must ensure that you work with the facility’s requirements. Some facilities keep specific rooms free for respite aged care so you can book ahead, while others will only agree based on availability at the time.

It is also worth considering that respite fees are different to permanent fees – respite care comes at a daily fee, while there are more charges associated with permanent care.

Respite care at home can be arranged privately or with your current home care provider. Respite home care can be paid for if you have unspent funds in your home care package budget.

Whatever your choice, there are options available for you and your loved ones this holiday season. Wishing you a happy, healthy and safe break.

If you require aged care coordination please, get in touch with My Care Path today!

Aged care industry myths busted

older couple smiling

There are many myths and misconceptions within the aged care industry, which often make it difficult for people to access the right information for what they need.

As a team of expert aged care coordinators, My Care Path is here to dispel misinformation and help you navigate the system with ease and clarity to get the best results for your circumstances and requirements.

MYTH: Residents are locked into one facility

 There is a misconception that once a resident is admitted into a facility, they are required to stay there. This is false – just as your permanent address can change if you move house, there is flexibility around living in aged care.

There may be charges associated with moving out of an aged care facility. Typically this can be between 7 and 14 days’ worth of fees, with a similar notice period.

Residents are not locked into a facility physically, either – while doors are locked for safety reasons, residents are permitted to leave the facility any time if they have the ability to do so. Similarly, visitors can come and go freely.

MYTH: Aged care is not affordable

The perception that aged care is only for those who have money is false. There is affordable accommodation for everyone in every financial bracket, and the aged care system is geared to cater for people of different backgrounds. While not everyone will be able to afford every facility, there are still good options available if you don’t have a lot of money, and there are a variety of ways to pay for your accommodation.

MYTH: You have to sell your home if you move into aged care  

This is false. Whether or not you wish to sell your home before you move into aged care is your choice. However, it is important to understand the consequences of home ownership while in aged care – keeping your home may incur or affect fees and charges, including your pension, if you lease it out.

MYTH: All aged care facilities are the same and can meet every client’s needs

This is a dangerous misconception about aged care. All facilities are different, and not all facilities have the resources to look after individual’s specific needs, especially for more advanced illnesses such as dementia.

You do not have to take the first vacancy that is offered to you – it’s important to look at the options and consider the facility as a whole, not just a room. Will you fit in to the community, and can they offer the level of care needed?

Differences in facilities may include physical environment (the building itself as well as individual rooms), setup and care models, activities program, religion and cultural mix and extra services offered.

Facilities have a right of refusal if they do not feel that they can meet your needs in the current vacancy, or that you will not fit into their facility mix.

MYTH: There is no one to help you move into aged care

This is false. Aged care coordination services such as My Care Path exist as a trusted independent advisor to help people identify appropriate aged care options and navigate the administrative side of the process.

MYTH: Public aged care facilities are better than private

There are significantly more private residential aged care facilities than public or state-owned facilities. In Victoria, 5,400 out of 50,000 beds are in the public system, largely in regional areas and usually small and attached to a hospital. This means that it is more likely you will end up in private care. Private residential aged care includes both for-profit and not-for-profit facilities.

All facilities, including public, private for-profit and not-for-profit residential, are managed under the same federal regulatory system but are run by individual providers.

(Source: https://www.smh.com.au/national/who-is-responsible-for-aged-care-homes-20200729-p55gig.html)

MYTH: More information makes the situation more transparent

Especially in a complex area such as aged care, transparency requires more than simply an increase of available information. The jargon used in the aged care industry is often difficult to understand for those outside of the profession. We need to ensure that information is accessible and available in a format that everyone can understand, including people from culturally and linguistically diverse backgrounds. To create transparency, information needs to be accessible and consistent in both language and process.

Do you or someone you know require an aged care solution? Contact us today and make an inquiry.

How can we fix the aged care sector’s trust issues?

Man in aged care

 

We are now firmly in the midst of an aged care crisis. Looking forward beyond the Royal Commission into Aged Care and the COVID-19 pandemic, the sector will have to deal with lack of trust from the general public in the aged care industry across the board.

To rebuild trust in the industry, transparency and clear communication will be key. Transparency within aged care starts with navigating the system and admission process. Every provider presents their information in a different format, making it difficult for client to compare, and every client’s situation and care needs are different. This will never be a simple process, there are just too many variables when it comes to each client. However that does not mean the process can’t be transparent. In this situation transparency means understanding and if clients understand they have choice then they will trust themselves to make good choices and trust providers to deliver what they promise.

The introduction and admission process can often be disorganised, overwhelming and complicated, with bureaucratic paperwork and misinformation. Clients can be lost simply because no one returned their call. Each facility requires different information to be included on their admission paperwork – some expect the client to disclose their full financial position before they will even allow the client to tour the facility, and I know of one facility that will not even disclose if they have a vacancy until after the client has submitted their paperwork. This process is exhausting for individuals trying to navigate aged care options for the first time, and we believe that it needs to be streamlined to be uniform across the board – one basic form for all facilities should be adequate to begin the introductions stage.

 

Making aged care easier

While providers are mostly willing to give the client a breakdown of their fees prior to admission, the issue arises from the fact that the actual cost of accommodation and care can be confusing when comparing the numbers, including considerations such as Centrelink rules and pension entitlements.

For example, with residential aged care, one facility may have annual fees of $550,000 plus an additional $45 per day fee, while another might have an annual fee of $950,000 with no additional daily fee. Essentially, these options are equivalent when broken down into a daily fee.

There needs to be more transparency around these figures in order for clients to have a proper understanding of the breakdown of costs and the implications it may have on their Centrelink entitlements. We often recommend our clients see an accredited aged care financial planner. This guarantees they have full disclosure regarding fees when they signed a permanent residential aged care contract.

We have been listening to the industry and to the clients, who are becoming more educated and more demanding in what they expect. Organisations need to understand these concerns and allow clients to feel heard, keeping in mind that each situation is different and the same approach may not suit every client.

While simplifying the process is of utmost importance, it’s critical that we don’t stifle providers from offering a variety of options, as everyone’s needs and preferences will differ. The positive of opening the industry to the market is variety and choice; the challenge now is to make sure that clients have genuine choice. As an independent voice, My Care Path is able to clearly explain the differences between the facilities and whether they suit your situation.

 

Case Study

Mary is 94 and recovering in hospital from a recent fall. She no longer feels safe at home and would like to consider her options. Mary’s daughter lives 50km away and her son lives 5km away but is not home most of the time.

Facility 1 has posted her information to her home, yet she is in hospital.

Facility 2 wants to visit and assess her in hospital before they will offer her a bed.

Facility 3 wants all their admission paperwork completed, including financial disclosure and Centrelink assessment letter, prior to any offer of placement taking place

Facility 4 will accept her from a hospital referral as they have several shared rooms vacant.

Without the help of an independent body like My Care Path, Mary is moved by the hospital to Facility 4 in a shared room as she is unable to assess her options.

With the help of My Care Path, all facilities are reviewed and identified as unsuitable based on price, room size and location. Three alternate options were identified based on Mary’s care needs, location, size and quality of room and vacancy. Based on the information provided by My Care Path, Mary selects a single room with private ensuite and beautiful garden view, knowing that if it does not work out we can reassess her choice. The family is happy that they now have more appropriate facilities to choose from, and the facility is happy that they are not wasting valuable resources trying to support a client who will not fit into or benefit from their community.

Do you or someone you know require an aged care solution? Contact us today and make an inquiry.

What the aged care sector can learn from COVID-19

smiling older couple

COVID-19 has exposed flaws in the aged care sector. Together, we can craft a solution.

 

The challenge of COVID-19 has made its way into all industries, and the aged care sector is no different. The impacts of the virus have added a new layer to existing issues that must be addressed within our industry, including numbers of staff, the training process and the findings of the Royal Commission into aged care. What this means is that the industry needs to work harder to prepare for future crises, as well as to establish a unified voice, mission and understanding to present a singular front to the public to rebuild confidence within the sector.

While the Royal Commission’s findings in their interim report have been scathing, the industry should not see this as an attack – rather, it should be viewed as an encouragement to do things differently and better. In this report, the Commission calls for a fundamental overhaul of regulation and funding of Australian aged care, and in the age of COVID-19 this has never been more important.

An excellent recent conversation between Patricia Sparrow and Michelle Grattan highlighted some of the existing issues in the sector, which have been exacerbated by COVID-19. Among these issues was the nebulous definition of aged care, including the conflation with nursing homes – she suggests that one important move going forward would be to determine what services aged care should provide and, from there, determine how funding should work on a community basis in order for the sector to delivered the expected level of care. Of course, part of this would be staff reform and an emphasis on appropriate training.

The industry also needs to be better at communicating appropriate, factual information, using terminology that is accessible to people outside of the sector. There is a lack of understanding around the difference between public and private care – to improve the public perception of the sector, we need to find a way to present unified information so that there can be no misunderstandings.

The schism between public and private facilities needs to be addressed, as there are ongoing issues between these spheres that often come down to a lack of communication – in an ideal world, these systems can work together to maximise the resources that we have access to.

COVID-19 has shone a light on the need for aged care to develop stricter protocols around infection control.  COVID-19 is highly infectious, and we have seen the devastating consequences when it is exposed in aged care facilities.. We must develop legislation and protocols around this matter to prevent future outbreaks to the extent that we have seen recently. Appropriate legislation around staffing levels and training will ensure they have the knowledge, support and equipment required to prevent future outbreaks to the extent that we have seen recently.

Aged care staff are doing their very best.   The aged care sector is made up of passionate people who want to provide the best care possible for some of the most vulnerable members of our community. It is our responsibility to ensure that the industry is properly governed and funded to ensure that happens.

Paying more for aged care might save you in the long run

I am a passionate believer that aged care is about choice. Ageing is a natural part of life and we hope that we will all see our parents reach their senior years.

However, with the ageing process comes the need for aged care. For many of us, a role reversal happens where we begin to give our elderly parents the care they often gave us while we grew up. This is often an emotionally overwhelming time but then you need to dive into what is often an unfamiliar world with plenty of jargon – RADs, DAPs, Level 1 home care package (HCP), additional service fees etc.

In my previous columns, I have broken down what to expect when it comes to aged care fees and what you can reasonably be expected to pay. I have also written about how to negotiate thousands of dollars off aged care fees, as aged care is a market and like any market – there is often room for negotiation.

However, it may not always pay to negotiate aged care fees. Aged care needs to be about your individual circumstances and what options suit you and your family best. Although there are plenty of times when it’s better to negotiate, it’s important to look at options where paying a higher amount upfront might be better for your loved one than paying a smaller, daily fee.

What does it mean to pay a higher amount?

To be clear, there are aged care fees that are set by the government and cannot be changed. This includes fees such as the basic daily fee and the means tested care fee.

It’s also illegal for you to pay more money for a specific aged care bed (this is known as a Refundable Accommodation Deposit, or RAD) or for an aged care home to ask you to pay above these fees to guarantee your place.

 The RAD is the cost of an aged care bed and is what looks like the most eye-watering sum at first – often sitting in the hundreds of thousands of dollars range. As an alternative, this can be paid as a Daily Accommodation Payment (DAP) instead. This is essentially the interest on the RAD calculated as a daily payment, which may be more affordable than a lump sum. However, I’ve had clients who have chosen to pay this large sum rather than its smaller alternative.

I once had a client Brenda* who had chosen an aged care home with a RAD of $775,000. Brenda could have paid in theory a lot less with the DAP, however once all of her assets were taken into consideration, we found it was better for her to offer to pay the full RAD in exchange for lower additional service fees.

 Additional service fees cover what I call ‘luxury’ items that are on top of your care needs. These may include extra meal choices for breakfast, lunch and dinner, Foxtel in your room etc., with each facility offering a different range of additional services. Brenda offered to pay the full RAD in exchange for a reduction in her additional service fees from $60 a day to $10 a day. That’s a savings of about $18,250 a year and she still got to enjoy all the benefits that came with the additional service fees.

From the aged care home’s point of view, it was worth agreeing to reduce the additional service fee when they were going to receive the full cost for her place straight away. So, in Brenda’s case, she was a lot happier and better off with more of her money in the RAD and more of her daily money in her pocket.

Centrelink rules may mean there’s more sense in paying more

One important thing to note is that you are not required to disclose your income and assets to an aged care facility. This was a requirement in the past but is not the case now. However, to ensure you are charged the appropriate fees, it is recommended that you disclose this information to Centrelink as those assets and income may have an impact on your pension.

For example, if you own your home and have a small amount of money outside of it, you could be considered a full pensioner. Let’s say your home is worth $800,000 and you decide to sell it to partially pay for aged care costs. If you pay an aged care facility $400,000 for the RAD and then you have $400,000 in the bank once you sell your house, Centrelink will consider this to be an asset and it may subsequently affect your pension entitlements.

However, if you find an aged care home that is charging you $775,000 for a RAD – and you choose to pay that instead, that lump sum payment will be exempt for pension purposes. Centrelink will assess the remaining assets and as a result, you may keep your pension. In terms of day-to-day living, you may very well prefer to keep your pension, fully pay for your aged care bed and have a little bit of cash in the bank.

Please note – the above scenarios are only general and this is where I recommend engaging a financial planner to crunch the numbers correctly for you, as well as working with an aged care consultant to present you all the options in the market. At this time in life the correct professional advice is essential.

Overall, planning aged care is about engaging the right professional services to be your advocates and to ensure you have thought through every available option and made the best choice for you and your loved one. Once we understand we have more choices than we think, this time of life becomes a lot easier for everyone.

*Names have been changed to protect privacy

PLEASE NOTE: This article is of a general nature and FYI only, because it doesn’t take into account your financial situation, objectives or needs. That means it’s not financial product advice and shouldn’t be relied upon as if it is. Before making a financial decision, you should work out if the info is appropriate for your situation and get independent, licensed financial services advice.

This article by My Care Path CEO Dana Sawyer originally published on Starts at 60.

An insider’s advice on how to negotiate thousands off aged care fees

An insider’s advice on how to negotiate thousands off aged care fees

If you are in the process of helping a family member transition from their own home to residential aged care, it can often be daunting for both you and your loved one. It seems like overnight you have to enter a whole new world, while trying to understand what aged care means for them financially, particularly when it comes to aged care fees.

The Australian government expects you to partially or fully contribute to the cost of your aged care – if you can afford it. I break down exactly what that means in this column but, essentially, if you have an income below $27,460 a year and assets worth less than $49,500 (including the family home*), the government will pay for your residential aged care.

If you are above this threshold, there will be an expectation that you contribute at least some of the cost towards your aged care needs.

However, it’s important to remember that there is often room to negotiate aged care fees and, as with any market-driven sector, it pays to shop around. In aged care, not all facilities will charge the same fees and depending on your situation, it may pay well to negotiate.

What aged care fees may be flexible?

There are a number of common care fees that you will come across when looking to access residential aged care, also known as an aged care home or nursing home. These are:

  • Refundable Accommodation Deposit (RAD) or Daily Accommodation Payment (DAP)
  • Basic Daily Fee
  • Means-Tested Care Fee
  • Additional Service Fee

For a full breakdown on what each of these fees mean read my previous column.

Out of the above fees, generally your basic daily fee and means-tested care fee are not negotiable because they are set by the government. You are also, for example, unable to pay more than the advertised RAD in exchange for a lower Additional Service Fee. But the RAD, DAP or Additional Service Fee can still have wriggle room.

How to negotiate on age care fees

Gladys came to me because she needed advice on helping her 84-year-old father find residential aged care. She had spoken with an aged care home in her area, which explained her father needed to pay a RAD of $300,000 for a bed.

Gladys believed there was no way they could afford the RAD, so in that situation the aged care facility was obligated to offer the DAP as an alternative. (Remember that if you want to pay for aged care through the DAP, the facility must accept your decision.)

This meant that Gladys’ father would only pay the interest on $300,000, currently capped at 4.91 per cent. But while Gladys initially felt happy with this, there was room for more negotiation.

While working with Gladys I found that there were two other aged care homes in her area, which were charging a RAD that was $50,000 less than that of the first home Gladys approached. So took this information to the original aged care home and were able negotiate the overall cost of the RAD down, which in turn reduced the DAP Gladys’ father had to pay.

There are other fees to consider as well, such as Additional Service Fees. I refer to these as ‘luxury fees’ as they are for items that add a bit of luxury, in that they may mean more meals to choose from at dinner time, Foxtel, a daily newspaper etc.

It’s important to note, though, that if an aged care home is charging an Additional Service Fee, there is an expectation that the resident is able to use those additional services. I had as a client a lady in her late 60s who was unfortunately in the late stages of dementia. When her family were going through the process of placing her in residential care, we were able to point out to the aged care home that the resident was unable to utilise the Additional Service Fee benefits that were offered, which eliminated that cost.

This ‘luxury’ fee can range from anywhere from $10 a day to $60-plus per day, so you can see where the benefits are of truly looking at all of your options. Even if you have to pay some Additional Service Fee, you may be in a position to pay a higher percentage of the RAD than initially planned, then negotiate the Additional Service Fee from there.

Aged care advice can pay for itself

Many of us cannot see what all of our choices are when we are working with an industry that is unknown to us and where we may need to make a decision in a short amount of time. It’s important when you are considering negotiating your aged care fees or simply want to see what your options are, that you get help from a professional if you can.

You may think a financial planner is the best point of call and while I do recommend engaging a financial planner when planning your aged care, an aged care consultant is a better advisor for negotiating residential aged care fees.

A financial planner is unlikely to understand the aged care market, what is standard for facilities to charge or what they are charging within the same area. An aged care consultant, on the other hand, is paid to represent you and will know what the facilities in your area are charging for an aged care bed.

When we don’t have to navigate the aged care process on our own, we often realise we have more options than we thought we did.

*Keep in mind that the family home is only exempt if a ‘protected person’ is living in the home, this is defined by Centrelink and typically refers to either a spouse, child or someone living on a support pension. However make sure to check with Centrelink that anyone living in your home qualifies under this definition.

Important information: The information provided on this website is of a general nature and for information purposes only. It does not take into account your objectives, financial situation or needs. It is not financial product advice and must not be relied upon as such. Before making any financial decision you should determine whether the information is appropriate in terms of your particular circumstances and seek advice from an independent licensed financial services professional.

This article was originally published on Starts at 60. 

Don’t rule out aged care – it could be the best option, expert says

Don’t rule out aged care – it could be the best option, expert says

There is a common belief in our society that the elderly prefer to remain in their own home rather than live in aged care. While this is an understandable presumption, and choosing to stay within your own home as you age is a genuine and legitimate choice, it’s not always the best option when our health declines and everyday activities become almost impossible. The reality is even with a Level 2 Home Care Package (HCP), which includes about 4-5 hours per week of care, many people are spending day after day at home alone. For adult children helping Mum or Dad navigate aged care, it’s important to make sure you’re not assuming your parents will be better off or happier at home. In my experience, it’s essential we show people all of their options before they make a decision. Either way at least they know what they’re saying yes or no too.

Paranoia 

I help hundreds of families navigate the aged care system every year and one thing I frequently come across is elderly people who are scared to leave their own house as they’re unsteady on their feet, or they’re terrified when someone knocks on the door. When people experience cognitive decline, some can also experience incidences of paranoia. This is particularly the case if they feel isolated. If the neighbour no longer pops around and friends have passed away or no longer visit, it can become very lonely and in turn home can become a scary place to be.

Loneliness 

When we talk about home, we often forget to talk about social networks. Home is much more than bricks and mortar. Home is also about our community, friends, work and hobbies. In fact, loneliness is one of the biggest causes of health decline for the elderly. If Dad has been on his own for a few years since Mum passed or the neighbour that always used to check in on him has passed away, then maybe a community-style living arrangement will be a positive move. Independent retirement villages or aged care homes will ensure more social interaction and a sense of security knowing people are close by.
Communal living is important for our wellbeing and when the elderly are interacting with their peers, aged care staff and visitors, it can provide a great boost to their overall health.

Quality of life

If you’re concerned about whether your parents should continue to stay at home, have a look around at the quality of the home to get an indication of how they’re coping. Is the bed made? Is there food in the pantry? Is the food in date and being eaten? I frequently meet elderly people who are eating nothing but toast for breakfast, lunch and dinner, which is unlikely to meet their nutritional needs. By contrast, an aged care home would provide three hot, nutritious meals daily, which are designed by a dietitian who understands your parents’ nutritional needs and are most often cooked onsite by a chef. I know if I was in that situation which option I would choose for myself.

When to make a change

There are of course elderly people who are genuinely happier at home. In my experience, these tend to be people who do not require 24/7 nursing care to ensure their physical and cognitive health and have access to weekly help such as a home care service. They’re also likely to have a strong connection to their community, have neighbours they chat to daily or are active in a church group or gardening club. If you feel your parents are unlikely to tick these boxes, then they may in fact be happier in an aged care home. However, this is still never an easy conversation to have. If you directly ask ‘do you want to move into an aged care home?’ it’s natural to have an immediate negative reaction. When it’s phrased like that, the answer is going to be no. Despite the benefits of aged care, it’s still a big change to consider and people are often resistant to change. Instead, focus on finding out what your parent wants and needs and then find suitable options they might consider. You could ask questions such as:
  • How are you going at home Mum?
  • Are you coping with the gardening and cleaning Dad?
  • How are you coping following the loss of your partner?
  • Do you have a lot of visitors? Does the neighbour still drop by regularly?
Maybe also suggest going to have a look at some accommodation options so you can talk about them down the track. Whatever your situation, remember to take the time to find out what the options are and if they will work for your loved one. Everyone is different. Your parents’ aged care needs should be about what works for their situation and not what we assume they want or need. This article was originally published on Startsat60.com

Celebrating Christmas in Aged Care

Christmas
can be a time of mixed emotions for many of us. While there are times of joy,
there can also be times of overwhelm and stress – particularly if you are
celebrating Christmas with a loved one in aged care.

If
this is your first Christmas with a loved one living in care, whether it’s your
mum, dad or partner then it will be a time to consider how you cope with the
various emotions that are likely to come up, which could be a mixture of
sadness, guilt or even anger. It’s important to know that while this Christmas
will be different, it can still be a time of festivity and celebration.

Our
CEO and aged care expert Dana Sawyer has put together her advice for
celebrating Christmas in aged care.

Accepting change during the
holidays

If
this is your first Christmas with a loved one in aged care, it’s a time of
great change and that can resurface emotions regarding guilt and sadness. I
have previously written about why for most of us, there’s no reason to feel
guilty about placing a loved one in aged care
, as the vast majority
of families make this decision because their parent is genuinely happier and
safer there than at home.

So
make sure to remind yourself that you know you made the best decision for your
mum or dad. This may be the first Christmas they will not be in their own home,
but they are likely to be a lot happier than they were, with the additional
social interaction, nutritious meals and nursing care ensuring they are being
looked after.

Most
aged care homes also celebrate Christmas with festive decorations, a special Christmas
menu and special activities or Christmas church services. Ask the aged care
home manager what is planned for the holiday season. If your family doesn’t
celebrate Christmas but other cultural holidays common at this time i.e.
Chanukah, then ask about celebration options for these holidays.

Take mum/dad home for
Christmas

An
aged care home is just that – a home. Similar to when you are at home, you are
free to come and go. Aged care homes in Australia allow for 52 days of social
leave per year for residents (this is capped due to homes only wanting to
provide rooms to people who genuinely need the 24/7 nursing care aged care
homes provide).

Therefore
why not plan to have mum or dad home for a few days at Christmas if this is an
option? You will need to let the aged care staff know about your plans so they
don’t worry about the whereabouts of your loved one.

However
make sure to take daily care needs into consideration, are you able to make
sure dad takes his medication, help feed or clothe if necessary? Consider all
the small daily tasks an aged care nurse does for your loved one as part of
your holiday planning.

If
you’re starting to realise that you won’t be able to provide the necessary
care, speak to the aged care staff about spending Christmas in the aged care
home. Perhaps you can enjoy the Christmas feast with all the residents, bring
some of your own Christmas treats to enjoy in the home’s lounge or exchange
gifts in mum’s aged care bedroom.

Decorate their room with
Christmas decorations

You
can also add festive cheer by decorating your loved one’s aged care bedroom.
Perhaps a Christmas wreath on the door, some tinsel or a small tree depending
on what is suitable and safe. Christmas music is also a great option, if you
can arrange a small stereo or even vinyl record player. Look for records of
Christmas classics like Billy Holiday and Frank Sinatra – tunes your parents
would like have grown up with. Music creates a calming, peaceful atmosphere and
for those with cognitive decline, music from their youth can be a powerful
method of relaxation.

Celebrating Christmas when
parents have cognitive decline

One
particular challenge is when your parent is experiencing cognitive decline,
particularly if they have been diagnosed with Alzheimer’s disease. Even if you
want to bring your parent home, lots of new faces and noise can overwhelm them.
An option is to keep the Christmas festivities in the aged care home or create
a quiet space for your loved one. Dedicate a room that you can decorate with
Christmas decorations, but everyone knows this is the ‘quiet room’ and is where
grandpa or grandma can have some peace and quiet if needed.

Ageing
loved ones often presents its challenges and the holiday season is no
different. Just because this Christmas will be different from ones of the past,
doesn’t mean it will be any less festive and joyful. No matter what stage of
life we are in, having a merry Christmas is often a matter of perspective than
circumstance.