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Tuesday, August 9, 2022

While in-home care remains preferable for most, approval of home care packages remains a major stumbling block

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More older Australians are favouring in-home care as opposed to entering residential aged care facilities (RACFs) according to newly released Federal Government data.

The Productivity Commission’s Report on Government Services, published on Tuesday, shows that the total number of home care packages (HCPs) hit 236,554 last financial year, while the population of residential aged care remained stable at 243,117.

However, government spending on RACFs still exceeded that of HCPs, with the services costing $14.3 billion (60.7 per cent) and 7.8 billion, respectively.

In 2020-21 there were 1246 fewer people in residential aged care than the year before; sadly, hundreds of COVID-19 related deaths contributed to this outcome.

Karen Ivanka, team leader of COTA Victoria’s Patient Navigator trial, which provides older Australians with independent advice on what aged care service is most appropriate, tells Aged Care News that increased uptake of home care packages aligns with older Australians’ desire for ongoing independence and agency.  

“The goal is that people can stay in their home,” she says.

“[Being afforded a home care package] may mean they don’t have to enter residential, which might be something they absolutely don’t want.

“Because there’s a lot of grief and loss attached to going into aged care.”

Although care is delivered primarily at home through HCPs, provisions for temporary respite are inbuilt, which allows secondary carers, such as the recipient’s spouse or children, to take breaks when needed without having to commit their loved one to a RACF full time.

“There’s flexibility in what people could get depending on what works for them,” Ivanka says.

Whilst the Federal Government committed to providing an extra 61,562 HCPs, lengthy waiting times remain an issue for the service, with the report indicating that 53,203 were still waiting for package approval at time of writing.

This is a major issue for quality of care, with older persons and their carers left struggling for months on their own.

“The reality is, by that time [when their package is finally approved], people’s circumstances can change.

“You know, in 12 months, they could deteriorate, they might end up in hospital again.”

Ivanka notes that by the time many HCPs are approved, many older Australians have already given up and moved into a RACF.

The Productivity Commission report also found that, nationally, state and territory recurrent spending on public housing fell in 2020-21 to $3.1 billion from $3.2 billion the year before.

This is despite calls from Kate Colvin, spokesperson for fairer housing system campaign Everybody’s Home, noting that increased public housing supply is necessary to mitigate the risk of low income Australians, including thousands of aged care workers, becoming homeless.  

“As that reduction [in supply] has happened, states have tightened eligibility,” Colvin told Aged Care News in November.

“The consequence of that is that someone might be at risk of homelessness because their income is not enough to keep up with rents in the private market, but they might not get access to social housing until they’ve actually become homeless.”

In 2021, 96.8 per cent of public housing was occupied.

Across Australia, there has been a decline in the number of public housing households, from 323,423 in 2012 to 288,345 in 2021.

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