Heralded a success in aiding older Australians and their carers navigate the complex and often confusing systems of aged care, Council on the Ageing (COTA) Victoria is expanding its Aged Care Navigator service to the Eastern Metropolitan areas of Melbourne, with the trial ongoing until December 2022.
Established in 2019, the trial service has helped older Victorians in the Southern Metro and Loddon-Mallee (City of Greater Bendigo) regions on a daily basis, with COTA Navigators providing free, independent, one-on-one support to elders.
The navigators can assist with a range of inquiries and support, including:
- understanding the assistance an older Victorian can receive to help them remain safely in their home;
- understanding their options if they prefer to move to a residential aged care facility (RACF);
- helping older Victorians register with My Aged Care; having a representative from COTA Victoria attend an assessment meeting with the older Victorian; helping the older Victorian find a local aged care provider and also referring the older person to other support services to meet their particular needs.
Karen Ivanka, team leader at Aged Care Navigators, COTA Victoria, tells Aged Care News that having trusted, independent advice has meant that more Victorians have felt comfortable seeking assistance, especially home care packages.
“You can meet somebody and their whole day has been absorbed just in survival mode, just trying to manage things that have become a struggle,” she says.
“Putting in a simple hand-rail could change everything for someone.”
Unpacking a complex system
Ivanka notes that many do not realise how complex the aged care system is; older clients face frustration when those around them buy into ageist stereotypes, believing their difficulty navigating the system is due to their own incompetence.
“That’s one thing that I’m very careful about, acknowledging their ability, because this system, no matter who you are, can be confusing.
“I met a lady yesterday: she was in her 90s and she was a really capable person, had traveled the world throughout her life.
“And she said, ‘why is the system so hard, why is it so confusing? I don’t understand who would have ever created a system like this!”
Without an intermediary such as a COTA Navigator, Ivanka explains that the onus is on the older consumer and/or their carer to differentiate between the numerous providers and service options.
“They get bombarded with a lot of paperwork, they’ve had an assessor, they’ve had contact with My Aged Care and they get a series of letters, then people leave them with things and they get told ‘just ring some of these people and choose a provider’.”
On the other hand, sometimes an older person is referred to a single provider, raising issues of freedom of choice.
“They almost think that the person they spoke to, which was just a company telling them all about their services…, they think that’s who they have to go to.
“They don’t realise they could actually talk to a couple of others as well… So that’s where it’s important that people know who they’re talking to.”
It is for this reason that the COTA Navigators trial has been such a success; and despite dissatisfaction with aged care providers being commonplace Australia-wide, Ivanka has found this tailored support to result in less complaints or need to transition services.
“They feel like they are in control,” Ivanka says.
“I think it’s about building up that trust … you’ve got to be able to trust other people coming in to your house and helping you.
“I have to build up that rapport and reassure people.
“And the good thing about navigator programs is that we’re independent.
“We’re not the government; we’re not a service provider; we’re here and we’re not charging them for the service.”
Dispelling misconceptions about home care and the perceived inevitability of residential care
Through the service trial, Ivanka has come to realise that whilst there are a vast number of Australians who could benefit from government assistance, especially home care, many have a deep seated trepidation of initiating the process.
“People are fearful and resistant because they soldier on and think that it is like letting your guard down, that ‘if I accept this, it’s the beginning of the end’.”
Whilst many fear that engaging with government services means that induction into a RACF is inevitable, Ivanka emphasises to her clients that keeping them in their homes is her top priority.
“If you get help with the small things… it means you might not get to that desperate level,” she says.
“And it means that they might not 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, I find.
“Sometimes the people around someone are pushing for them [to enter residential aged care], they say ‘I just don’t think they could stay [in their home] any more’.
“But they can: if the home care is right they could stay there, definitely.”
Alleviating stressful, time-pressured scenarios
Once an older person initiates a claim, news of a short deadline can cause an immense amount of stress.
“They get a letter that says you’ve got 56 days to choose a provider,” Ivanka explains.
“It might sound like a long time but… they know they’ve got this ticking time bomb… until they choose that provider it’s this thing on their to-do-list which is just bothering them.”
Ivanka recently completed a home visit to a client in such a situation, assisting the lady for a few hours in narrowing down the options based on her personal needs.
“[We] progressively eliminate[d] ones that we thought might not meet her needs… And so we did ring one, which she had chosen, and we got it all set up there and then.
“She was so relieved, she said, ‘I am now going to be able to sleep tonight’.”
Trial moves to final stage
This year marks the final year of the trial, after which Ivanka notes the service should transition to a permanent service, hopefully scaling to a nation-wide service.
“But there’s lots of work to be done in the meantime while we’re still doing the trial,” she says.
“We provide reports on a monthly basis; we write case studies; and all that’s helping to inform the Government in making their final decision around these roles [becoming permanent].”
According to Tina Hogarth-Clarke, chief executive officer of COTA Victoria, the success of the Dandenong and Casey-Cardinia projects has assisted in the development of a model for community engagement that will form the basis of the on-going service from 2023.
“It will involve connecting with local community organisations, provision of information, linking with assessment teams and financial information service officers, identifying individuals seeking assistance and providing an appropriate level of support.
“Where appropriate, specialist support, such as interpreter services, will be sought to assist with individual needs.”
She adds that around ten volunteers will be added to the expansion program, which should build capacity significantly.
“For many, identifying and sifting through the labyrinth of aged care options can be confusing and daunting.
“We are confident that COTA Victoria’s Aged Care System Navigator Trial will strip back those complexities and create a more streamlined and user-friendly approach to aged care in Victoria.”
COTA Victoria’s network of community-based volunteers, peer educators and other special interest groups, will also provide a direct link to people with the highest needs in their communities.
Vulnerable clients will be identified through its referrer network, local community organisations and networks, which include LGA’s, community health services, as well as community houses and migrant resource centres.
To find out more about the service and whether an older Victorian you know is eligible for assistance, visit www.cotavic.org.au/information/aged-care-navigator-service/