This blog was created as part of our Journey of Care for the Ageing Event in collaboration with B’nai B’rith and Caulfield Shule.
“Home is where the heart is”….. “there’s no place like home”……
These are just a few age-old and much-used sayings that ring true today perhaps more than ever.
As we age, the place we call “home” often increases in importance to us and we want to remain living there, independently, for as long as possible. And yet, many people put off thinking about (and actually getting) the support that they need to help them stay right where they want to be!
Staying at home longer is a more viable option today than it has ever been, with government funding available to those that need it. Home care has also changed a lot over the years in the way it is provided and the approach of those delivering it. So much so, that it is often an enriching experience and an opportunity to become more independent and to improve all sort of aspects of life.
When done well, home care not only supports you to remain living independently at home but is designed to help you remain as active and engaged as possible, promoting your well-being and your independence, and putting you firmly in control of what your care looks like. These days, it’s really about supporting you to live your life, your way.
So what exactly is home care? And how does it work?
Like most things, care and support means different things to different people, depending on their stage of life, their health, their needs and their own personal goals and lifestyle choices.
Care and support at home enables highly tailored solutions, designed specifically for you.
Sometimes people just need a few hours of help around the house each week – a bit of cleaning, some help changing the bed sheets or getting the vacuum into those hard-to-reach spots that are a bit tricky these days. This is often a great, ‘gentle’ way to start out with home support – so you get used to having someone in your home and find out what works well and what you most need as you go along.
‘Care’ can also be support with things like cooking and food preparation or someone to take you to appointments, access local services or get out and about in your community to do things you enjoy. Perhaps you don’t like to drive much anymore or would find some help in the supermarket useful. Perhaps you’d like someone to go with you to the things you enjoy like movies, the theatre or Gardens; or someone to have a cup of tea and a chat with on your way to an appointment.
Personal Care at home includes things like assistance showering or bathing, grooming and getting yourself up and about. It might include support with medications or continence support.
For those living with a long-term illness or dementia or other significant disability, care and support may be more comprehensive and involve all of the above. Around the clock (24hr) care can also be provided with carers sleeping in your home to be ‘on call’ if needed.
Home nursing is also available for clinical care including things like wound dressing, medication administration or nursing assessments.
How much does Home Care cost and what funding is available?
Home care can either be funded privately or you can access government funding. You can also combine both, ‘topping-up’ government funding with additional private care.
Privately funded care is usually charged at an hourly rate and you can choose to have as many, or as few, hours as you like. Most providers don’t lock you into a contract and have reasonable cancellation terms if you need to cancel a visit.
Government funded care
There are two primary programmes for government funded home care. Both programmes are run by My Aged Care – the government agency responsible for delivering Aged Care.
i) Commonwealth Home Support Programme (CHSP):
This provides ‘entry-level’ home care, some nursing and allied health, and things like transport, meals-on-wheels and cleaning. This Programme is often provided by local
Councils or large, not-for-profit organisations. You generally do not have a choice of which provider you get and although the CHSP is predominantly funded by the Government, you will usually have to pay a contribution for your services.
ii) Home Care Packages programme
This is a more comprehensive care programme that provides you with a set amount of funding each year to be spent on care services and products or equipment associated with your care. You have more choice and control over what care and support you receive and who from. You choose the provider you would like to provide your Home Care Package. It can take some time (up to 12 months) to get a Home Care Package. Find out more here:
How do I choose a provider?
When you’re looking for a home care provider, here’s some questions that can help you choose the Provider that’s right for you and help you get the most out of your care.
* Is the Provider a Registered Home Care Provider with My Aged Care?
In order to provide Government funded aged care such as Home Care Packages, providers must be registered with My Aged Care and must meet certain Quality Standards which are regularly assessed.
* What qualifications and training do the carers have?
Does the carer have a Certificate III or IV qualification in Individual Support, Aged Care or Disability? And how does the provider manage their ongoing training and development?
Do you have to commit to a certain amount of care or for a certain period?
If you’re paying privately for home care, you should not have to commit to a long- term contract or any ‘locked-in’ set amount of hours.
If you have a government-funded Home Care Package, you will need to sign a Care Agreement but are still in charge of what care you want to receive and when.
* What is the price and cancellation terms?
If you’re paying privately for home care, most providers charge an hourly rate. It’s also important to ask about their cancellation terms. Many providers offer cancellation terms which allow you to cancel up to 24 hours before each shift without a charge.
If you have a Home Care Package you should ask them about their Care Management and Package Management Fees which are taken out of your Package.
* Will you have a Care Manager and is there a fee charged for this?
Care Management is a really important part of a care programme. A Care Manager usually has overall responsibility for your care programme; ensuring that an appropriate Care Plan is in place and that the care provided meets your needs and is in line with your wishes and requirements. They will make sure that your care needs are properly understood and that suitable carers are allocated to your programme.
Paying a few for this separately to the actual cost of the direct care service, isn’t necessarily a bad thing because it means you are paying for a specific service and can expect a certain level of service. If you have a Home Care Package, Care Management must be provided and a fee is charged – make sure you ask providers what their fee is.
Does the provider directly employ your carers?
Some care providers provide the Care Management component directly and ‘sub- contract’ the care workers through other organisations. This can work especially if your needs are fairly straightforward and are not complex or if you only want a small amount of care. Where your care needs are higher and / or you’re receiving a lot of hours of care, it can be better to go with a provider who directly employs its care staff.
* How much choice do I get in the carer who is sent to me and what if I don’t get on with them?
It’s important that you feel comfortable with the person coming into your home. For some people, especially if they’re having a carer in their home for a long time, it’s important to have someone of a particular gender; or someone who understands their cultural background; or someone who they have things in common with or can have a good conversation with. How does the provider enable this and what happens if you just don’t like the person they send?
What pitfalls should you be aware of?
* Leaving it to the last minute – preparation is key!
As with anything, when you have to rush, things are more likely go wrong. It’s better to start thinking about what care you might need and what you would want it to look like sooner rather than later. People are often reluctant to think about their care needs in advance until a ‘trigger event’ happens – like going into hospital unexpectedly or being suddenly diagnosed with a long-term illness. And then you find yourself navigating a brand new space at a time when you are already under pressure and stress or in ill-health.
A good provider should still be able to organise and start your care programme quickly, but the more prepared both they and you are, the smoother it will go! If you do need to start care quickly eg within a couple of days, ask the provider if they have a specific rapid intake process and what that involves. Be aware that they may need quick responses from you in order to get the care up and running in time.
* Be open to suggestions
Remember, care providers do this every day – they may have suggestions or recommendations that you don’t immediately like. Perhaps it’s a particular carer you rejected because you thought they were too young, perhaps it’s a different schedule or suggestions for how your daily care routine might work better. Or perhaps it’s just something you hadn’t considered before. Take a bit of time to consider it, ask questions and be willing to give it a go!
So how do you get started?
Do some research;
* Online: There are a lot of good online resources out there to find out more about Home Care, what it is and how it works and what to expect. Some trusted websites include:
Myagedcare.gov.au https://www.cotavic.org.au/ Absolutecarehealth.com.au//aged-care/
* Your health care professional: your GP, hospital or allied health provider may be able to recommend a number of providers that they have worked with or have heard good things about.
* Word of mouth: talk to people about their experiences and what’s worked for them. Recommendations from friends and family is often a good place to start.
* Care Finders: There are organisations in each State who are funded by the Government to provide a free service to people who need some extra support to access aged care services. You can find a list of Care Finders in your State here: https://www.myagedcare.gov.au/help-care-finder
About The Author:
Founder and Executive Chair, Absolute Care & Health
P: 03 9978 9110
F: 03 9827 8321
L3, 199 Toorak Road South Yarra, 3141 Victoria, Australia