Aged Care Insite Issue 111 | Feb-March 2019 | Page 18

industry & reform MAIN TAKEAWAYS FROM TABLE 1 The long wait Tiered assistance and care model can fill service gaps. By Safdar Ali G overnment figures show there are more than 69,000 older Australians waiting for their approved level package, and who are without an interim package, as at 30 September last year. Although the federal government announced an additional 14,000 higher care packages as part of the 2018–19 budget, and the recent delivery of 10,000 packages, it falls well short of meeting ever-increasing demand based on the government’s target ratio of 4.5 per cent for people over the age of 70 by 2022. Our Brisbane-based agency has found that it can take up to two years to access a government-funded home care package in some areas. This shortfall in supply may result in unnecessary early entry into residential aged care for some of those eagerly waiting. Outside of government-provided home support and care packages, piecemeal assistance services are often provided by the operators of seniors’ living communities. However, coherent, tiered, fee-for‑service support and care that addresses the spectrum of support and care needs are not commonly available in these communities. ASSISTED LIVING PACKAGES Fee-for-service assisted living packages are one way of addressing the service and care needs gap between independent living and residential aged care. 16 agedcareinsite.com.au Many people are used to the government being ‘the payer’ for care and health needs. However, there is a growing segment of older Australians with a capacity to pay for care and support driven by societal factors such as newfound wealth from the sale proceeds of their homes, greater superannuation, a lessening of the intent of past generations to ‘leave money for the kids’ and a desire to live as well as they can now. Most of all, they wish to defer admission to residential aged care. I propose a model of tiered assistance and care delivered in seniors’ communities that would provide certainty of continuous care for those with deteriorating wellbeing who cannot wait months, let alone years, for a government-funded assisted living package. Such models of service are available in Canada and northern Europe, for example, but have not been implemented to a considerable extent in Australia. The handful of operators who have done so have found this approach meets market demand and customer needs, and fills a major gap in the continuum of care. At two modern campuses in Wheelers Hill in Melbourne, New Zealand-based Ryman Healthcare provides assisted living, fee-for- service packages to fill the support and care gap and enhance the consumer experience offered by traditional lifestyle retirement villages. Ryman responds to the spectrum of residents’ assistance and care needs with tiered packages and optional occasion of care services between the tiers, such as help with medication and wound management. Another example is Aveo’s recently opened higher-end development in Newstead, Brisbane, which offers modern independent living, assisted living and residential aged care. Like Ryman Healthcare, Aveo offers a mandatory base package that includes mainly assistance services, laundry and meals with some care services. Additional services and care are available as an optional package – up to 14 hours per week and on an hourly basis. Table 1 summarises some fees and benefits associated with government-delivered home care packages and a selected fee-for-service package delivered into a seniors’ living campus. • A  t levels 1 and 2, depending on the income levels of a care recipient, the cost to a consumer of government-funded and the selected fee-for-service packages are similar. • I  mmediate availability of packages and 24/7 onsite care in the event of an emergency are compelling features of the fee-for-service packages. ASSISTED LIVING ADVANTAGES Coherent, tiered, assisted living packages delivered within a seniors’ living environment offer advantages for both consumers and providers compared with government- funded at-home care and such services delivered into the broader community. Consumers • 2  4/7 onsite support in case of either an emergency or a simple, but immediate, need for assistance • R  eady and timely assistance with daily living tasks, assistance and care • M  ore long-term relationships with the care giver – the shift to consumer selection of the providers with government-funded packages has led to dis-integration of delivery among service providers • L  ess administration – if residents are living in a seniors’ community compared with seeking care services from different providers • M  ore personalised care with more likely fewer provider staffing changes • G  reater value for money with providers in a seniors’ community not needing to recoup downtime through travelling • G  reater chance to remain in their home for as long as they can and defer or prevent a move to residential aged care. Operators of seniors’ communities • M  eaningful assistance and care offering – to provide the compelling proposition for a move to a seniors’ living environment – not just companionship, activities and accommodation • L  ower cost delivery – with care recipients located close together in a village or apartment building • A  nother revenue stream from care and support services • G  reater range of accommodation choices – laundry and full kitchen areas are not