industry & reform
residential aged care. As ACFA notes,
more and more women are participating
in the workforce, the divorce rate has
risen over the years and families are
having fewer babies. These changes
point to more older people being ‘home
alone’ and potentially an increased
need for higher level care outside of the
family home.
• The needs of diverse groups may be
better responded to in future residential
aged care settings. These may include
people from Aboriginal and Torres
Strait Islander communities, people
from culturally and linguistically diverse
backgrounds, people who live in rural
or remote areas, people who are
financially or socially disadvantaged,
veterans, people who are homeless
or at risk of becoming homeless,
care leavers, parents separated from
their children by forced adoption or
removal, and lesbian, gay, bisexual,
trans and/or intersex people. The health
department encourages providers to
develop communities within their aged
care homes.
• Onsite allied health services will support
the frail elderly effectively in residential
aged care.
• Responses to social isolation for frail
elderly may be met more effectively in a
residential care setting.
• Complex care needs including dementia
may be met more safely, effectively and
cost efficiently in an environment with
24/7 onsite specialist care.
• Medical advances resulting in people
living longer with higher levels of frailty
and complex care needs.
• Innovation in individualised
accommodation, care and services may
overcome some of the present perceived
and real deficiencies in residential care.
NEGATIVE
• Generational change and greater
resistance to living in institutional aged
care settings exacerbated by the much-
publicised failures in care which led to
the present royal commission.
• Government policy:
• An increased proportion of government-
funded home care.
• Ongoing funding pressures impacting
residential aged care staff ratios and the
public perception of residential aged
care facilities.
• Technology such as artificial intelligence
and robotics enabling people to be
supported longer in their smart home.
• Medical advances deferring entry to
residential aged care can be expected
to create shorter lengths of stay in
residential care.
• Substitution through innovation of
alternatives to funded residential aged
care such as assisted living and private
aged care environments.
On balance, we expect that in the longer
term residential aged care facilities will be
more specialised, providing complex care
to a much larger cohort of frail, elderly
Australians.
ACAR APPLICATIONS
ACAR gives providers the opportunity to
expand their presence and cater to their
local communities. Each year, the places
are allocated on a priority basis. In ACAR
2018–19, the focus was on providing
more supply to remote, regional and rural
communities and the places were allocated
based on the remoteness of area. In the
previous ACAR (2016-17), the places were
awarded on the need/demand basis.
An evidenced-based application is
more compelling
Previous studies by The Ageing Equation
have revealed catchments across the
country that require significant urgent
residential aged care supply to meet
the demand.
To support an evidenced-based
application, it is important that providers
conduct detailed research to study their
local market to gain insights into market
environment and competition.
While there are many factors which
make an application successful, the health
department may consider while assessing
the applications:
• The Aged Care Act 1997.
• Which priority category area the
proposed facilities are located in (yet to
be announced by the department).
• Tailoring the provision of care particularly
to residents in the Special Needs Group
and with key issues such as dementia,
respite and mental health.
• Financial capacity to undertake the
capital works.
• Demonstration that the places will be
operational in a timely manner.
• Compliance history.
• Provider’s track record of previous
provisionally allocated places.
• Track record of provision of care and
information on operational/clinical
processes to adequately meet clients’
care needs.
• R
esearch on local area and services and
provider’s understanding of need based
on evidence.
• H
ow the provision ratio of the geographic
area the facility/facilities are located in
compare to the national target provision
ratio of 78 people per 1000 older than 70.
CONCLUSION
The fall in residential aged care service
occupancy in the last few years appears to
reflect greater availability of government-
funded home care services in combination
with a greater desire by potential residents
and their families to avoid residential care.
The latter has been exacerbated by the
For providers intent on
expanding their residential aged
care offering, it is imperative
to view the big picture and
consider longer-term factors.
much-publicised failures in care.
Although residential aged care services
continue to face significant challenges,
the projected growth in the population
of older Australians can be expected to
underpin strong medium and long-term
demand. Diminished availability of family
for informal at-home support and people
living longer in frailty will contribute
to demand.
It is likely that there will be particular
catchments across the country which
require significant urgent residential aged
care supply to meet the demand.
On the supply side, much of the existing
stock of residential aged care facilities will
not meet the needs of future residents who
will seek more individualised, home-like
accommodation.
Likewise, future residents and their
families will demand more personalised
care and tailored services.
For residential aged care providers with
an intent to expand their services, 2020
ACAR will provide the opportunity to
reposition with accommodation, care and
personalised services to meet the higher
expectations of residents who will be very
different to those that have gone before. ■
Safdar Ali and Peter Hoare are directors of
The Ageing Equation.
* For references and tables, go to
agedcareinsite.com.au
agedcareinsite.com.au 17