Comment: Aged care, let’s talk

Chief advocate of National Seniors Australia, Ian Henschke. Photo: Contributed

Comment

Ian Henschke

FROM July 1, 2023, at least one registered nurse must be on-site and on duty at all times at every residential aged care facility.

This requirement prompted some providers to say they’re closing, and since last September, 23 homes have shut or announced they’ll shut.

In April the Brightwater Care Group in WA said it was closing three nursing homes, affecting 75 residents. But added in a press release, that it recently opened a 128-bed facility.

It makes you wonder what’s really going on.

Sydney’s Wesley Mission said it was getting out of residential care citing “challenges to workforce and flow on impacts from the reforms to Aged Care”.

It shut one home last year and then announced it was closing the remaining three, but said it would continue to provide home care and retirement living “to help people stay in their homes for longer”.

These closures have become a political issue as well an aged care welfare issue.

The opposition says it’s because of the Labor government’s “reckless” push to speed up improvement in aged care.

Labor’s announcement to get nurses into nursing homes 24/7 was a year ahead of the previous government’s schedule.

So, are homes closing because it’s all got too hard to improve the workforce to provide better care?

National Seniors always looks at the evidence, and it’s worth noting, although 23 homes have closed in the last nine months, we know from government data 51 homes closed between 2020 and 2022.

A home closed on average almost every two weeks before Labor announced the July 1, 2023, commitment.

We also know from the OECD (OrganiSation for Economic Cooperation and Development), Australia has one of the highest rates of residential care for people over 80.

Australia has 18.9 per cent of its over-80 population in care, compared with Germany’s 10.7 per cent, Canada’s 12.0 per cent, and Sweden’s 12.6 per cent.

But now that’s changing as more and more people stay at home for as long as possible.

The revelations of the Royal Commission into Aged Care Quality and Safety and the tragic events of COVID have seen that trend grow.

It’s so strong the latest budget showed savings of $2.2 billion in aged care costs over the forward estimates because home care is cheaper than residential care.

The average occupancy rate in residential care homes in Australia was 95 per cent in 2018, by 2020 it had fallen to 88 per cent and the most recent figure from June 30, 2022, revealed an occupancy rate of 86 per cent.

We know people are going into residential aged care with more frailty, more complex health issues, and more dementia. Aged care homes are becoming more like hospices.

Perhaps we should see them as an integral part of the hospital system, and fund them accordingly to provide more nursing care, dementia care, palliative care, and end of life care.

The royal commission outlined the urgent need for better paid and better trained workers, and laid out a pathway for better care.

The better pay is happening, now we need better care and better training.

How to fund this is the big question.

The royal commission recommended a levy. This was rejected by the government and the opposition. But seniors have made their view quite clear.

When we surveyed members, an overwhelming 85 per cent wanted aged care funded from general revenue or through a levy, just like the rest of the health system.

Remember, although the government pays most of residential aged care cost, non-pensioners pay almost $32,000 per year because of means testing.

Pensioners lose the bulk of their pension paying almost $22,000 as part of their contribution.

In addition, the provider can have separate charges. And there’s the payment of the RAD (Refundable Accommodation Deposit) or the DAP (Daily Accommodation Payment). It’s complex but suffice to say there’s user pay at play.

Our 2021 research paper ‘Planning for aged care costs’ showed more than 90 per cent of NSA members owned their home, so the idea of staying in your home is a reality for most.

Using some of that equity to stay out of residential care and buy extra care to top up a home care package may be the way of the future.

The government has just released the draft National Strategy for the Care and Support Economy.

It talks about the need for a “national conversation” about the split in contributions between government and individuals.

Should people pay more? Let’s talk.

You can also have your say at pmc.gov.au/domestic-policy/nationalstrategy-care-and-support-economy/have-your-say

You can read our Aged Care research here at nationalseniors.com.au/uploads/Planning-for-care-costs-24.8.21.pdf

About the author: Ian Henschke is chief advocate of National Seniors Australia.

As National Seniors Australia’s Chief Advocate, Ian Henschke works to raise the profile of older Australians and strengthens the collective voice of National Senior Australia members.