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The aim of the Australian aged care system is to provide accessible, appropriate and efficient care [3]. It supports the wellbeing and independence of older people through high-quality and person-centred care. Although aged care services are aimed at those aged 65 and over, they are provided on the basis of need, rather than specific age criteria. The system provides a range of services that support older people—and a small number of younger people with disability—in both residential and community-based settings.

The Australian Government provides the majority of funding for aged care. As part of the government's on-going aged care reform, changes have been progressively implemented since 2013. These changes are aimed at ensuring aged care is sustainable, affordable and responds to people's needs. In particular, the changes give priority to providing more support and care in the home for all older and frail people (including specifically for those with dementia), as well as better access to residential aged care, and a stronger aged care workforce [3].

An Aged Care Assessment Team (ACAT) must assess and approve a person before they can access government-funded residential aged care, Home Care or flexible care services. ACAT provides an approval for both the type and level of care (see Accessing aged care services).

Types of care

Residential aged care


Pie chart shows 7.8% of people aged 65+ are in residential aged care.

7.8%

of the Australian population aged 65 and over (270,559 people) were in residential aged care over the 2013–14 financial year [4].


There are two types of care provided in residential aged care facilities: permanent and respite care.

Permanent residential aged care

When people can no longer be supported to live independently in the community, they may move into a residential aged care facility permanently. Permanent care was offered at two levels in 2013–14: low care and high care. Generally, people in low-care permanent care receive accommodation and personal care, while people in high care require up to 24-hour nursing care in addition to their low-care needs.

A person’s care level is determined in two ways, with both assessments considering a person’s physical, medical, psychological, cultural and social needs. First, an ACAT assesses a person and provides approval for the type and level of care they are eligible to apply for (see Accessing aged care services). After a person enters permanent care, the Aged Care Funding Instrument (ACFI) confirms the level of care required (see Care needs of people in aged care), calculating an overall score which is then used to determine a government subsidy amount. From 1 July 2014, individuals did not need approval for a particular level of residential aged care (high or low), and they no longer have to move between facilities as their care needs change.

Respite residential aged care  

People who live in the community can receive short-term respite care in aged care facilities. Respite care is available on either a planned or emergency basis to older people who intend to return to their own home, but require temporary residential aged care. It supports older people in transition stages of health, as well as providing carers with a break from their caring duties. Respite care is offered as either low or high care. The government provides a pre-determined, corresponding subsidy amount; respite residential aged care does not use the ACFI.

Home Care


Pie chart shows 2.4% of people aged 65+ receive Home Care PNG

2.4%

of the Australian population aged 65 and over (83,481 people) received Home Care over the 2013–14 financial year [4].


The Home Care Packages Programme offers an alternative to residential aged care. It is designed to provide clients with an individually tailored and co-ordinated package of services to support them to live independently in the community for as long as possible. The programme commenced on 1 August 2013, replacing the former community packaged care program, which consisted of Community Aged Care Packages (CACP), Extended Aged Care at Home (EACH) and Extended Aged Care at Home Dementia (EACHD).

Levels of care

Home Care Packages are available at four levels of care, offering progressive support to those with basic, low, intermediate, or high care needs. Existing packages transitioned to the new framework on 1 August 2013, when CACP packages became Home Care Level 2, and EACH and EACHD packages became Home Care Level 4.

Unlike the former community packaged care program, the type of care available at each Home Care Package level does not differ. Instead, the main difference is the amount of care and services provided, with more available at higher levels. A package contains a range of services to support a person living at home. These may include transport services, domestic assistance (including meal delivery or preparation and home or garden maintenance and modifications), personal care, social support, aids and equipment, as well as nursing, allied health and other clinical services.

Flexible care

In addition to residential aged care and Home Care, flexible aged care services provide care in mixed delivery settings. The three types of flexible care are Transition Care, Innovative Care (or Pool), and Multi-Purpose Services. They are designed to meet people's needs in ways other than those provided through mainstream residential aged care and Home Care:

  • Transition Care Program assisted some 23,000 older people during 2013–14 to return home after a hospital stay through 4,000 operational places, with an average length of stay of 72 days for completed episodes [1].
  • Innovative Care provided 92 operational places at 30 June 2014 in developing and testing service delivery for people who were not adequately supported by mainstream services [1].
  • Multi-Purpose Services provided 3,553 operational places at 30 June 2014 in rural or remote areas where mainstream services were not viable [1].

The National Aboriginal and Torres Strait Islander Flexible Aged Care Program, which is administered outside of the Aged Care Act 1997, provides culturally appropriate care for older Aboriginal and Torres Strait Islander Australians close to their homes and communities. At 30 June 2014, the program provided funding for 739 operational aged care places [1].

These care types are not otherwise reported in this web report.

Other care

Other programs provide assistance to older people wishing to remain in the community. These include the Commonwealth Home and Community Care (HACC), National Respite for Carers, Day Therapy Centres, and Assistance with Care and Housing for the Aged programs, and the Veteran's Home Care program.

The largest of these programs is the Commonwealth HACC, which provides a range of basic maintenance and support services for frail older people living in the community. The program is available to those aged 65 and over (50 and over for Aboriginal and Torres Strait Islander people). The Australian Government has administered the program for older people since 2012 in all states expect Victoria and Western Australia, while state and territory governments continue to deliver home and community care services for people under 65 years, or under 50 for Aboriginal and Torres Strait Islander people.

An annual report on the Commonwealth HACC program for 2013–14, derived from the HACC Minimum Data Set, can be obtained from the Department of Social Services website. During 2013–14, more than 775,000 people aged 65 and over used Commonwealth HACC services [2].

Private facilities and providers also offer a range of parallel options, such as retirement villages and in-home nursing care, in addition to the government-funded services.

These care types are not otherwise reported in this web report.

Further reforms to aged care

In 2013, the government implemented the first stage of progressive reforms to aged care. These reforms included the launch of the My Aged Care gateway, the establishment of the Aged Care Pricing Commissioner, reviews of existing fees and charges in residential aged care, and the commencement of the new Home Care Packages Programme from August 2013.

The Commonwealth Home Support Programme launched on 1 July 2015, consolidating four existing programs (Home and Community Care, National Respite for Carers, Day Therapy Centres, and Assistance with Care and Housing for the Aged) into one.

From 1 August 2013, all new Home Care packages have been delivered on a Consumer Directed Care (CDC) basis, and existing packages have been transitioning to CDC. Since 1 July 2015, all new and existing Home Care packages have been delivered on a consumer-directed basis. This approach encourages aged care clients to have a higher level of involvement in their own care. People may make decisions about the types of care and services they receive within their individualised budget, and the way those services are delivered.

For more information about Home Care packages and CDC, visit the Department of Social Services website. DSS also provides an overview of the aged care reforms.


References

  1. Department of Social Services (DSS) 2014. 2013–14 Concise facts and figures in aged care. Canberra: DSS.
  2. DSS 2014. Home and community care program minimum data set 2013–14 annual bulletin. Canberra: DSS.
  3. DSS 2014. 2013–14 Report on the operation of the Aged Care Act 1997. Canberra: DSS.
  4. SCRGSP (Steering Committee for the Review of Government Service Provision) 2015. Report on government services 2015. Canberra: Productivity Commission.