May 24, 2024 • 30 mins
As your parents get older, you might notice some changes around their house. The laundry is stacking up, food in the fridge is going off, or the carpet needs a good vacuum.
Perhaps you’ve noticed a change in your parents themselves—the shopping is getting harder to carry, they’re eating less, or not going out as much.
These could all be signs they need some extra help—but getting your parents to accept that they need help might be a different question altogether. Putting it bluntly, suggesting that your parents need some extra help can be a minefield.
In this episode Australian Unity's CEO of Home Health, Prue Bowden, and General Manager of Service Delivery, Elizabeth Albury, join performer, author and 'Parenting Up with Australian Unity' host, Jean Kittson AM, to discuss how to navigate these conversations, and how in-home help can be used to help your parents stay independent for longer.
To learn more about parenting up, visit: https://www.australianunity.com.au/wellbeing/community-and-relationships/how-to-help-ageing-parents-with-their-health
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jean Kittson (00:00):
This is Parenting Up with Australian Unity, a podcast where
we're talking about ageing, and we're looking at some of
those essential conversations that we need to have with our
loved ones as they get older. I'm Jean Kittson, and
(00:21):
I've had a bit of experience in this area. Having
cared for my own parents for the last 15 years.
I would say mum is just about to turn 99
and dad just turned 96. I've even written a book
about it to help us all, but mainly to help me.
We need to talk about Mum and dad. A guide
to parenting our ageing parents. Each episode I'm going to
(00:43):
be joined by experts, and we love experts and people
who have been through this process themselves. And we're going
to lay it all on the table and get get
real about some of these challenging topics so that you
can navigate them with care and compassion and empathy and
respect and the right information. This episode is a big one,
(01:06):
assisted living, which is all about getting some help at home,
and anyone who's been through this knows that it can
be a minefield, particularly the terminology you really need to
speak fluent acronym. So we have an expert to help
us with this today. And I'd like to welcome Elizabeth Albury,
who is the general manager of service delivery for Australian Unity.
(01:29):
So welcome Elizabeth.
Elizabeth Albury, (01:31):
Thank you Jean, it's an absolute privilege to be with
you and try and help your listeners on this very
important topic.
Jean Kittson (01:37):
Oh, yeah. Well, it's so confusing. There are so many acronyms.
Unless we understand what people are talking about, we it
can be a lot of stress. So we want to
reduce the levels of WTF and and increase the levels
of wtd, which is what to do because there's a
Cat and acres and HCP and HSP and SSC. Uh,
(02:02):
it just does your head in. So could we go
through these acronyms? And if you explain to us what
they mean, then we'll be perfectly set up to have
to be able to articulate what we need and how
to go about getting it. So could you. We'll start
with a cat and acres.
Elizabeth Albury, (02:20):
Yeah. So you're absolutely right that it is a minefield.
And even my aged care is fondly known as Mac.
So right at the beginning it's a problem. But Acas
is short for the Aged Care Assessment Services, which is
the government area that I guess do all of the
assessments to assign appropriate funding to the elderly and the
(02:43):
frail people at home that need it. So from aged
care assessment services, that is where the a cat people are,
which is the aged care assessment team. So they're the
team of people that simply go and run the assessments
with the elderly and with their families to assist determine
(03:04):
the best way to help them live, you know, safely
and independently in their home. They do very valuable work.
The a cat team they do.
Jean Kittson (03:13):
I know my parents have been assessed. They're very astute
to the A cat team because my parents, when they
got assessed, they rang me up and said, oh, Jean,
the assessment teams come today. And I was going, oh no,
I wanted to be there. And they said, um, yes.
And I think we did really well, you know, and
I'm going, don't do well, just be honest. So the
(03:33):
really important thing I think for you, if you're worrying
or you're caring or you want to help your elders
as they age, is to get an assessment book, an
assessment that will take weeks. First of all, you've got
to ring up and talk to my aged care and
they will give you a number, you know. And don't
forget that number. That's your reference number. Tattoo that number
(03:56):
on your forehead. Name your pet after that number. That
is a really important number.
Elizabeth Albury, (04:01):
So you ring up my aged care and you start
to outline exactly what some of the challenges and some
of the things that you've noticed are happening with your
parents in the home. And it's probably quite important to
do a bit of preparation around that prior to the
phone call, because from there, you kind of have to
(04:22):
repeat your story a number of times through some screening
calls and and then to actually, um, have the assessment done. Um,
and there's, there's about ten key areas to really think about, um,
that can assist, you know, drive those conversations more successfully.
And they're things like, you know, who is the main
(04:46):
carer for my parents? Are there family members involved? Or,
you know, if there's one parent not doing as well
as the other, is that parent picking up the majority
of the responsibility? And there's things like what are their
levels of function in their activities of daily living? Um,
just simply getting out of bed, making a meal, having
(05:06):
a shower, getting dressed. Are there falls risks? Um, probably
the other two main ones are having a really good, um,
detailed statement of their medical history and then also thinking
about their cognitive capacity and their psychosocial circumstances. Um, so
you kind of need to prepare and have a lot
(05:28):
of dot points under those main headings so that you
can present a very compelling picture of their needs at
the time of the assessment.
Jean Kittson (05:36):
Yes. You give that to the team when they come.
Elizabeth Albury, (05:38):
You give it at every single opportunity. So you give
it at the my aged care opportunity, because that is
the determination of what type of assessment you are given. Um,
because it may not be an acat aged care assessment
team assessment, it may be a Razz assessment team, regional
(05:59):
assessment support. Um, but they then lead to different levels
of funding. So if you don't start delivering and painting
the picture early on in the piece, um, it does
change what some of the benefits that Mum and Dad
may need.
Jean Kittson (06:15):
Well, when you first ring my aged care, it's good
to register as a nominee for your parents. Otherwise they
won't talk to you anyway. They'll have you and your
parents may want to talk to my aged care themselves,
but it's good if you're in the room because it
can be very difficult to understand and they can get
very frustrated repeating their own story.
Elizabeth Albury, (06:36):
Yes, yes, you absolutely do. And and I agree. Um, Jean,
you do need to be in the room to prompt them,
but also to remind them to your point earlier. Talk
about your worst day, not your best day. And you know,
we all like to be independent and capable and reliable
and responsible. But if you talk about how you are
(06:59):
on a great day, that's not actually the true picture.
That's often happening in the home.
Jean Kittson (07:04):
No, I was horrified when Mum and Dad said that.
I thought, oh no, they're not going to get any
help because they were so competent. You know, they were
almost sitting on a Pilates ball while hoovering the house.
That's how capable we are. But luckily the assessment team
I think has, you know, is able to see beyond that.
(07:25):
So then once you get the assessment, then the assessment
team will suggest either an HCP, a HSP or even
an SSC. Is that correct? So could you, could you
could you that's like cling on to me. So could
(07:45):
you talk us through those, um, those acronyms, please?
Elizabeth Albury, (07:49):
Oh, well, yeah, that is a bit of alphabet soup
right there. And and I'll talk about them. Jean, in
kind of the order that we should be thinking about them, um,
and that they would normally flow in a customer's journey
through ageing. So the first one, yeah, the first one
to talk about is Strc, which is short for short
(08:10):
term restorative care. And this is a very brief but
intense piece of funding for about eight weeks. Um, it's
around about $12,000 worth of funding. And the philosophy and
intent behind it is to try and assist the elderly
come back to a better baseline of independence in their home.
(08:34):
So it would include things that are possibly around personal care. Um,
quite a bit of allied health support. So particularly from
physios that are trying to improve mobility and just simply
the ability to get out of a chair, um, more comfortably. Um,
often there's nursing services involved if there's, you know, perhaps
(08:57):
some wounds that need looking after, but just to try
and restore, um, those people back to a good baseline. Um,
it's also a nice piece of funding that is often
used to bridge a waiting time while we're waiting for
something more permanent to come along and help them permanently
(09:17):
in the home. So that's short term restorative care strike.
The next level of funding is, as you say, HSP,
but more formally known as the Commonwealth Home Support Program.
So this program is I would describe it as entry
level support. So it provides a very small amount of
(09:41):
services to help frail and older people maintain independence and
live safely at home. So if you think about the
time of or the time of support that you might get,
it's perhaps 1 to 2 hours per week. Um, and
it's generally focused around just some of those domestic support, um,
(10:04):
domestic duty support. Um, it can be focused around some
personal care. Um, so it might be just assistance with dressing,
assistance with showering, that type of thing. And it does
also provide for those that qualify. Some meals support if
they just simply need some help preparing their their meal
(10:26):
each you know preparing a group of meals to to
serve them for the week. There is also an element
of home modifications under that KSP funding.
Jean Kittson (10:38):
Great.
Elizabeth Albury, (10:38):
Yeah. For people that need something done just to help
them perhaps get safely in and out of their front door.
Jean Kittson (10:44):
Oh, great. So then the next one is the HCP.
Is it?
Elizabeth Albury, (10:48):
Yes. So the HCP, um, also known formally as the
home care package.
Prue Bowden (10:54):
Is.
Elizabeth Albury, (10:54):
I guess, the ultimate in home care funding program is
what I would call it. Um, it helps Australians who've
got much more complex age related needs to live sort
of independently in their home, and it adopts a very
consumer directed care type of philosophy. So people with a
(11:18):
home care package have a lot more ability to have
a say in how they want their package used, as
long as it, you know, falls within the intent and, um,
purpose of the funding and the appropriate use, of course,
of the government funding. It has about 130 page, um,
(11:38):
guideline document behind it, which is available to, you know,
people that are given a home care package for reading. Um,
not an easy document to wade through, but certainly a
very helpful document. If you've just got a one, you know,
one specific query, you can easily, you know, find the answer. Yeah.
Within the index. Yeah. Home care packages have four levels, Jean,
(12:03):
as you no doubt know.
Jean Kittson (12:04):
Yes my mum's on a level four now. She started
on a level two and my dad started on a
level one and he's now a level three.
Elizabeth Albury, (12:13):
So the level one, um, is around about and I'll
talk some approximate figures here, but around about $9,000 per
year of funding. And generally that would provide people with
about six hours of care each month in their home. Um,
level two, around $15,000 in about ten hours of care
(12:34):
in their home. Um, level three, about $34,000 a year,
and that equates to around 19 hours in their home.
And then the maximum level currently level four, it's just
a bit over $50,000 a year. Um, and can provide
up to about 30 hours of care in the home.
(12:55):
So obviously you see the degree of complexity increase there,
As you know, the aging related needs increase.
Jean Kittson (13:03):
Yes. It's they're marvelous packages. I suppose the main thing
to remember, um, is that these things take time. There is.
You talked about the, uh, short term restorative care program
being a sort of bridge while you're waiting to be allocated,
maybe a home care package. And that's because it can
(13:24):
take a number, a number of months for all this
to fall into place. If it's a really high level, uh,
care package, it can take even longer. Yeah, you.
Elizabeth Albury, (13:36):
Make a perfect point there. You've got to, uh, certainly
be considering ahead 6 to 12 months ahead. For what?
You know, the little signs that you might be seeing
that are needed and start the process early, even to
have an assessment done by the aged care assessment team
can take kind of three, four, maybe longer in more
(13:59):
regional areas 3 or 4 months before the actual assessment
will take. And then once you're assessed and let's say
approved for funding, um, there is a ranking. There's a
national ranking in the wait list, um, which you're given
a low, medium or high priority depending on how urgent
(14:20):
the support is needed. And that ranking then equates to
somewhere between three months and 12 months before the funding
will actually be available.
Jean Kittson (14:31):
I've already applied for my home care package. You know,
I'm waiting for my assessment, but, you know, because, um,
these these programs aren't there to meet your crisis. They're there.
They'll take their own sweet time. But. So that's why
you have to know these things and and think in
advance and plan in advance. I think we've had enough acronyms,
(14:54):
but it's great to hear them explain so clearly, because
it's all sometimes you think you can't ever cope with
all this, but when you hear it explained so clearly
and in such a clear order, Elizabeth's like you have
done it just makes it it all feel possible that
we can, you know, do what we need to do
(15:14):
to help our elders. And now we've got the acronym
straight and we know the programs are available there. I'd
like to bring in another person, Prue Bowden, who's the
CEO of Home Health at Australian Unity, to chat about
the services these programs can provide to help our parents
stay safely at home and in the best health and
(15:38):
wellbeing possible for as long as possible.
Prue Bowden (15:41):
Thanks, Jean. Lovely to be here. I mean.
Jean Kittson (15:43):
Let's start with the first thing, which is, you know,
how to talk to our parents about maybe getting some
home help. Well, I.
Prue Bowden (15:50):
Think opening the conversation is really important to treat your
parents in a way that you would like to be
treated when it comes to the moment in your life
where you need to contemplate how you live best and
how you live well and safely at home. But I
think it's important to talk to your parents about the
worst day rather than the best day. Because if we
(16:11):
focus just on their best day, then you often, you know,
sort of tend to, um.
Jean Kittson (16:16):
Overlook.
Prue Bowden (16:17):
Overlook. Yes. Thank you. Overlook some of the issues that
are actually very real, that need to be managed for
their own safety and for their own well-being. So if
you focus on their worst day and you get real
in the conversation, but you lead with an open heart
and compassion, then I think that's the very best way
to enter that discussion with your parents. And it's a
tough one, but an important one.
Jean Kittson (16:37):
Yes. Well, I mean, there's always resistance. If you say,
do you need some help cleaning around the house, they'll say, why?
You know why, you know they'll bristle. Is there something
you know? Are we not clean? And my parents love cleaning.
They used to clean everything. And my mother with her. Walker,
still has a duster that sits on the top of
(16:58):
the walker every single day. Wow. But I think having
that conversation about that getting help is and taking away
your independence, is it?
Prue Bowden (17:07):
No, no, it's just the support you need to be
able to keep doing the things you love to do.
And it may mean that she can still go around
your mum and do light dusting in a safe way,
but there's someone who can come in and help do
some of the things that she's just perhaps not able
to do anymore. So it's giving them still space and
time to feel like they're valuably contributing. And they're they've
(17:29):
got purpose in their day, and they're able to do
many of the activities that they used to do before,
but a recognition that help is needed to help them maintain, um,
you know, living safely at home.
Jean Kittson (17:40):
And I suppose, um, what we think of we're talking
sort of about cleaning now, but there's so many other
things available, so many other services, aren't there?
Prue Bowden (17:48):
Yeah. I mean, look, basic domestic support is really where
people start, you know, very, very sort of low level
entry support. And it's light housekeeping, light support around the home.
But it can be, um, out to shopping and helping
people maintain. But it's also really important about thinking about
how they maintain their functional health, you know, maintain the
(18:11):
activities of daily living. And that might mean having early
intervention support from a physio or an occupational therapist so
that they're able to not just, you know, do some
of the basics at home, but they're maintaining their functional
capacity to live well at home longer. What do you.
Jean Kittson (18:28):
Mean by that?
Prue Bowden (18:28):
So your physical strength, you know, so when we when
people come to home health for support, the first conversation
we have with them are what goals are they're trying
to achieve. It might be that they want to be
able to continue to walk to the local shops and back,
or it might be that they want to be able
to still maintain doing some gardening. So then we start
(18:50):
to think about, okay, well let's assess their functional capacity.
What what is their movement ability. What is their ability
to maintain strength and stamina. How what's their sort of
gait and ease of walking. And can they still do
those things? And if they can't and that's a goal
that they're wanting to achieve, then we look at how
do we support them to to achieve that or be
(19:11):
able to maintain that if they're already doing it. And
so that might be things like some physio support to,
to maintain their physical strength, to be able to do those.
Jean Kittson (19:20):
Marvellous to hear because I must say my experience, we
get the physios as rehab after some injury, but to
have to think of services as maintaining your capacity and
capabilities as a preventative? Yes, as a preventative service rather
than a rehabilitation or a fixing up thing, then that
(19:43):
is fantastic. The most important thing is to get in soon.
Get in when your loved one is a level one,
you know. get in the system, get registered, get the
reference number, and then you can have access to the
most amazing help because it takes a team, a lot
of collaboration, of a lot of resources to help your
(20:07):
elder to age.
Prue Bowden (20:08):
Well, yes, absolutely. It it takes a combination of the
support team, but it's also the the way that that
support team collaborates with the family members. And so that
there's the unpaid help that comes and volunteers and supports
that person in the community. And there's also the the
ways in which providers play a really meaningful role as well.
Jean Kittson (20:31):
So a provider, once you get an assessed and allocated
a home care package, then you choose a provider so
you have that's your money, and then you choose someone
to manage that for you to provide the services. Yes.
So how should people choose a provider?
Prue Bowden (20:50):
Well, I think, you know, it's about fit. And as
we all know, there's huge challenges with the health care
workforce and the care workforce in this country, just with
the capacities available to care for an ageing aging population.
And so I think really looking at the providers, looking
at the quality of their workforce and the availability of
(21:11):
the workforce to care for your parent is really important.
And ask some probing questions about stability and consistency of
the of the team that would be assigned to to
care for your parents. But it's like everything in life,
it's important that you feel comfortable with the people coming in,
in and out of your home as well. So I
think it's it's just due diligence, positive inquiry and, and,
(21:35):
and being quite discerning about which provider you pick, because
quality care is the most important aspect to be looking for.
Jean Kittson (21:41):
Oh, that's without a doubt. It really is, because I
know that the trouble we get into with care is
when there's a churn of different people coming all the time, Because,
as we know, one of the great antidotes to feeling
like you have lost your independence and autonomy is to
have really, or you're feeling isolated or vulnerable is to
(22:04):
have really strong relationships. And those relationships extend to the
professional people in your life, too.
Prue Bowden (22:10):
Yes. Yeah. Which is which goes to this sort of
early intervention mindset. The earlier you you get the support.
So to your advice just before about get into the
system early, get your loved ones assessed, because once they're assessed,
then you can start to use some of that support
and service to actually help them in more of a
(22:30):
preventative sense, or to relabel them to build strength, to
build some of the stability that's going to be needed
for them to maintain those activities of daily living for longer,
which allows them to live independently for longer at home.
And so that's really when people have their package assigned
and they come to our organization in home health. That's
(22:52):
really how we have that really important initial conversation to
firstly understand, as I said, what are their goals? And
then we work with them to develop the right sort
of plan to support them, to achieve their objectives.
Jean Kittson (23:05):
Yes, it's interesting to do the plan because it's not
just based on what you're observing. It might be based
on who the person is and what they feel they
may not have been able to do for the last
year or something. So you can find out, you know,
what is important to them, what gives their life meaning.
It's not just about the cleaning and the cooking.
Prue Bowden (23:27):
No, it's social support. Uh, it's it's the ways that,
you know, they look to connect in the community. So
it's how we support their transport and travel to the
things that are meaningful to them. So it's it's absolutely
not just domestic and basic personal care support. Um, and
there's going to be increasing levels of complexity of people
(23:49):
aging at home in the future as the population ages,
and there's less and less capacity available in aged care facilities.
So you'll start to see much more diversity in the
sorts of services and supports that are provided to people
in the home in the future.
Jean Kittson (24:07):
Well, we'll have to get support with technology for a start.
Prue Bowden (24:10):
But yeah, yeah. And virtual models of care. We already
start to work with our ageing customers in in using
virtual models of care, you know, virtual physio and exercise
assessments where our clients can be doing their activities at home.
But we can be monitoring them, monitoring them remotely as well.
Jean Kittson (24:29):
Yes, I think that's wonderful. We sort of talked we
talked about that in the in the health care episode
about all the different ways you can monitor and, um,
engage virtually. Yes. And effectively. Yeah. And in an intimate
and human way. I'm not talking about robots doing the
washing up.
Prue Bowden (24:50):
No, no, no. You can convey empathy and compassion and
you can deliver quality care in a virtual setting just
as much as you can do it in a physical setting.
Jean Kittson (24:59):
So there are many more things you can get on
the package as well. There's physio, podiatry. Can you get
dietician support?
Prue Bowden (25:08):
Yes. Yeah. Can you get preparation support.
Jean Kittson (25:11):
And these packages can help you. If you have an
accident or something they can help you with crutches and wheelchairs.
You know hiring things. All of.
Prue Bowden (25:19):
The home modifications.
Jean Kittson (25:21):
Home modifications.
Prue Bowden (25:23):
Mobility aids, all of those things can be provisioned for
as part of the funding arrangements as well, which are
all really important aids to helping people live and age
well at home.
Jean Kittson (25:35):
So get on to those home care packages if you
I mean, you're assessed financially too. There's a means test.
You know, if you fail the means test if you
have to provide your own. Are there private people who
provide those services too?
Prue Bowden (25:50):
Yes. There are providers who provide, um, private paid services.
There are also providers like Home Health at Australian Unity
who do blended arrangements. So you can be funded to
a point. But you you may want additional supports and
services for your loved one and more certainty around their
safety living at home. And so you can therefore, you know,
(26:12):
pay out of pocket for additional services or home monitoring
or those sorts of things. So you've got greater peace
of mind of your parents aging well at home.
Jean Kittson (26:21):
So in terms of helping our parents live safely and
confidently and and really to live at home for as
long as possible, that means that at some point we
most people have to talk about moving from the family
home that might have a lot of steps or might
(26:42):
be isolated somewhere where it's not close to shops. I mean, yeah.
Prue Bowden (26:47):
Look, I think there often comes a point and it's
different for every individual about when the transition might need
to be from home into another form of assisted living.
It might be a retirement village, or it might be
an aged care facility. And I think listening to the
clinicians and the specialists who are supporting your your loved ones,
(27:10):
listening to the feedback from the OTS who might have
done a home assessment and really just thinking forward about
what what your parent might need in the near term,
not just the now term, is really important to guiding
that particular conversation. And I think there's also the the
dignity of risk, you know, discussion with your with your
(27:30):
parents because we may with the perspective that we bring as,
as sons and daughters, as neighbors and community members, we
may have a particular view about what that individual needs,
but there's a dignity of choice in actually whether that
individual wants to move or stay in their home. And
so we we, as we often work with our clients,
(27:52):
have to really consciously understand the risk an individual is
wanting to take on and allow them to have the
dignity of making that decision.
Jean Kittson (28:02):
Definitely. That's a really strong message to leave this episode on.
Thank you so much, Prue. Thank you Jean. Just a
few key takeaways. Now, the first thing you need to
do is register with my aged. Care to register? You
need your elders Medicare card. Then my aged care will
tell you which program is most suited to your parents.
(28:22):
If your parents prefer to make that call, just sit
with them while they do it. Otherwise they'll just say
they don't need any help at all. Thank you very much.
We're fine. Then you need to get the appointment for
a C assessment. Then you have the assessment, then you
have the approval. Then you get the allocation. So that's
four days. And don't forget to register as their nominee
(28:43):
with my aged care, so you can speak to them
directly on behalf of your parents when you need to,
and they'll give you a reference number. Um, but the
final tip waiting times for actual allocation can be extraordinary,
as we've heard months, sometimes years. That's no exaggeration. So
make sure you get in early because they're not there
(29:04):
to meet your crisis. They will take their own sweet time.
Thank you so much for joining me for this podcast series,
Parenting Up with Australian Unity. I've really enjoyed chatting to
all these wonderful experts, and I hope their knowledge and
experience has helped you to support your loved ones and
make sure they are healthy, safe, independent and most importantly,
(29:28):
happy for as long as possible. Thank you. The information
provided in this episode of Parenting Up is general in
(29:49):
nature and does not consider your personal circumstances. Australian unity
accepts no responsibility for the accuracy of any opinions, advice,
representations or information contained in this podcast. Listeners should rely
on their own independent advice and inquiries when making decisions
(30:10):
affecting their own or their loved ones finances, health, wellbeing
or other interests.
This is Parenting Up with Australian Unity, a podcast where
we're talking about ageing, and we're looking at some of
those essential conversations that we need to have with our
loved ones as they get older. I'm Jean Kittson, and
(00:21):
I've had a bit of experience in this area. Having
cared for my own parents for the last 15 years.
I would say mum is just about to turn 99
and dad just turned 96. I've even written a book
about it to help us all, but mainly to help me.
We need to talk about Mum and dad. A guide
to parenting our ageing parents. Each episode I'm going to
(00:43):
be joined by experts, and we love experts and people
who have been through this process themselves. And we're going
to lay it all on the table and get get
real about some of these challenging topics so that you
can navigate them with care and compassion and empathy and
respect and the right information. This episode is a big one,
(01:06):
assisted living, which is all about getting some help at home,
and anyone who's been through this knows that it can
be a minefield, particularly the terminology you really need to
speak fluent acronym. So we have an expert to help
us with this today. And I'd like to welcome Elizabeth Albury,
who is the general manager of service delivery for Australian Unity.
(01:29):
So welcome Elizabeth.
Elizabeth Albury, (01:31):
Thank you Jean, it's an absolute privilege to be with
you and try and help your listeners on this very
important topic.
Jean Kittson (01:37):
Oh, yeah. Well, it's so confusing. There are so many acronyms.
Unless we understand what people are talking about, we it
can be a lot of stress. So we want to
reduce the levels of WTF and and increase the levels
of wtd, which is what to do because there's a
Cat and acres and HCP and HSP and SSC. Uh,
(02:02):
it just does your head in. So could we go
through these acronyms? And if you explain to us what
they mean, then we'll be perfectly set up to have
to be able to articulate what we need and how
to go about getting it. So could you. We'll start
with a cat and acres.
Elizabeth Albury, (02:20):
Yeah. So you're absolutely right that it is a minefield.
And even my aged care is fondly known as Mac.
So right at the beginning it's a problem. But Acas
is short for the Aged Care Assessment Services, which is
the government area that I guess do all of the
assessments to assign appropriate funding to the elderly and the
(02:43):
frail people at home that need it. So from aged
care assessment services, that is where the a cat people are,
which is the aged care assessment team. So they're the
team of people that simply go and run the assessments
with the elderly and with their families to assist determine
(03:04):
the best way to help them live, you know, safely
and independently in their home. They do very valuable work.
The a cat team they do.
Jean Kittson (03:13):
I know my parents have been assessed. They're very astute
to the A cat team because my parents, when they
got assessed, they rang me up and said, oh, Jean,
the assessment teams come today. And I was going, oh no,
I wanted to be there. And they said, um, yes.
And I think we did really well, you know, and
I'm going, don't do well, just be honest. So the
(03:33):
really important thing I think for you, if you're worrying
or you're caring or you want to help your elders
as they age, is to get an assessment book, an
assessment that will take weeks. First of all, you've got
to ring up and talk to my aged care and
they will give you a number, you know. And don't
forget that number. That's your reference number. Tattoo that number
(03:56):
on your forehead. Name your pet after that number. That
is a really important number.
Elizabeth Albury, (04:01):
So you ring up my aged care and you start
to outline exactly what some of the challenges and some
of the things that you've noticed are happening with your
parents in the home. And it's probably quite important to
do a bit of preparation around that prior to the
phone call, because from there, you kind of have to
(04:22):
repeat your story a number of times through some screening
calls and and then to actually, um, have the assessment done. Um,
and there's, there's about ten key areas to really think about, um,
that can assist, you know, drive those conversations more successfully.
And they're things like, you know, who is the main
(04:46):
carer for my parents? Are there family members involved? Or,
you know, if there's one parent not doing as well
as the other, is that parent picking up the majority
of the responsibility? And there's things like what are their
levels of function in their activities of daily living? Um,
just simply getting out of bed, making a meal, having
(05:06):
a shower, getting dressed. Are there falls risks? Um, probably
the other two main ones are having a really good, um,
detailed statement of their medical history and then also thinking
about their cognitive capacity and their psychosocial circumstances. Um, so
you kind of need to prepare and have a lot
(05:28):
of dot points under those main headings so that you
can present a very compelling picture of their needs at
the time of the assessment.
Jean Kittson (05:36):
Yes. You give that to the team when they come.
Elizabeth Albury, (05:38):
You give it at every single opportunity. So you give
it at the my aged care opportunity, because that is
the determination of what type of assessment you are given. Um,
because it may not be an acat aged care assessment
team assessment, it may be a Razz assessment team, regional
(05:59):
assessment support. Um, but they then lead to different levels
of funding. So if you don't start delivering and painting
the picture early on in the piece, um, it does
change what some of the benefits that Mum and Dad
may need.
Jean Kittson (06:15):
Well, when you first ring my aged care, it's good
to register as a nominee for your parents. Otherwise they
won't talk to you anyway. They'll have you and your
parents may want to talk to my aged care themselves,
but it's good if you're in the room because it
can be very difficult to understand and they can get
very frustrated repeating their own story.
Elizabeth Albury, (06:36):
Yes, yes, you absolutely do. And and I agree. Um, Jean,
you do need to be in the room to prompt them,
but also to remind them to your point earlier. Talk
about your worst day, not your best day. And you know,
we all like to be independent and capable and reliable
and responsible. But if you talk about how you are
(06:59):
on a great day, that's not actually the true picture.
That's often happening in the home.
Jean Kittson (07:04):
No, I was horrified when Mum and Dad said that.
I thought, oh no, they're not going to get any
help because they were so competent. You know, they were
almost sitting on a Pilates ball while hoovering the house.
That's how capable we are. But luckily the assessment team
I think has, you know, is able to see beyond that.
(07:25):
So then once you get the assessment, then the assessment
team will suggest either an HCP, a HSP or even
an SSC. Is that correct? So could you, could you
could you that's like cling on to me. So could
(07:45):
you talk us through those, um, those acronyms, please?
Elizabeth Albury, (07:49):
Oh, well, yeah, that is a bit of alphabet soup
right there. And and I'll talk about them. Jean, in
kind of the order that we should be thinking about them, um,
and that they would normally flow in a customer's journey
through ageing. So the first one, yeah, the first one
to talk about is Strc, which is short for short
(08:10):
term restorative care. And this is a very brief but
intense piece of funding for about eight weeks. Um, it's
around about $12,000 worth of funding. And the philosophy and
intent behind it is to try and assist the elderly
come back to a better baseline of independence in their home.
(08:34):
So it would include things that are possibly around personal care. Um,
quite a bit of allied health support. So particularly from
physios that are trying to improve mobility and just simply
the ability to get out of a chair, um, more comfortably. Um,
often there's nursing services involved if there's, you know, perhaps
(08:57):
some wounds that need looking after, but just to try
and restore, um, those people back to a good baseline. Um,
it's also a nice piece of funding that is often
used to bridge a waiting time while we're waiting for
something more permanent to come along and help them permanently
(09:17):
in the home. So that's short term restorative care strike.
The next level of funding is, as you say, HSP,
but more formally known as the Commonwealth Home Support Program.
So this program is I would describe it as entry
level support. So it provides a very small amount of
(09:41):
services to help frail and older people maintain independence and
live safely at home. So if you think about the
time of or the time of support that you might get,
it's perhaps 1 to 2 hours per week. Um, and
it's generally focused around just some of those domestic support, um,
(10:04):
domestic duty support. Um, it can be focused around some
personal care. Um, so it might be just assistance with dressing,
assistance with showering, that type of thing. And it does
also provide for those that qualify. Some meals support if
they just simply need some help preparing their their meal
(10:26):
each you know preparing a group of meals to to
serve them for the week. There is also an element
of home modifications under that KSP funding.
Jean Kittson (10:38):
Great.
Elizabeth Albury, (10:38):
Yeah. For people that need something done just to help
them perhaps get safely in and out of their front door.
Jean Kittson (10:44):
Oh, great. So then the next one is the HCP.
Is it?
Elizabeth Albury, (10:48):
Yes. So the HCP, um, also known formally as the
home care package.
Prue Bowden (10:54):
Is.
Elizabeth Albury, (10:54):
I guess, the ultimate in home care funding program is
what I would call it. Um, it helps Australians who've
got much more complex age related needs to live sort
of independently in their home, and it adopts a very
consumer directed care type of philosophy. So people with a
(11:18):
home care package have a lot more ability to have
a say in how they want their package used, as
long as it, you know, falls within the intent and, um,
purpose of the funding and the appropriate use, of course,
of the government funding. It has about 130 page, um,
(11:38):
guideline document behind it, which is available to, you know,
people that are given a home care package for reading. Um,
not an easy document to wade through, but certainly a
very helpful document. If you've just got a one, you know,
one specific query, you can easily, you know, find the answer. Yeah.
Within the index. Yeah. Home care packages have four levels, Jean,
(12:03):
as you no doubt know.
Jean Kittson (12:04):
Yes my mum's on a level four now. She started
on a level two and my dad started on a
level one and he's now a level three.
Elizabeth Albury, (12:13):
So the level one, um, is around about and I'll
talk some approximate figures here, but around about $9,000 per
year of funding. And generally that would provide people with
about six hours of care each month in their home. Um,
level two, around $15,000 in about ten hours of care
(12:34):
in their home. Um, level three, about $34,000 a year,
and that equates to around 19 hours in their home.
And then the maximum level currently level four, it's just
a bit over $50,000 a year. Um, and can provide
up to about 30 hours of care in the home.
(12:55):
So obviously you see the degree of complexity increase there,
As you know, the aging related needs increase.
Jean Kittson (13:03):
Yes. It's they're marvelous packages. I suppose the main thing
to remember, um, is that these things take time. There is.
You talked about the, uh, short term restorative care program
being a sort of bridge while you're waiting to be allocated,
maybe a home care package. And that's because it can
(13:24):
take a number, a number of months for all this
to fall into place. If it's a really high level, uh,
care package, it can take even longer. Yeah, you.
Elizabeth Albury, (13:36):
Make a perfect point there. You've got to, uh, certainly
be considering ahead 6 to 12 months ahead. For what?
You know, the little signs that you might be seeing
that are needed and start the process early, even to
have an assessment done by the aged care assessment team
can take kind of three, four, maybe longer in more
(13:59):
regional areas 3 or 4 months before the actual assessment
will take. And then once you're assessed and let's say
approved for funding, um, there is a ranking. There's a
national ranking in the wait list, um, which you're given
a low, medium or high priority depending on how urgent
(14:20):
the support is needed. And that ranking then equates to
somewhere between three months and 12 months before the funding
will actually be available.
Jean Kittson (14:31):
I've already applied for my home care package. You know,
I'm waiting for my assessment, but, you know, because, um,
these these programs aren't there to meet your crisis. They're there.
They'll take their own sweet time. But. So that's why
you have to know these things and and think in
advance and plan in advance. I think we've had enough acronyms,
(14:54):
but it's great to hear them explain so clearly, because
it's all sometimes you think you can't ever cope with
all this, but when you hear it explained so clearly
and in such a clear order, Elizabeth's like you have
done it just makes it it all feel possible that
we can, you know, do what we need to do
(15:14):
to help our elders. And now we've got the acronym
straight and we know the programs are available there. I'd
like to bring in another person, Prue Bowden, who's the
CEO of Home Health at Australian Unity, to chat about
the services these programs can provide to help our parents
stay safely at home and in the best health and
(15:38):
wellbeing possible for as long as possible.
Prue Bowden (15:41):
Thanks, Jean. Lovely to be here. I mean.
Jean Kittson (15:43):
Let's start with the first thing, which is, you know,
how to talk to our parents about maybe getting some
home help. Well, I.
Prue Bowden (15:50):
Think opening the conversation is really important to treat your
parents in a way that you would like to be
treated when it comes to the moment in your life
where you need to contemplate how you live best and
how you live well and safely at home. But I
think it's important to talk to your parents about the
worst day rather than the best day. Because if we
(16:11):
focus just on their best day, then you often, you know,
sort of tend to, um.
Jean Kittson (16:16):
Overlook.
Prue Bowden (16:17):
Overlook. Yes. Thank you. Overlook some of the issues that
are actually very real, that need to be managed for
their own safety and for their own well-being. So if
you focus on their worst day and you get real
in the conversation, but you lead with an open heart
and compassion, then I think that's the very best way
to enter that discussion with your parents. And it's a
tough one, but an important one.
Jean Kittson (16:37):
Yes. Well, I mean, there's always resistance. If you say,
do you need some help cleaning around the house, they'll say, why?
You know why, you know they'll bristle. Is there something
you know? Are we not clean? And my parents love cleaning.
They used to clean everything. And my mother with her. Walker,
still has a duster that sits on the top of
(16:58):
the walker every single day. Wow. But I think having
that conversation about that getting help is and taking away
your independence, is it?
Prue Bowden (17:07):
No, no, it's just the support you need to be
able to keep doing the things you love to do.
And it may mean that she can still go around
your mum and do light dusting in a safe way,
but there's someone who can come in and help do
some of the things that she's just perhaps not able
to do anymore. So it's giving them still space and
time to feel like they're valuably contributing. And they're they've
(17:29):
got purpose in their day, and they're able to do
many of the activities that they used to do before,
but a recognition that help is needed to help them maintain, um,
you know, living safely at home.
Jean Kittson (17:40):
And I suppose, um, what we think of we're talking
sort of about cleaning now, but there's so many other
things available, so many other services, aren't there?
Prue Bowden (17:48):
Yeah. I mean, look, basic domestic support is really where
people start, you know, very, very sort of low level
entry support. And it's light housekeeping, light support around the home.
But it can be, um, out to shopping and helping
people maintain. But it's also really important about thinking about
how they maintain their functional health, you know, maintain the
(18:11):
activities of daily living. And that might mean having early
intervention support from a physio or an occupational therapist so
that they're able to not just, you know, do some
of the basics at home, but they're maintaining their functional
capacity to live well at home longer. What do you.
Jean Kittson (18:28):
Mean by that?
Prue Bowden (18:28):
So your physical strength, you know, so when we when
people come to home health for support, the first conversation
we have with them are what goals are they're trying
to achieve. It might be that they want to be
able to continue to walk to the local shops and back,
or it might be that they want to be able
to still maintain doing some gardening. So then we start
(18:50):
to think about, okay, well let's assess their functional capacity.
What what is their movement ability. What is their ability
to maintain strength and stamina. How what's their sort of
gait and ease of walking. And can they still do
those things? And if they can't and that's a goal
that they're wanting to achieve, then we look at how
do we support them to to achieve that or be
(19:11):
able to maintain that if they're already doing it. And
so that might be things like some physio support to,
to maintain their physical strength, to be able to do those.
Jean Kittson (19:20):
Marvellous to hear because I must say my experience, we
get the physios as rehab after some injury, but to
have to think of services as maintaining your capacity and
capabilities as a preventative? Yes, as a preventative service rather
than a rehabilitation or a fixing up thing, then that
(19:43):
is fantastic. The most important thing is to get in soon.
Get in when your loved one is a level one,
you know. get in the system, get registered, get the
reference number, and then you can have access to the
most amazing help because it takes a team, a lot
of collaboration, of a lot of resources to help your
(20:07):
elder to age.
Prue Bowden (20:08):
Well, yes, absolutely. It it takes a combination of the
support team, but it's also the the way that that
support team collaborates with the family members. And so that
there's the unpaid help that comes and volunteers and supports
that person in the community. And there's also the the
ways in which providers play a really meaningful role as well.
Jean Kittson (20:31):
So a provider, once you get an assessed and allocated
a home care package, then you choose a provider so
you have that's your money, and then you choose someone
to manage that for you to provide the services. Yes.
So how should people choose a provider?
Prue Bowden (20:50):
Well, I think, you know, it's about fit. And as
we all know, there's huge challenges with the health care
workforce and the care workforce in this country, just with
the capacities available to care for an ageing aging population.
And so I think really looking at the providers, looking
at the quality of their workforce and the availability of
(21:11):
the workforce to care for your parent is really important.
And ask some probing questions about stability and consistency of
the of the team that would be assigned to to
care for your parents. But it's like everything in life,
it's important that you feel comfortable with the people coming in,
in and out of your home as well. So I
think it's it's just due diligence, positive inquiry and, and,
(21:35):
and being quite discerning about which provider you pick, because
quality care is the most important aspect to be looking for.
Jean Kittson (21:41):
Oh, that's without a doubt. It really is, because I
know that the trouble we get into with care is
when there's a churn of different people coming all the time, Because,
as we know, one of the great antidotes to feeling
like you have lost your independence and autonomy is to
have really, or you're feeling isolated or vulnerable is to
(22:04):
have really strong relationships. And those relationships extend to the
professional people in your life, too.
Prue Bowden (22:10):
Yes. Yeah. Which is which goes to this sort of
early intervention mindset. The earlier you you get the support.
So to your advice just before about get into the
system early, get your loved ones assessed, because once they're assessed,
then you can start to use some of that support
and service to actually help them in more of a
(22:30):
preventative sense, or to relabel them to build strength, to
build some of the stability that's going to be needed
for them to maintain those activities of daily living for longer,
which allows them to live independently for longer at home.
And so that's really when people have their package assigned
and they come to our organization in home health. That's
(22:52):
really how we have that really important initial conversation to
firstly understand, as I said, what are their goals? And
then we work with them to develop the right sort
of plan to support them, to achieve their objectives.
Jean Kittson (23:05):
Yes, it's interesting to do the plan because it's not
just based on what you're observing. It might be based
on who the person is and what they feel they
may not have been able to do for the last
year or something. So you can find out, you know,
what is important to them, what gives their life meaning.
It's not just about the cleaning and the cooking.
Prue Bowden (23:27):
No, it's social support. Uh, it's it's the ways that,
you know, they look to connect in the community. So
it's how we support their transport and travel to the
things that are meaningful to them. So it's it's absolutely
not just domestic and basic personal care support. Um, and
there's going to be increasing levels of complexity of people
(23:49):
aging at home in the future as the population ages,
and there's less and less capacity available in aged care facilities.
So you'll start to see much more diversity in the
sorts of services and supports that are provided to people
in the home in the future.
Jean Kittson (24:07):
Well, we'll have to get support with technology for a start.
Prue Bowden (24:10):
But yeah, yeah. And virtual models of care. We already
start to work with our ageing customers in in using
virtual models of care, you know, virtual physio and exercise
assessments where our clients can be doing their activities at home.
But we can be monitoring them, monitoring them remotely as well.
Jean Kittson (24:29):
Yes, I think that's wonderful. We sort of talked we
talked about that in the in the health care episode
about all the different ways you can monitor and, um,
engage virtually. Yes. And effectively. Yeah. And in an intimate
and human way. I'm not talking about robots doing the
washing up.
Prue Bowden (24:50):
No, no, no. You can convey empathy and compassion and
you can deliver quality care in a virtual setting just
as much as you can do it in a physical setting.
Jean Kittson (24:59):
So there are many more things you can get on
the package as well. There's physio, podiatry. Can you get
dietician support?
Prue Bowden (25:08):
Yes. Yeah. Can you get preparation support.
Jean Kittson (25:11):
And these packages can help you. If you have an
accident or something they can help you with crutches and wheelchairs.
You know hiring things. All of.
Prue Bowden (25:19):
The home modifications.
Jean Kittson (25:21):
Home modifications.
Prue Bowden (25:23):
Mobility aids, all of those things can be provisioned for
as part of the funding arrangements as well, which are
all really important aids to helping people live and age
well at home.
Jean Kittson (25:35):
So get on to those home care packages if you
I mean, you're assessed financially too. There's a means test.
You know, if you fail the means test if you
have to provide your own. Are there private people who
provide those services too?
Prue Bowden (25:50):
Yes. There are providers who provide, um, private paid services.
There are also providers like Home Health at Australian Unity
who do blended arrangements. So you can be funded to
a point. But you you may want additional supports and
services for your loved one and more certainty around their
safety living at home. And so you can therefore, you know,
(26:12):
pay out of pocket for additional services or home monitoring
or those sorts of things. So you've got greater peace
of mind of your parents aging well at home.
Jean Kittson (26:21):
So in terms of helping our parents live safely and
confidently and and really to live at home for as
long as possible, that means that at some point we
most people have to talk about moving from the family
home that might have a lot of steps or might
(26:42):
be isolated somewhere where it's not close to shops. I mean, yeah.
Prue Bowden (26:47):
Look, I think there often comes a point and it's
different for every individual about when the transition might need
to be from home into another form of assisted living.
It might be a retirement village, or it might be
an aged care facility. And I think listening to the
clinicians and the specialists who are supporting your your loved ones,
(27:10):
listening to the feedback from the OTS who might have
done a home assessment and really just thinking forward about
what what your parent might need in the near term,
not just the now term, is really important to guiding
that particular conversation. And I think there's also the the
dignity of risk, you know, discussion with your with your
(27:30):
parents because we may with the perspective that we bring as,
as sons and daughters, as neighbors and community members, we
may have a particular view about what that individual needs,
but there's a dignity of choice in actually whether that
individual wants to move or stay in their home. And
so we we, as we often work with our clients,
(27:52):
have to really consciously understand the risk an individual is
wanting to take on and allow them to have the
dignity of making that decision.
Jean Kittson (28:02):
Definitely. That's a really strong message to leave this episode on.
Thank you so much, Prue. Thank you Jean. Just a
few key takeaways. Now, the first thing you need to
do is register with my aged. Care to register? You
need your elders Medicare card. Then my aged care will
tell you which program is most suited to your parents.
(28:22):
If your parents prefer to make that call, just sit
with them while they do it. Otherwise they'll just say
they don't need any help at all. Thank you very much.
We're fine. Then you need to get the appointment for
a C assessment. Then you have the assessment, then you
have the approval. Then you get the allocation. So that's
four days. And don't forget to register as their nominee
(28:43):
with my aged care, so you can speak to them
directly on behalf of your parents when you need to,
and they'll give you a reference number. Um, but the
final tip waiting times for actual allocation can be extraordinary,
as we've heard months, sometimes years. That's no exaggeration. So
make sure you get in early because they're not there
(29:04):
to meet your crisis. They will take their own sweet time.
Thank you so much for joining me for this podcast series,
Parenting Up with Australian Unity. I've really enjoyed chatting to
all these wonderful experts, and I hope their knowledge and
experience has helped you to support your loved ones and
make sure they are healthy, safe, independent and most importantly,
(29:28):
happy for as long as possible. Thank you. The information
provided in this episode of Parenting Up is general in
(29:49):
nature and does not consider your personal circumstances. Australian unity
accepts no responsibility for the accuracy of any opinions, advice,
representations or information contained in this podcast. Listeners should rely
on their own independent advice and inquiries when making decisions
(30:10):
affecting their own or their loved ones finances, health, wellbeing
or other interests.
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.