Why can’t we just stop and get aged care right? Support at home is designed to penalise frailty and will push people into aged care beds that don’t yet exist. Come on.
I don’t know about you lot, but I’m scared. I’m scared of the new aged care system rocketing our way on 1 November and what it means for myself, and my partner, as we likewise rocket towards old age.
Don’t get me wrong – I’m 60 and retirement isn’t even on my agenda, let alone aged care, but life has taught me that shit happens and you can end up somewhere you never imagined you would be, despite your best planning.
My father spent his last year paying $12,000 a week for 24/7 in-home care while waiting for his assigned Level 4 package which, of course, outlived him. My mother is in (excellent) care while she waits for the dementia to finally take her – but she has done the right thing by herself (and me) by beating the bank. She now pays a capped fee for her care – an amount less than half what she paid for the first three years she was in residential aged care.
But come 1 November things change, and I am now starting to wonder if I will be able to afford to stay out of care when my time comes, despite being very much better off than a lot of my generation.
How often does major aged care reform happen? History tells us that before 2024-25, the last time big change came about was in the John Howard era. That’s a quarter-century ago.
You can easily imagine that when 1 November rolls around and the new Aged Care Act kicks off, the politicians, at least, will sit back and say, “Phew, don’t have to worry about that aged care thing for another 25 years, you beauty”.
All very well for Sam “Boy Wonder” Rae and his generation. Not so great for those of us 60 and up who will be stuck with whatever 1 November brings until 2050-ish.
Just quietly, who decided to put a 38-year-old former PwC consultant in charge of aged care? Did nobody think about the optics? As one aged care advocate told the recent Senate inquiry, Mr Rae is “a personable young man, but he didn’t seem to have his head around the issues at all”.
Why would he? When I was 38 I was still trying to get as far away from my parents as possible.
Back to reality. On Thursday Mr Rae quietly tabled the final Aged Care Rules 2025 on the federal register of legislation – all 666 pages of it. The devil’s number, indeed.
Add in the 729 pages of explanatory notes and you’ve got 1395 pages of hell for aged care providers and advocates to not only read and digest, but act on over the next 35 days.
(By the way, any time the explanatory notes outweigh the thing they are explaining you can put your money on the original document being very badly written.)
The big stumbling block for me is the Support at Home program. And this is where I’m going to hand over to an expert, Professor Kathy Eagar.
In her latest commentary, published on Pearls and Irritations on Thursday, Professor Eagar breaks down what’s wrong with Support at Home better than I ever could.
“The new Support at Home payment model links fees to the number of hours of support needed per week,” Professor Eagar writes.
“This unfairly penalises frailty. Those who are more vulnerable and in need of more support will face higher costs, effectively punishing them for their failing physical and mental health and their frailty.
“The consequences for individuals are obvious.
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“The changes will have little or no impact on wealthy people and it will hit the poorest the hardest. Frail, vulnerable people will not receive the care and support they need because they cannot afford it. While there is a proposed lifetime cap on charges, this is of no use if one cannot afford to buy groceries this week and many will die long before they reach the lifelong cap.
“To be fair, there is provision for a person to apply for a fee reduction because they cannot afford it.
“But the form to apply for hardship consideration is 17 pages long. It is clearly designed so that our most fragile citizens are not capable of completing it. This is one of many details that is at odds with the government’s rhetoric of a ‘rights-based’ aged care system.
“At the system level, excessive and unaffordable fees will inevitably force vulnerable people who want to stay at home into hospitals and care homes. It contradicts the government’s stated intention to reduce demand for residential care, will inevitably increase the number of older Australians being admitted to hospital suffering from neglect and will increase the cost of health and aged care overall.
“Plainly speaking, it is penny wise, pound stupid.”
Go read the whole thing. Not now. Finish this first.
I’ll be equally blunt.
If Mark Butler, Anthony Albanese and the Boy Wonder are serious about making this the biggest reform to aged care in at least a generation, and if they’re serious about making that reform a good one, then they need to stop right now.
Redesign Support at Home. Listen to the experts. Listen to older Australians. Put away the politics and the optics and then try to shut out the bleating from the opposition who will, you know, oppose.
Make it worthwhile to build new aged care homes.
Make it affordable for EVERY Australian to stay in their home as long as is humanly possible.
Make working in aged care attractive, affordable and secure.
Make living in aged care attractive, affordable, safe and secure.
Pay what it is worth. Pay it, regardless of what it costs. Just. Pay. It.
I’m off to watch the granny. Not my granny. THE granny. Go Lions.