Retirement villages and aged care

RETIREMENT villages are very suitable places for people to receive aged care at home, because a village concentrates care recipients in an area and care workers don’t have to spend hours in traffic to move from one to another.

CPSA supports a model of aged care being delivered in retirement village type accommodation units clustered around a nursing home for the very few people who cannot or can no longer be cared for at home.

Not surprisingly, big retirement village operator and Home Care Package provider ECH is only too keen to expand its retirement village empire and its Home Care Package (HCP) operations.

ECH has carried out a study which found a Level 5 HCP would allow more people to remain at home and die at home. Home Care Packages currently go to Level 4.

ECH retirement villages do not feature a nursing home. ECH’s business model is to keep its retirement village residents at home until they die.

The idea for an HCP Level 5 is not new. One of the many recent aged care reviews also recommended its introduction, noting that the cost of an HCP Level 5 would be similar to the cost of caring for someone in a nursing home.

However, how realistic is a push for HCP Level 5 when the overall Home Care Package program is in crisis? Three-quarters of HCP recipients are on a lower-level package than they should be and this proportion is rising. People assessed as needing an HCP who can’t get one are stuck on the basic care provided through the Commonwealth Home Support Programme and, at the other end, people needing an HCP Level 3 or 4 who can’t get one are going into nursing homes.

The business case for a massive increase in the number of Home Care Packages is compelling, as is the business case for introducing HCP Level 5. No one disputes this.

The ECH study looked at twelve people aged over 70 who were not dealing with a complex terminal condition but were already on an HCP and were considered likely candidates for entry into a nursing home.

The study found that by receiving appropriate home support, ten of the twelve managed to avoid permanent admission to residential care. The additional cost of doing so came to a maximum of $11,000 additional to their HCP subsidy, not much in the scheme of things and certainly cheaper than a nursing home.

It is very clear that the care subsidies for nursing home care and HCPs should come from the same source and that the rationing of nursing home places and HCPs should be abandoned. This would allow care recipients to get the right care at the right time in the right place, namely the place of their choosing.

That change is coming, but it is being delayed by a nursing home industry worried about nursing home admissions becoming the exception rather than the rule.