Submission to the inquiry into young people living in nursing homes

Submission to the Community Affairs References Committee’s inquiry into the adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia

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CPSA appreciates the opportunity to make a submission to this important inquiry looking into the adequacy of residential care arrangements for young people with a severe disability.

It is grossly unacceptable that 8,658 people aged under 65 live in aged care facilities in Australia. This figure jumped 15.5% from 2012/13, with the number of people aged under 50 living in nursing homes rising by almost ten per cent since 2012/13.[1]

While the Australian and state governments have made some inroads into moving young people out of residential aged care, these measures have done little to reduce overall numbers. For example, most young people living in residential aged care are aged between 50 and 65, but the Younger People with Disability in Residential Care (YPDRC) initiative gave priority to people aged under 50. It would appear, though, that the ending of this program in 2011 has had a negative impact on the numbers of people aged under 50 living in permanent residential care. In 2008/09, 974 people under 50 lived in permanent residential aged care, which dropped to 740 2011/12, but then rose to 830 in 2013/14. The numbers of people aged between 50 and 65 remained relatively stable over this period, except for a sharp rise in 2013/14.[2] This suggests that the extra funding under the YPDRC program was somewhat successful in moving young people out of residential aged care. However, it clearly fell short, only assisting a fraction of the priority group and did little to help those aged between 50 and 65.

The National Disability Insurance Agency (NDIA) expects there to be an accessible affordable housing shortfall of between 83,000 and 122,000 dwellings for NDIS participants. Considering that there are currently around 414,000 social housing households and 150,000 applicants on social housing waiting lists, Australia needs to substantially increase its social housing stock to meet demand.

CPSA fears that the number of young people inappropriately housed in residential aged care will grow unless serious efforts and money are put into developing affordable and accessible housing for people with a disability. The National Disability Insurance Scheme (NDIS) does not contribute funds towards housing and, as such, many eligible for the NDIS may find they are stuck in the inappropriate aged care system because a nursing home offers the only viable accommodation option.

Eighty per cent of residential aged care residents are aged 80 or over.[3] The majority have dementia or a cognitive impairment. Most residents are frail and have limited mobility. Residential aged care is therefore designed to meet the needs of older, frail people; not those of a young person with a disability. Young people living in residential aged care report feeling isolated, constricted, depressed and unable to exercise freedom of choice. In general, residential aged care residents often feel disconnected from their community because they cannot come and go as they please and enjoy life outside the nursing home. For many, aged care facilities are institutions.  

Residential aged care is not designed to accommodate young people who, rather than being at the end of their lives, have lives to live. Aside from offering round-the-clock care, there is little in residential aged care that young people need, such as rehabilitation.

CPSA recommends that the Federal and state governments commit to rehousing all people aged under 65 who wish to no longer live in residential aged care as a matter of urgency.  As a start, young people living in nursing homes who are eligible for the NDIS should be placed on priority social housing waiting lists.

CPSA also calls for investment in accessible housing for people with a disability. This housing should be made available through the social housing system so that it is affordable for people in receipt of the Disability Support Pension. Although the NDIS will contribute to the cost of modifications and specialist accommodation in certain circumstances, which will greatly assist many individuals, it will not fund new supply. If the Australian and state governments wish to move young people out of nursing homes and inappropriate institutions, there must be investment in affordable accessible housing.

There is also a need for people aged 65 and over who acquire a non-age-related disability to receive assistance for home modifications and specialist accommodation support. These people will not be covered by the NDIS and may have to prematurely move into a residential aged care facility if they cannot access sufficient support to modify their homes or access suitable accommodation. Having to move into residential aged care removes them from their family, limits or ceases access to their community, and diminishes their quality of life. These people would be far better served if they were able to continue living in their homes with access to home care services. Home care is cheaper to provide than residential aged care and satisfies the wishes of the vast majority of people needing care, that is, to receive care in their homes.

CPSA opposes the age cap of 65 on the NDIS and calls for its removal. This would ensure that all people who acquire a non-age related disability are treated equally. In the meantime, the Australian Government should make a greater investment in home care packages under the aged care system so that people do not have to wait for several months to access home care.

 


[1] Productivity Commission (2015) Report on Government Services, page 2 of Table 13A.3

[2] Ibid., page 1 of Table 13A.3.

[3] Ibid., page 2 of Table 13A.3.