January is when many families confront the need for aged care, after spending time together over Christmas.
When Barry Ridge, 87, was diagnosed seven years ago with Lewy body dementia his wife Edith, 87, and family knew that his care needs would steadily increase.
For several years they managed in their home of 25 years with four hours a week of professional help though a government-subsidised Home Care Package.
But as the symptoms of memory impairment, Parkinson’s, hallucinations, slurred speech and shuffling took their grip on the former Uniting Church minister it became increasingly difficult to provide the constant care he needed.
Daughter Alison Ridge, 54, describes the past 12 months as a roller coaster ride where every day they were presented with new challenges. Her mother was physically and emotionally exhausted.
“We could put his walker in front of him and he’d see it as a hedge trimmer. He’d need to go to the toilet but would have trouble remembering there was a toilet let alone where it was,” Alison says.
“It got to the stage where the only way we could manage Dad at home was for me to give up my nursing job and move in with Mum and Dad. I wasn’t prepared to do that and my family wasn’t keen either,” she says.
The dementia type means that Barry is mostly aware of what is going on, even if it isn’t 100 per cent clear.
They discussed as a family the point at which they would look at residential care before finally making the move a week before Christmas. A lot of tears are still being shed.
“It has not been an easy decision and it is not something we are 100 per cent OK with, but it is the right decision for Mum and Dad. At the end of the day it was not being fair to Dad to not give him the care he needs,” she says.
They chose a facility in north-west Sydney based on word of mouth, affordability and the help that was available through Affinity Aged Care advisors.
“As soon as I heard there was a 32-page Centrelink form I went for the professional help. It is such a minefield, ” Alison says.
Aged care season
Council on the Ageing chairman Ian Yates expects there to be the usual spike in inquiries to various aged care service providers, assessors and the government’s myagedcare.com.au website this month.
Families have come together for the first time in a while and recognise changes in their parent’s health and/or ability to look after themselves.
“It worries us because sometimes it is a genuine recognition and something happens to genuinely help them and sometimes it is fly-in kids who start organising their parents’ lives,” Yates says.
He urges well-meaning children looking to help ageing parents to “work hard to talk to them and be really clear about the range of options”.
“Most people would prefer to get help at home and so they need to know there is an increased range of opportunity for help at home and that it doesn’t have to mean losing control,” he says.
Any conversation about getting some extra support should be started on a positive note and with focus around increasing independence, says Denise Tomaras, Equity Trustees national manager, Aged Care Solutions.
“Chat about what they can do and how it can be supplemented, rather than focusing attention on ways they are not managing. Keep the lines of communication open, flexible – and varied,” she says.
Tomaras says that like everyone, older people want to feel capable and maintain their dignity, so treat them like the adults they are.
“Put yourself in their shoes and enable and empower them as much as possible to make their own choices. They want to appear to be coping and will not want to admit to failing health or cognitive decline – or helplessness,” she says.
To be eligible for government subsidised home care packages or residential aged care an individual needs to first be assessed by an Aged Care Assessment Team (ACAS in Victoria) via the myagedcare website.
Once approved, the government pays a large part of the care costs and individuals make a contribution depending on their income in the case of home care and income and assets for residential care.
Community-based care is delivered through two main programs, the Commonwealth Home Support Programme (Home and Community Care in Victoria) and the Home Care Packages Programme.
The CHSP doesn’t require an assessment and provides entry-level support services for older people who need some assistance with daily living in order to live independently at home. The HCPP provides more complex, co-ordinated and personalised care at home and offers four levels of care packages to progressively support people with basic (cleaning), low, intermediate and high care (personal care and nursing) needs.
Home Care Packages can help delay a move into residential care provided there is other support from family members and friends or privately funded care workers.
Two types of care is offered in residential aged care facilities: permanent care, where care needs are tailored to an individual no longer able to live at home; respite care for temporary, short-term care in a residential aged care facility to support both older people and their carers to live at home for as long as possible.
According to the Australian Institute of Health and Welfare, 7.8 per cent of the Australian population aged 65 and over were in residential aged care in 2013-14.
Permanent residential care is provided on a user pays basis, with the accommodation costs and care fees dependent upon which residential facility you move into, how much income you have, the value of your assets and the services you take up.
Respite is available to ACAT approved individuals for up to 63 days a year.