Aged Care Advice and FAQs

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna Land.

00:00:22 Kate
Hello and welcome to another episode of Age Old Problems: New Aged Care. I’m your host, Kate Holland. This episode is one of three that we are devoting to dementia, a condition that an estimated 433,000 Australians currently live with. Joining me back on the podcast is Tanya McIver, who is Group Manager of Residential Services at Helping Hand. Together we’re going to explore the reasons why someone living with dementia may need to enter a residential care home and how care homes enable people living with dementia to live their best lives. Welcome back Tanya.

00:00:52 Tanya
Thank you Kate.

00:00:53 Kate
So for those who haven’t listened to the previous episode, can you just briefly describe what your role is at Helping Hand and what that involves?

00:01:00 Tanya
I work in residential services and my background is clinical and operational leadership in aged care. I’ve been in aged care for about 20 years and my current role is to oversee and support four of our residential aged care homes, and the staff, to provide high quality care and safe care to our residents.

00:01:17 Kate
In this previous episode we spoke about the different ways that you can keep someone living with dementia safe in their home and how you can make life easier for them and there are some great tips around that. But in most cases there comes a point when living at home is no longer the best option. Can you run through the types of reasons why someone might need to go into care?

00:01:34 Tanya
Sure, it does get to a point where there are some real trigger points that do require that supportive residential care. It can be the safety of the person living with dementia. If you’re unable to maintain them within the home, there may be risk of wandering, not being able to find their way home. Increased care needs, that’s when you might need a lot more assistance with your showering and with that general support, because it can become quite difficult to provide that care, and it’s sometimes very difficult for the person providing the care to be doing those tasks. Increased clinical needs, such as need for medication, support to take medications. Sometimes it’s a falls risk. So overall, the really big one also is carer fatigue. So often a carer has just spent so much time, it’s a 24 hour job, which one person can’t do. So the main trigger is, there’s going to need to be some help to look after the person with dementia and also really importantly for the caregivers that have just given so much to their person.

00:02:34 Kate
And I imagine if there’s a safety risk and there’s a worry that comes, you know, all of us worry about leaving the iron on or the stove top, but if that’s actually happening more frequently, that’s going to be a real concern both for the person living and the person caring for them.

00:02:47 Tanya
It’s an absolute concern. That safety, that potential for harm just for the person with dementia or for someone living with that person, it becomes a real concern from the safety and then a real concern for the other members of the family that want to look after both the people. So if it’s a couple living at home and one’s doing all the care, family and friends are going to be really worried about both of them.

00:03:10 Kate
So what are the benefits of a care home? Obviously it’s going to alleviate some of the issues, but what are some of the other benefits of a care home for someone living with dementia?

00:03:18 Tanya
It’s the 24-hour clinical and care at all times. It’s the support in the middle of the night that’s needed. It’s the opportunity for the carer to be able to step back and also look after themselves. We often say you need to trust us to do the care so you can go back to being the loved person and re-establish that relationship with your loved one. You know, let us worry about getting your person, your loved one into the shower, you worry about coming and having a coffee with them.

00:03:49 Kate
Yeah, you’ve got more space just to be back having that relationship again, don’t you? And you mentioned 24-7. Now again, if someone missed earlier episodes about dementia, and I didn’t know this either, that sometimes the body clock changes and people are up a lot later at night, so that is an interesting fact for people to understand. That’s why the 24-7 is really important, isn’t it?

00:04:09 Tanya
Absolutely. So if you think about someone living at home that’s having trouble with their time, which can happen with dementia, so the middle of the night is suddenly the middle of the day. As a carer, you’re having to be on task 24 hours a day. If it happens here at our care homes, we’ve got registered nurses and care staff there to guide, redirect, support. What it also means is the caregiver at home is getting a good night’s sleep and can come in and give themselves back again.

00:04:37 Kate
So the benefits to family members of residential care for someone living with that, that’s a really big part of it, isn’t it? It’s letting them rest, it’s letting them return to their original relationship and just be partner or daughter or son.

00:04:49 Tanya
The partnering is so important and when someone comes into care, the most important relationship is the staff and of course the person living in our care, the resident, but also a partnership with the family members that know this person better than anyone. So they’re the ones that need to support and guide the way we deliver care to their loved one because we vary it for each person. So it’s making sure we really partner with loved ones and that helps build the way we deliver care.

00:05:17 Kate
So does that mean you have quite an in-depth intake conversation with the person who cares?

00:05:22 Tanya
We do. It’s quite a detailed process and we want to set the person that’s coming into our care up to succeed. We want to set the staff up to succeed and give the right care to the right people. And we want to set up the family. They’re trusting us with their most important person in the world to them. So we need to make sure they’re part of that care planning. So there are assessments and planning. There’s opportunities to get to know the resident, who they are now and who they have always been.

00:05:52 Kate
Yeah, is that an important part of it, understanding who they may have been and what their life was and maybe what their career was and how that might show up in some of their behaviours?

00:06:00 Tanya
It’s vital because people present in very different ways. They’ll often present on different timelines. So they may on certain days think they’re back as a 25 year old school teacher. There’s no arguing that, it’s supporting where they are and how they’re feeling. It’s understanding what some experiences might be. I’ve looked after people that have even served in wars or been prisoner of wars. Their experience and the way we have to interact with them is very different. Someone that has been a stay at home mum is going to be busily looking for the kids at 4 o’clock. So it’s really important that our staff know all of those things about each resident and adapt. They have to meet them in their world and adapt to each person.

00:06:44 Kate
That’s great. That’s a very deep dedication you have. And I assume that part of your process is reassuring the carer that all the people who are assigned to looking after their loved one are going to have this deep understanding.

00:06:55 Tanya
It is. It’s about the staff training. It’s about the reassurance and building the trust. It’s also about them understanding that they’re coming into care because they do have very high care needs. Things will still happen. Falls may still happen because we’re encouraging some independence. So some of the things that were still happening at home will still happen in care. There’s someone there 24 hours a day to support, pick up, treat and assess. So that’s why it’s so important to be able to have that reassurance that if something happens tonight, someone’s going to be there.

00:07:28 Kate
And obviously people will come in with slightly different levels of needs. Helping Hand has 11 care homes with dedicated memory support units, or otherwise known as MSUs, I think, aren’t they, within the system?

00:07:40 Tanya
Yes.

00:07:41 Kate
Does somebody living with dementia necessarily always need an MSU?

00:07:45 Tanya
Not always. So over half of our residents in Helping Hand have got a diagnosis of dementia. It’s what brings them into care. For others, it’s in conjunction with other illnesses. The demand is huge. As we go through it, not everyone is going to present in the same way. And that’s one of the real challenges of dementia. It’s not a predictable way of presenting. It’s not a predictable timeline of how you’re going to deteriorate. Some people can live in our open areas quite safely. It’s when it’s again a risk of potentially exit seeking or leaving and getting lost. And the other real reason that we see people needing memory support is to go into a smaller, more contained unit.

00:08:27 Tanya
The world becomes very overwhelming when you’re living with dementia. You know, you think about young people travel the world. With dementia, you start to see the world needs to get smaller and smaller to cope. Often we might say to a family member, we think they’ll do really well in a more contained unit where they can cope, they can familiarise themselves. And then, you know, they find that they’re more comfortable with a smaller room, a smaller area, it’s not so overwhelming. So sometimes it’s that emotional need to go into a smaller unit, where it’s got those real specialised staff members as well.

00:09:01 Kate
And are there particular activities that are undertaken within those units as well?

00:09:06 Tanya
We try and give a really varied lifestyle program. We’ve got some incredible technology coming in as well. So obviously company, social support, chatting, engaging – everyone needs social engagement and company. But there’s also ways of supporting it. We’ve got Tovertafel tables, and I never say that correctly, but…

00:09:24 Kate
And you need to explain what they are.

00:09:26 Tanya
I like to call them a magic table. There’s some AI, it’s like a computer program. It’s a tabletop, and there’s some incredible interactive games that can stimulate cognitive and also physical capability.

00:09:38 Kate
They have music too, don’t they?

00:09:39 Tanya
Music’s a massive thing. Bubbles that go pop, but there’s also other people, they’re not able to use those. So we have to adapt to different stages, because there are different stages for people living with dementia. Some people remain really mobile, other people may lose their mobility and need a lifestyle program that’s still able to be provided. Even if they’re not able to get out of their chair anymore, we still provide the right level of lifestyle engagement to keep their social and emotional content going.

00:10:08 Kate
So that remains an ongoing focus. There are always activities that are designed and aligned to someone’s situation.

00:10:14 Tanya
Yes, we certainly adapt. We’ve got lifestyle programs, we’ve got some incredible staff. But the other thing in a memory support unit is all of our staff, whether you’re the nurse, the carer, working in hotel services, has an understanding of people living with dementia because our residents don’t know who we are. They just know how we make them feel and they know who their people are.

00:10:37 Kate
And I’ve met several people since doing some activities with Helping Hand who genuinely enjoy their time at the memory support unit. So maybe that outside perspective that dealing with people who are living with dementia is all hard work. That’s not actually true, isn’t it? There’s some real moments of joy and happiness.

00:10:51 Tanya
It’s a beautiful place to work. The staff that go in there give their heart and soul for 8 hours a day to people that they genuinely care about. We really try and put people in there that have this as their passion. We know our residents so well, we really care for them. I’ve seen care staff that treat them like family and provide the care as if they would for their own family. And I know if I had to put my person into aged care, I’d want a group of people that genuinely care and love my person. And that’s how I’m going to get respect and dignity and trust.

00:11:24 Kate
And seek out moments of joy with those people.

00:11:26 Tanya
The moments are so important. And someone living with dementia can have a really great day, can have a really great hour or a really great 5 minutes. And if we can grab that 5 minutes and a family can get that 5 minutes back of clarity with their person, that’s why we do it.

00:11:44 Kate
So can family members come and visit within the memory support unit?

00:11:46 Tanya
At any time. We absolutely support that. We like to partner with people, they can get involved in activities. So just because you live in a memory support unit, you can still come out, be in the other areas of the home, come for coffee at the cafes, come to other concerts and activities. So there’s life within an aged care home. It’s a really lively, beautiful place. It’s a community.

00:12:09 Kate
I know the government is pushing harder and harder for person-centered care, which is actually something Helping Hand has been doing for a very long time. But is there something that you can provide as an example about how you have delivered person-centered care to someone living with dementia? I think you sort of have alluded to it anyway, but is there a sort of a standout thing that you might do?

00:12:26 Tanya
It’s the life history is how we actually can deliver it. I was walking through a memory support unit last week and the first lady spoke to me about her country town. So it was important that I knew which country town that was. She thought she was there. So rather than saying, no, you’re not, it was, tell me about the main street. The next person I knew was a farmer. And he actually said to me, let’s get out there and shoot the rabbits. We encourage staff to change for each person. So it’s knowing that’s what’s important to that person. The next lady presents beautifully with bright red lipstick. First thing she said is, when are you going to get your hair done? So we can do really big projects, but it’s those small things that make a difference.

00:13:08 Kate
And understanding that about those people, is that part of that early gathering of information with their carers?

00:13:13 Tanya
Yes, it is. I’ve had ex-nurses that have come in and because I’m a nurse, I remember having one lady sitting in doing the rosters with me. She just was looking and looking for something to do. And she said, you look like you’re really busy. And I said, I need help with my rosters. She said, leave it with me. And it was beautiful.

00:13:29 Kate
So she sat side by side with you.

00:13:30 Tanya
She sat there and we did the rosters.

00:13:32 Kate
I’ve heard a similar story of a previous GP who got really agitated at the end of the day. And eventually somebody understood that was his previous life and they set him up a table in the corner and he would sit there writing scripts for hours and was really happy.

00:13:45 Tanya
So it’s meaningful engagement. So we can do wonderful activities. But it’s those meaningful moments and that meaningful engagement. Not everyone wants to sit and do rosters or write the scripts, but it meant something that person felt and the GP example would have felt they were adding value again.

00:14:02 Kate
There’s lots of reasons why it makes sense to me having chatted to you about why a residential care home would be a really valuable next step for people. But for anybody that is listening to this episode, what would be the top three reasons you would say they should start thinking about a residential care home and what are the key benefits?

00:14:19 Tanya
The top three reasons would be safety, getting the right level of care that every person deserves, and looking after the carers. And the benefits are that everyone can step back. There’s a reason why we have 24-hour care. It’s because people have care needs that require that. And it’s about supporting the carers to know it’s okay to say it’s time, it’s actually okay, and that that’s what we’re here for.

00:14:46 Kate
That would be a moment for people, wouldn’t it? There’s a sense of guilt sometimes that they are saying, this is what we need. Is that part of your role to actually assure them that that’s okay?

00:14:54 Tanya
Absolutely. The guilt when someone feels that it’s time to put someone into care is huge. I should have been able to look after them. I’ve failed them. I promised them I’d never do this. But sometimes that just has to happen. And that’s why we’re here and the conversations are very much about – you have done an amazing job, you have got your person to this point, we are really here to look after your person and we’re here to look after you. And so it is okay for it to be time.

00:15:24 Kate
We’re going to talk further about tips for somebody coping with looking after a loved one. And we’ve alluded to this now. And like you said before, by you helping them out, they can return to their previous role as a family member or a loved one and they can have the energy and attention to grab hold of those glimmers, those 5 minutes where they might get their person back. And that’s really, really important, isn’t it?

00:15:45 Tanya
It’s so important. Sometimes I’ll have a family come and say, we’ve had a great morning. And I’ll say, what a gift. What a gift you’ve got back today. Grab today. Can’t promise what tomorrow will look like, but grab what happened today.

00:15:57 Kate
That’s beautiful, Tanya. Thank you so much again for your invaluable knowledge on this area.

00:16:02 Tanya
Thank you.

00:16:06 Kate
For more information on Helping Hand and their services, please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:22 Kate
Hello and welcome to another episode of Age Old Problems: New Aged Care. I’m your host, Kate Holland. Did you know that it’s estimated that in Australia there are more than 433,000 people living with dementia? So with this knowledge at hand, we’ve decided to devote three episodes to understanding it better. And this one’s the first.

00:00:40 Kate
Dementia is not a normal part of getting older. Instead, it’s a broad term that describes a collection of symptoms caused by disorders affecting the brain. And while everyone’s experience is unique, there are some early warning signs that you can look out for. Joining me to help you understand all of this a bit better is Tanya McIver, who is Group Manager of Residential Services at Helping Hand. Welcome Tanya.

00:01:00 Tanya
Thank you Kate.

00:01:01 Kate
So can you start by telling me a little bit about your role at Helping Hand. What does that involve?

00:01:05 Tanya
My background is clinical and a registered nurse, and currently I oversee and support four of our residential aged care homes at Helping Hand. And that’s supporting them with their clinical care, operational care, family and staff care.

00:01:18 Kate
Great. So how does that tie into understanding dementia? Can you talk me through your background and your experience in working with people with dementia?

00:01:25 Tanya
Sure. I was at university and worked as a carer while I was doing my registered nurse training. I moved into acute for a while, but always had an absolute love and passion for delivering respectful, dignified care to our older Australians, so I’ve been back in aged care for over 20 years, managing homes, and am very passionate about supporting staff involvement to ensure that there’s respect and dignity at all times.

00:01:49 Kate
And you did mention to me before we started this, you were drawn to work in aged care and with other people, why was that?

00:01:54 Tanya
The older people have created this country that we live in, and people deserve care, and they deserve the absolute best care after all the work that they’ve done to create this beautiful place that we live in. Staff need to respect, understand, and then make sure that we’re giving them the best experience possible in aged care, which is their final home.

00:02:15 Kate
So dementia, which unfortunately does impact a lot of people. So it’s not just one disease. How can you define dementia and what are some of the diseases that are linked with it?

00:02:23 Tanya
So there are a lot of different variants of dementia. There’s some that are diagnosed as part of another condition, like a Parkinson’s can lead to a dementia. There’s different parts of the brain that can be impacted which develop like a frontal lobe dementia, which will give different signs and symptoms. So there’s lots of early signs that people will pick up at home across that variety of disease diagnoses.

00:02:46 Kate
So is that why it appears quite differently in different people because of the condition leading towards it?

00:02:51 Tanya
It does. Because of different areas of the brain that it can affect, because different parts of our brain control different parts of our emotion, personality and behaviours. So there are different ways that signs and symptoms can come, and also people are individuals. So it impacts individuals differently and sometimes because of their life experience and lived experience, it will impact someone differently.

00:03:13 Kate
The differences aside and what leads to it aside, what are some of the common early signs of dementia that people might be able to look out for?

00:03:20 Tanya
You see, there’s the forgetting things, but it’s not just where’s my car keys. It’s actually. I don’t know where my bathroom is. I’m at my front door and I haven’t just forgotten my keys. I’m not sure if I know where my car is, so there’s the small forgetful things. People can also become very repetitive, so you might start to see someone ask the same thing over and over again, and no matter how many times you give the answer, that person is not able to retain it. Real changes in routine, often people are awake a lot at night, so that can change. And there’s also the fear of security, so people might go out their front door and not be sure where they are, so that’s when safety becomes a concern. And changes in someone’s personality, you might start to look and go, well, that’s just not like mum. She doesn’t do that. So things that are really out of character. It’s sort of a myth that it’s just, I’ll just start to forget things – there’s some critical personality changes that might start to get you worried that something’s going on.

00:04:18 Kate
I have heard, actually through personal experience, that not being able to deal with basic numbers and things like that, is that another indicator?

00:04:23 Tanya
Definitely. Something that’s always been familiar to a person, and you just forget your sequencing, so things no longer make sense and, you know, I’ve looked after people who are, say, school teachers that no longer can process putting prose and language together. Mathematicians, doctors, that just lose those real basic things that have been part of their life, and that has been what makes them who they are.

00:04:50 Kate
Can you sense their frustration with that?

00:04:52 Tanya
The early signs of dementia, and living with dementia early in life, is incredibly frustrating. Because you have moments of absolute clarity where you think, ‘what on earth am I doing?’ and that’s confronting and embarrassing for some people, especially people that have had very high pride in what they do. It can become very embarrassing trying to understand why you’re doing what you’re doing.

00:05:15 Kate
It must be a bit frightening for them if they start to be suspicious that this is something that’s becoming a problem. And then for family members, if they start to detect some things like these, where’s the best place for them to turn for help or advice? If they’re suspicious that maybe some of this forgetting is a bit more significant than the rest of us losing our keys, which we all do?

00:05:33 Tanya
Yes, there’s some really good starting points. Often people find that if they’ve got a family GP, it’s a really good place to start, because if you’ve got that relationship, they will also support understanding. There’s organisations such as Dementia Support Australia, there’s dementia hotlines that you can call. There are really great external supports, and also your own friends and family. So it’s, you know, opening up and just saying, look, I think this is what’s happening and asking for help. But absolutely the first starting point is your GP.

00:06:05 Kate
Great. Well, we’ll make sure we put some links in the show notes for Dementia Australia, etcetera. So people know where to turn to. What about broaching the recognition of these signs with the loved one that you think might be behaving differently than you’ve seen before? How’s what’s the best way to broach that?

00:06:18 Tanya
Again, it’s very individual. Some people will be really open to it. A diagnosis of dementia is absolutely life changing. And if the person’s living with dementia, their ability to process that may be very varied, so it’s gauging where they’re at as far as coping, and at that point, sometimes the real care has to go to the caregivers themselves to support them with it. Because sometimes you have to explain over and over again, so it’s not just saying on one occasion you’ve got dementia. It may be a daily and hourly recurrence of that person having no insight into that diagnosis.

00:06:59 Kate
What about anger or frustration that you’re saying to somebody you think this might be the situation? Do some people push back and just not want to hear it?

00:07:05 Tanya
Absolutely, because it is confronting and it’s uncomfortable to think that you might have that. Plus in the early stages, you know, you do come in and out of understanding. So when you are able to process it, it’s really scary. When you’re not able to process it, you don’t understand why people are saying that to you. That’s when you could become quite upset and agitated about it, and that’s not fun.

00:07:27 Kate
You don’t want to see your loved one upset. But am I right in thinking that the earlier that you address this situation, the better?

00:07:34 Tanya
Yeah, absolutely. If possible, that is the best way to get the help. There are medications in very early stages and that’s why it’s important to get that medical support from a GP who may then refer on to a geriatrician who specialises, so there are people that specialise in looking after people with dementia. So the sooner you can get to it, the better. And it also allows you to start changing your environment at home to support. So if you start to understand and get help for the symptoms, you may be able to then change your environment to support their wellbeing even longer.

00:08:06 Kate
And those support lines you talked about before, do they also provide support and advice for the carer as they’re trying to deal with this?

00:08:11 Tanya
Yes, there’s incredible support for carers because it’s a 24 hour job when you start caring for someone. So places like Dementia Support Australia have incredible hotlines. They have a whole series of training and podcasts and courses that you can actually do, that will support you to understand what’s happening, and give you some tips and some help, and also keep showing you different places to go for that help, and also allows you to connect with the community that’s going through the same thing as you are.

00:08:41 Kate
Which is really, really helpful, isn’t it, when you can relate – because not everybody can understand if they’re not going through it themselves. So is it possible for people living with dementia to remain at home?

00:08:52 Tanya
Yes, for a period of time, it absolutely can be. And there there’s ways of supporting that to happen. It may be decluttering your home, it may be putting some signage up, using different colours, ensuring familiar items are around, getting some help, bringing people in to help you, some home care so that you can have a break yourself. Because home is such a familiar environment, so if someone can stay at home for a longer period of time, it’s just so important. So there are people that can come in and do that, so home care is a great way to bring carers in if that helps out, because there may be times where the person living with dementia is now struggling to even sequence a shower, so you bring someone in to do that and get support for the caregiver as well.

00:09:38 Kate
But the familiarity for them living at home, that’s very reassuring, isn’t.

00:09:42 Tanya
Oh it is. It’s all the familiar things. It’s where the memories are. It’s, you know, where the photos are. That may help them orientate themselves to time and place again. And all those familiar items that are really important.

00:09:54 Kate
Now I imagine the answer to this question is varied, because we’ve already talked about the fact that everyone experiences this differently. But how long can people with dementia, or people living with dementia, usually stay at home?

00:10:04 Tanya
Totally varied. It depends on what signs and symptoms become more prevalent, when safety becomes an issue, that’s usually the trick. The two real triggers to have to come into care are safety of the person living with dementia, or carer fatigue for the person caring for someone with dementia. When someone is at risk of leaving the home in the middle of the night and getting lost, it’s time to think about do we need a more secure environment? If someone’s unable to even get the just general personal care and they’re at risk of other things like infection or skin breakdown, it’s really time to think about coming into care. Home services are great, but ultimately we have to look after the people looking after people with dementia as well. And if it gets to the point, you know, sometimes we call it the breaking point or the crisis point. It’s important to know that there’s incredible services available that can pick your loved one up, like residential aged care, and bring them into a safe place to land.

00:11:05 Kate
Now we’re going to do a whole other episode about residential aged care and why that’s very beneficial for both the person who’s living with dementia and their family. But before we wrap this one, if someone was going to reflect on listening to this episode, what would be sort of key advice or key things you’d like them to remember? Maybe in terms of what they should really look out for, and how they should broach it with a loved one if they think that maybe there’s some signs happening?

00:11:29 Tanya
The most important thing to remember is you know your person the best. You are gonna pick up the signs sooner than anyone else, because of your relationship with your person. That is really hard to do, but there’s so many services to help and the sooner you can open up, discuss it, bring that help in the sooner you’ll actually feel you can get the support and wrap around that person and give them all the care and support that they need.

00:11:53 Kate
That’s great. That’s a really good insight and understanding and while we know that it is going to affect people differently, there are some really key things people can look out for there. So thank you so much for joining us, and we’ll speak to you again soon.

00:12:04 Tanya
Thanks, Kate.

00:12:11 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.

00:00:00 Kate
Welcome to Age Old Problems: New Aged Care, a podcast by Helping Hand that offers information and advice to help you find and access the right aged care services. This podcast was recorded on Kaurna land.

00:00:23 Kate
Hello and thank you for listening to Age Old Problems: New Aged Care. I’m your host, Kate Holland. Now in response to the Royal Commission into Aged Care Quality and Safety, the government is introducing some changes with the aim of helping older Australians live independently at home for as long as possible. One of those is a new home care program called Support at Home, which will eventually replace Home Care Packages.

00:00:43 Kate
This change was expected to come in from the 1st of July this year, but the changeover has been pushed back until the 1st of November. Support at Home will eventually replace the Commonwealth Home Support Programme too, but no earlier than July 2027. Now we all know that with change comes many questions and Helping Hand has received many from those with existing home care packages. Someone who holds plenty of answers is the wonderful Mel Bassham. She is Aged Care Connector for Helping Hand and she joins me now to explain a few things before any changes take place. Welcome Mel.

00:01:13 Mel
Hello. Thank you.

00:01:14 Kate
Now let’s start with your role as Aged Care Connector. What exactly does that mean?

00:01:18 Mel
Many things. I can help people to register with My Aged Care and help them through the process to get access to supports at home. That could include anything from domestic assistance to social support to allied health therapies, it depends on what their need is. Do they have someone in their life that can support them but they’re feeling a bit overwhelmed as well and they need a bit of a nudge in the right direction? It can be a one on one support face to face, helping them through the assessment as well. So depending on what the person needs I can help them to get access to what they require.

00:01:53 Kate
And how do they reach out and make connection with you?

00:01:55 Mel
So they can call our 1300 number or there is an email connect@helpinghand.org.au?

00:02:01 Kate
Is that a free service through Helping Hand?

00:02:04 Mel
Yes, currently it is. Yes.

00:02:06 Kate
Now that the introduction of the new Aged Care Act is on hold, which also has an impact on Support at Home, we understand there’s still more information to come, but can you explain to the listeners exactly what Support at Home is and why it was going to be introduced?

00:02:18 Mel
It was introduced that Support at Home should be a fairer, user-friendly system to better meet the needs for older people. I do see how they have changed the way that it is structured, so it’s about the clinical need, your independence need, and then your everyday living. And then obviously the contribution towards that has changed as well. So in that regard, it is making that fairer, and I do think that they’re also looking at reducing the wait times to have access to those supports, as well as any goods and equipment or modifications to their home. Currently at the moment, you would need to accumulate your funds through the package, whereas with this new scheme there will be access to funding immediately. And also previously if you were waiting for a Home Care Level 4 for instance, which is the highest level at present, you could opt in to have a lower level. So a Level 2 and then you’d wait another time to get that extra funding. From what I understand, you will be allocated a higher level according to your needs and you will be able to access 60% of that funding after a small period of time, I think the aim is for three months that you would wait, which is significantly less where we’re looking at 12 to 18 months at present. When I first started in this role in another organisation six years ago, the wait time was blown out to two years. So it has come down. It’s just, for my liking, it’s not soon enough to access, and people are wanting help and don’t know what to do.

00:03:50 Kate
So when Support at Home comes in what will this mean for current and existing home care package holders?

00:03:59 Mel
So it depends on when their approvals are for their package that they have at the moment. And it all depends on one date which is the 12th of September. If you were approved and accessing, or on a wait list, prior to the 12th of September, you will transition, or in other terms grandfather, to Support at Home.

00:04:19 Kate
I see. So that’s for people who were approved prior to September 12th 2024.

00:04:24 Mel
After that date. So if you’re on the 13th of September and have an assessment and got approval, you will move in directly as being a new Support at Home customer.

00:04:32 Kate
OK, so there’s a lot of information for people to try and get their heads around. I believe with this in mind, Helping Hand has set up a dedicated hotline to answer these questions?

00:04:39 Mel
Sure, yes, they have that number is 1300 050 435. We have deep dived into the world of Support at Home and we kind of know the ins and outs of how it works and if we don’t know, we will look into it further and get back to that person if needed.

00:04:56 Kate
We’ll put that number in the show notes so people can go to it. Has it been busy?

00:04:59 Mel
There’s been times, yes, definitely. When Helping Hand has provided some information or when the government has sent out letters, we do get some concerns and worries, and by the end of the call, those people have been reassured and they understand that a bit more, so don’t be worried. Have a conversation before you start worrying. More often than not, it’s a better outcome of what they are actually seeing at the moment. There are some people that are better off, some people have had no change whatsoever. It’s just business as usual.

00:05:29 Kate
Are there any repeated questions that seem to be coming up, I think co-contributions was one of the ones?

00:05:30 Mel
Definitely. Co-contributions and rolling over of built up funds. They’ve been for a period where they’ve had to save everything, the new model will show that you’ll be able to reassess to get access to funding, to purchase goods and equipment and or have home modifications. At the moment it’s Home Care Packages Level 1 to 4; new world: Support at Home it is a classification of between 1 and 8, so there’s more higher levels of funding. So I think at present it’s close to around $60,000; new world: the highest level of packages is around $80,000. That’s kind of how I see it. The take away point is, don’t panic. There will be support to access the goods and equipment. You will be able to roll over funds in the Support at Home. It’s just not going to be as a higher level as what it was before because the government would like you to use your services, use that classification to ensure that you’re getting those services at home, whereas at this point, at the moment, is some people don’t use it for services and they go without certain things to save for equipment and that worries me because that can be a bad implication, that someone’s not having a personal care because they need to get a wheelchair. Well, we want someone in that home to support that person.

00:06:50 Kate
Now when it comes to crunching these numbers, I do think there’s a new tool that has just been released that might help people.

00:06:55 Mel
That is for the co-contribution. So it’s a fee estimator that the government, because they’re aligning that with the three areas of care: the clinical, the independence, and the everyday living – so that’s separate to the budget. The budget you would go through with your coordinator or in the new world, it’s called a care partner. So that’s another change that’s been implemented.

00:07:17 Kate
OK. So that co-contribution question that comes up, that calculator will help people to get their heads around that? And is that available online now?

00:07:23 Mel
Yes, that definitely is on the My Aged Care website. And then also you can have a conversation with Services Australia.

00:07:30 Kate
So if you were going to give a key piece of advice to someone in the process of transitioning from a Home Care Package to Support at Home, what would that advice be keeping in mind? And everybody needs to know that the changeover is no longer July 1st. It’s going to be the first November. So there’s a bit more time to play with which is good. But should they be getting prepared as soon as possible anyway?

00:07:49 Mel
Definitely. My key takeaway advice is to firstly work out what kind of support that you really require, and looking at the areas of clinical, that would range from any allied health therapies to nursing. Anything to help you be independent and keeping mobile, whether it be an exercise class or a balance class. Then looking at your independence, so the social support – you’re going to the shops, transport. And then everyday living is your gardening and domestic assistance, etcetera. Making sure that part of your assessment to get that, like so reaching out to My Aged Care for that assessment, and making sure that you share what you are wanting to access. What’s your goal, how do you want that to work for you? I don’t think you should discount the help that you might need.

00:08:42 Mel
Personally, from my experience, I’ve had grandparents that moved into residential aged care far too early, and knowing what I know now, if they’d had some more support at home, that would definitely have changed that outcome. So you know, it’s the case of what I know now, I wish I knew back then. So I think that’s what drove me to do what I do to today. I have had customers that I’ve helped before through an assessment process and it can be tricky, because the language isn’t what you would normally use. So I’ve been an interpreter at times. I had a gentleman that I assisted who was having some issues with his back and there’d be times where he would be laid in bed every day. The question was ‘how do you go about getting meals?’ And he actually said, ‘yep, I’m fine. I can cook and do all that.’ But I knew that there was times where he wouldn’t actually cook for himself. And so I just kind of steered the question of ‘what do you do on your bad day?’ ‘What happens when you’re bad?’ And he said, ‘well, I make a cup of tea, a piece of toast.’ And that’s not sustainable for a week in bed. So that changed the conversation to, ‘would you like to have some meals delivered or would you like to have someone to help you to prepare some meals at home?’ So very different outcome from that very first conversation of ‘I’m OK. I can cook.’ Yeah, he absolutely could cook on a good day, but not when he was having a bad back day.

00:10:02 Kate
So putting aside all of their complicated information around funding, all the rest of it, if somebody’s goal for themselves or for a loved one is for them to live at home independently as long as possible, would you recommend the best starting point is reaching out and talking to somebody like you, because obviously your talent and skillset is in drawing the important information out to help assist them live as best possible.

00:10:26 Mel
Definitely talk to family, talk to My Aged Care, reach out to us, start the conversation. Don’t be afraid to think that you need some help at home. It doesn’t mean that you failed as an older person. It just means that you’re gonna have some more people in your life to help you to support you be at home, be upright, reduce falls, whatever it might be that you need to keep being at home.

00:10:48 Kate
That’s right. And that benefits not only them, but also their carers and their loved ones.

00:10:52 Mel
Absolutely, yeah.

00:10:53 Kate
Look, I think we must reassure people that throughout this transition, which is now ongoing and extended through to November, all the services that they’re currently receiving will continue as normal and they’ll get the same level of care and support, and I’m sure you and your team will make sure that people get updated information as soon as it comes to light at your end as well.

00:11:09 Mel
Definitely. You continue to call our hotline for the Support at Home if you wish. The organisation is also providing information and newsletters and updates by email too.

00:11:20 Kate
Well, it’s a very, very busy time. All the people out there are lucky to have you with your passion and desire to want to help them. So thanks so much for helping to uncover some of the mystery around this for us today.

00:11:29 Mel
No problem, thanks for having me.

00:11:34 Kate
For more information on Helping Hand and their services please head to www.helpinghand.org.au or call Helping Hand directly on 1300 653 600.