Reform Aged Care in Australia

Our care of our ageing population is a National scandal, and a disgrace. There is an appalling shortfall of support services for both participants and carers in the home, lack of real in home respite options, chronic lack of available services in rural areas in particular, poor acknowledgement of the Carers Recognition Act in all dealings with government departments and the health care system...the list goes on and on.

Residential Aged Care is a nightmare to navigate for carers who are already exhausted by the time the need for facility care is needed. Carers will avoid placing loved ones into care until there is no other option left - quite naturally, given what the current Royal Commission is bringing to light, and which those who work in Aged Care already know all too well. By the time this becomes their only option they are usually completely burnt out and overwhelmed. They are then confronted with the financial aspects of residential placement, at the time they are least able to do so.

Government department delays, an almost deliberately dense and complex process, conflicting advice from Centrelink, government run "advocacy" services, and the shortfalls of My Aged Care: all of these are things with which carers are all too familiar. And there are many, many older members of our community who have no advocacy at all from family or friends who best know their needs. These poor unfortunates are thrown into the system, to be churned through, stripped of their assets, and forgotten. After all, who would care?

The financing of Aged Care is unjust and uses figures which are unrealistic for the poorest members of our society to meet. Unless the person is "fully concessional", they fall into the murky category of "partial concessional". Figures of $350 *per week* are not unheard of, ABOVE the 85% of the Aged Pension. Hardship can be applied for...but only after 6 months of trying to sell whatever tiny assets that person has (usually the family home). Families are being forced to sell assets well under market value due to the urgency of needing to come up with funds immediately. Reasonable debts, such as unpaid council rates, are NOT included in the calculation of what the asset is worth. The net effect of this on a broader scale is simple: channeling the assets of the very poorest into the the profit margins of our for-profit Aged Care Homes.

For all the controversy surrounding the issue, we already have a "death tax" in this country. Or rather, maybe we should be calling it the "pre-death" tax, since none of this applies if you are fortunate enough to die before you are unfortunate enough to require care in a facility. Of course, this only applies if you are poor. The wealthy can simply pay the RAD and be done with it, and when the end comes, it is returned to them, as the very name suggests: Refundable Accommodation Deposit. The poor are left with what little remains of the assets from their beloved family home after it is sold for whatever it can get on the market at the time. The "6 month hardship" rule (hardship cannot be applied for until the home has been on the market for at least 6 months) leaves pensioners, with no other source of income, no relief from whatever Centrelink decides the person has the ability to pay, whether or not this has any reflection in the reality of their actual income. This is usually only the aged care pension, of which 85% is taken before these additional fees come into play. "Ability to pay" in those 6 months is based upon what the *asset* is deemed to be worth, from the day the person moves into permanent care, and *not* upon their actual income. This is counter to the way that every other institution will calculate a person's ability to cover their actual expenses. Theoretically, this can be negotiated with the nursing home. In reality, most facilities require up-front direct-debit arrangements to be in place at the time of placement.

The broader societal effects of this are far-reaching. The traditional passing on of wealth to the next generation becomes out of reach of those who most need it. In the immediate term, for those 6 months, the shortfall must come from somewhere. This puts incredible emotional and financial pressure on family and carers themselves, who do not cease to care simply because their loved one is in a residential facility. Many of these people are already burnt out, exhausted, and probably have not been able to work for years due to the burden of in home care (which has already saved the government, collectively, millions if not billions of dollars). They are often in no position to cover this shortfall themselves, and yet this is exactly what is being asked of them. From where can anyone access money that simply does not exist?

And what does all this pay for? The Royal Commission and recent media reports have made this fairly clear. Shocking abuse on a daily basis. Burnt out and cynical staff who can no longer actually give a damn, through their own need to survive emotionally. Ants in the wounds of the dying. All because profit is king and proper compassionate staffing ratios are expensive to maintain. Absolute human misery and suffering.

Why should anyone care about this anyhow?

The demographics of the coming two decades show very, very clearly that we are on the brink of a tsunami of the ageing population. Directly, or indirectly, you WILL be confronted with these issues.

And because none of this is fair, or just, or right, or - most importantly - compassionate to the slightest degree.

And if you can't find it in yourself to care for those reasons, here are two more: the economic aspects of this will have long lasting implications for our economy, and none of them are good with the system we now have in place. And the second reason? You will be old one day too. What sort of care do you think will be awaiting you when you no longer have any other options left?