New Aged Care Commission welcomed

  • Talking Age Care

Consumer groups, advocates and aged care providers from across the nation are starting to respond to the federal government announcement of a new ‘streamlined; Aged Care Safety and Quality Commission.

The announcement, made by Federal Minister for Aged Care Ken Wyatt, will see the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and the aged care regulatory functions of the Department of Health come together under the one entity.

Minister Wyatt says the new Commission, developed in response to the Carnell-Patterson review into failures at South Australia’s Oakden Older Persons Mental Health Service, will be a responsive, one-stop shop to prevent failures, highlight quality concerns and have them “quickly rectified”.

“This builds on the Government’s recent introduction of unannounced re-accreditation audits across every one of Australia’s residential aged care facilities,” he explains.

“Importantly, the new Commission will give senior Australians and their loved ones a single point of contact when they need help in dealing with claims of sub-standard care.”

Australia’s leading advocacy body for older Australians and aged care consumers Council on the Ageing (COTA) has come forward to welcome the Government’s announcement, with Chief Executive Officer (CEO) Ian Yates saying it is another significant step towards better monitoring and enforcement of quality in Australia’s aged care system, together with the new regime of unannounced visits by quality assessors.

“These are welcome steps towards rebuilding confidence that older Australians will receive safe and appropriate care,” Mr Yates explains.

“Although, Government still needs to go further and give consumers direct control over their aged care funding, as recommended by several inquiries and this Government’s own aged care advisory body.”

The Aged Care Guild, made up of Australia’s largest residential aged care providers, has also welcomed the key elements of the Federal Government’s proposed reforms, with Interim CEO of the Guild Lee Hill saying that his organisation looked forward to working with the government to ensure that the reforms fulfilled the recommendations set out in the Review of National Aged Care Quality Regulatory Processes.

“We’ve been very clear through the review process about the need to eliminate the inconsistencies in how the industry is regulated by the relevant government agencies and to increase accountability for aged care policy, regulation and the consumer feedback and appeals mechanism,” Mr Hill says.

“The establishment of an Aged Care Quality and Safety Commission is a positive step to address these issues, but it is important that it doesn’t become just another layer of bureaucracy.

“The government should take the opportunity provided by the establishment of this Commission to more efficiently regulate the aged care sector and allow our staff to focus on caring for our residents rather than red tape.”

Australian peak body for seniors, National Seniors, is another consumer advocacy group to step forward and be encouraged by the introduction of the Commission, with Chief Advocate Ian Henschke saying that having a single point of contact for the aged care industry was a welcome move for consumers, however he warns that it needs to be well implemented, if it is to lead to better monitoring and early detection of quality care issues.

All three peak bodies – COTA, National Seniors and the Guild – have also welcomed the additional announcements made by government which include the introduction or performance ratings for aged care providers, as well as the inclusion of a Chief Clinical Advisor and a Serious Incident Response Scheme.

A day prior to the Government’s announcement, the Australian Nursing and Midwifery Federation (ANMF) released a statement saying that “better staffing will fix the crisis in aged care”.

In the statement, ANMF Federal Secretary Annie Butler suggested that increasing staffing levels is “precisely what will solve the problem for elderly, vulnerable Australians in nursing homes”.

“The aged care sector presents complex problems that successive governments have grapples with, unsuccessfully, for years,” Ms Butler explains.

“They’ve conducted myriad reports, reviews and inquiries looking for complex solutions to complex problems rather than going straight to the core of the problem – chronic understaffing.

“Ensuring the right number of people with the right mix of skills to care for our elderly  Australians is what can be delivered by mandating minimum staffing ratios and skills mix.

“It works in our public hospitals, and it works in our childcare centres.”

The Government’s announced Aged Care Safety and Quality Commission will commence from 1 January 2019.

Rest home resident ‘slept in chair for 24 days’

By Nicholas Jones
Political Reporter
NZ Herald

A 95-year-old slept in a recliner chair for 24 days because a New Zealand rest home couldn’t provide a suitable bed, her family says.

The woman’s daughter eventually called 111 after her mother’s legs swelled and she became confused.

Bupa NZ has apologised for the “distress caused to the resident and her family” but did not answer specific questions about the chair.

The woman moved into Whakatane’s Mary Shapley Care Home in early 2016, originally for respite care. Her daughter told the Weekend Herald there was a small bed in her room, but it couldn’t be used because her mother was unable to lie flat.

She repeatedly asked for a hospital-style bed that could be adjusted, she said, but was told there were none available. As a result, she said her mother was put in an old recliner chair in the room, and stayed there day and night, including for meals.

“I kept saying, ‘Can she have a bed? Can she have a bed?’ You can’t sleep in a La-Z-Boy at 95 for that length of time.

“All she wanted was a bed that they could [use to] raise her head a little bit, which I don’t think is an unreasonable request in a place taking $1800 a week off you.”

åThe daughter, who asked for names to be withheld given the small community she lives in, said her mother’s mobility meant she couldn’t get up herself.

“Basically, they put her in a chair and took her away and showered her. If she wanted to go to the toilet they would get her out.

“But my mum was an independent lady, she didn’t like bothering people. So it took her awhile to get into the idea that when she wanted something, she had to ring the bell.

“She’d sort of sit there to the stage where she was jolly near wetting herself. And then she would finally push the [call] bell.”

Her daughter visited every day. In March 2016 she called an ambulance after her mother, who was mentally sound, seemed “away with the fairies” and had badly swollen legs.

She said the paramedic asked about an adjustable bed but a rest home staff member told him there weren’t any available. He then took the 95-year-old to the local hospital.

After she was discharged her daughter moved her to another local aged care facility for hospital-level care. Her mother died in June 2016, and her daughter believes removing her from Mary Shapley was the only real option available to her.

Mary Shapley is owned by Bupa NZ, which is one of the biggest aged care companies and owns more than 50 rest homes. A spokeswoman said the company apologised for the distress caused to the resident and her family.

“The wellbeing of our residents is our absolute priority and we take all concerns about the care received in our homes extremely seriously. We encourage an open dialogue with residents and their family.”

Bupa contacted the daughter on Thursday and offered a “sincere apology”, the spokeswoman said.

The company declined to answer Weekend Herald questions sent Tuesday morning, including whether it accepted the resident had used the chair and not a bed, and about the family’s concerns that medical treatment wasn’t sought.

“We will be engaging with them in our review of the circumstances around the care provided in 2016. Respecting the privacy of the family, it would be inappropriate to publicly comment further at this stage.”

The daughter said she kept her mother at home as long as possible, but her own illness meant she couldn’t lift her when she lost the ability to walk.

“It tore my heart out, and still tears my heart out right now. It was just one of the most horrible things I had to do. I promised my dad the day he died that I would look after mum for as long as I could. And I really, really tried.”

She said her only motivation to speak out was out of concern for the roughly 36,000 people in aged care facilities. She did so after reading a Weekend Herald article, part of a series on aged care that found:

  • A third of the country’s 651 aged care facilities have had recent shortcomings related to resident care. Residents have died from festering bedsores.
  • Cases of residents being strapped to chairs all day with minimal movement or repositioning. Staffing levels so low at some facilities there is a risk to the safety of residents.

Consumer and health advocates are pressing Labour to act on policy held in opposition, including updating voluntary aged care standards and making them mandatory.

Responsibility for the sector was recently transferred to Associate Health Minister Jenny Salesa, who said the complaint, and any failure of care, was distressing.

“These events are sporadically highlighted by the media. In general, the media discover these events from the audit process, which shows the audit process works,” Salesa said in a statement.

The Health and Disability Service Standards were currently being reviewed, and this gave to opportunity to strengthen safeguards “and better reflect contemporary best practice guidance in aged care”, Salesa said.


Aged care ‘super agency’ a farce – elder advocate

The Aged Care Quality and Safety Commission will be a one-stop shop for highlighting failures in nursing homes and bringing them into line while raising quality benchmarks.

The move would see the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and parts of the Department of Health merge into one body.

Additionally, the department would provide a single point of contact for the elderly and their families.

Member for Hinkler Keith Pitt praised the announcement, which was made yesterday by Aged Care Minister Ken Wyatt, saying reforms would bring much-needed reassurance that everyone receiving aged care was being looked after properly.

“I’ve been advocating for change for the past year,” he said.

“I’ve met with constituents and met with Minister for Aged Care Ken Wyatt multiple times.

“One such meeting with constituents was taken to the Minister and resulted in the Aged Care Quality Agency undertaking unannounced inspections of local aged care facilities within a matter of days,” Mr Pitt said.

He said the Federal Government recently introduced unannounced re-accreditation audits across every residential aged care facility in Australia.

The Hinkler MP said the announcement takes a significant step towards raising the bar in aged care.

“However, I will continue to advocate on behalf of constituents that bring their concerns to my office,” he said.

“These reforms will deliver the care grounded in the principles of dignity and respect that our senior Australians deserve.”

A new performance rating system will also be introduced which will act as a comparison tool when selecting providers.

Mr Wyatt said the new federal model for aged care was a major step in identifying issues.

“Risks to senior Australians will be investigated promptly and care failures identified faster,” he said.

However, a spokeswoman for the Queensland Nurses and Midwives Union said the announcement was a Band-Aid fix slotted in before an anticipated 2019 federal election.

Bundaberg aged care advocate Heather Mansell-Brown, whose husband suffered horrifying neglect in a nursing home, labelled the agency a “farce”.

“I think it’s a joke about the flying squad,” she said.

“All of a sudden our honourable member has realised we do have a problem in aged care.”

Mrs Mansell-Brown said she was adamant that mandatory nurse ratios and a royal commission into the industry were the only firm solutions.

Previously labelling the aged care industry as a “national disaster”, she put out a challenge to Hinkler MP Keith Pitt, saying the “fight was on”.

“When it comes to mandatory ratios the honourable member is in for one hell of a big shock within a few days,” Mrs Mansell-Brown warned.


Free ‘super flu’ vaccines for over-65s are available now


Two ground-breaking flu vaccines are now available free to Australians aged 65 and over.
Health authorities introduced the ‘super vaccines’ targeted at this age group in response to last year’s deadly flu season.
Of the 1100 influenza-associated deaths recorded in 2017, 90 per cent were in the elderly.
With winter less than two months away, the federal government on Wednesday encouraged older Australians to take advantage of the enhanced vaccines.
“Last year we saw the highest influenza activity in Australia in almost a decade, mirroring a global trend, with more than 250,000 Australians testing positive for influenza and double the normal hospitalisations,” Federal Health Minister Greg Hunt said this week.
It’s not just older members of the community encouraged to get the flu shot.
Data suggests 56 per cent of Australians don’t intend to get the vaccination.
“I urge all Australians to consider getting a flu shot this year. Annual influenza vaccination is recommended for any person six months of age and older, with vaccines also available on the private market,” Mr Hunt said
Those who are eligible for a free flu shot under the National Immunisation Program include people aged 65 years and over, most Aboriginal and Torres Strait Islander people, and those who suffer from chronic conditions.
Infectious disease experts are predicting a moderate to severe flu season in 2018, with more than 11,000 laboratory confirmed notifications of influenza in Australia already recorded by the Immunisation Coalition.
The data shows both influenza A and B strains are circulating at similar levels, including confirmed cases of influenza A (H3N2) – the ‘worst kind’ of flu.
Australia’s Chief Medical Officer, Professor Brendan Murphy, said now is the time to make plans to get the vaccination.
“Getting vaccinated from mid-April will ensure you are protected before Australia’s peak flu period, from around June to September.”
Professor Murphy also stressed that people cannot get the flu from the vaccination.
“The flu jab does not contain any live virus, so you cannot get the flu from the vaccine and we know that high vaccination rates contribute to a healthy community,” Professor Murphy said.
Influenza Strains Contained in the 2018 Flu Vaccine

  • A(H1N1): an A/Michigan/45/2015(H1N1) pdm09 like virus
  • A(H3N2): an A/Singapore/INFIMH-16-0019/2016(H3N2) like virus
  • B: a B/Phuket/3073/2013 like virus
  • B: a B/Brisbane/60/2008 like virus

Source: AAP – SBS

Aged care safety commission a ‘one-stop shop’ to tackle elder abuse

– ABC online April 18, 2018


Australia’s aged care sector will soon have to answer to a single watchdog under Federal Government reforms in the wake of the Oakden elder abuse scandal in South Australia.

Aged Care Minister Ken Wyatt has announced plans to combine three separate agencies which handle quality control and complaints in the aged care sector by the beginning of 2019.

A new ratings system allowing facilities to be graded against key benchmarks, and a comparison tool on the My Aged Care website, will also be introduced.

“The unified new commission will be a responsive, one-stop shop to prevent failures, highlight quality concerns and have them quickly rectified,” Mr Wyatt said.

The consolidation of services was recommended by a review of national aged care regulation established in direct response to revelations about the Oakden aged care facility in Adelaide’s north-east.

South Australia’s chief psychiatrist found elderly dementia patients at the facility were abused and neglected by their carers over a decade.
The whistle was blown when the family of Oakden patient Bob Spriggs raised concerns about his treatment, including over-prescription of medication and unexplained bruises.
That prompted other families to come forward with similar concerns.
A scathing report from the South Australian anti-corruption commissioner, Bruce Lander, later made damning maladministration findings against five individuals and the public authority overseeing the facility, which was closed last year.
The former Labor minister at the centre of the Oakden nursing home scandal, Leesa Vlahos, announced she was quitting politics days before Mr Lander released his report.
The Council on the Ageing has described the latest federal reforms as a “significant step” towards “better monitoring and enforcement” of aged care compliance, and rebuilding trust in the system.
The new agency, to be called the Aged Care Quality and Safety Commission, will bring together the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and the aged care regulatory arm of the Health Department.

“We’ll also have a serious incident response scheme, which came out of the Australian Law Reform Commission recommendations, so that we protect senior Australians who are vulnerable in facilities,” Mr Wyatt said.

A chief clinical advisor will advise the commission on complex clinical issues, and risk profiling of aged care workers will also be bolstered.

“What we’ve seen around this country is that … staff who have been trained in a very short timeframe, and who have not had hands-on experience, struggle,” Mr Wyatt said.

“Some individuals are not suited. They’ve not realised what the job is.”

The Government will establish a taskforce within the Health Department to implement the changes by January 1.

Mr Wyatt said the reforms follow a move to make all re-accreditation audits at aged care facilities unannounced, rather than allowing advanced notice.





Australian tradies build a shed for seniors with dementia

By Philippa Land

The latest build from the hipages tradie crew is in Perth for Silver Chain, a charity providing health services for people living with dementia.
Dementia is the second leading cause of death in Australia with an estimated 425,416  people living with the condition.

The crew, consisting of  local qualified tradies found via the hipages platform, volunteer its time to build for charitable causes around the country with materials also being donated.

This complete renovation of the Silver Chain’s Rockingham centre garden included a colourful shed designed to help clients build their everyday skills. The yard was also landscaped to make it more dementia-friendly.

The reaction from the clients when they saw the finished shed was pure delight. It turned out to be much grander than they expected, with the centre clients now spending every day outside in the yard enjoying the new shed.

The crew built a small shed to be used as a cafe for clients to practice basic social and life interactions such as buying coffee and bread, as well as giving clients the ability to sell vegetables they grew in the garden themselves. Nine local qualified tradies volunteered their time to build the shed and renovate the garden.

The shed was sketched up from photos sent through by Silverchain. It was then built using standard pine and Western red cedar to include weatherboard cladding with brick paving and a tin roof. When it was first built is was just a wooden shed, but the paint job brought it to life to almost resemble a beach kiosk. Outside the shed is brick paving which extends throughout the yard which was also a major part of the job.

The whole project took 4 weeks with a full team of trades including a carpenter, electrician, paver, roof tiler, painter and some labourers as well as landscaping provided by Bunnings.  The shed is built from timber and has shutter windows which open up like a cafe, is 2.2m high by 2.6m wide and painted in bright engaging colours.

Elements of the design and build which were essential to ensuring the overall space was dementia-friendly included the installation of non-slip matting on the floors of the cafe shed, safe flooring in front of the shed for tables and chairs, as well as bench height shelves to serve from. Other renovation elements of the project included a clean-up of the side garden with new flowers and plants, as well as maintenance and a clean up of the raised garden beds which allows the garden to be used for the growing and selling of veggies and flowers.

Silver Chain’s Social Centres offer a comfortable, home-like setting for the organisation’s clients to socialise, relax and have fun with a range of activities to keep them active and engaged. Many of the clients who attend the Social Centres are living with dementia and the centre’s programs help them to maintain their life, social skills and remain living in their own home. In Western Australia alone, Silver Chain helps 98,000 people with health services in their home.

Silver Chain Social Centre Coordinator Mandy Holmshaw said the new backyard is remarkable and already having a positive impact on all our clients.

“Our clients’ response has been unbelievable, for many of them, our social centre is a home away from home and they’ve been out here every day since it opened,” Mandy said.

“It’s important for people living with dementia to have access to facilities like our renovated backyard. It empowers and enables them to set personal goals for themselves so they can maintain their social skills.”

Caring for a person living with dementia can be quite costly, with it being estimated to cost $88,000 annually for a person to be living in residential care with dementia.

These findings have to lead to calls for reform of this cost and for extra funding into the disease. Especially with an aging population, it is expected that dementia will double by 2050 with 1 in 3 Australians predicted to develop the condition later in life.

Silver Chain’s services and community allow people to continue living in their own home, lessening the cost to support them in residential care.


Why aged care should begin at 50

News-Mail 16 April 2018


SENIOR Australians are waiting too long to think about aged care, putting unnecessary strain on themselves and their finances.

Despite more choice being offered around aged care, the system remains a maze for most people and is becoming more user-pays.

Aged care specialists say while the average age of people entering residential care is around 83, people should start thinking about and planning for their future needs in their 50s and 60s.

Delaying decisions can increase stress when a crisis occurs, and long waiting lists for new home care packages mean that over-65s need to prepare earlier.

Age Care Directions executive manager Andrew Boden said many people put off thinking about it because they did not want to lose independence, did not want carers in their homes, and had heard negative stories about nursing homes.

“They see it as a negative experience,” he said. “The biggest issue with aged care and accommodation is the lack of education, with misinformation prevalent, and part of the reason is that people are fearful.”

There are several levels of care available, and government financial support for it.

Home care packages were overhauled last year to give seniors greater choice in spending their government funding of up to $49,000 annually to enable them to remain at home.

Waiting lists for these packages already have stretched beyond a year, and Mr Boden said people might be able to get a lower level home care package – perhaps $16,000 a year – as an interim step, or benefit from the Commonwealth Home Support Program which delivered discounted services.

Leading Age Services Australia CEO Sean Rooney said the long waiting list was unacceptable and could result in higher costs to the government if more seniors went into nursing homes.

“While the current wait list raises the importance of planning, people can only enter the wait list once they have been assessed as requiring care,” he said.

Don’t wait: Aged care planning should start long before retirement.

People should understand that timing gaps for home care and residential care might need to be managed by extra help from family, friend and community groups, Mr Rooney said.

He said the portal was a good support for aged care planning. The website has plenty of educational information and online tools to find services.

Advantage One Financial Services managing director Andrew Venning said early advice could lead to better structured assets and seniors not paying more than they should.

“Talk with your family. Have them understand your feelings and needs. Get help. Do your research,” he said.

Mr Venning said the idea of having to give up the family home to move into aged care was false, although “with recent government changes it is less attractive to rent the family home as the rental income is now part assessed”.


Insurance warning after man, 84, stranded in Bali hospital after accident

by Rob Scott – Yahoo7

Experts say the situation faced by a gravely ill grandfather stranded in a Bali hospital should serve as a warning to older Australians.

84-year-old Alan Conway, from Mandurah in Western Australia, took out travel insurance before he left Perth, but his level of cover is nowhere near enough to pay for an emergency medical evacuation.

It’s not the way he imagined his Bali holiday would end.

Mr Conway needs a hip replacement after a fall, but he’s developed a viral rash, making the already risky procedure even more dangerous.

“If the virus gets into his blood stream it will go to his brain, he’s just had a stroke in the last three days, and it could possibly kill him,” Mr Conway’s son Marc said.

Marc wants to get his father home for treatment, but he says because of his age his travel insurance is limited.

Mr Conway needs a hip replacement after a fall, but he’s developed a viral rash, making the already risky procedure even more dangerous.

“If the virus gets into his blood stream it will go to his brain, he’s just had a stroke in the last three days, and it could possibly kill him,” Mr Conway’s son Marc said.

Marc wants to get his father home for treatment, but he says because of his age his travel insurance is limited.

Mr Conway’s insurer, FastCover, has confirmed an “air ambulance is on standby to medivac our insured back to Australia once medical clearance to fly is provided.”

Despite assurances from FastCover that his father’s case is a priority, Marc’s unsure if the family will have to pay for the flight.

They have set up a GoFundMe page to help raise funds for Mr Conway to return home.


Flu vaccine dilemma for seniors

A dangerous strain of influenza, set to hit Queensland’s south-east this flu season, has been left out of a potentially lifesaving vaccine for the state’s seniors.

The Brisbane virus, deemed severe by the World Health Organisation, isn’t included in this year’s jab for residents aged over 65.

Raceview’s Doctor Wade Wilson received his batch of Federal Government funded vaccines yesterday and quickly realised the difference.

The vaccine for under 65s, protects against four Influenza strains. Two As and two Bs.

But for seniors, there’s only protection from three. Two As and the one B.

“If I’m going to use this over-65 vaccine I won’t be protecting my patients from the Brisbane Virus,” he said.

“Unfortunately they’ve left the wrong virus out of it.”

The Brisbane virus has been detected in Europe and America over the past few months, and authorities predict it will return to Australia, after starting here in 2008.

The country’s chief medical officer admitted they left it out, deliberately.

This year, the Federal Government was advised to try a new vaccine for the elderly, replacing the second B strain with high doses of immunity fighters.

“It’s much better for the elderly to have a vaccine that gives them a better immune response generally – rather than one that might have one more virus but they won’t respond to very well at all like we saw last year,” Chief Medical Officer Professor Brendan Murphy said.

A full 90 percent of the 1100 flu related deaths last year were in the over-65 bracket.

To avoid that same high number again this year, authorities say the seniors vaccine is tougher and stronger than any other on the international market.

Professor Murphy says some seniors could already be safeguarded from the Brisbane strain.

“[Those] who have often had exposure to B in the past there is probably some cross protection between the B strains so having the one B strain will probably provide some protection,” he said.

© Nine Digital Pty Ltd 2018




Wait for home-care packages pushing elderly into nursing homes

– Sydney Morning Herald


Two years ago Wanda Solomon, 94, was allocated a level-four home-care package, which enabled her to get the help she needed to continue living on her own.
With worsening macular degeneration but a fierce determination to remain independent, she was able to manage – with a few hours help a week – to prepare an evening meal. Her sister Irena Zuraszek, 91, generally did the cleaning and helped with the shopping.But because Wanda was not yet using the level-four package to its full extent, her chosen provider downgraded it to a level-two package. The reduced care hours worked well until earlier this year when her health took a turn for the worse and she needed more help. Wanda’s name went onto the national queue for a level-four package, for which she is still waiting.

Irena was able to carry much of the increased load until her own health started to suffer, which meant Wanda’s only real option was to go into respite care in an aged-care facility while they work out a longer term plan.

“Wanda is being well cared for but she is very confused in a new environment in which she can’t see. I am constantly worrying about her, so really I’m not sleeping. She is my only sister and – if it wasn’t for her eyes and some memory loss – we would probably be able to manage at home with some extra help,” Irena says.

Home-care packages

Most people want to remain living in their own home until the end. However, often the reality is very different.

Much depends on your health and ongoing care needs as well as the help that is available, be it from friends, family or professionals.

The federal government has two home-care programs aimed at keeping people at home rather than having to move into a residential aged-care facility. Both programs are desperately in need of review and increased funding if they are going to meet the demands of the ageing population.

About 80,000 people are accessing help through the Home Care Packages (HCP) program and an estimated one million people receive support from Commonwealth Home Support Services.

Irena Zuraszek believes the sisters could have remained at home if they’d been able to get a higher-level home-care package.

The Home Care Package Program Data Report reveals, as of December 2017, there were a further 104,602 people in a national queue for an HCP, about half of whom are receiving services at levels below what they have been assessed for.

HCPs allocate a budget, which is held for you by an approved care provider. The HCPs range from level-one packages for low care needs, such as cleaning, to level four for higher care needs, such as personal care and showering.

It is up to you to find a provider who can meet your care needs. Each HCP provides a number of care hours. HCPs can also be used to make home modifications or buy equipment such as walkers.

One of the biggest frustrations is getting a few regular care workers to visit your home.

RSL Life Care manager of HCP provider Life Care at Home, Wendy Marshall, says most people working with a package lower than what they have been assessed manage with “great difficulty”.

“They either go without or they pay for extra services themselves, and that cost can be substantial,” she says.

Eligibility for the appropriate package level is determined by government-funded health professionals known as the Aged Care Assessment Team (ACAT).

One key issue for receiving appropriate care is the time it takes between being assessed for a package and being allocated one. Currently, the wait for a level-two package is about six months, and one year for level three and four.