Editor's note

Six months ago, the Royal Commission into Aged Care Quality and Safety launched in response to accounts of horrific abuse and neglect in residential aged care facilities.

This week the commission turned its attention to aged care in the home. Around 116,000 Australians received home care last financial year, with two-thirds aged 80 or over. But there aren’t enough home care packages for everyone who is eligible, so waiting times for appropriate packages have blown out to 18 to 24 months. The royal commission heard some people died while waiting, while some others had to go into aged care facilities.

The aged care in the home system is incredibly confusing. The commission heard unscrupulous providers took advantage of this confusion and offered sub-standard care packages to older Australians, and charged exorbitant fees. To help you make sense of how the system works, and where the money is going, we’ve created an explainer-style article with ten charts.

In our other home care coverage this week, Lyn Phillipson and Louisa Smith outline how home care packages are becoming big revenue-raisers for some companies, but clients aren’t receiving personalised care. Michael Woods and Sarah Wise explain why there’s a shortfall of home care packages, but the solution isn’t as simple as uncapping the number of places. And Alison Rhan has some timely advice for people who want to grow old in their homes: start planning and saving now.

Fron Jackson-Webb

Deputy Editor/Senior Health + Medicine Editor

Home care

Home care providers’ profits are growing but many older Australians are missing out on quality care. The Conversation / Shutterstock

Confused about aged care in the home? These 10 charts explain how it works

Fron Jackson-Webb, The Conversation; Emil Jeyaratnam, The Conversation

This week the aged care royal commission heard evidence of long waits for home care, poorly trained staff and high fees. These 10 charts explain how the system works and why it's under such pressure.

Many older Australians prefer to stay at home than enter residential aged care – but the process of securing home care is riddled with complexities. From shutterstock.com

As home care packages become big business, older people are not getting the personalised support they need

Lyn Phillipson, University of Wollongong; Louisa Smith, University of Wollongong

An elderly lady needs to change the time a carer visits to help her shower. The reality of today's market-driven home care system means she has to call a centralised 1800 number to arrange this.

In December, more than 127,000 Australians were waiting for a home care package. From shutterstock.com

Would you like to grow old at home? Why we’re struggling to meet demand for subsidised home care

Michael Woods, University of Technology Sydney; Sarah Wise, University of Technology Sydney

The government will keep increasing the number of subsidised home care services, but it needs to find the right funding balance for the system to remain sustainable.

The earlier you start planning, the better. Shutterstock

Don’t wait for a crisis – start planning your aged care now

Alison Rahn, Western Sydney University

If you don't plan for your aged care and make your wishes known, you may be admitted to a hospital or aged care facility when something goes wrong. That's where most Australians end up dying.

Many older Australians want to stay at home, but will need help to be able to do so. From shutterstock.com

Explainer: what is a home care package and who is eligible?

Tracy Comans, The University of Queensland

Home care packages are a viable alternative to residential aged care for many older Australians. But the process to secure these packages can be long and complicated.

Residential care

Australia’s residential aged care facilities are getting bigger and less home-like

Ralph Hampson, University of Melbourne

Large institutions for people with disability and mental illness were once commonplace. These have now been replaced with smaller community-based services. With aged care, we're doing the opposite.

What is ‘quality’ in aged care? Here’s what studies (and our readers) say

Joseph Ibrahim, Monash University

The Conversation asked readers how they would want a loved one to be cared for in a residential aged care facility. What they said was similar to what surveys around the world have consistently found.

Chemical restraint has no place in aged care, but poorly designed reforms can easily go wrong

Juanita Westbury, University of Tasmania

Antipsychotic drugs are often used to "chemically restrain" aged care residents and control their behaviour. The system needs to change – but lessons from the US tell us it's not going to be easy.

Physical restraint doesn’t protect patients – there are better alternatives

Joseph Ibrahim, Monash University

New regulations to stop the use of physical restraint on the elderly recognise a serious problem in our aged care system. But in order to really fix this issue, we need to address what's causing it.

Want to improve care in nursing homes? Mandate minimum staffing levels

Julie Henderson, Flinders University; Eileen Willis, Flinders University

The biggest system failure in aged care is staffing. We don't need to wait until the royal commission is over to fix it – this can be done now.

Four lessons for Australia from England’s system of rating its aged care homes

Lisa Trigg, London School of Economics and Political Science

In England, each home is given a rating against five questions: is it safe, is it effective, is it responsive, it is caring and is it well led?


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