Aged-care providers are overhauling the services they offer and expanding the care they can provide in people's own homes as baby boomers declare that when it comes to slowing down, they'll do it their way. And that can often mean keeping a very firm grip on their independence.
UnitingCare Ageing, which provides services to 14,000 elderly people in NSW, has redefined its service model over the past two years because more retirees intend to remain at home.
“Traditional modes of … residential aged care are going to become more and more a thing of the past,'' the director of operations at UnitingCare Ageing, Joanne Toohey, says.
“That's the way aged care has been moving anyway but certainly, as an organisation, we're absolutely ramping that up.''
The Uniting Church-backed group has started separating its accommodation from its care services.
“We are looking at the care outcomes that people want to achieve, regardless of the accommodation setting,'' Toohey says.
“That's in total recognition of the fact that's what people want.''
Service providers say they would like to provide greater levels of in-home care to the frail elderly but are limited by a complex government system. However, they are anticipating a greater push towards more services offered in the home in the near future.
The federal government's Productivity Commission is investigating aged care in Australia and is due to release its final report next month. In its draft report, published in January, it found more than 1 million older Australians receive some form of aged care and support each year.
The report acknowledged the growing trend for in-home care, noting also that due to a growing affluence, the standard of care older people expect will also rise.
Over the next 40 years, the number of Australians aged 85 and over - those most in need of care - is projected to more than quadruple, from about 400,000 last year to 1.8 million by 2050.
UnitingCare Ageing is taking part in a trial of consumer-directed care packages. In the trial, funds are allocated to each client, who then get a say as to how they want to spend the money.
“It actually becomes the client choosing from a whole suite of different types of services and telling us how they want their money spent; what are the things that are important for them to help them remain at home,'' Toohey says.
“That's a completely different shift, usually the aged-care provider is the one in that seat.''
The results so far show clients are a lot happier - and their ideas can be quite different.
“We've had some people for whom the social aspects of their day are far more important than having someone come in and assisting with the cleaning of their home, for example,'' Toohey says.
Despite the desire among retirees to stay in their own homes, many properties are not suitable as people age, the general manager for ageing at the Benevolent Society, Barbara Squires, says.
The Benevolent Society has received planning approval for its Apartments For Life concept, which it hopes to build in Ocean Street, Bondi. It is now in the challenging stage of raising funds for the 140-apartment development.
“Because we're wanting to provide 40 per cent of affordable housing, it makes the financing quite difficult,'' Squires says.
The concept is based on a Dutch project and the Benevolent Society says it would allow 95 per cent of people to remain in their own apartment for the rest of their life.
Jason Falinski, MD of CareWell Health, added that there is ample evidence now that the community based approach is delivering inferior care outcomes for patients. "And the best evidence of this comes primarily from the providers themselves, who say that people are entering their age care homes less healthy than ever before. Well if they have been looking after them in their own homes, how is that happening?"
Types of care
In 2009-10, more than 610,000 people aged 70 or over received Home and Community Care services.
About 70,000 people received more intensive packaged community care at home.
About 215,000 people received permanent residential care, of whom 70 per cent received high-level care.
About 70 per cent of residents in recent years were female and 55 per cent were aged 85 or older.
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