The Aged Care Placement Process
Below is an idealised timeline of the Personal Guidance in Aged Care placement process. Although the order of these events looks deceptively linear, they will differ substantially with each experience.
Stage 1 - Information
The process really begins when a decline in safety or independence is first observed by the family, or someone close to the person or couple. This is the best time to start jotting down brief notes of concerns and events as they arise. You will need a sturdy folder. Down the track you may even need two, as the first swells with notes, reports, statements, summaries, and subdividers.
The MyAgedCare ‘My Support Plan’ (formerly known as an ‘ACAT’) is the essential passport for accessing aged care services in Australia. Most important is the ‘My Care Approvals’ section towards the back, covering Home Care Package Levels 1-4, Residential Respite Low & High Care, and Residential Permanent.
Support Plans are prepared by an Aged Care Assessment Team member (ACAT Assessor) after a thorough, personal interview with the person in their home, or at their hospital bed.
The process for arranging an ACAT assessment begins with either a call to MyAgedCare on 1800 200 422, or a referral from the GP. Callers are asked a series of questions over roughly 15 minutes; essentially a triage of care needs and risk factors before joining the queue for an appointment with an assessor.
Waiting times are inconsistent so it’s best to report in with any further decline during that period, if observed. Sometimes this decline may involve an unplanned hospital admission, which will set in motion its own train of events, including ACAT assessment.
Nomination of Powers
A few legal declarations and nominations become relevant when dealing with the aged care system, especially permanent placement. While DIY kits do exist for making these declarations, they are consequential legal documents and engaging a solicitor’s advice is generally recommended:
● Enduring Power of Attorney
● Advance Care Directive (supersedes: Enduring Power of Guardianship, Medical Power of Attorney, Anticipatory Declaration)
Keep track of the following cards, as they apply, for the person(s) needing care:
● Pensioner Concession
● Private health cover
● Ambulance cover
● DVA Gold
If you have access to a scanner, keeping clear and readable images of current cards is ideal. A black & white photocopy will also do, although some cards may need lightening or darkening to retain legibility.
Create a partition in The Folder for income and assets statements, plus other supporting documents, as they apply:
● Council Rates
● Centrelink letters
● Bank balances
● Superannuation and other income stream products
● Any other investments
You will want to have this information, collated in one place and at your fingertips, should you ever need to move forward with a permanent residential placement process. The Folder.
What About Hospital?
Many people will be able to find placement direct from their homes, in their own time, with no hospital admission necessary. For others, hospital is the most potent wildcard in this entire process.
Admission to hospital has the power to supersede the best laid plans, and will, if treating staff determine the patient is no longer safe to return home and unlikely to benefit from Rehabilitation or Transitional Care. From there, a clock begins ticking to find appropriate accommodation and discharge from hospital as soon as possible. The pressure to do so rises fast and expert advice is in especially high demand at these times.
The following actions are best left until the family anticipates launching an application process within the following two months. This is because the statements received will either lapse or decay in relevance shortly thereafter.
Assets & Income Assessment Form (permanent only; not required for respite)
To gain access to government-funded permanent care, completion and lodgement of the ‘Permanent Residential Aged Care Request for Combined Assets & Income Assessment‘ form [SA457] is essential.
This is the government means-testing instrument for Australian residential aged care fees. These 26 pages are not to be taken lightly; for the uninitiated they are to be taken with a hot mug and an hour’s berth, at bare minimum. Even with the accompanying ‘Information you need to know about your …(SA457)‘ booklet [CI020], many find this whole process tedious and maddening and ask me to relieve them of the nuisance, and I am more than happy to do so. Others simply don’t have the time to begin with and want to be able to leave the task in professional hands.
A brief summary covering known medical issues, medications, and immunisations. Normally provided by the GP upon request, but a recent hospital Discharge/Separation Summary will also serve the same purpose, where applicable.
Stage 2 - Placement
A full application consists of an application form, with all necessary supporting documentation attached. Permanent referrals through this service are also lodged with a targeted Referral Letter, a copy of which is also provided to the family to be added to The Folder.
a) Active Case Management
Clients of this service receive professional liaison and advocacy on their behalf with aged care providers, hospitals, GPs, specialists, and more, as we work towards finding the most appropriate vacancy. This period, more than any other, is prone to sudden bursts of hectic activity, when management of the whole process needs to be most responsive, agile, and informed.
b) Offer & Viewing
Once a provider has made a formal offer, the site manager usually wants to meet with the family and show them around within a day or two. That said, rooms are occasionally offered while still completing refurbishment, to become available in following days.
Either way, I put you in direct contact with the site to arrange an appointment to view, and am available to discuss how it all went afterwards.
Decline » continue Active Case Management (within realistic expectations).
Accept » proceed immediately to an Admission Process.
An admission date is established with the site. Where applicable, hospital discharge can then be arranged, for which the hospital will want a confirmed name for pickup and transport. If instead the treating staff have determined an ambulance is required, they will proceed to make that booking.
On the day itself, the admission can take two to three hours and it is optimal if the person has a family or friendly support with them for the early stages.
In the week following admission, I like to touch base to check that everyone has landed safely and things are off to a positive start. It takes some weeks for a new resident to settle fully into their new home and community, but most issues will have presented themselves within the first week and my call is an opportunity to iron out any such concerns.