Home Care Package Advice for Elderly Parent - Perth

whitfords on 16/09/2024 - 15:43
Last edited 16/09/2024 - 15:59 by 1 other user

My family are in the process of considering Home Care Package providers for my dad.

He experienced a bad fall and as a result now has problems standing up and walking, even if using a mobility aid. He is currently in the rehabilitation ward and is regularly visited by physios and is starting to show signs of improvement but at an extremely slow rate. We expect him to continue rehabilitation in transitional care, but this is only for up to 3 months.

Although our family is hoping his condition improves to the point where he can move around by himself (either with/without the use of a mobility aid), he is not so sure that by the end of the transitional care period he will be able to do so.

We think for his mental wellbeing he would be happier at home after finishing up at transitional care, so he's applied for and been approved for Level 4 HCP. My mum is still healthy and fit but is not strong enough to be able to help him up.

I've been looking at providers on: https://www.myagedcare.gov.au/ , however there are so many providers to choose from and the pricing also seems to vary quite a lot. Additionally it seems that there is some info that doesn't match up with the providers websites (like whether they provide services on weekends).

I was hoping to get some real world experiences from people who have had to use the benefit, and arm myself with the right questions when contacting providers.

I've come up with a list of services from HCP providers my dad will likely need:
- Wound redressing
- Bathing/changing
- Physio
- Transport to appointments
- Respite
- Home modifications (i.e. handrails, toilet, bed)

Would specifically like to know:
- Any good/bad experiences of HCP providers in Perth?
- Any gotchas I need to be aware of?
- Thoughts on fully vs self-managed options: My mum thinks self-managed would be better to allow them to use the HCP benefit in the way that they want, but I'm wondering if it involves a lot more admin work to get appointments organised
- Home modifications: Is there usually a wait time for this? I've briefly spoke to a rep of one provider at the hospital and they inferred that you couldn't get it done straight away which seemed odd.
- Not-for-profits: Have read that they are generally better
- Carers allowance: Would my mum be eligible for this or any other benefit?
- Any must ask questions for providers?

TIA

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  sumyungguy on 16/09/2024 - 16:01

  I recently viewed a friend's ACAT assessment. It included suggested providers for each category based on current servicing capacity. Wait time from approval for HCP4 is currently 9-12 months but I gather you can get services in the interim via CHSP. There are more clients than providers so I'm not sure you have much discretion to choose. I know a few seniors on HCPs but none of them self-manage. They wouldn't have been capable of doing the admin when they were younger so there's no hope of them taking it on now. For carer payment & carer allowance eligibility, consult Services Australia.

  • 

    whitfords on 16/09/2024 - 18:11

    I'll need to double check the letter my dad received, but I think he already got the approval letter. It could be that his condition meant it got approved quicker.

    Noted about the admin work. My mum would most likely be handling most of it and seems up to the task but will check if there is an option to switch to provider managed.

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  CurlCurl on 16/09/2024 - 16:21

  Will this be permanent?

  If yes, immediately apply for My Age care.

  Your dad will have to be assessed.

  Depending on his assets it can be free, or if he is over the assets text he will need pay a contribution towards his care.

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  lbft on 16/09/2024 - 17:45

  +2

  • Thoughts on fully vs self-managed options: My mum thinks self-managed would be better to allow them to use the HCP benefit in the way that they want, but I'm wondering if it involves a lot more admin work to get appointments organised

  Traditional HCP providers are run off their feet trying to keep up with demand. You'll have all the admin work done for you, but admin things will take longer than you'd like to get done and you won't usually have choices of things like who the staff are on each shift.

  Self management of a HCP involves you choosing all your own providers, booking appointments, etc. The provider works with you to draw up a care plan and budget for you to stick to (and remember, there's nothing higher than a Level 4, if you need more then ACAT will say go into a nursing home). It can be a lot better in the sense that since the provider does a lot less work their fees can be waaaay lower, giving your family member more support, and the providers can tend to be a bit more responsive since they are. It can be worse in the sense that you have more BS to worry about while you're just trying to keep your family member safe and happy.

  Personally I think the self-managed trade off is worth it for my family member's circumstances. But be prepared for a lot of things to not be allowed under the HCP rules - no matter whether you go with a self managed provider or a normal provider, they have a legal requirement to ensure the rules are followed. Be prepared for the provider to want to cover their backside by requiring a letter from someone like a GP or an OT for everything you want in terms of assistive technology that is not mentioned in the ACAT assessment (the HCP will generally pay for those appointments to get those letters). The government have been auditing the living daylights out of the sector to try and save money and they're scared out of their minds.

  Re: home modifications, the Home Care Package is presented as a yearly budget but the government actually calculates it over a much shorter period of time, I believe as a daily rate. That daily money is added to an account but the government only reimburses providers out of that account for what they spend once at the end of the month. So you have to build up enough funding to pay for the home modifications (hope you didn't need to spend any money on basic care in the meantime, because it's drawing out of the same account, oops!) It's moronic and is hopefully changing next year.

  I self-manage my dad's home care package with PlanCare who are based in Perth but operate by telehealth nationally. They charge low fees and have been good at getting out of the way but helping us know what he can and can't spend his package on. Their main thing is self management but I think they do fully managed stuff now too with fees a bit lower than some others.

  • 

    whitfords on 16/09/2024 - 18:32

    Thanks for your detailed response and clarifying the thing about home modifications - makes a bit more sense now that you've explained how the funds change hands. So the ideal situation is to get a care plan that is under budget so that after some time you can put funds towards home modifications/mobility aids?

    We were actually considering going down the self-managed route with PlanCare, partially because it's local and the rates seemed better than most. It's nice to have some insight of what the reality of day to day is going to be like, and what red tape we might have to go through to get things approved.

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  bmxr on 16/09/2024 - 18:25

  +1

  Sorry to hear about your father. We have been/are going through this recently OP.

  Dad fell and fractured his pelvis in August last year. He was in public hospital then a private rehab hospital for about 2 months. During this period his ACAT was updated to higher level assistance. Then the Occupational Therapist, Social Worker and his Doctor at the hospital recommended a Respite stint in a Residential Aged Care Facility for further rehabilitation - with a view to potentially becoming a permanent option.

  We used this much needed time in rebah and respite care (preferred provider would only do 2 weeks at a time) to get the home modiciations done, they took months to complete. Not the modifications, but access to an OT, was what took the time. Looking at your list you may also face the same challenges we did with regards to accessing the service providers with capacity. As noted above, you may not have the option of "choosing" a provider, you may need to take the first available. As one provider told us "there is plenty of funding available, but no one to do the work". We had our first gardener's visit 14 months after we applied, and are yet to have any domestic cleaning providers, now 18 months of waiting.

  Mobility aids, bed, sit/stand aids, etc.. will all be covered by private health insurance if you have it, best to get it covered there rather than take it out of your budget.

  Managed vs self-managed, if you have the time go self-managed. If not, just beware that some providers will attempt to spend your budget on some things of questionable aid or care. You will need to keep an eye on all quotes and all activities.

  Carer's allowance - your mother will qualify for this, it's only $75/week or so but better than nothing. If it is almost all day care, for 12 months or more, she may qualify for the carer's payment which is more substantial but also has implications for other social benefits, including the aged pension.

  The worst/annoying/unfortunate thing about all this. Dad had been assessed as a fall risk in March 2023. We applied to numerous home modification providers to install ramps and rails to mitigate the fall risk but unfortunately there were no OTs available to do the assessment. There were plenty of home modification companies ready to do the work, just no OTs to review/approve it. He fell in August 2023. Immediately after the fall we were able to access an OT via the hospital.

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    whitfords on 16/09/2024 - 18:58

    That is terrible about the delays in home modifications resulting in your dad's second fall. Sounds like they are reactive instead of proactive.

    I never really had much of an idea how bad the aged care system was until my dad's incident happened and we started looking into options.

    Can I ask if your dad was on managed or self-managed? I may have wrongly assumed that with self-managed you could find your own specialists to use or do you need to wait to use one that is affiliated with your provider?

    Good to know about my mum possibly being eligible for carer allowance. Every little bit will help. I also didn't even consider that private health would cover the beds/mobility aids so thanks for mentioning that.

    • 

      coffeeinmyveins on 17/09/2024 - 10:45

      I never really had much of an idea how bad the aged care system was until my dad's incident happened and we started looking into options.

      It gets worse, trust me.

    • 

      bmxr on 17/09/2024 - 13:00

      That is terrible about the delays in home modifications resulting in your dad's second fall. Sounds like they are reactive instead of proactive.

      The delays caused his first, and only, fall. The whole thing may have been prevented if we could get access to an OT within the 6 months prior to his fall t have the modifications done, one of which was a handrail and a smaller step at the front door, which is where the fall occurred.

      Best of luck for you and your family.

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  Protractor on 16/09/2024 - 18:31

  Avoid the church based trough lurkers and do (as many as you can) background checks to make sure the company has it roots and heart in WA and in your and your Dads interests.You don't want decision makers based online,offshore or interstate.
  Independent reviews, if you can find them. Unless you get resounding recommendations online (that you can verify) take them with pinches of salt.

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  holdenmg on 16/09/2024 - 19:00

  Hi,

  I have been through this (twice).

  I used https://www.careabout.com.au/ to assist me through the maze and help select a provider that has been exceptional.

  Back to your questions…

  Thoughts on fully vs self-managed options

  I'd go with Fully Managed because a HCP Level 4 is quite generous and it is better to have someone manage the whole thing.
  If someone leaves or goes on Holiday, they will find you someone.

  Home modifications: Is there usually a wait time for this?
  As a general rule, they have a list of providers they use. They have to get quotes, approval, and then the company has to schedule the work and order the materials.
  It doesn't happen overnight. But it does happen.
  Rails and ramps and things have Standards and not everyone does that sort of work.

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  Baron-K on 16/09/2024 - 19:58

  +1

  As a full time live in carer I've personally not got one positive thing to say about the home care package system, that said every case is different and sounds like you need more info you can trust, Facebook groups with real users/clients is where you should start….
  https://www.facebook.com/groups/828159324367118/
  https://www.facebook.com/groups/selfmanagedhcp
  …goodluck :)

  • 

    holdenmg on 17/09/2024 - 09:50

    Both the FB Groups you list say: "This group is paused"

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  coffeeinmyveins on 17/09/2024 - 10:44

  • Home modifications: Is there usually a wait time for this? I've briefly spoke to a rep of one provider at the hospital and they inferred that you couldn't get it done straight away which seemed odd.

  there is always a wait time with these things.

  My inlaws are on the waiting list to get on the home care packages and the wait list in NSW is approaching 12 months.

  We had to push push push to get some home modifications done.

  When you deal with this stuff you realise how poorly the elderly are treated and how much better it should be.

  Educate yourself on the scams that are "aged care facilities". They are designed to part your family with their money and offer very little in return.