Mobility issues and dementia are big instigators of last-minute aged care admissions
Hospitals can organise aged care assessments and place you in any available aged care bed they can find
A placement consultant or any form of preplanning can reduce, or prevent, unplanned entrance into an aged care facility
Sometimes life can take us by surprise and an unexpected move into aged care can be traumatic. You can't always know what is around the corner, yet, even checking out a couple of nearby aged care facilities is better than doing no research at all.
Otherwise you could end up in an unfamiliar aged care facility, far away from family, that’s not providing the type of accommodation and care that fits your needs.
Bina Brown from Third Age Matters, aged care placement and relocation service in Canberra, explains that being prepared to move into aged care will make the transition a lot easier than if it was a last minute decision due to an emergency.
While the emergency placement process isn't different too different from a normal placement process, she says everything is fast-tracked and doesn't provide you a lot of choices.
What can cause urgent entry into aged care?
Aged care caters towards older Australians who can't live at home by themselves anymore but aren't acute patients that require hospital care.
If you are living at home, mobility issues or dementia could be an indicator of needing higher intensity care. For example, if you are struggling to get out of bed, not able to make meals or cannot walk around for long distances, this could have an influence on whether you need aged care.
In many cases, fall incidents at home results in families having to find an aged care facility to take care of their older loved one.
If you are placed in a hospital for acute care, whether that is a sudden medical episode, fall or other major health issue, you can only remain there for a certain amount of time.
Depending on your condition, most hospitals would require you to vacate your bed approximately 5 days from admission.
You will not be discharged if you are not able to be left on your own, however, hospitals will start suggesting alternative accommodation.
Emergency admission or normal admission?
If you are in desperate need of aged care and can no longer stay at home safely by yourself, your Aged Care Assessment Team/Service (ACAT/S) will fast track your face to face assessment and referral code.
Once you receive your referral code, you can begin calling around aged care facilities to find an available bed.
"If you are in hospital, you are assessed by the ACAT team a lot quicker. But you would need to be assessed by the aged care team, if they haven't already come to you, then you would be assessed in hospital," says Ms Brown.
"Once you have a referral code, then you can apply and ring around aged care facilities and see who has got a bed. They will want that code and then it goes from there. How quickly you move in depends on your care needs."
Ms Brown says that placement can be incredibly swift, saying she has seen many clients placed and moved into a facility within two days.
If you already have an assessment and referral, you may not have to undertake another updated assessment. However, this is only the case if the initial visit from the ACAT/ACAS ticked that you were eligible for residential aged care.
Hospitals may not give you a choice
Every hospital has limited space within their facility, so having an older person in one of their beds after you no longer require acute care can lead to pressure from the hospital to move into aged care.
If your family prefers you to stay in the hospital, the fees will change and the hospital would require you to pay the same as if it was a residential aged care. This is currently $51.63 (as of January 2020) a day, or $722.82 for a fortnight.
"The hospital would say, ‘You are not acute, you could stay here as an aged care patient but we are going to charge you a daily aged care rate.’ That could be anywhere between $51.63 which is the standard, up to $150 a day… That tends to move the family along to look for aged care," says Ms Brown.
Even then, hospitals are not ideal for older people. There have been proven studies that hospitals can cause "hospital delirium" and is the most common case of hospital related complications in people over the age of 65.
If it is not safe for you to go back home, the hospital may ask the family to move their relative on to aged care.
Ms Brown says, "The hospital won't release you to home if they don't think you can look after yourself, they think you will end up back in hospital. That is when they say you need to go into residential aged care."
A hospital can bring in an assessment team to undertake a face to face assessment on behalf of their patient.
If the family has not made a decision by the deadline date, determined by the hospital, the older person could be placed anywhere that has an available bed. This could be further out than expected from their own home, or from family.
Additionally, if the older person already had an assessment with approval for residential aged care, a hospital may only give a family a day's notice on where they are placing your family member before being discharged from hospital.
Preparation is better for separation
Generally, most people moving into an aged care facility are aware of where they are moving, how the nursing home works or why they are there.
They will also be aware of the new available facilities, the size of their room and activities running at the home.
But if you have been placed last minute or by a hospital, you can be left completely confused and displaced.
"If you think there is a likelihood that you might have to go into residential care at some point, then it is really good to look at a couple of facilities so you can tell people what your preferred one would be," says Ms Brown.
In many cases, older people will be transferred to an aged care facility via an ambulance, which can be another trauma altogether.
"If you arrive in an ambulance and you have never been to the place, you might be in there for the first couple of weeks just recovering. That would be horrible," she adds.
She adds that aged care placement consultants can take all the stress out of choosing an aged care and can also prevent urgent admissions to unfamiliar nursing homes.
Even if a person has dementia, Ms Brown says that a placement consultant can gauge from a person with dementia's reactions if they like an aged care facility or not.
"Aged care placement consultants really are worth their weight in gold in terms of stress. It is such a big thing, it helps people take an element of control from themselves really," says Ms Brown.
Are you prepared for moving into aged care? What do you want in an aged care facility? Tell us more below.