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What will aged care look like in five years?

It has been a tumultuous 18 months in aged care with COVID-19 providing a stark look into the sector's areas of failure and where the system falls short.

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The Federal Government has introduced their Five Year, Five Pillar plan, which aims to fix the issues in aged care and provider better quality care to older Australians. [Source: iStock]

Last month, the Government rolled out its Aged Care Reform Plan in a bid to change the sector for the better over the next five years.

The reform plan is a direct response to the Final Report from the Royal Commission into Aged Care Quality and Safety released in March.

It outlines the huge changes that need to be made in the aged care system to bring about high quality care for older Australians.

We asked some of the main aged care peak bodies about where they think aged care will be in five years time.

The Government's five year plan

The Government's plan for aged care, unveiled at the same time as the May Federal Budget, consisted of five different pillars - home care, residential aged care services and sustainability, residential aged care quality and safety, workforce, and governance - and has been budgeted at $17.7 billion.

This plan scopes out the different reforms and strategies for each pillar and when they will be rolled out each year.

For instance, the Government has released 40,000 extra home care packages, a new supplement for nutrition of $10 per resident per day, up to 120,000 additional General Practitioner services through the Aged Care Access Incentive, up to 6,000 new personal care workers in workplaces, and has started to establish a Council of Elders. These are just a few of the reforms the Government has intended to implement by the end of the year.

The Government believes that once they reach the end of the Five Pillar, Five Year plan, they will have successfully made a "once in a generation reform" of the aged care sector.

You can see the full plan on the Government Health website.

Will the Government meet their promises?

Consumer advocacy body National Seniors Chief Executive Officer (CEO), Professor John McCallum, doesn't believe they will.

"It is a massive reform agenda. The timings will not be met. It is not a talented public sector to be able to meet such timings," says Professor McCallum.

"...I think the timelines will not be met, even though we will be holding them closely to them."

Professor McCallum says he would prefer that the targets in the plan not be met and done well, rather than have reform on the plan meet the timelines but not done properly.

He added that getting the ball rolling is going to be difficult for the Government, but once it starts, hopefully, the strategy should work.

"It's like pushing a rock, I think the momentum will be harder first, and then things will begin to move and start to fall into place… Getting it moving is the hard bit, and getting it moving in the right direction," says Professor McCallum.

Mary Patetsos, Chair of the Federation of Ethnic Communities' Councils of Australia (FECCA) believes that the Government's plan is a good start and does seem like a genuine attempt to respond to the Royal Commission recommendations.

"We certainly recognise this funding as an initial investment of funds and resources, that is a really good thing. What we think is under-invested in is workforce," explains Ms Patetsos.

"We believe the combination of growing numbers of older people, a tight workforce, and restrictions in terms of population growth/overseas migration, will place undue pressure on [workforce] numbers."

She believes that if these workforce areas are not improved on, then the reform will struggle to be established during the five year period.

Patricia Sparrow, CEO of industry peak body Aged & Community Services Australia (ACSA), is of a similar opinion. 

"Previous experience tells us that aged care reform and funding of aged care is not 'set and forget'. We all have a role to play and we need to hold each other accountable for the momentum and achievement of reform goals," says Ms Sparrow.

"If momentum is continued, we may get an improved rights based system that ensures all older Australians can age with dignity and get the supports when and where they need them. If momentum is lost and falls back to business as usual, it will have been a lost opportunity. Collectively, we have no intention of letting that happen."

If all goes well, what can we expect at the end of five years?

Ms Patetsos from FECCA believes that home care will be able to sustain people to live at home for as long as possible, and residential aged care will only be for more serious health cases.

"Residential care will look a lot more... like a quasi-hospital, you know, a quasi-health space. It will be much more reflecting people with comorbidities, complex health needs, probably palliation and rehabilitation," says Ms Patetsos.

"But residential care will be adjoined more to hospitals I think than it would be to home, because people will be able to stay at home for longer.

"People are not going into aged care well, just to have a meal and play bingo. They are really going into aged care because their health needs don't allow them to stay home, so the funding model needs to recognise the level of acuity and level of unwellness they are dealing with now in residential care."

She also thinks people will be able to move between systems a lot easier than before. So if people require a short hospital stay they can easily move back home, or someone moving into residential care for a time and then moving back home once they get better. 

Ms Patetsos describes aged care in five years as a more "multi-directional" system than we have previously seen.

Professor McCallum agrees with Ms Patetsos' comments about home care being the most common form of aged care in Australia in five years.

"There will be an expanded capacity to handle people at home because it is massively cheaper to [have] someone at home rather than put them into any sort of residential care," says Professor McCallum.

He believes the industry will be a system that not only speaks to people but people can also speak back to it. A system that can understand what people need and has capabilities to adapt to what people want as well.

Professor McCallum says, "The system is not going in the right direction if you are not respecting what older Australians want and think."

He adds that with all the new governance and system regulation in place in five years, the Council of Elders will be a critical part of the aged care sector providing a voice to the community and a powerful element for consumers.

Chief Executive of Council on the Ageing (COTA), Ian Yates, is positive about the changes to be put in place but doesn't believe Australia should expect aged care to be perfect by the end of the five year plan.

"It won’t be perfect yet, but it should be a lot better. For a start it will be much easier to get access to care," explains Mr Yates.

"You will get assessed quickly by a specialist aged care assessor, and with the help of “care finders” - real people who can help you face to face - you will get linked to services much faster than now, whether it's home care or care in one of a variety of housing options.

"For home care, there will be lots more of it - many more places than residential care - and you will receive a set of services designed for and by you jointly with your assessor."

Mr Yates believes that residential care as we know it will have changed for the better and  residents will be receiving more staff time from a better trained workforce.

He adds that residential care will look like smaller buildings that are designed to be more home-like. Additionally, consumers will have more control over the funding, as there will be no provider bed licenses anymore.

Craig Gear OAM, Older Persons Advocacy Network CEO, expects that in five years, depending on the success of the reform plan, older people will be able to access services they need without having to wait for care or receiving interim services.

He believes that, thanks to the new funding model, people will be able to access care they need that promotes their choice, control and self-determination without worrying about a cap on the funding they receive.

What do you expect the aged care system to look like in five years? Tell us in the comments below.

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