Financial Care Services Newsletter

by Christine Hopper
Volume 13 Edition 8 – 31 August 2023

Christine at Financial Care Services, the specialist adviser to seniors in transition to new lifestyles

Help to stay at home

We are told by the media that seniors want to remain in their own homes for as long as possible and not to go into nursing homes.
No supporting evidence is offered by the media.

Maybe a substantial proportion of home owning seniors want to stay in their homes forever.

Staying in your fully updated home with level access to everything could be very comforting.
Staying home with an able bodied partner to provide companionship and share the household tasks is attractive.
For senior homeowners with good social supports, ‘help to stay at home’ could be all they need for gracious ageing at home.

In practice, the cost to governments is lower if seniors would stay longer in homes that they own.
Then they might only need just a little government funded ‘help to stay at home’.

What does ‘help to stay at home’ look like?

Just a little ‘help to stay at home’.

‘Help to stay at home’ could be as little as an able-bodied adult visiting for a few hours per week to help with hanging out the heavy laundry and cleaning the home.

A less robust senior could reduce her risk of falls and dehydration by being accompanied on routine outings.
Avoiding falls helps maintain dignity and willingness to engage in social activities.
A ‘personal care attendant’ could provide assistance with personal care and light household tasks.
A carer could also accompany a senior to the hairdresser, podiatrist and local shopping centre.

The ongoing costs to the government of the lower ‘help to stay at home’ packages could be more than offset by the savings on medical costs and hospital stays from doing it ‘my way’ alone.

When you need extensive ‘help to stay at home’

More frail seniors need significant levels of personal support and nursing care.

The highest level of ‘help to stay at home’ could cover daily visits from a registered nurse.

Qualifying for the highest level of ‘help to stay at home’ could imply incapacity for any household tasks.
Thus, recipients of the highest levels of ‘help to stay at home’ could be depending on family and close friends, to provide the domestic services.
An able-bodied person is assumed to be there to answer the door when the nurse arrives.

The resident carer would also bring the meals, hot drinks and clean clothes then clear away the used items.

If you have no able-bodied person living with you then the highest level of the Commonwealth subsidized ‘help to stay at home’ package might not fund all of the personal care and domestic help that you need to remain at home safely.

Your options could include using your own money to purchase additional services, inviting a family member to live with you as your carer or moving into residential aged care.

Financing ‘help to stay at home’.

The Commonwealth funds Home Care Packages to provide seniors with subsidized ‘help to stay at home’.

The Commonwealth contributes to ‘help to stay at home’ packages at fixed maximum amounts for each level of ‘help to stay at home’ package.

Seniors must to be assessed by ACAS as needing a particular level of ‘help to stay at home’ Home Care package.
Then they join the queue to actually be allocated a Home Care package at their assessed level.

You might need to wait many months for a ‘help to stay at home’ Home Care package at your assessed level to become available.
You might be able to access a Home Care package at a lower level while you wait for a ‘help to stay at home’ Home Care package at your assessed level to become available.

For example, you might accept a Level 2 Home Care package to get some subsidized carer help while you wait to be allocated a Level 4 Home Care package.

The care recipient contributes a fixed Basic Daily fee plus an income tested fee to fund her of ‘help to stay at home’ package.
The Commonwealth contributes to ‘help to stay at home’ packages at fixed maximum amounts for each level of ‘help to stay at home’ package.
The Commonwealth subsidy is reduced by the amount of care recipient’s Income Tested fee that the care recipient could pay.

The care recipient and/or her family, together with their chosen home care provider determine how the ‘help to stay at home’ package is to be ‘spent’.

If the care recipient chooses not to pay the Income Tested fee towards her of ‘help to stay at home’ package then the amount available to spend is reduced by the amount of the unpaid part.

How much does the Commonwealth pay towards Home Care Packages

The Commonwealth sets subsidy rates for of ‘help to stay at home’ packages.
The amount of subsidy allocated to an individual Home Care Package consists of a Basic Home Care Subsidy together with any Supplements applicable to that care recipient.

Care recipients with significant challenges arising from dementia and/or impaired cognition could be eligible for a ‘Dementia and cognition supplement’ to their Home Care package.
The ‘dementia and cognition supplement’ also has four levels reflecting the different additional care needs of seniors’ cognitive decline.

The Commonwealth reviews the Home Care Subsidy rates each year.

Home Care Daily Subsidy Rates from July 2023

Home care package level	Maximum Basic Home Care Subsidy	Dementia and cognition supplement
Level 1	$28.14	$3.24
Level 2	$49.49	$5.69
Level 3	$107.70	$12.39
Level 4	$163.27	$18.78

Additional subsidies are available for care recipients who require oxygen and/or enteral feeding.

Care recipients’ contributions to their ‘help to stay at home’ packages

All home care packages require the care recipient to pay a Basic Daily Home Care fee.
The amounts of the Basic Daily Home Care fee are different for each Home Care Package Level.

Home care package level	Basic Daily Home Care fee	Maximum Daily Home Care Subsidy	Maximum daily spend on home care Excluding Supplements
Level 1	$10.88	$28.14	$39.02
Level 2	$11.50	$49.49	$60.99
Level 3	$11.83	$107.70	$119.53
Level 4	$12.14	$163.27	$175.41

Income Tested Fees for ‘help to stay at home’.

Home care recipients who have more income then a full Age Pensioner could have are also asked to pay an Income Tested Home Care fee.

Your Income Tested Home Care fee calculation is complex.

The Income Tested Home Care fee takes half of your fortnightly income in excess of what a full Age Pensioner could have.
But the total amount of your Income Tested Home Care fees are subject to daily and annual caps.

Centrelink undertake the calculation of Income Tested Home Care fees.
Centrelink use the Income and Asset data that you provided for your Age Pension means test assessment.

If you do not qualify for a means tested Pension from Centrelink or DVA then you need to submit Income and Asset information to Centrelink to have your Income Tested Home Care fee calculated.

Therefore, Blind Age Pensioners and self -funded retirees are asked to provide their asset and income information to Centrelink.

If you choose not to engage with Centrelink then you would be assigned the maximum rate of Income Tested Fee for your Home Care Package.

Current maximum Income Tested Home Care fee rates

Seniors who receive the full rate of Age Pension do not pay any Income Tested Home Care fees.
Full rate Age Pensioners do not have any excess income to be hit.

Seniors who receive a part Age Pension pay an Income Tested Home Care fee similar to half of their extra income over what a full Age Pensioner could have.

The maximum Income Tested Home Care fee an Age Pensioner could be charged is $17.42 per day in August 2023.
Seniors who are not Age Pensioners could be asked to pay up to $34.84 per day in August 2023, as an Income Tested Home Care fee.

Using your Home Care Package

Once you have been allocated a Home Care Package, you need to link up with a home care provider to manage your package.
The care recipient and/or her family negotiate with their home care provider about their actual ‘help to stay at home’ services.

The home care provider could be allowed to charge a ‘package management fee’.
The package management fee and the hourly rates for the different types of home care services must be shown in your service agreement.

Then the balance of your Home Care Package money is available for you to ‘buy’ services from your home care provider.

Remember that if you choose not to pay the Income Tested Fee then your Home Care Package would collect less money for you to spend on home care services.

Funding your own home care

Seniors are free to arrange and pay for the help they want in their homes.
Self-funded retirees could contract with the same service providers that deliver the Commonwealth subsidized ‘help to stay at home’ packages.

Alternatively, you could engage nurses, carers, cleaners and gardeners from different providers if you so choose.
Under this approach, you would contract directly with each service provider and pay for the services that you chose.

Expect to pay at least $70 per hour of a ‘personal care attendant’ during ‘ordinary hours’ Monday to Friday.
Then allow for significant loadings for evening visits and any services on weekends and/or public holidays.

Higher charge rates apply for Registered or Enrolled nurses to visit your home.
You might need a nurse to attend to bed sore and other wounds or dispense medications.

When ‘help to stay at home’ is not enough

As a general rule, you could ‘stay at home with help’ provided that you always managed your own toileting needs well.
That means always getting to the bathroom in a timely and dignified style, without the risk of falling on the way.

In contrast, residential aged care could be appropriate if you cannot get up out of your chair and take yourself to the bathroom without being assisted or prompted.

Secure residential aged care could be the most appropriate home for a senior who is becoming aggressive and/or extremely agitated.
When the executive part of your brain becomes unreliable then secure residential aged care could be necessary for the safety of yourself and your family.

Remember, arranging a loved one’s admission to residential aged care is showing your practical concern for her wellbeing.
This is not a moral judgment but the provision of essential care and protection.

When staying home is not the smart option.

Not every senior lives with an able-bodied family member in their own comfortable home providing easy level access to all amenities.

Many seniors might be living alone with no family close enough for daily visits.
Some seniors might have older homes with the only bathroom upstairs and the only kitchen downstairs.
Other seniors might be renting an older style walk-up flat which is expensive to heat.

Thus for many seniors the warmth, care and companionship of residential aged care could be very attractive.

The first step towards aged care help is to arrange an ACAS Assessment.
Your ACAS Assessment report sets out the types of Commonwealth aged care help that you could get now.

If you are becoming anxious about staying in your present home, then you could try some respite or restorative care in a residential aged care facility.

Help to understand the costs of aged care for your family

Christine at Financial Care Services helps clients to understand the costs of using Home Care packages and/or placing a family member into residential aged care.

Christine could illustrate the various accommodation costs and means tested care fees that could be levied for your preferred aged care place.
You could ask Christine to illustrate some different Accommodation Room Prices so that you do not sign up for a place that would unduly stretch your family finances.

Contact Christine Hopper or call +61 3 9808 0338 to arrange an aged care consultation.

Christine at Financial Care Services your independent adviser

Christine at Financial Care Services is an independent adviser specialising in retirees of modest means and aged care entrants.
Our core values include working with clients in claiming DVA and Centrelink entitlements.

Christine at Financial Care Services is here to answer your Health Card and Age Pension questions and guide your understanding of aged care costs.

Help with Centrelink challenges is available from Christine Hopper at Financial Care Services, the specialist adviser to seniors in transition to new lifestyles.

Christine has neat handwriting just right for inserting your data into small printed spaces.
She helps clients complete Centrelink forms.
Christine could help you with collating your supporting documents and then mailing your form to Centrelink.

Assistance with completing Age Pension, Low Income Health Card and Commonwealth Seniors Health Card Claims and the Commonwealth aged care means testing forms is available to clients of Christine at Financial Care Services.

Christine charges fees based on the work involved in advising you about health cards, pensions and aged care fee solutions.

To make an appointment for confidential, independent and professional advice about aged care, retirement lifestyle costs, granny flat or Age Pension issues please contact Christine Hopper or call +61 3 9808 0338.
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Christine Hopper
Financial Care Services
Independent aged care, strategic lifestyle and Social Security advice for seniors in Melbourne, Victoria, Australia
Telephone – call +61 3 9808 0338
Email – contact Christine@financialcareservices.com.au
Address – mail to 2B Thomas Street, Camberwell Victoria 3124
Website – visit financialcareservices.com.au
LinkedIn – connect https://www.linkedin.com/in/christinehopper1
Past newsletters – see http://financialcareservices.com.au/newsletters/
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Disclaimer: The information contained in this newsletter is of a general nature only and does not constitute “financial advice”.
All eligibility for Commonwealth benefits will be determined by Centrelink or DVA, based on your personal position as documented and the legislation and Regulations in force at that time.