Aged Care in Australia

History of aged care 1890 to 1900

• Destitute elderly were incarcerated in ‘protective’ asylums and given basic support (food and water)

• NSW records show that from 1890 to 1900 some of the number of inmates doubled. Due to relatives disowning their family older members some changed their name!

• These places were called asylums.• The Melbourne Benevolent asylum which

was dependent upon charity for finances inmate numbers tripled from 1891 to 1897 and those that couldn’t be accommodated we incarcerated in Pentridge prison

How aged care was provided in 1900’s

• In the early 1900’s many of the inmates of the old people’s asylum in NSW were older men.

• Many had been labourers without property or relatives to care for them

• In Australia at this time older women were more likely to be taken into families as unpaid help doing housework and child minding.

Before World War II• Before World War II and up

until about the 1950’aged care services developed through voluntary organisations with various religious and social philosophies.

• In Australia the Uniting Church, Red Cross and the Country Women's Association were heavily involved in caring for and advocating for the needs of elderly people.

After World War II• During World War II

taxation powers were handed over to the Commonwealth (previously collected by the states.

• Approximately 80% of all taxes are still collected by the Commonwealth because of this a large amount of financial power still rests largely with the commonwealth government.

The Aged Person’s Homes Act 1954

• The Federal Government entered the aged care field in 1954 with the Aged Persons Homes Act which provided capital subsidies to approved charitable organisations to provide essentially self contained and hostel type accommodation.

History of aged care 1962 - 1969

• The introduction in 1962 of a Commonwealth nursing home benefit heralded an explosion in the provision of nursing home care provided principally by the for-profit sector.

• With recurrent subsidies being extended to hostels in 1969 this resulted in a significant increase in the number of hostels constructed by the Church and charitable sector.

History of aged care1963 -1971

• This period saw a rapid growth in nursing homes when the number of nursing home beds increased from a national average of 29 beds per thousand people aged 65+ to 46.5 per thousand.

• However this growth was scattered and unevenly distributed and funded and led to very unequal access in different states.

1980’s Reforms

• During the early 1980 s there were four major reviews and inquiries into aged care services:– 1980 by the House of Representatives Standing

Committee on Expenditure Sub Committee on– Accommodation and Home Care for the Aged;– 1981 the establishment of a Senate Select

Committee on Private Hospitals and Nursing Homes;

– 1984 the establishment of a Joint Review of Hostel Care Subsidy Arrangements; and

– 1985 the Joint Review of Nursing Homes and Hostels.

What the Reforms of the 1980’s did

• The changes implemented from 1985 by the Labor Government came to be referred to with increasing frequency as the aged care reform strategy. The major objectives of this first wave of aged care reform were the reform of both home based care and residential care, the implementation of appropriate assessment strategies, an emphasis on improved access, equity and participation across a wide range of policy areas.

The Aged Care Act 1997 introduced the following

– Aged Care standards & Accreditation– Principles to guide assessment, eligibility and approval (ACAT)– An appeals process – The complaints resolution scheme and

funding of Advocacy services– The current funding targets – Community Aged Care Packages and Extended Aged Care

Packages– Accommodation Charges and Means Testing – Concessional Beds– Building Certification – Residential Classification Scale (RCS) – Ageing in Place

Aged Care Planning

• Since the 1980’s, the federal government has

planned and developed extensive strategies to

manage the increasing future demand for aged

care services

• Community care places and residential beds

allocated according to population changes

Aged Care Planning

• Places/beds allocated as 100:1000 persons over 70

• Broken up this wayLow Care

High Care

CommunityPackages

Aged Care Assessment TeamsACAT’s

• Assess older people who believe they need assistance with care to identify their needs and choose the available service that most suits their needs

• Assessment teams are comprised of people from a range of health professionals

Monitoring

• The Aged Care Act 1997 sets down what providers have to do for people in their care

• It also sets down what will happen if they fail to meet their responsibilities

• Gives the Department and its officers power to enter premises, conduct investigations, seize documents etc

Aged Care Funding Instrument

• Under the new changes to the aged care system in the strategy statement from the Department of Health and Ageing “Securing the future of Aged Care in Australia”

• ACFI will replace the RCS in 2008