Amid major national policy changes and a struggling system facing rising pressures, leaders in aged care came together to address the future of the sector.
A panel of leaders in the aged care sector came together at a Business News event to discuss how the sector should move forward amid significant changes impacting the nation.
The introduction of the new Aged Care Act and the Support at Home program from November 1, alongside a transition to a new Commonwealth Home Support Program from July 2027 has added turbulence to the care industry.
WA Health director general Shirley Bowen said the nation’s rapidly aging population has reached “uncharted territory” for all involved.
“Currently, one in six Australians are aged over 65 and this will go to one in four in 2066, 25 per cent of the population will be over 65,” she said.
WA Health has estimated more than 11,000 bed days per month are occupied by people with dementia, the leading cause of disease burden in people over the age of 65.
Shirley Bowen was complimented on her involvement in the aged care sector. Photo: John Koh
Graeme Prior is the co-founder and chief executive of Hall and Prior Aged Care Group, which operates 39 aged care communities around the country.
“Dementia is the one disease that's going to kill everyone,” he said on the first panel.
“It’s coming for you.
“It’s coming for your children.
“It’s coming for your grandchildren.”
The panels were moderated by Lavan Perth care and living law partner Amber Crosthwaite who stressed the need for certainty in revenue, capital and delivery.
“WA has the worst access to aged care in the country,” she said.
“We have some of the lowest ratios in the country for Home Care Packages, [Commonwealth Home Support Programs] and residential aged care.
“Over 9,000 Western Australians are waiting for home care, for essential services at the moment…”
“We’re 2,000 beds short right now in residential aged care.”
And building new infrastructure in WA faces further barriers as construction costs top the nation.
Panel one
The first panel explored the topics of confidence driving investment, funding following unified outcomes and stakeholders working as one system, not one sector.
The Australian National Aged Care Classification funding model was introduced in October 2022.
Chief operating officer Bethanie Annie Pathak said the care sector has been used to operating in conditions of regulatory uncertainty.
“In a relatively short period of time, we're going to be funded retrospectively, rather than prospectively,” she said.
Ms Pathak is calling for policy stability and funding alignment, noting 70-80 per cent of Bethanie’s revenue is directed to cover labour costs.
“So the funding that we are actually seeking means to not only cover the cost of the workforce, but also the cost of compliance and the cost of innovating in the future,” she said.
To address the severe shortfalls, Ageing Australia chief executive Tom Symondson was adamant co-commissioning between governments would be a sound response, but one Australia was unfamiliar with.
"When we're talking about ageing, the outcome needs to be something along the lines of that older people are able to live the life of their choosing with agency for as long as it is possible for that to be true, and when you start from that point, things start to line up," he said.
Panel two
A general consensus among panelists was a desire for a united vision not only among aged care providers, but disability, health, early childhood, veteran services, and housing providers.
Recently elected AMA WA president Kyle Hoath said this communication among stakeholders, which could be improved with the use of technology, would help identify key pressure areas in care.
"... We know when people step into care... even if that's staying at home, that's an exposure point [where] 70 per cent of people present with depression at that timeline," he said.
"If we know those things, we can then start to build capacity.
"Over time, [we can] be a little bit more proactive rather than reactionary..."
Mr Hoath has observed as individuals age, they receive less specialised care, leading to increases of preventable conditions.
Renae Lavell, Catherine Stoddart, Kyle Hoath and Stephanie Buckland on panel two focused on the realities of attempting to provide person-centred care. Photo: John Koh
"The de-prescribing of medication is another one in that inflection model moving into care," he said.
"... People accumulate medications or their doses aren't adjusted [leading to] the decline of renal function... and it provides risk factors for things like falls amongst many other things.
"That opportunity to intervene when we know there is a step change in risk, I think, is pretty important."
The state executive director of the largest home care provider in WA, Silverchain's Renae Lavell, said the not-for-profit is increasingly offering more allied health and clinical health care.
She said providers need to set up clinical governance to help tackle the complexity of needs.
Brightwater Care Group chief executive Catherine Stoddart felt the care sector has been treated as "subservient" to the health sector.
"The way that we are now funded in the residential aged care environment is slightly less sophisticated than the hospital system around recognising the weight and the complexity," she said.
"I think that's going to be really important in Support at Home.
"...But it's not sophisticated enough to pick up things like emerging dementia that is escalating over a period of six months with the rapid decline.
"… If we could actually have a mechanism that aligns to the way that health does it, so that we all understand it as we understand how health is done, I think that might allow for [transparent] discussions... about moving funds to go with the person."
Ms Stoddart looked to creative solutions that require courage from stakeholders to test different models in the sector.
"I think we need the agility thinking about different models as aged care evolves," she said.
"The concept of [Transition Care Program] plus or something similar, [which] might be additional clinical supports for some specialty services [or] ... additional care support..."
"I think there's innovative ways that we can test the models safely and have a go at it.
"But one of the things that sits behind all of this is the need for escalation in and out of different parts of the sector, and that's where there's a real opportunity with technology..."
Amana Living chief executive Stephanie Buckland was concerned the new Support at Home program would create additional challenges with wait times between assessment of individuals and providers carrying out the care plans.
She said wait times could be up to 12 months and the care plans require an array of services and skills.
"There's nursing services, there's knowledge and understanding of dementia, there is mental health understanding and the understanding for when we might need to refer a person for additional services if that's required, wound care, medication management [and] palliative care," Ms Buckland said.
"The home care provider is also responsible for doing the case management for that individual.
"So what is the right mix of services and who's going to be providing that service, whether it's a service that's being provided by the provider themselves, or subcontracted, in some instances, to an associated provider."
