Category: Elder Advice

A look at dying well


It is the last thing that you will ever do, so why not do it well?


How we can die better

The Grattan Institute, a Melbourne think tank, issued a report on dying well. The report shows that, although 70% of people want to die at home, only 14% do. Well worth a read but as you may not have time, we have picked out the best parts for you.

The key recommendations of the report are:

1. Implement a national public education campaign on the limits of health care and end-of-life decision making.
2. Ensure end-of-life discussions and plans occur by introducing incentives and services at relevant touchpoints (e.g. 75+ health reviews and entry into care).
3. Better coordination and implementation of end of life plans to ensure end-of-life plans are followed (e.g. legalise them).
4. Provide home-based support for carers to support people to die at home rather than in a hospital or a residential facility. This is done with an additional 39,000 palliative care services which would be overall cost-neutral.


What does a good death look like?

Recently, there have been some findings on what a good death looks like. Here is what some experts say, taken in turn from Smith, R. (2000) ‘A good death’, British Medical Journal, 320 (15 January).

  • To know when death is coming, and to understand what can be expected
  • To be able to retain control of what happens
  • To be afforded dignity and privacy
  • To have control over pain relief and other symptom control
  • To have choice and control over where death occurs (at home or elsewhere)
  • To have access to information and expertise of whatever kind is necessary
  • To have access to any spiritual or emotional support required
  • To have access to hospice care in any location including home, not only in the hospital
  • To have control over who is present and who shares the end
  • To be able to issue advance directives that ensure wishes are respected
  • To have time to say goodbye and control over other aspects of timing
  • To be able to leave when it is time to go, and not to have life prolonged pointlessly

This fairly summarises what our clients tell us. Let’s hope this report gains some traction.

If you wish to read the full report, you can find it here.

If you or someone you know wishes to do an advanced care plan, call us on 1800 500 780.

Until next time

Margaret Harrison

Organising a break for carers


Carers need a break

Carers provide countless hours of care and support for our ageing population.  Sometimes they need a break.  This can be organised through respite care.


Respite options

There are different types of respite which are outlined below:
1. In Home Respite, this is when a carer comes into your home so the carer can get a break for a few hours or the carer can take the person requiring respite out for a while. This type of care can be delivered during the day or overnight.
2. Centre Day Based Respite. This respite takes place at a day centre or club. It offers activities and outings and usually runs between 10 am – 3 pm. Some of these centres offer a pickup and drop off service as well.
3. Residential Respite Care. This is for individuals who need help every day and therefore enter into an aged care residential facility or a supported residential service for a short stay. This can be planned for a rest break or the carer may be going on a holiday.

Residential Respite Care can be paid for privately (cost varies from facility to facility) or through subsidised services.  It can cost as little as about $50 per day. In order to have access to a subsidised bed care recipient must have an ACAS assessment approving respite. ACAS is a free service and an assessment can be organised by calling My Aged Care on 1800 200 422.

Residential Respite Care that is accessed through an ACAS entitles individuals to up to 63 days respite per financial year, most aged care residential facilities require respite to be taken in 2-week blocks.

Not all aged care facilities have respite beds available to be booked in advance so plan ahead and make a booking.


Carer Gateway

Carer Gateway is a Commonwealth Government funded service which provides help and assistance for carers.  You can talk to them about what services are available in your area and they can assist with finding respite care in an emergency.  You can contact Carer Gateway on 1800 422 737 or more information is available here.

If you need help organising a break, call us on 1800 500 780 and we can help.


Until next time
Margaret Harrison

Aged Care fees and charges explained simply

Since the Living Longer Living Better changes to aged care fees and charges came into effect on 1 July 2014, the costs of aged care have become very complicated and confusing. It is easy to find information about the costs of residential aged care by just doing a google search or going on to the website. But understanding those costs is a different matter altogether.  To save you that trouble, in summary, here are the 4 components to the costs of aged care:

  1. Daily care fees which every resident pays. These are pegged at 85% of the full aged pension, currently $52.25 per day and revised every March and September;
  2. Means tested care fee which, as the name suggests, are calculated using a complicated formula on the resident’s income and assets. The formula complicated due to the convoluted definitions of the various elements and the rules around what is included and excluded from each of the elements. They vary from $0 per day to around $260 per day;
  3. Extra services or additional services fees which some facilities (but not all facilities) charge. These fees have no bearing on the care provided; they are just extra or additional services such as wine with meals or newspapers. These items can usually be purchased independently of the facility. If you are considering a facility with these charges, ask what the resident gets for those charges and work out whether it is worth the cost.
  4. Accommodation Payment (what used to be called the bond). This can be paid to the facility in whole or in part as either cash which is called a Refundable Accommodation Deposit (RAD) or as a Daily Accommodation Payment (DAP). The DAP is calculated as an interest payment on the amount of Accommodation Payment that is not paid as a RAD. The interest rate is fixed by the Government, currently 4.1% per annum, and paid on any part of the Accommodation Payment that is not paid as a RAD for each day in care. The RAD is guaranteed by the federal government and refunded when the resident leaves the facility.

You pay some or all of these charges, depending on the resident’s means and whether the facility charges extra services or additional services fees. The aged care residential facility, in conjunction with Centrelink, will work out the payments for you if you want them to or if you do not take control. Residents will most likely but not always need to complete the Centrelink assessment form and aged care residential facilities now often hand them out during a tour of the facility and want them filled out before the resident is admitted. However, it is not their job to optimise these costs. There are numerous ways to ensure that you are not paying more than you should for aged care and every situation is different. It is nigh impossible to work out how to do it unless you are an aged care specialist financial adviser.Pensions are affected by how aged care is funded and paid for. How the resident organises the funding of aged care can be to their financial detriment. Seek advice from a specialist in aged care. We are experts and we can assist.


Until next time
Margaret Harrison