Fees, contracts and duty of care: the bigger issues no one wants to talk about

The broader issue of aged care fees, contracts and duty of care has been discussed at length on LinkedIn this week, with a number of field leaders noting an absence of industry response following the media reports about retirement village operator, Aveo.

While the Retirement Living Council, part of The Property Council, was quick to put out this statement on Monday morning, no other association has issued a public statement, despite the reports also questioning Aveo’s residential care fees.

Following its initial response to the Fairfax and ABC media coverage over the last week, Aveo took out a full-page advertisement in The Australian yesterday.

Headlined, “The story not told by Four Corners”, the ad was presented as a letter from CEO Geoff Grady and contained the information from its ASX announcement issued earlier in the week.

The ad also noted that many Aveo residents are shareholders in the company and have indicated the reports have hurt their interests.

Inside Ageing understands that a number of retirement village operators have sent letters to clients this week clarifying their fee structures, terminology and reminding people to raise any concerns they may have directly with management.

Other providers – particularly broker services – have used the information vacuum as an opportunity to highlight the value of using such brokerage services, mostly through increased social media activity over the week.

On LinkedIn Dr Drew Dwyer, consultant gerontologist, educator and motivator, published a lengthy opinion piece on the social media platform on Tuesday, in a bid to “provide some feedback to followers and interested connections as a matter of leadership thinking and providing balance through understanding on the facts.”

While the post doubled as a timely promotion for his new book that came out last month, Dr Dwyer raised the broader issue of the difference between duty of care and the definition of care in a binding contract, and the assumption that consumers are educated and savvy about agreements they enter into.

Those who know me will know that I am a huge advocate for the rights of our elderly members of society. I am also an advocate for residential aged care , community care and service provision, the best outcome for the client, the workers and the providers. I have no personal interest in the company AVEO and have no conflict of interest in regards to the reports. However giving this story the wrong and unbalanced bias does nothing but damage to the industry itself and that something that I cannot join in the chorus of.

If you have experienced or worked inn (sic) the retirement living sector, you would have a clear appreciation of the rules and regulations of this sector of the industry. Given that the statutory regulations and rules are in need of a massive overhaul, the providers are in reality following the law.

The emphasis here would be to ensure that the elderly client looking to enter the retirement living space is educated and savvy on the pitfalls and traps that the agreements they would enter into to live in the village.

Villages traditionally attract the retiree who is active, independent and empowered to their rights for privacy, independence and being left alone to manage themselves as a small community. Aged Care is something they have usually not even considered and do not wish to talk about when engaged. 

There are a number of basic …….. and I do mean basic conditions that need to be understood and although they seem OK on the surface, I would not enter the agreement without my lawyers advice and neither should an elderly consumer as a mater of best practice.

The the (sic) first point of interest would be that CARE is not something that a retirement village would offer its fully independent resident as a matter of agreement.

Care services and servicing a unit would come at a cost and as such would be passed onto the tenant. These costs would be known, listed and understood, congruently also refused as they are high and offensive to the elderly resident.

Most residents in a village that I have worked with access support through each other or friends and family, unless of course it was included inline with the new CDC regulations and the resident was in full understanding that the village was an ‘age in place ‘ site and had the options to provide CARE services as assessed and managed through approved package providers or contracted brokered services.

In the story on the 4 Corners program it was obvious that the residents in focus were under a system of agreement that was not contemporaneous to modern models of service for the elderly and of course there were some obvious ‘read between the lines’ or the fine details of contracts that required a specialist in law for advice prior to signing.

It is sad that the proprietor, AVEO was taking full advantage of the laws and that the ethical intent to support the resident was lacking integrity and duty of care, however the fact remains that our elderly should be aware of the sticky situations as a consumer themselves and may have left their run too late to get out. Its a classic case of dotting i’s and crossing T’s, and choosing the right fit for your consumer needs and rights.

I noticed that one section of the report was detailing the current move for the proprietor to transform the villages into ‘age in place’ facilities to perhaps provide options for care services or the availability for full RACF services, however, this concept seemed to upset the residents of the village as they did not see themselves as ‘in need of aged care’ and they did not want their village to go this way.

In regards to this I say that the push and pull factors for supporting the growing ageing population is driving the market to open up to new business looking for the same money grabs.

COTA has pushed hard for the reforms in demand for different aged care models and at some point the, AVEO group will have to make the transition to include its current ageing client base for more and better services and the future independent consumer currently in the community looking for purpose build accommodation with services.

The game is on for the winner of the most customers as the market grows, being mindful that one glove does not fit all and any agreements will need the keen eye of a lawyer as at some point the customer is going to need more than just a roof over their heads.” 

This story has highlighted some of the more confrontational issues for the elderly consumer that needs the light placed on them to make the right informed decisions for their own lives in a balanced way.

The stoic notion that a person can remain fiercely independent in their choices and decisions in life no matter what, is not only silly, it is dangerous. Dangerous because not all humans are experts in all knowledge pertaining to ageing and wellness and not always do we make the right choices due to circles of influence and personal transitions.

Yes we learn through our mistakes and we can improve through that learning, however, not at the cost of health and wellness, safety and security of ourselves and others due to ignorance as a best policy.

 Our elderly who are independent and well in their active ageing are savvy and smart when it comes to their ideas about ageing independently and spending the money that they have.  

Unfortunately they do lack the contemporary knowledge that is needed to grow old in the modern world and also have open room for growth in their emotional intelligence to handle the complexity that ageing bestows upon us individually.

 As the numbers of elderly increase and every family will have to deal with their older loved ones at some point. I ask you all to take the 4 corners story with more balance than bias, and at least reflect on yourself, your situation, your needs, your wants and desires.

The world is changing fast in this space and the choices and decisions will not be so easy to make and not be as clean as they appear on the surface… Above all I think that seeking legal advice and support in accommodation, healthcare and welfare of the money is paramount and only fools will disagree.

One person commented, “Advocacy groups like COTA have been bleating for consumers to be given the ability to make decisions and take control … we need to realise that many are ill-equipped to do just that and this is the result. You can’t expect a full consumer driven market sector and have all the protections of regulation at the same time”.

Herein lies the challenge for providers, Government and associations negotiating the next stages of reform.


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