In this guest post, Ricki Smith, CEO, Access Care Network Australia, shares her views on the Royal Commission’s Final Report and its response to reablement and rehabilitation. She draws comparisons with the United Kingdom where legislation is in place to deliver programs in this area.
While the Royal Commission recognises that reablement and rehabilitation should be a central focus of our aged care system, it’s disappointing that the Final Report fails to build a strong case for it to come to fruition anytime soon.
Implementing a complimentary period of reablement to all older Australians who have experienced a setback, period of hospitalisation, or have an increase in needs is a necessary and important step in providing them the support and care required to improve their function, adapt to their environment or develop and embed new strategies and enable them to maximise their independence. Supporting older people to regain and improve their physical function, independence, social connection, and improving their home environment has the potential to delay the need for expensive, or ongoing higher-level care.
The United Kingdom was so convinced in the effectiveness of the period of reablement that they legislated for it. There are now regulations in place that require intermediate care and reablement be provided for up to 6 weeks, along with minor aids and adaptations to the value of £1000 free of charge. This has proven to deliver positive outcomes for the older person as well as taxpayers.
Australia should adopt a similar approach where all older people are given the opportunity to participate in a reablement/restorative care stream at no cost to them before being considered for ongoing care. Moreover, while reablement and restorative care programs feature in the current aged care policy, such as Short Term Restorative Care packages, they are only available to those who qualify for it, as opposed to being available to all
If we want to reset our aged care system, respite and reablement must be available not only in the entry level support stream but across all levels to support quality of life planning, maximise functional independence and delay or prevent deterioration for older Australians as they age.
By implementing the proposed single assessment process and embedding an active assessment that incorporates reablement strategies, older Australians will have the best chance of adapting and improving their ability to live independently as long as possible.
Importantly by assessing and identifying long term care needs post the period of reablement, the funding required to support their ongoing needs is likely to more accurately reflect those needs. This would result in more efficient allocation of aged care funding to those who really need it and are waiting for support.
Although it will take longer to change the incentives for service providers to fully support their clients to embrace reablement strategies (as recommended by the Commissioner), our evidence has shown even changing the assessment process alone can have a significant impact on the health and wellbeing of older Australians, and on service demand.
Let’s bring ‘streamlined assessment’ back and quickly. But let’s also add more opportunities for our skilled hospital based teams to assist older Australians access short term reablement support immediately upon discharge from hospital with assessment to identify ongoing care needs occurring after that period of reablement. Older Australians, our health systems and taxpayers will all benefit.