People on the NDIS can build plans based on their goals and aspirations, why don’t we give older Australians the same opportunity?
As the public’s anger over the horrific revelations detailed throughout the final report of the Royal Commission into Aged Care Quality and Safety boils over, and the Federal Government swings into election mode, it may well be that approaches to reforming our broken aged care system feature as a key component of the different parties’ election platforms.
This could be an opportunity to really push for the things that matter most to older Australians who are increasingly being left behind in light of the more expansive model of support offered for younger Australians with disability under the NDIS.
I’ve heard many people say, ‘Why can’t we just include over-65s in the NDIS?’ This is a valid question.
Part of the reason why I cannot personally see this happening for most people who are currently supported by the aged care system is that the two systems are philosophically very different.
The NDIS as an insurance model is based on the idea that you provide a range of supports to people with disability as early as possible, giving them the greatest opportunity to eventually exit the scheme. The rationale is that a front-loaded investment saves taxpayer money in the long run. The NDIS is therefore geared towards upskilling people to exit the scheme, hence the emphasis on social supports, assistance to seek employment, goals and aspirations.
What works is that there’s a double benefit – cost savings to taxpayers and a more holistic approach to supports and services for people with disability. Theoretically everyone is better off.
In comparison, the aged care system has no incentives driving investment in participants. Sadly, in many ways, the aged care system is a mirror on how we generally view ageing and older people as a society. The system is built on the idea that participants will continue to need greater supports as they age, not less. Resources are allocated as they are needed (or is more often the case, well after) and funding is tight and lean, because resources will continue to be required over the lifetime of the individual. When you consider that this could easily amount to 25 years or more of increased investment, you start to understand the thinking that sits behind things like participant co-contributions.
What the aged care system doesn’t consider is that older Australians as a demographic are changing. Older Australians are healthier and more engaged in their communities through employment, informal and formal volunteer work and more.
There is an increasing argument that a person in the aged care system should have the same opportunity to access assistive technology supports to assist them in the workplace, and exercise choice and control in how the funds they receive are spent on the things that matter to them. Handrails and practical modifications to homes are important of course, but it might be equally important to attend that book club that allows for social engagement and gets you out of the house, or to access a powered mobility device to get to work.
It would be interesting to consider the true savings to be had if the aged care scheme were expanded on lines similar to the NDIS, particularly across health care and employment.
How many older Australians would maintain a better quality of life for longer if they had access to early intervention supports and rehabilitation services? How many would like to continue to work in some capacity, with adequate supports, past the age of 65?
I am reminded of a comment by my physiotherapist: ‘If you don’t use it, you lose it’. Currently we have a scenario where older Australians are being deprived of the opportunity to age well.
At the same time there is a serious problem, in that people who acquire significant disabilities that are not specifically age-related currently lose out on the supports that they vitally need under the aged care system.
There needs to be a way to support these people who are betwixt and between the two schemes.
As we move closer to the federal election, PDCN will look towards formalising our key asks and connecting with the various political parties to lock in some tangible commitments on reform of the aged care system.
If you have comments on what you think needs to be done to reform the aged care system, please get in touch with our policy team. You can reach us at firstname.lastname@example.org or 1800 688 831. Case studies and real-life examples have significant impact in our lobbying work, and we’d be grateful for any insights from our members and supporters.