Just one in five older Australians with home care packages say all their care needs are being met

An “alarming” report for the aged-care royal commission has found less than a quarter of the people in residential care feel fully taken care of.

Australia’s troubled aged-care system is failing to fully meet the needs of more than three-quarters of older Australians in residential care, and even fewer of those receiving home care packages, according to an “alarming” report for the aged-care royal commission.

The Flinders University survey found only one in five Australians with home packages felt their needs were “always met”.

The research, led by Professor Julie Ratcliffe, said the survey of people in care also revealed only 24 per cent in nursing homes felt their needs were always met.

Even the proportion of those who felt those care needs were “mostly met” was just half of people at home, while in residential care, it rose to 58 per cent, said Prof Ratcliffe, an expert in health economics at the university’s Caring Futures Institute.

This is despite Australians spending about $25bn on aged care this financial year.

“The state of aged care in Australia is undeniably alarming,” concluded the report, which was released yesterday by the Royal Commission into Aged Care Quality and Safety, which will deliver its findings on February 26. The survey had asked people to rate their experience on key issues designed to determine how they felt about their care – a missing ingredient in assessments that usually focus on clinical issues like falls, fractures, pressure sores and prescription drug use.

The Flinders University survey found only one in five Australians with home packages felt their needs were “always met”.

It asked if they felt they were treated with respect and dignity; supported to decide themselves the care they received; helped to maintain social relationships; receiving support from staff with appropriate training; and able to make complaints that would be acted upon.

The reason for the higher level of dissatisfaction among people with support packages at home was not explained but could reflect the fact many receive a lower level care package than they have been approved for and need.

As well, monitoring of home care, where carers visit to provide services such as showering, cleaning and gardening, is far more difficult than in nursing homes, which have about 240,000 residents.

Poor care delivery would be much harder to monitor.

Yet top-level home care will be a major future priority for Australia since it is where most older people want to receive help. About 170,000 people now have home care packages, set at four different levels ranging from $9000-$52,000 a year, but there is a waiting list of 100,000 places. Prof Ratcliffe said the good news about the study was that it showed the value of questioning people receiving aged care about their personal views about the quality of care they received.

Combined with a related survey asking about the quality of their lives, it would provide a better picture of how well aged care was performing and drive improvements to the system.

“What we are missing here is the voice of the older person and their family,” she said. “Yet they are the most important voice.”

She said it was also important that a separate survey of the public showed that most Australians placed great importance on having a quality aged-care system, and had a similar view to people in care about what it should look like.

Most people also agreed the system needed to be fixed, and were prepared to pay for it.

“The majority of respondents (61 per cent) indicated they would be willing to pay more income tax to support aged care,” she said of the previously released study. “These taxpayers were willing to pay an additional 1.4 per cent on average to ensure … a satisfactory level of quality aged care and an addition 3.1 per cent per year on average to ensure that all Australians had access to a high level of quality aged care.”