The massive ‘care gaps’ exposing Australia’s aged care crisis

For months, much of the conversation about at-home aged care has centred on co-contributions – how much you pay, and how you and your family copes as hourly rates reach $300 and contribution levels climb as high as 80 per cent.

That focus is understandable, but it risks missing a bigger issue. The government’s Support at Home program is often spoken about as though it will meet your care needs – provided you can manage your share of the bill.

That’s where the danger lies. The real challenge in home care isn’t just what you contribute – it’s what isn’t covered at all. Think of these as “care gaps”.

From the moment you apply, it can take up to 12 months to receive your Support at Home package. During that time, your care needs don’t pause. In that gap, you may receive entry-level services but beyond that, your options are limited: you either pay for private care or rely heavily on family and friends to step in.

Even when your package arrives, it may not reflect your current situation. Your funding is based on the assessment you completed months earlier – a snapshot in time. If your needs have changed since then, as they often do, your package will fall short.

There is also the reality of how assessments work. You are expected to clearly explain what you need, but many people find that difficult. You might downplay things out of pride, optimism or simply not realising what support is available. If that happens, you can end up with a lower-level package than you actually need.

Administration fees of up to 10 per cent reduce what’s available for services. Moreover, prices vary widely between providers.

And even if your needs are assessed correctly, you may not receive that level of funding straight away. Interim packages are common, which means you could be getting 60 per cent of what you’ve been approved for. The gap doesn’t disappear – it shifts back onto you and those around you.

To stay at home safely, your home may need significant modifications – widening doorways, full bathroom and kitchen re-modelling, installing lifts. These can cost tens of thousands of dollars, but the funding through your package is limited to $15,000. The rest is up to you.

Then there’s how much care you actually receive. Administration fees of up to 10 per cent reduce what’s available for services. Moreover, prices vary widely between providers.

If you don’t compare options carefully, you can end up paying more per hour than necessary or being locked into minimum visit times that don’t suit you. Many people find it is necessary to “top up” their package to meet their care needs.

None of this is to downplay the impact of co-contributions. They are real, and they can add up quickly. But focusing on them entirely risks creating a false sense of security – the idea that once they are known and budgeted for, the system will take care of the rest.

For many people, it doesn’t. The reality is this: if you want to stay at home, you need to plan not just for the cost of the care you will receive, but also for the care you won’t.

Rachel Lane is the author of Downsizing Made Simple, a book and website aimed at demystifying downsizing.

• Advice given in this article is general in nature and not intended to influence readers’ decisions about investing or financial products. They should always seek their own professional advice that takes into account their own personal circumstances before making any financial decisions.

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