Global GCoA Text Coalition on Aging Global Coalition on Aging RELATIONSHIP-BASED HOME CARE: A Sustainable Solution for Aged Care in Australia Outline 2.7M PEOPLE PROVIDE INFORMAL CARE IN AUSTRALIA Public expenditure on services for older people in the UK are expected to more than double by 2035. Research predicts an overall 1.1 million shortfall in professional care workers of 1.1 million by 2037. IN THE UK EXPENDITURE ON SERVICES FOR OLDER PEOPLE 11M AUSTRALIANS ARE PROJECTED TO BY 20358 BE LIVING WITH DEMENTIA 2.7M BY 20566 PEOPLE PROVIDE INFORMAL CARE IN 2.7M AUSTRALIA PEOPLE PROVIDE INFORMAL CARE IN AUSTRALIA SHORTFALL1.1M IN 21% INCREASE PROFESSIONAL TO $17 BILLION CARE WORKERS 2.7MAustralia’s Population Is Rapidly Ageing, At The Same Time, Australia’sBY 2037Care9 PEOPLELeading PROVIDE To An Increased Demand For Care Needs Are Becoming More Complex INFORMAL CARE IN 2.7M2.7M PEOPLE PROVIDEPEOPLE PROVIDE AUSTRALIA INFORMALINFORMAL CARE IN CARE IN AUSTRALIAAUSTRALIA 2066 Growth in Population 65 and older1 % Australians are living longer. 11M22 AUSTRALIANS% BETWEEN APPROVALS 15BRITISH: 2011 & 2017 ARE PROJECTED TO 11M INCREASED AUSTRALIA’S POPULATION 65 AND OLDER AUSTRALIANS WILL MORE THAN DOUBLE OVER 3.7M BE LIVINGThe number WITH of 8.7M 2 ARE PROJECTED TO 50% THE NEXT 40 YEARS. AustraliansdisabledDEMENTIA older peopleAustralians OF21% AUSTRALIANS 6 BE LIVING WITH INCREASE65+ LIVE WITH TO 23% 85+ SINCE MARCH is projectedBY 2056 to increase DISABILITY7 DEMENTIA $17 BILLION 201710 6 65+ BY 2056 2016 2056 2016 2066 between 11M11M 2015–2035 AUSTRALIANSAUSTRALIANS ARE PROJECTEDARE PROJECTED TO TO 65+ overtakes <14 0-14 BE LIVINGBE WITH LIVING WITH 11M DEMENTIADEMENTIA Birth rates are declining. 6 6 AUSTRALIANS 1.1M BY 2056 BY 2056 ARE PROJECTED TO SHORTFALL IN 21% INCREASE 65+ THE NUMBERPROFESSIONAL OF PEOPLE AGED 65 AND 1.1M BE LIVING WITH TO $17 BILLION SHORTFALL IN 21% OLDER CAREWILL OVERTAKE WORKERS THE NUMBER OF INCREASE DEMENTIA CHILDREN AGED 0 TO 14 YEARS BY AROUND PROFESSIONAL TO $17 BILLION 6 9 BY 2056 BY 20372025.3 PopulationCARE Ageing WORKERS Is Putting Australia Under Pressure 9 BREXIT: BY 2037 2025 2025 There could be SHORTFALL1.1MSHORTFALL1.1M IN IN 21%21% INCREASE INCREASE PROFESSIONALPROFESSIONAL TO $17 BILLIONTO $17 BILLION CARE WORKERSCARE WORKERS BY 20379BY 20379 Government Spend Home Care Demand in Increased Burden BETWEENfewer British APPROVALS on Aged Care the Aged Care Sector on Families More older1.1M adults are living alone. 2011 & 2017 SHORTFALL IN 21%workers in the INCREASED BETWEEN APPROVALS INCREASE 2011 & 2017 60+ 80+ care sector INCREASED 24% OF PROFESSIONALAUSTRALIAN ADULTS AGED 60 TO $17 BILLION 2/3 24% OF WHOM AND OLDER LIVE ALONE AND 15% OF CARE WORKERS OF21% AUSTRALIANS ARE WOMEN11 INCREASE TO 23% AUSTRALIANSBY WHO2037 LIVE9 ALONE ARE 60+ LIVE ALONE AND SINCE MARCH BETWEEN BETWEEN21% APPROVALSAPPROVALS $17 BILLION 10 2011 & 20172011INCREASE & 2017 TO 23% 80 OR OLDER.4 2017 INCREASEDINCREASED SINCE MARCH $17 BILLION 201710 2.7M PEOPLE PROVIDE 15% 21%21% INCREASE TOINCREASE TO 23%23% INFORMAL CARE IN ARE 80+ SINCE MARCHSINCE MARCH $17 BILLION$17 BILLION 10 10 AN ESTIMATED 2017 2017 AUSTRALIA 22B BY 20218,9 Loneliness is a growing challenge to BETWEEN APPROVALS AUSTRALIA IS STRUGGLING TO MEET THE RAPIDLY 2011 & 2017 Australians’ health and well-being. INCREASED GROWING DEMAND FOR IN-HOME CARE. 21% THE EFFECT OF LONELINESS ON HEALTH INCREASE TO 23% SINCE MARCHIS COMPARABLE TO THE IMPACT OF $17 BILLION 2017WELL-KNOWN10 RISK FACTORS, SUCH AS OBESITY, AND HAS A SIMILAR IMPACT AS IN 2012, 22% OF ALL CARERS WERE AGE 65 OR THE AGED CARE SECTOR FORMALLY CIGARETTE SMOKING.5 OLDER. NEARLY 20% OF OLDER AUSTRALIANS EMPLOYS ONLY 360,000 PEOPLE.13 PROVIDED CARE, AND 54% OF OLDER CARERS HAD SOME DEGREE AS OF 2018, 103,000 PEOPLE REMAINED ON 14 OF DISABILITY THEMSELVES.12 THE WAITLIST FOR A HOME CARE11M PACKAGE. AUSTRALIANS ARE PROJECTED TO BE LIVING WITH DEMENTIA BY 20566 SHORTFALL1.1M IN 21% INCREASE PROFESSIONAL TO $17 BILLION CARE WORKERS BY 20379 BETWEEN APPROVALS 2011 & 2017 INCREASED 21% INCREASE TO 23% SINCE MARCH $17 BILLION 201710 Relationship-Based Home Care Has Multiple Benefits Relationship-Based Home Care Delivers On Australia’s Promise Of High-Quality Care CARE ECOSYSTEM Relationship-based home care can help Australia sustainably address the growing challenges in aged care, ensuring that we continue to deliver the quality of care that our parents want and deserve. Relationship-based home care improves quality of care and lowers costs. Relationship-based home care enables coordination of care across the entire care team, WHAT IS RELATIONSHIP-BASED HOME CARE? including family members, physicians, nurses, and pharmacists. According to the Australian Commission on Safety and Quality in Healthcare, this type of patient-centred care improves Relationship-based home care is an innovative Relationship-based home care is innovative the quality and safety of care, decreases costs, improves satisfaction among care providers, type of care designed to deliver impact, not just in that it aims to keep care recipients healthy and improves the experience of the care recipient.15 inputs. It is organised around the needs of the and independent, in addition to addressing care recipient and his or her family, rather than any acute needs. By putting the individual around the completion of a predefined set of at the centre of a comprehensive care plan, tasks. Relationship-based home care is often relationship-based home care offers many referred to as outcomes-based home care or benefits to older adults and their families, as INDIVIDUALS & person-centred home care. well as to society. THEIR FAMILIES The extent to which older Australians and those who provide them with care engage Relationship-based care allows for greater trust and comfort in caregiving. collabora tively and purposefully, while also connecting emotionally, sits as the cornerstone of Research shows that meeting the emotional needs of individuals is just as important to their well- relationship-based home care. Lives that are connected through caring relationships have the being as their physical state.16 Relationship-based care supports continuity of care, which is critical to greatest opportunity to realise the outcomes we aspire to achieve. Relationship-based home supporting emotional health, particularly for those living with dementia.17,18 With relationship-based care is an approach we should all strive to emulate in supporting ageing in place. This should home care, the caregivers knows the care recipient, her needs and preferences, and often her family. be our commitment to an ageing Australia. SEAN ROONEY, CHIEF EXECUTIVE OFFICER, LEADING AGE SERVICES AUSTRALIA LTD. SOCIETY I spend a lot of time getting to know my clients, their history, and likes and dislikes so that I can tailor my care to best support them. I make a point of listening to their needs and expectations and I involve them with everything I am doing in their home, encouraging them to participate in activities even though it might be quicker to do the tasks myself. This enables my clients to retain some level of independence, which is so important for their self-confidence and well-being. BARBARA, PROFESSIONAL CAREGIVER, Relationship-based home care creates career opportunities and HOME INSTEAD SENIOR CARE AUSTRALIA improves job satisfaction and retention among professional caregivers. In 2016, care job vacancies in Australia exceeded applicants by 400%.19 A focus on relationship-based home care can help grow the pool of professional trained caregivers. I have been fortunate to have had the same caregiver assist me for many years. She under- Research from Europe and the US suggests that relationship-based care is more rewarding stands me, my family, and my interests, which enables her to encourage me, despite my heath for caregivers than giving them a checklist of tasks to complete.20,21 challenges, to remain as active as possible. With my caregiver, I am able to retain my indepen- dence and participate in all the activities and events that I wish to go to. NGAIRETTA, CARE RECIPIENT, HOME INSTEAD SENIOR CARE AUSTRALIA The Time To Act Is Now SOURCES 1Older Australia at a glance. In: Australian 9Aged Care Financing Authority. Sixth report 16Australian Commission on Safety and Quality Institute of Health and Welfare [website]. Can- on the funding and financing of the aged care on Health Care. Patient-centred care: Improv- With relationship-based home care, government and families can spend smarter on aged care, berra: Australian Government; 2017 (https:// sector. Canberra: Australian Government; 2018 ing quality and safety through partner- rather than simply spending more. Yet, much of the in-home care provided in Australia is task-based www.aihw.gov.au/reports/older-people/older- (https://agedcare.health.gov.au/sites/g/files/ ships with patients and consumers. Sydney: care, and few consumers know the difference. Below are several steps that our policy-makers and australia-at-a-glance/contents/demographics- net1426/f/documents/08_2018/acfa-sixth- ACSQHC; 2011 (https://www.safetyandquality. of-older-australians/australia-s-changing-age- report-2018-short-report-fa.pdf accessed 29 gov.au/wp-content/uploads/2012/03/PCC_Pa- leaders from across the aged care sector can take to help ensure that more Australians can benefit and-gender-profile, accessed 16 August 2018). August 2018). per_August.pdf, accessed 30 August 2018). from this innovative, outcomes-based, and personalised type of care: 2Older Australia at a glance. In: Australian 10More than 100,000 Australians waiting for 17Amjad H, Carmichael D, Austin A, Chang C, Institute of Health and Welfare [website]. Can- home care support “unacceptable.” In: Demen- Bynum JPW. Continuity of care and healthcare berra: Australian Government; 2017 (https:// tia Australia [website]. Canberra: Dementia utilization in older adults with dementia in www.aihw.gov.au/reports/older-people/older- Australia; 2017 (https://www.dementia.org.au/ fee-for-service Medicare.