CARE AND SUPPORT

5.1 Introduction
5.2 Care in the Home
5.3 Cared Accommodation

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5.1 INTRODUCTION

The growing number of older people in our society is expected to lead to an increase in demand for care and support services.

Over recent years there has been a focus on providing care to people in their own homes rather than in institutional settings. This is in response to the preference of most people to continue to live at home in the community.

There are a number of Government funded programs that provide care and support to people in the community. The largest is the Home and Community Care (HACC) program, which is a joint Australian, State and Territory Government initiative to help people in need. The HACC program helps frail older people and people with a disability, who would otherwise be prematurely or inappropriately admitted to residential care, to live independently in their own home.

Three smaller community care programs, funded by the Australian Government, assist people who have been found to be eligible for residential aged care. These programs are:

• the Community Aged Care Packages (CACP) program, which provides support services for older people with complex needs living at home who would otherwise be eligible for admission to low-level residential care;
• the Extended Aged Care at Home (EACH) program, which aims to deliver care at home that is equivalent to high-level residential care; and
• the Extended Aged Care at Home Dementia (EACH Dementia) program, which provides the equivalent of high-level residential care in the home to frail older people who experience behaviours of concern and psychological symptoms associated with dementia.

In addition to community based care, aged care facilities continue to provide residential aged care to older people whose care needs mean they are no longer able to remain in their own homes.

This Chapter presents information on the people who are currently receiving community based or residential care through the programs outlined above.
5.2 CARE IN THE HOME

In 2006-07, people aged 65 years and over made up 80% of all HACC clients in NSW. The highest proportion of HACC clients were aged 85 years and over (25%), with more females than males using HACC services within this age group (26% and 21% respectively).

The proportion of HACC recipients living alone increased with age, from 34% of clients 65-74 years old to 48% of clients aged 85 years and over. The average hours of HACC services per month per client varied between 44 hours for persons 65-74 years and 48 hours for those aged 85 years and over.

5.1 HOME AND COMMUNITY CARE CLIENTS (HACC), By age and sex, NSW - 2006-07
	Males	Females	Persons(a)	Males	Females	Persons(a)
Age group (years)	'000	'000	'000	%	%	%
0-49	8.9	11.3	20.4	12.4	8.2	9.6
50-54	2.1	3.2	5.4	2.9	2.4	2.5
55-59	2.9	4.4	7.4	4.0	3.2	3.5
60-64	3.9	6.2	10.2	5.5	4.5	4.8
65-69	5.3	9.4	14.9	7.4	6.9	7.0
70-74	7.7	14.4	22.4	10.8	10.5	10.6
75-79	12.3	23.2	36.0	17.2	16.9	17.0
80-84	13.5	28.8	43.0	18.7	21.0	20.3
85 and over	15.2	36.1	52.0	21.1	26.3	24.6
Total persons	71.9	137.2	211.7	100.0	100.0	100.0
(a) Includes clients whose sex was unknown.
Source: Home and Community Care Minimum Dataset, Department of Ageing, Disability and Home Care, 2006-07.

Community Aged Care Packages (CACP) and Extended Aged Care at Home (EACH) services provide support to people in the community instead of in a residential aged care setting. In 2007, most recipients of both types of packages were aged 75 years and over (83% of CACP clients and 74% of EACH clients). The majority of recipients aged 75 years and over were females (75% of CACP and 65% of EACH clients).

5.2 COMMUNITY BASED AGED CARE PACKAGE RECIPIENTS, By age and sex, NSW(a) - 2007
		Community Aged Care Packages (CACP)						Extended Aged Care at Home (EACH)
		Males	Females	Persons	Males	Females	Persons	Males	Females	Persons	Males	Females	Persons
		no.	no.	no.	%	%	%	no.	no.	no.	%	%	%
Age group (years)
	0-49	16	33	49	0.5	0.4	0.4	3	3	6	0.9	0.5	0.6
	50-54	32	35	67	1.0	0.4	0.6	4	4	8	1.1	0.7	0.8
	55-59	54	76	130	1.7	0.9	1.1	1	6	7	0.3	1.0	0.7
	60-64	96	176	272	3.0	2.0	2.3	10	20	30	2.8	3.3	3.1
	65-69	197	391	588	6.2	4.4	4.9	26	47	73	7.4	7.6	7.5
	70-74	295	676	971	9.2	7.7	8.1	61	68	129	17.3	11.1	13.3
	75-79	540	1 355	1 895	16.9	15.4	15.8	94	102	196	26.7	16.6	20.3
	80-84	728	2 273	3 001	22.8	25.9	25.0	55	122	177	15.6	19.8	18.3
	85-89	761	2 262	3 023	23.8	25.7	25.2	55	116	171	15.6	18.9	17.7
	90-94	397	1 204	1 601	12.4	13.7	13.4	35	91	126	9.9	14.8	13.0
	95 and over	83	306	389	2.6	3.5	3.2	8	36	44	2.3	5.9	4.6
Total persons		3 199	8 787	11 986	100.0	100.0	100.0	352	615	967	100.0	100.0	100.0
(a) NSW is the location of the outlet providing the service.
Source: Australian Institute of Health and Welfare, Aged care packages in the community, 2006-07, Aged Care Statistics Series Number 27, August 2008.

5.3 CARED ACCOMMODATION

Since 1996, the number of people aged 65 years and over living in hostels for the disabled, nursing homes and retirement villages has increased. On the other hand, the number of people aged 65 years and over living in accommodation for the retired or aged (not self-contained) has decreased.

5.3 PERSONS AGED 65 YEARS AND OVER LIVING IN SELECTED ACCOMMODATION(a), NSW
	1996	2001	2006	1996	2001	2006
	no.	no.	no.	%	%	%
Nursing home(b)	26 666	27 259	32 923	40.1	37.5	38.7
Accommodation for the retired or aged (not self-contained)(c)	19 646	18 618	18 126	29.5	25.6	21.3
Retirement village (self-contained)	18 918	25 439	32 340	28.4	35.0	38.0
Hostel for the disabled	728	1 021	1 186	1.1	1.4	1.4
Psychiatric hospital or institution	419	318	343	0.6	0.4	0.4
Hostel for homeless, night shelter, refuge	194	66	84	0.3	0.1	0.1
Persons aged 65 years and over living in selected accommodation	66 571	72 721	85 002	100.0	100.0	100.0
Total persons aged 65 years and over	762 902	828 475	901 717	. .	. .	. .
. . not applicable
(a) Based on location on Census night. Excludes overseas visitors.
(b) Includes high level care accommodation.
(c) Includes low level care accommodation.
Source: ABS data available on request, Census of Population and Housing.

In NSW in 2006, 32,923 people aged 65 years and over spent Census night in a nursing home; an increase of 23% since 1996. The growth, between 1996 and 2006, of the number of older people living in other types of accommodation may partly explain the comparatively small growth in the proportion of the older population in nursing homes. For example, in the 10 years to 2006 there was a 71% increase in the number of people aged 65 years and over living in retirement villages.

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