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Before people are able to access most government-funded aged care services, they undergo an assessment. Aged Care Assessment Teams (ACAT) conduct assessments in line with the government's Aged Care Assessment Program (ACAP) guidelines and relevant legislation, and approve people for entry into the aged care programs that operate under the Aged Care Act 1997—these are residential aged care (permanent or respite), Home Care and Transition Care. The Commonwealth Home Support Program is accessed through a Regional Assessment Service.
At 30 June 2016, 80 ACATs operated across Australia. The teams are based in hospitals or in the local community, and they are generally made up of—or consult with—a range of health professionals. There are no age limits to assessments, as ACATs carry out comprehensive assessments of people’s circumstances and care needs, and identify the most appropriate ongoing supports.
For more information, see Accessing aged care services. Information on assessments undertaken in permanent residential aged care is available through Care needs in residential aged care.
In 2014–15, over 167,000 people had at least one completed ACAT assessment, almost all of whom were aged 65 years and over (96%) .
Half (50%) were aged between 65 and 84 and almost half (46%) were aged 85 and over.
3 in 5 (60%) were women.
1.4% were Indigenous.
1 in 3 (33%) were born overseas, with non-English speaking countries of birth accounting for over three-fifths (63%) of this.
More than 2 in 5 (44%) had a co-resident carer, most commonly their spouse or partner.
Around 1 in 10 (11%) had a DVA entitlement (such as a health card).
Source: NACDC .
People’s living arrangements at the time of assessment varied. More than 8 in 10 (86%) people were usually living in a private residence at the time of their assessment. For 11%, their usual residence was a retirement village—includes persons living in self-care or independent-living units within a retirement village. Overall, 2 in 5 (45%) people lived alone, and the likelihood increased with age—39% of people aged 65–74, 40% of 75–84, and 51% of those aged 85 and over lived alone. Women were also more likely to live alone (53%, compared with 34% of men) .
The 6 most common main health conditions recorded on assessment were dementia (15%), musculoskeletal disorders (8%), injuries (8%), cancer (8%), cerebrovascular disease (6%, primarily stroke), and nervous system disorders (6%). Among these broader groupings, some specific conditions were common—arthritis was the most frequent musculoskeletal disorder, fractures the most common injury, lung cancer the most frequently specified type of cancer, and Parkinson’s disease accounted for the majority of nervous system disorders .
There were around 182,000 completed ACAT assessments in 2014–15—some people may receive more than one assessment in a year. Around 44% of ACAT assessments were completed within 1 week of a referral being received. On average, for ACAT assessments completed during that year, it took almost 18 days from the day the referral for assessment was received to its completion .
ACAT assessments are a comprehensive assessment of a person’s physical, medical, psychological and social needs, and they identify whether people have activity limitations in 10 specific activities (self-care, movement, moving around, communication, health care tasks, transport, social or community participation, domestic duties, meal preparation and home maintenance). Almost all completed ACAT assessments identified limitations that required the help or support of another person in more than one of these activities—there were only 1,955 (1.1%) assessments where the person was assessed as having no limitation in any activity. Most commonly, assessments identified activity limitations in domestic duties (95% of all completed ACAT assessments), transport for getting to and from places (90%) and social or community participation (88%) .
ACAT assessments make recommendations regarding future needs and support services. This includes recommendations for assistance for specific activity limitations, and for specific government aged care programs or supports, as well as recommending the most appropriate long-term care setting for the person assessed.
The majority of completed assessments recommended private residence or residential aged care as the most appropriate settings (Figure 1). The majority (86%) of completed ACAT assessments were undertaken for people who usually lived in a private residence, and for more than half of these (56%) a private residence was recommended as the most appropriate long-term care setting, while for most of the remainder residential aged care was recommended (29%). (Figure 1).
Source: NACDC .
In addition to recommendations for formal support from specific government-funded aged care programs, ACAT assessments provide the required approval for accessing these services, such as permanent or respite residential aged care. It is possible that an individual can have a recommendation and approval for different services—for example an individual may have an approval for permanent residential aged care (as it is likely they will require this in the future) but they are currently still being recommended to live at home.
More than 98% of completed assessments resulted in approval for at least one aged care program—there were just 2,452 (1.4%) completed assessments with no approval for any program—and approvals for more than one program were common. Overall, more than two-thirds of completed ACAT assessments in 2014–15 concluded with approval for either respite or permanent residential aged care (75% and 67% respectively). Combined, approval was given for both permanent and respite residential aged care in 59% of completed assessments .