Community-based aged care
Home based aged care services are a vital resource for supporting older Australians to remain living in their own home for as long as possible. Many older people express a desire to continue to live in a familiar setting in the community, with the Royal Commission into Aged Care Quality and Safety reporting that 80% of older Australians want to remain living in their current home and 62% want to receive community-based aged care services (Royal Commission 2020).
There are two types of community-based aged care services available:
- Commonwealth Home Support Programme (CHSP) – provides entry level care for people who require a low level of support to remain living independently.
- Home Care Packages (HCP) program – provides community-based care to people with greater or more complex care needs.
For more information on these services, see My Aged Care and for more information on the use of these services, see GEN Aged Care data.
Health conditions (such as dementia) are recorded in aged care assessments undertaken for people seeking access to aged care services, but they are not recorded directly for people using these services. However, there is some information on home care provided to people living with dementia who receive the Dementia and Cognition Supplement. This supplement is available to people with moderate or severe cognitive impairment to acknowledge the additional costs of caring for this group. However, there are a number of factors to consider when using this information to describe the use of community-based aged care services by people living with dementia.
The Home Care Dementia and Cognition Supplement was introduced in 2013 to provide additional funding for people with moderate or severe cognitive impairment to acknowledge the additional costs associated with caring for this group. To receive the Dementia and Cognition Supplement, a person must meet specified criteria as part of a psychogeriatric assessment performed by a medical professional trained in the particular cognitive assessment tool.
It is acknowledged that this will not identify all people with dementia Home Care services, for a number of reasons:
- A dementia diagnosis alone does not mean that a Home Care recipient is eligible for receipt of the supplement. People with lower levels of cognitive impairment do not attract the supplement and thus, people with less severe dementia may not be eligible for the supplement.
- Home Care recipients who are eligible for the Veterans’ Supplement will not also receive the Dementia and Cognition Supplement.
- People with cognitive impairment associated with conditions other than dementia may also be found eligible for the supplement.
Therefore, the number of people using Home Care Packages who receive the Dementia and Cognition Supplement may not accurately describe the provision and need for community-based aged care services for people living with dementia.
As at 30 June 2022, over 17,200 people were receiving the Dementia and Cognition Supplement as part of their Home Care Package (10,900 women and 6,400 men). Around 80% of both men and women who were receiving the Dementia and Cognition Supplement were receiving high levels of care (Home Care Package Level 3 designed for those with intermediate care needs and Home Care Package Level 4 for those with high care needs) (Table S10.23).
Respite care
Respite care is especially important for people caring for someone with dementia, where the demands of the caring role may involve providing substantial amounts of physical, psychological, cognitive and social support, while behaviour changes may add to the complexity of caring.
The Australian Government subsidises community-based and residential respite with the aim of providing a person and their carer with a break from their usual care arrangements, or during emergencies.
Aged care assessments data records whether the person being assessed has received any respite services (informal, community or residential respite) in the past 12 months. For those living with dementia who completed a comprehensive aged care assessment in 2021–22, about 21,600 people were approved for residential respite care (72% of people with dementia approved for care – see Table S10.10).
Previous studies have shown that people living with dementia often use residential respite care as part of a transition to permanent residential aged care (AIHW 2023b, AIHW 2023c). Analysis of linked data showed that in 2019, 70% of people living with dementia used residential respite care in the 12 months before entry to permanent residential aged care, compared with 5.4% of people who did not enter permanent care, suggesting that early uptake is low (AIHW 2023a).
For information on expenditure on respite care for people with dementia in 2020–21, see Expenditure on aged care services. Due to the lack of data on the use of respite care by people living with dementia, expenditure was estimated using the proportion of approvals for respite care for people not currently living in residential care and were associated with a dementia diagnosis from the National Screening and Assessment Form (NSAF) data.
Almost 1 in 4 (23%) primary carers of people with dementia in 2018 reported they needed more respite care. This was higher than what was reported by primary carers of people without dementia (13%). Refer to Carers unmet needs for more information.
AIHW (Australian Institute of Health and Welfare) (2023a) Geographical variation in health service use by people living with dementia, AIHW, Australian Government, accessed 26 June 2024.
AIHW (2023b) Respite use on the way to permanent residential aged care, AIHW, Australian Government, accessed 26 June 2024.
AIHW (2023c) Transitions to residential aged care after hospital for people living with dementia, AIHW, Australian Government, accessed 26 June 2024.
Royal Commission (2020) What Australians Think of Ageing and Aged Care- external site opens in new window, Research paper 4, Australian Government.