Respite Crisis - June Newsletter
- Kate Helmore
- Jun 12
- 8 min read
I often write these newsletters based on themes I see with my clients or enquiries, and I’ve recently been seeing high volumes of carers seeking residential respite care. Residential respite is when an individual is admitted to an aged care facility on a short-term basis (usually a minimum of 2 weeks). If approved, an individual is eligible for 63 days of respite per financial year and can request an extension for an additional 21 days. Individuals currently pay $63.82/day (set at 85% of the full aged daily pension) to access respite. Respite can be a wonderful way for carers to have a break from caring, whilst ultimately keeping their loved one at home.
The issue I’m seeing arise is that fewer and fewer organisations are willing to take on respite clients, especially if it involves booking in advance. Today I wanted to unpack what this crisis looks like, why I think it’s happening and what we can do to work around it.
For this reason, the theme I’ve chosen for June is
Respite Crisis.
Before I dive into the world of respite, I want to explain the concept of occupancy in aged care facilities and why it’s so important. Ultimately (whether for profit of not-for-profit) aged care facilities are businesses who need to remain profitable. The way facilities make the most money is by having as many of their beds filled as possible. Each resident within a facility has a daily Government subsidy attached to them (higher for those with more complex needs), so facilities need bodies in beds to make money. Every day that a bed in a facility is vacant is a missed opportunity for funding. Keep this concept in mind as we start to unpack the current respite crisis.
WHAT’S GOING ON?
The key issues I see at present are:
- Ability to book respite in advance
- Ability to access respite for clients with complex care needs
ADVANCE BOOKINGS
Often when clients call me wanting to book respite they’re planning for when the primary carer will be unavailable. Sometimes the carer is going on a much-needed holiday, other times they may have planned surgery. Occasionally respite is used for when someone needs more recovery time after a hospital admission or purely wants to trial a facility they may consider for permanent admission down the track.
In South Australia, most major aged care organisations will not take respite bookings in advance and some will not take respite bookings at all. There are a few key organisations I know that will take respite bookings, but only up to three months in advance*.
One of these organisations that does accept respite bookings, keeps one bed per site available for respite only. Now, I’m not going to criticise them for this at all, the opposite in fact! I’m incredibly grateful that they see the value of respite and are willing to keep some beds aside purely for that purpose. However, the fact they have 12 respite beds out of their 1290 rooms (not even 1%) really demonstrates the issue we’re facing with respite availability.
Those facilities that won’t take respite in advance, appear to only use it as a back-up when there are too many un-filled beds (low occupancy!). Facilities will almost always preference a permanent resident, but if they forecast their coming weeks and know they are likely to have a few vacant beds, they maybe willing to consider a respite admission.
* Previously people were able to book further in advance, but facilities reported issues with drastically changing care needs between accepting someone for respite and the actual booking.
COMPLEX NEEDS
The problem is multiplied when we’re talking about respite for clients with any kind of complex care needs e.g. dementia with behaviours that require individualised support, those who require significant assistance mobilising or transferring, people that have complex wound care regimes etc. I am finding most clients with these kinds of needs will be knocked back from residential respite.
Similar with permanent care, just because someone is approved for residential respite does not mean the facilities have to accept them. Facilities will review each individual respite application and decide if their sites can manage the care for that individual. Unfortunately, this means those with more complex needs (who often need respite the most!) are almost impossible to find respite for.
RESPITE WITH VIEW FOR PERMANENCY
I do quickly want to note, that it is still common practice for facilities to offer respite prior to a permanent admission – commonly known as ‘respite with a view for permanency’. This respite period gives the individual a chance to ‘trial’ the facility before becoming permanent and likewise gives the facility the opportunity to ensure they can meet the individuals care needs before taking them on permanently. This is the main way facilities are using respite.
WHY IS THIS HAPPENING?
PAPERWORK
From speaking with aged care providers and admissions teams, it appears to be the significant administrative load associated with respite admissions that is a key factor to reducing availability. When someone is admitted to an aged care facility (for respite or permanent care) there is a mountain of paperwork required to ensure they receive appropriate, person-centred care. This involves individualised care plans, assessment of care needs like mobility, wounds, feeding, falls risk, showering, pressure sore risk etc. It is necessary for providers to have a solid understanding of every resident needs to ensure their health is optimised during their stay, regardless of how long.
Whilst this significant amount of paperwork is undoubtedly best practice (and legally required), it is incredibly time consuming for administrative and on-site nursing staff. It’s not uncommon for sites to put on additional nursing staff for admissions to get through these assessments as quickly and smoothly as possible, with the assessment period often taking a minimum of two weeks to complete.
FUNDING
As with everything, I believe these decisions are also driven by funding and money. At present, there are four main respite classes with facilities receiving $103.09/day for independently mobile respite clients and up to $195.17/day for immobile respite clients. This is fairly comparable to permanent residents, however there are higher levels of funding available for those who are palliative or have several complex needs.
Whilst the funding is similar, the initial ‘outlay’ of staffing hours to complete the assessments required for admission can be absorbed over time for permanent residents. However, if someone is only in for 2 weeks respite, there is a significantly higher cost associated with the admission. Therefore, most facilities would prefer to fill beds with permanent residents, than respite.
Additionally, respite beds require more ongoing coordination. Admissions teams work tirelessly to try source accommodation for everyones preferred respite dates, whilst also having to minimise any vacant days. The turnover of respite residents is far higher and therefore requires considerably more hours of coordination.
DEMAND
This is compounded by the fact that there is a higher demand than ever before for beds. Facilities are inundated with applications from hospitals, individuals and consultants for every vacancy. I’ve spoken about this before in my September 2024 Navigate Newsletter, but I am on the vacancy lists for many South Australian aged care providers and they consistently sit around 95-98% occupancy. When there is such a high demand with minimal supply, facilities can afford to be more selective about who they fill the beds with.
WHAT CAN WE DO ABOUT IT?
This is the tricky part… I don’t feel like I have a perfect answer for this, but I’ll walk you through what I’ve been explaining to my clients.
Be as proactive as possible
IF YOU NEED SCHEDULED RESPITE
With facilities only taking bookings a maximum of 3 months in advance, it can be helpful to have a conversation with a consultant (like me) around 3-4 months prior so that we can get everything needed to send those applications right on 3 months prior. This gives us the best chance of securing a booking, but be prepared that if we can’t schedule then, we may be relying on something more last minute.
IF YOU NEED URGENT RESPITE
As soon as you know you may require residential respite, either start contacting facilities yourself or utilise a consultant to make applications on your behalf. It can often be a numbers game – the more applications we get in, the greater chance of getting you in somewhere ASAP.
Be open to a wide catchment of facilities
Very closely linked to point 1 – due to the scarcity of vacancies, having an open mind to where the facility may be located is incredibly helpful. I am always happy to preference facilities in a particular location for clients, but the wider the search area, the greater chance we have of securing a bed.
Access alternative forms of respite within the community
Whilst this doesn’t provide the same level of ‘switch off’ downtime as residential respite, carers can utilise other forms of community respite. You can have a carer attend your house for ‘in-home respite’, whilst you can leave and do something on your own. I find this best utilised when carers book regular in-home respite blocks, so they know there’s downtime ahead (e.g. 2hr block on a Monday afternoon and Thursday morning).
There are also community day respite centres, often referred to as ‘day programs’. These can also be Government funded and provide a full day care option (most often Monday to Friday, 9.30am-3.30pm). If you are in receipt of a Home Care Package (soon to be Support at Home), you may also arrange a carer to pick up and drop off your loved one to the program. This can be a more affordable way of receiving large chunks of respite.
Some providers also offer ‘cottage respite’ which can involves overnight care at a respite centre. This isn’t typically offered for long blocks of time, but each provider will have their own booking system which you can enquire about. Cottage respite can be accessed through your Home CarePackage or Commonwealth Home Support Programme funding and is not the same as residential respite.
Lastly many providers offer overnight care options. This can be a more expensive option, but provides care overnight in the home allowing the carer to leave or be off duty.
If you’re unsure which option might be best suited to you, either have a chat with your provider or feel free to give me a call and we can work through what might be best in your situation.
Maximise community supports before considering permanent admission
Some carers only consider residential respite when they’re on the edge of carer burnout. After an initial discussion about the individual care needs and what support they’re already utilising, I find it’s sometimes getting close to the stage of that individual needing to go into full time care.
I’m always a big advocate for utilising all community-based supports first, before we move to permanent residential care. However, I am also big on carer wellbeing and if they’re nearing burnout it’s probably time for us to start looking at more permanent solutions.
If the info above still leaves you feeling overwhelmed of confused, you can always speak to your existing provider about what options are available to you. Alternatively, I’m always happy to chat through your individual circumstance and point you in the right direction where I can. My number is 0402 353 426 if you ever want to get in touch.
If you want to have a look through some old podcast episodes, you can search for ‘The Truth About Ageing’. I release episodes sporadically which are available through your favourite podcast app (Apple Podcasts, Spotify) or at www.navigateagedcare.com.au/podcast.
Occasionally I also post updates on socials, which you can find at:
Facebook - @navigateagedcareau
Instagram - @thetruthaboutageing
Thank you again for being part of the Navigate gang.
Big love,
Kate.
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