Older Australians are facing distressing delays for aged care assessments, highlighting a serious flaw in the system. This reality was starkly illustrated when Peter O'Shannessy returned home from the hospital in January after undergoing extensive throat cancer surgery. At 74 years old, he found himself in a dire situation—unable to communicate or eat properly. Following a thorough evaluation, he was granted approval for a level-three home care package that would provide essential support items such as a recliner for better comfort, a suction machine to aid his breathing, and a personal carer to assist him with showers and personal hygiene.
However, the family quickly discovered a daunting national waiting list of 121,000 individuals for care packages, meaning it could take between seven to nine months before any concrete support would arrive. Tragically, when Peter’s cancer recurred months later, he was diagnosed as terminal and required urgent nursing care.
In hopes of expediting the support he so desperately needed, the family sought a reassessment. Eloise Randall, Peter's daughter, expressed the severity of the situation: "Dad's needs were increasing by the moment," she lamented. "We needed personal care assistance and nursing support immediately."
My Aged Care directed the family to Aspire4Life, a new organization contracted by the government to handle reassessments for aged care. Historically, aged care evaluations were conducted by Aged Care Assessment Teams (ACAT) over the past four decades, but the government opted for partial privatization of this system late last year, a decision that came with a staggering cost of over $1.2 billion.
As alarming as it sounds, recent statistics reveal over 116,000 people are currently waiting for aged care assessments. Eloise recounted multiple instances of pleading over the phone with both My Aged Care and Aspire4Life for more immediate assistance. Eventually, Aspire4Life managed to provide a reassessment date that was eight weeks away, the soonest available. Eloise reiterated her concern, saying, "I warned them repeatedly; he'd be gone before help arrived."
Sadly, Peter passed away just four weeks before his urgent reassessment could take place. Through tears, Eloise shared the gravity of their situation, describing how her father went from lively exchanges in their family WhatsApp group to sending a distress message to her mother saying, "Help."
In those final moments, the family endured unimaginable pain as Peter experienced a catastrophic hemorrhage at home, leaving his wife to navigate this emergency alone. "He spent his last days in fear and anxiety, laying on an uncomfortable couch, while my mum struggled to care for him without any help, despite countless hours spent trying to reach out for assistance," Eloise recounted.
Aspire4Life, identified as a non-profit organization, stated it was not at liberty to comment on Peter’s specific case due to its agreement with the government, but acknowledged the high demand for subsidized aged care assessment services. They indicated investments were being made to address the escalating need and noted that they had provided over 100,000 services in the past year.
Families are reaching their breaking point. In Cairns, Coral Wilkinson, a former ACAT assessor, is now assisting families who are lost in the complicated aged care landscape, facilitating communication with multiple assessment organizations across Queensland. She revealed that families frequently reach out, exasperated and desperate for quicker assessments. "Some individuals have been waiting for nine to ten months, and the reality is heartbreaking—they're calling us in tears and some even wind up in hospitals or nursing homes as a result of delayed support at home."
Coral believes there's a lack of preparedness among both the Department of Health and the newly contracted organizations that are stepping into this crucial role. "There's an evident gap in the workforce's readiness, stemming from a lack of understanding about the specialized expertise required to assess elderly individuals with complex needs," she asserted.
On the matter of wait times, the government maintains a different perspective. A representative for Aged Care Minister Sam Rae claimed the median wait time for assessments was actually 23 days during the July-September time frame, promising to continue efforts aimed at reducing wait times further.
The situation has reached alarming levels. Janine Mason, a former clinical assessor who briefly worked for one of the new private companies (not Aspire4Life), departed within months, feeling pressured to expedite assessments unfavorably. "The process has become impersonal due to the frantic pace required to complete assessments—it's almost as if the human element is being sacrificed," she shared.
Janine found it particularly troubling that elderly individuals might be removed from waiting lists—often without their awareness—simply for failing to respond sufficiently to phone outreach. "They set a strict guideline: only three phone calls were to be made, and any lack of response resulted in a referral rejection."
Though her previous employer claimed they strived to maintain contact with clients, reports from various workers and families suggest this troubling practice is occurring across multiple organizations.
The aged care royal commission, which reported its findings in 2021, made recommendations for streamlining the assessment process into a singular system, clearly stating it was not in favor of privatization. They also recommended independence for assessors from approved service providers to prevent conflicts of interest during the evaluation process.
Despite these recommendations, it has come to light that over half of the companies contracted for assessments are affiliated with service providers or associated entities. Mr. Rae's office defended the government's stance, insisting robust measures are in place to avoid conflicts of interest while clarifying that the Department of Health has various options, including contract terminations, should any conflicts be discovered.
In an official tender document, the government outlined several key performance indicators (KPIs), specifying that 90 percent of urgent assessments should take place within ten days and that 95 percent would need to be face-to-face. However, a recent Senate Estimates hearing revealed that the department admitted it would not enforce these KPI requirements for a full 12 months.
Peter's family continues to process the profound sadness from the last months of his life and worries for other vulnerable elderly Australians who might be in similar positions without the benefit of familial support. "I genuinely despair for the many elderly individuals lacking support in our country who are left to fend for themselves, struggling to navigate a complicated and overwhelming bureaucracy," Eloise stated.
"It’s often too much for them to sit on hold and fight through the system. My father’s ultimate wish was just to be able to communicate once more, but this experience shows we had to be the voice for him, and we still failed to find accessible help."
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