7. What does Live in Care cost for Elderly Australians?

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Live in Care costs between $520.64 and $645.60 each 24 hours/day, if we average the $4,519.20 weekly cost over 7 days, in a week with no Public Holidays. Why is there a price range? Well it depends what level of Government Subsidised Home Care Package you have says Daughterly Care, the leading provider of Live in Care in Sydney and New South Wales, Australia. Also for the FYE 2018/2019 and prior years, this cost can be further reduced by claiming the Medical Expenses Tax Offset in your tax return. This is explained in detail below on this page.

This page contains the most accurate explanation of Australian Live in Care costs. Let me explain why the cost of Live in Care is often misquoted as being far more expensive than it is.

21-years-of-live-in-elderly-aged-care-sydney

Why does Sydney’s leading provider of Live in Care cost less than what is often quoted in the media and by alternative suppliers?

This is a Snippet from a Google Search where a newspaper article published in the Sydney Morning Herald in 2015 quotes Live in Care as costing “about $1,000 a day”.  This cost was 100% overstated in 2015, 80% overstated in 2017, 66% overstated in 2018 and is now 59% overstated in 2019.

google snippet home residential care

Daughterly Care is the best and longest provider of Live in Care in Sydney and Regional NSW, Australia. What makes Daughterly Care the best provider of Live in Care?  Its our vast experience (21 years’ experience case managing 2.8 million hours of High Care Live in Care to clients, with Level 3 or 4 ACAT Assessments, or equivalent high care needs).

I read a website recently that said XYZ specialises in Live in Care, so we rang and asked how many Live in Care clients they have. Not one Live in Care client, not ever, they have just started. I’m sorry, that is not expertise, that is marketing b….t.

Our clients are smart enough to avoid inexperienced Live in Care service providers because most of our clients, 74%, are personally recommended to Daughterly Care by families who have used our services and health professionals who are aware of our exceptional Live in Carers. See the results of our 2017 Client Survey Results where 100% of our clients who completed the anonymous survey said Daughterly Care provides “exceptional care, care that exceeded or met their expectations”.

Let me say it, as it is.

Around the clock care, 24 hour presence care or Live in Care, whatever you like to call it, it is a niche service for the few self-funded Elders who can afford it (or for fortunate Seniors whose adult children either pay for their Live in Care or provide part of the care themselves to reduce the total cost to their parents’ budget).

Given Live in Care is a niche service…

….many in home care Approved Providers state (pretend) on their brochures and websites that they provide Live in Care because they want to ‘look like’ they provide the comprehensive range of in home care services that we provide.

But they don’t.

Instead when you ask if they provide Live in Care, they say they do, and then they proceed to quote you the cost of their:

  • 24 hour care with an inactive sleepover at night; or
  • 24 hour care with active care at night.

These options are commonly double the cost of our Live in Care service. And what they falsely quote in the name of Live in Care means they falsely over-state the true cost of Live in Care.  To get the true cost of Live in Care you need to ask a specialist provider of Live in Care, like Daughterly Care.

What does true Live in Care cost per week?

True Live in Care is charged at a flat-fee for each day (24 hours), so for Daughterly Care the cost per day and week is:

Monday to Friday $630.00 X 5 days = $3,150
Saturday = $658.80
Sunday = $710.40
Total for a week (with no Public Holidays) and no Home Care Package
= $4,519.20
Less $874.71 per week paid by your Home Care Package – $874.71
Live in Care cost per week = $3,644.49 per week

i.e an average of $520.64 per day

Whereas:

  • 24 hour care with an inactive night care costs $8,770 per week;
  • 24 hour care with active nights costs $11,615 per week; and…
    …both these options require 3 staff per day to operate within the award terms.

In Home Care… is Health Care for Elders, so the Government Subsidises the cost of Live in Care…

Just as any Australian can walk into the Accident and Emergency Department in any Public Hospital, to receive emergency health care, the 2010 Australian Productivity Commission Review of Australia’s aged care industry recommended that Government Subsidised Home Care Packages should be a universal benefit for all Senior Australians, who have care needs assessed by the Aged Care Assessment Team (ACAT)whereas previously Home Care Packages were just for pensioners.

Why did the Australian Productivity Commission recommend making Home Care Packages a universal benefit for Elderly Australians? Because in home care is health care for elders. International evidence-based research shows that when in home care is done well, like Daughterly Care provides in home care, it prevents hospitalisations and delays placement into a Nursing Home, which saves the Government a lot of money compared to subsidising in home care.

So for less money, the Government can improve the quality of life for Elderly Australians using in-home care whilst saving hospital and nursing home costs.  This is why the Government adopted the Productivity Commission’s recommendation to subsidise in home care for ALL Senior Australians with eligible care needs.

exceptional home care nurse equals a improved quality of life

At Daughterly Care we actively assist our Live in Care clients to secure a Government subsidised Home Care Package

As an example, Government Subsidised Level 4 in Home Care Package (with a cognitive supplement for dementia, which is an extra 11.5%pa of funding,) for a self-funded Elder, is a real financial benefit from the Government of $56,856.05 less Income Tested Care Fee of $11,012.99 = $45,843.06 pa per person.

Why is the actual financial benefit of the Level 4 Home Care Package less than the $56,856.05 annual Government Funding for a Level 4 with a Cognitive Supplement Home Care Package?

Simple. Because as a self-funded elder the Government does NOT pay you Government Funding equivalent to the Income Tested Care Fee of $11,012.99, until you have reached your Lifetime Contribution Cap, when you stop paying the Income Tested Fee. The following year you just pay the inflation increase for the Income Tested Care Fee. The Lifetime Contribution Cap and Income Tested Care Fees are explained on this page.

So once your Government Funding is assigned, (not approved), the Government calculates your funding daily and pays Daughterly Care monthly, if you have chosen us as your Approved Provider of Home Care Services.  We use the Government Funding to pay for part of your Live in Care i.e. we deduct the Government Funding we receive (less our Home Care Package Management and Care Management Fee) from your private live-in care invoice and charge you the balance owing.

Level 4 Home Care Package (with cognitive supplement) for a Self-Funded Elder Annual
Government subsidy less Income Tested Care Fee

$56,856.05 – $11,012.99

= $45,843.06
Income Tested Care Fee paid by Self Funded Consumer

The Income Tested Care Fee has a lifetime cap of $66,078.27. Therefore, once you have had a Home Care Package for 6 years, you only pay the inflation increase each year.

+ $11,012.99
Basic Daily Care Fee paid by Consumer $10.54 per day – WAIVED by DCCS for all clients from 1/7/2019 $0
Total Home Care Package Income = $56,856.05
Less 20% Total Home Care Package and Case Management Fee1 $11,371.21
Equals the amount we deduct from your Live in Care / Private Care cost

(Annual amount the Government pays for your Live in Care)

= $45,484.84
Divided by 26 fortnights

(this is the amount we deduct from our fortnightly invoice)

So the real Government payment towards your Live in Care is $1,749.42 per fortnight or 2.89 days.

= $1,749.42
or divided by 52 weeks

(this is the amount we deduct)

= $874.71 per week
Less Medical Offset Tax  Rebate. Ask your Accountant what this benefit could be worth to you.

The Tax offset available is:

  • 10% of your Live in Care costs (above $5,609), when your income is greater than $90k pa (single rate).
  • 20% of your Live in Care costs (above $2,377), when your income is less than $90k pa (single rate).

Please refer to the following two ATO website pages for more information:

https://www.ato.gov.au/individuals/mytax/2019/in-detail/medical-expenses/

https://www.ato.gov.au/individuals/mytax/2019/in-detail/medical-expenses/?anchor=Moreinformation#Moreinformation

Unfortunately this financial benefit no longer applies for the FYE 2019/2020 onwards.

If you had two self-funded parents or friends living together, both receiving a Level 4 plus Cognition or Oxygen Supplement, then the Government funding would be double the example above. If the Elders were Pensioners or had reached their Lifetime Cap then they pay no Income Tested Care Fee.

Families can further reduce the cost of Live in Care by all adult children equally sharing the provision of 24 hour care on the weekends. See example on this page.

Currently, July 2019, My Aged Care has advised that it is taking up to 2 years to receive a Level 3 or Level 4 Home Care Package, so you need to be able to afford our Live in Care fee without any Government Subsidy discount from day one of using our service.

“I wouldn’t be entitled to a Home Care Package to reduce the cost of my Live in Care, I have too many assets”

Well, actually you are.

The Home Care Package test looks at the total income of a person / couple to determine if you are self-funded. The Government does not look at your assets or the value of your home. So your asset level will not exclude you from receiving a Home Care Package. More about Home Care Package costs.

When it comes to costs, bear in mind…

…that prior to 2018 most of our Live in Care clients’ homes had more than doubled in value, capital gains tax free, over the previous 5 years, way in excess of the cost of their Live in Care. As a result they enjoyed:
✔ attentive, person-centred care,
✔ consistent care delivered by a small number of Live in Carers enabling their best quality of life possible,
✔ all without impinging on their busy adult children and co-incidentally maximising their children’s inheritance.

That outcome is a win-win-win – very rare indeed.

Asset Rich and Income Poor

Live in Care enables Elders to live their way, in the familiarity, safety and comfort of their loved home, where they remain the boss and receive attentive one-on-one direct care of up to 8 hours per 24 hours. Eight hours of attentive Live in Care compares to just 2.8 hours of direct care, per 24 hours, in an Australian Nursing Home. (Source: Bentley Chartered Accountants Annual Survey of Australian Aged Care Homes 2015.  The Bentley Survey was completed by the Nursing Homes themselves).

If you are asset rich and income poor, how can you pay for Live in Care? Perhaps sell down investments or borrow against your home. This is a very good alternative to upending your life and selling your home to pay a Nursing Home Bond, especially when you are so close to the end of your life. Staying at home with one-on-one, attentive, personalised care is far superior to the Nursing Home alternative and far less stressful.

Do you have to apply for a Home Care Package from the Government to use Daughterly Care’s Live in Care service?

No. Our Billionaire and Multi-multi-multi-millionaire clients don’t apply for a Home Care Package because they don’t need the subsidy, they don’t have time for the paperwork and they don’t want an ACAT Assessment on record. There is no requirement to have a Home Care Package.

Do you have to have an ACAT Assessment already to use Daughterly Care’s Live in Care service?

No.  You only need an ACAT Assessment if your want to apply for a Home Care Package and Daughterly Care can guide you through that process.

I already have a Home Care Package with another Approved Provider, can I use Daughterly Care’s Live in Care service?

Yes. You can exercise your Consumer Directed Care right to choose the type of care you want (ie Live in Care) and who provides the care (i.e. Daughterly Care).  Just tell your Current Approved Provider that you want to use Daughterly Care’s Live in Care service. Older people often use our Live in Care service to be re-enabled after a hospitalisation. (Check out your 9 Consumer Directed Care rights here).

Tip: If you choose to keep your Government Funded Home Care Package with your Current Approved Provider we recommend asking what their “3rd party processing fee” is. Many charge you between 10% to 25%pa of the cost of our Live in Care bought through your Home Care Package.  In January 2018 one faith based Approved Provider doubled their 3rd party processing fee to 20%pa. This fee is IN ADDITION to their Administration and Case Management fees which were already double our fee. The adult child then decided to transfer his parent’s Home Care Package to Daughterly Care Community Services as this meant his parent had 20% more Government Funding to pay for his parent’s Live in Care, along with HALF the Administration and Case Management Fees. Informed and educated Consumers receive better value and service.

Another Tip: As the cost of Live in Care is more than your Home Care Package, most Approved Providers will want you to pay for the whole cost through them. This enables them to charge their Home Care Package Fees on the total cost as well as their 3rd party processing fee (5% – 25%). This could see you paying thousands more for our Live in Care. If you don’t want to transfer your Home Care Package to us, just ask your current Approved Provider to pay for the cost up to the Government Funding and then you pay the remainder to us directly to minimise the 3rd party processing fee.

Does Live in Care cost more for a couple than a single person?

Sometimes yes. Sometimes no. It depends on our role and the number of hours of direct care within a 24 hour period you need our Live in Carer to provide.

Live in Care provides 8 hours of active direct care within a 24 hour period, spread over the 24 hours, when each client needs assistance.  Each client has different support and care needs, at different times of the day.

An example where there is no additional cost for a couple.

Mrs Smith has a neurological condition and cannot mobilise. She needs to be hoisted for all transfers and spends most of the day in an electric wheelchair which she drives.  Her husband has no chronic illnesses, good mobility and no cognitive deficit. This client pays no additional fee, just our standard Live in Care fee, because we are able to provide assistance for 8 hours within 24 hours.

In the morning our Live in Carer completes the personal care routine (toilet, shower, dress, hair styled and make up applied! Breakfast served and medication given) with Mrs Smith including preparing and serving breakfast for both Mr and Mrs Smith on their verandah over-looking Sydney Harbour.

Mr and Mrs Smith go out on their own for a walk and have lunch out by Sydney Harbour, often with family or friends joining them on the weekend. During this time our Live in Carer cleans up after breakfast and has a swim.

After lunch out our Live in Carer assists the client to the toilet and hoists her into bed for a chat and nap in her husband’s arms. Our Live in Carer goes for a walk and then starts preparing dinner for the 3 of them.

After dinner our Live in Carer cleans up and leaves Mr and Mrs Smith to watch their favourite TV shows together.  When it is time to go to bed, our Live in Carer assists Mrs Smith to the toilet, helps her clean her teeth, changes her into her PJs and hoists her into bed.

As you can see our Live in Carer and Mr Smith work together to support Mrs Smith. Private time alone, for Mr and Mrs Smith is a work break for our Live in Carer so that she stays within the 8 hour limit.

When the care needs of both spouses requires more than 8 hours of care, we bring in an hourly caregiver to provide as many hours of care as needed so our Live in Carer stays within the 8 hour limit. This ensures consistency of care and keeps costs to a minimum.  For example, another couple who require more than 8 hours of care in a 24 hour period, we bring in a Caregiver who is a Piano Teacher and this provides great enabling support to the client who was a concert pianist and gives our Live in Caregiver the opportunity to have a break and go for a walk.

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Read on 8. Where is Live in Care available?

Need more information? To know more about us, read why we started Daughterly Care, and take a look at our services. Meet the stars of our business, our in home Caregivers and case managers and operations team.

Read unsolicited feedback from our clients. We’re always thrilled to receive such kind words.

The next step is easy … contact us for a confidential chat about your needs or to organise your, free no obligation consultation email claireg@daughterlycare.com.au or call us on (02) 9970 7333.