WORKING TOGETHER

Policy on Ageing and Disability
 
July 2005

The population of people with lifelong disabilities is ageing. Historically it was rare for people with lifelong disabilities to reach old age, but now it is increasingly common. The needs that arise from ageing do not displace the needs that arise from a lifelong disability: they are in addition. Moreover, the needs associated with old age often arise earlier in people with lifelong disabilities.

As Australia’s population ages, the incidence of acquired disability also increases.

Public policy, eligibility for services, funding, service provision and service designs are not keeping pace with these trends. People who are ageing with a disability often require access to both disability and aged care services.  But rather than easy-to-traverse service pathways, they encounter bureaucratic barriers and cul de sacs. 

ACROD, Aged & Community Services Australia (ACSA), Carers Australia, COTA National Seniors and the Australian Federation of Disability Organisations – the Ageing & Disability Coalition - have joined forces to promote, and seek solutions to, the issues facing people with disabilities who are ageing and their carers.

Introduction

As Australia’s population ages, demand for support services is increasing.  Our ageing population is diverse and includes people from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islanders and people with disabilities. People want choice within a range of support options that includes residential care and community care.

With significant advances in general health and medical treatments a larger number of people with long-term disabilities are living to old age than ever before.  People age at different rates and some disabilities – such as Down Syndrome and Cerebral Palsy – are associated with premature ageing. 

The carers of people ageing with a disability - often their parents - are also ageing and finding it increasingly difficult to continue in their role as well as planning for the future. 

This situation highlights the weak interface between aged care and disability services.  While disability services are generally not equipped to manage the conditions and symptoms of ageing, aged care services are generally not able to meet specific disability support needs.  The two service systems are trying to address these issues to ensure that policy, practice and services support meet the individual needs of people with a disability who are ageing and their ageing carers.  This is made difficult by artificial and rigid program boundaries and inadequate funding. 



Policy Context

In recent years, in response to people’s preferences, governments have made commitments to support older people and younger people with disabilities to live in their own homes and community. This is evidenced by the closure of many disability institutions and the growth of home support services and individualised packages of care.

In 1997 the concept of “ageing in place” was enshrined in the Aged Care Act which legislated that people could remain in their home (however defined) regardless of their increasing care needs.  This concept is widely seen as giving all people the opportunity and support to choose where they live as they age. The choice of where to live needs to be underpinned by a comprehensive range of support for the person with a disability and their carer.  

The Future

People with a disability who are ageing will be adequately supported by both disability and aged care services working with a seamless interface.  This may best be achieved through individualised funding packages combining aged and disability funding.  

Services will be able to respond in a flexible and innovative way to meet individual needs, including the additional requirements of people with disabilities from Aboriginal and Torres Strait Islander backgrounds, culturally and linguistically diverse backgrounds and those living in rural and remote locations.

Staff in aged and community care services will have the skills to meet specific disability support needs.  Staff in disability services will be able to support people with ageing conditions and symptoms.

Support services will be available for carers to help them manage on a daily basis and to manage care transitions including relinquishing care.

Residential care options, including disability group homes and aged care facilities, will welcome and support people with disabilities who are ageing.

People with disabilities who are ageing will be able to retire from their employment and access the full range of retirement options.

People with disabilities who are ageing will be able to ‘age in place’ in the same way as older people.  The needs of the carer must also be considered.

Local disability and aged care providers will work together to ensure seamless transitions and appropriate support for individuals.  In some cases partnerships between services, sharing their respective expertise, may provide the best of both worlds.

Making the Future Happen

For this to become a reality significant reform of both aged care and disability funding and services is required.  The Australian Government’s funding of Innovative Pool Projects, specifically for people with disabilities who are ageing, has been a welcome first move.  Other important initiatives have included the establishment of an Advisory Body on options for ageing carers and increased funding for respite care (to be matched by State/Territory Governments).  

It is critical that this welcome start is expanded if we are to meet the individual needs of people with a disability who are ageing. To ensure that this occurs the Ageing & Disability Coalition: 

Will work with individual service providers and stakeholders to:
	
raise awareness of this issue and identify potential and practical responses; 
provide information and training on disability and ageing issues through conferences, seminars, resource material, newsletters, and journals; and
encourage partnerships between aged care and disability services at the local level to support people with disabilities who are ageing.

Calls on the Australian Government to:
 
expand funding, through individual packages, to support people with a disability who are ageing.  Packages would need to comprise both aged care and disability funding and be available to aged care and/or disability service organisations;
continue funding for successful Innovative Pool projects beyond the pilot period;
fund appropriate retirement options and day programs;
enable people with disabilities in State-funded shared supported accommodation to receive community aged care services, such as HACC community nursing and palliative care;
ensure that age-based eligibility criteria do not prevent the provision of appropriate services to people experiencing conditions arising from premature ageing; and
develop a wider range of options to support ageing carers including the transition arrangements needed in relinquishing care.

Calls on State/Territory Governments to:

provide appropriate, sufficient and flexible community accommodation options for people with disability who are ageing to meet demand; and
fund the purchase of Personal Alarm Call systems for Group Homes with retired residents to enable retirement options to include staying home where appropriate and desired by the individual; and
work with the Australian Government to enable younger people inappropriately accommodated in nursing homes or hostels to receive accommodation support in the community. 

Calls on National Industry Skill Training Councils to:

redevelop training packages to ensure that future workers in either sector have basic knowledge and understanding of ageing and disability issues and services.