Where’s The Map? Navigating Australia’s Housing and Aged Care Systems

For older people who are in housing stress and in need of aged care services, they have two disparate systems – both confusing individually, let alone together – to navigate, write Dr Victoria Cornell, Dr Alice Clark, and Jane Mussared.

As is now well recognised, Australia has an ageing population. Ageing in 2018, however, is different from the ageing of our parents and grandparents in a range of ways – diversity and inequality being just two examples. Modern older lives are enormously diverse, across a range of areas – cultural background and outlook, health status, assets and income, geographical location, housing and sexual orientation just for starters.   

Old age is when a lifetime of inequality, compounded and multiplied from life event to life event, can be in its starkest relief. Some inequality comes in later in life, following adverse life events such as divorce or redundancy. Disadvantage relating to unemployment in 50s and 60s, not owning a home and having little or no super exacerbates inequality.

We are yet to get a real handle on modern ageing, and still seem to develop policies and programs with a “one size fits all” approach. Let’s look at housing and aged care; policy areas that are looked after by both the Commonwealth and State governments, with multiple ministers, portfolios and departments that are related to older Australians across ageing, health, housing and social services.  

Statements regarding well-off older people owning large shares of the housing wealth are frequently cited. While this is true for some older Australians, there are many – and the numbers are rising – who are in low cost, substandard housing which is affecting their mental and physical wellbeing.

Our shrinking stock of public housing and the lack of housing affordability in the private rental market have a particular impact on older people living on low incomes. If housing is not suitable for an older person, either due to affordability, location, amenity or design, it can hamper access to in-home aged care services, and therefore health outcomes. Key messages are beginning to emerge from our research, showing that policy and service delivery in these areas require radical change if we are to adequately serve our older Australians.

Health and ageing policies may mention housing, but there is not currently an Australian housing strategy, that addresses the specific needs of older Australians, or their health.

The aged pension was designed to afford older people enough to live on if they owned their own home however, more and more retirees are still paying off a mortgage or renting into their older age. Commonwealth Rent Assistance is inadequate to relieve the financial hardship for many renters.  

Working in departmental silos does not solve complex social problems and it is time to improve the policy environment, alter the way services are delivered and deliver real support to low income older Australians.

In addition to a disjointed policy environment, older Australians face barriers when they attempt to access aged care services. Our research participants said that they often found themselves in a situation where they, or their families, were responding to a health and/ or housing needs at a time of crisis. They faced difficulties knowing where to look for information and support, and experienced further major challenges trying to access My Aged Care, the Commonwealth’s entry portal for aged care services.   

Housing has a confused persona. On the one hand, viewed as a sacred class of investment that will rise in value over time, hopefully aiding a comfortable retirement; and on the other hand viewed as welfare.

A national housing strategy that looks beyond these opposing ends of the spectrum is required. A strategy that takes all of the policy levers available to government, including taxation measures, home ownership, private rental, social housing and social security, into account. A new national housing strategy must work across portfolios to firmly embed within it health and ageing issues. Coordinated policy and spending, built on evidence, will ultimately save taxpayer dollars and improve health outcomes for all older Australians.

About the authors: Dr Victoria Cornell is a Postdoctoral Research Fellow at University of Adelaide. Her current research is exploring the implications of the aged care reforms on housing policy and agencies, specifically as relates to older people on low incomes and living in precarious housing situations. She is the convenor of the Australian Association of Gerontology’s Housing and the Built Environment Special Interest Group.

Dr Alice Clark is the executive director of Shelter SA. With a background predominantly in the community services sector, Alice is well suited to policy and advocacy work, and has also worked for state government and as a research only academic at the University of South Australia. She is currently the chairperson of National Shelter.

Jane Mussared, is the chief executive of the Council on the Ageing SA. She was previously the executive heading up first the Health and Community Services Division and later People and Innovation at a major aged care service provider. Prior to that Jane was the manager of the State Government Office for the Ageing. She is a past winner of the SA Innovation Award in the Telstra Business Women’s Awards. Jane is on the board of the Maggie Beer Foundation, and a member of the advisory group of the Centre of Research Excellence in Frailty and Healthy Ageing.