Navigating the world of residential care can be challenging for many people. For vulnerable or marginalised decision-makers, however, it can be almost impossible without specialist support.
The team at New Way to Stay, who provide advice and advocacy for older Australians, sought the support of Autonomy First for when working with their client, Neil (name changed for privacy reasons). Neil was a 67-year-old single Sydneysider who lived alone in a home he owned.
Neil was suffering from a number of conditions, both mental and physical, including Younger Onset Dementia, heart disease, vertigo, acute back pain and stress-related conditions.
While at home, Neil was seriously injured and was hospitalised. The opinion of his healthcare team was that there was a good chance that his injuries may have been self-inflicted.
As he recovered from the incident, the hospital wanted to dismiss Neil. However, he was unable to be sent home and live independently.
Finding the right residential care solution
Neil’s situation was evaluated by his Aged Care Assessment Team (ACAT) and they agreed that Neil could not return home and so approved him for residential care. Although the assessment had taken place, the family had not received the report. They were even unaware that the report was available to them. Before New Way to Stay started to work with the family, Neil’s immediate family consisted of two brothers who had strong opinions about what should happen next with Neil.
The goal of New Way to Stay was therefore to find Neil a suitable aged-care solution based on his personal circumstances.
How New Way to Stay helped
New Way to Stay provided seven options for residential care for Neil. These options took into consideration geography, his current medical conditions and prognosis, his financial situation, his personal preferences around accommodation features and the needs of his family.
It was also possible to obtain preapproval from most of the Residential Care homes on the list based on Neil’s ACAT assessment and the negotiation New Way to Stay undertook on his behalf.
The need for specialist legal and medical support
Neil’s brothers had Power of Attorney but not Enduring Guardianship, which was needed for them to be able to make decisions about their brother’s health and lifestyle if he was unable to make these decisions for himself. Neil had a Will, but his Estate Plan had been completed in 2005 and had not been reviewed or updated since then. New Way to Stay recommended that the family consult their solicitor immediately to review and update the plan and address the question of Guardianship.
New Way to Stay also introduced the family to the concept of Legal Capacity in general terms and suggested they seek specialist legal support. New Way to Stay had reservations about the dominant position taken by one brother and his tendency to take total control of his brother’s care requirements. They were concerned that Neil’s preferences about his future may not be taken into consideration by his brothers and they therefore recommended the services of Autonomy First.
They also recommended that the family seek qualified and specialist financial advice before making a decision about residential care placement.
“All ended very well under the circumstances. We gave them a plan and the confidence to implement it themselves,” – Les Mace, New Way to Stay
New Way to Stay Delivered their Care Solutions report to Neil and his brothers. The family followed the advice in the report and consulted a financial planner and a solicitor as advised. They also found a residential care facility very near to their ideal location.
“All ended very well under the circumstances. We gave them a plan and the confidence to implement it themselves,” said Les Mace, Director at New Way to Stay.
Talk to Autonomy First
If someone close to you is experiencing a similar situation to this, Autonomy First and New Way to Stay can work together to help you reach the best outcome for the person under care. Using Supported Decision Making processes, we put a client’s values, will and preference first. These must, in our experience, be taken into consideration to the greatest possible extent when life-changing decisions, such as moving into residential care accommodation or taking on home care resources, need to be made.
We accept that, not only must our clients must be extended the dignity of risk as they age, but also that their will and preference must be protected as far as possible by appropriate supports and safeguards.
We believe that substitute decision making should only ever be used as a last resort.