• Heavy Haul

    Aged
    Care

  • Heavy Haul

    Setting the
    Global standard
    for care

Introduction

Australia offers world-class products, services
and expertise to help other countries meet the
challenges of an ageing population and has many
decades of experience in aged care delivery.

As fertility rates decline, the worldwide proportion of persons aged 60 and over is expected to double between 2007 and 2050, and their actual number will more than triple, reaching two billion by 2050.1

Population ageing is creating new opportunities and challenges for governments, healthcare systems, social services and cultural traditions. The Australian aged care system is a global benchmark for best practice, thanks to strong government funding, a robust framework for accreditation, quality and regulation, and a long history of cooperation between government, service providers and the community.

Australian capabilities span infrastructure, services, products, technologies, research and development, education and training. Dementia care in particular is emerging as a health priority, and the Australian aged care sector has developed services and resources to meet the demands of a growing number of older people with dementia.

All these capabilities are supported by a world-leading legislative and quality framework, as well as substantial investment in research.

This industry capability statement provides an overview of Australian capabilities in the aged care sector, including examples of some of the many Australian companies with specialist expertise.

Talk to your local Austrade representative for more tailored advice and information on connecting and partnering with the Australian aged care sector.

Industry Overview

Of a total population of 23 million, over one million older Australians currently receive some form of aged care and support services each year. 2
These are funded and administered by all three levels of government (local, state and federal) working together.

Industry Overview

Of a total population of 23 million, over one million older Australians currently receive some form of aged care and support services each year.2 These are funded and administered by all three levels of government (local, state and federal) working together.

GOVERNMENT AGED CARE FUNDING

A high level of government support for aged care in Australia, going back many decades, has been a powerful factor in building capacity across the sector. The Australian Government plays a major role in funding and regulating aged care delivery through the private enterprise and not-for-profit sectors, although it does not directly provide services.

The non-government sector has a long history of providing both residential and community aged care services.

Aged care services are funded by government subsidies and grants, user contributions and volunteer care. Currently, 70-85 per cent of the cost of formal aged care is funded by the Australian Government from general taxation revenue. The Aged Care Funding Instrument (ACFI) was introduced on

20 March 2008 as the means of allocating Australian Government subsidy to residential aged care providers3.

User contributions comprise basic fees plus income and asset-tested co-payments.

In April 2012, the Commonwealth Government launched its Living Longer, Living Better reform package, which committed A$3.7 billion over five years towards improving the aged care system. Recent government budgets have significantly increased funds for home care, flexible care and respite care to help older people stay in their own homes for longer and to assist family carers.

Community and residential services

Aged care in Australia spans much more than residential aged care. Most older Australians prefer to remain at home for as long as possible, even those living with significant physical illnesses or dementia.

Dementia care in both the residential and community care settings poses specific challenges in an ageing population and has received increasing attention in recent years. In August 2012 dementia was designated a National Health Priority Area.

In order to ensure that residential aged care is provided to the most vulnerable older people, community care has expanded significantly in recent decades and Australia has built substantial capability in this area.

Today, a wide range of services can be tailored to individual needs, allowing older people to preserve their independence for as long as possible. Not only does this approach have clear social benefits, it is also highly cost-effective to delay the need for residential care.

Australia has developed a sophisticated system to deliver multiple levels of care to its ageing population and is investing strongly in resources and initiatives to support older people, carers and families.


Community care
Multiple levels of care are available to assist and support older people still living in their own homes:


  • Home and Community Care (HACC) includes support services such as nursing and allied health care services, respite services and carer support, home help, meal delivery, transportation, home modification and maintenance

  • Community Aged Care Packages (CACP) provide services for frail aged people with more complex needs

  • Extended Aged Care at Home Packages offer flexible, individualised service packages for those requiring a higher level of support than CACPs can provide

  • Extended Aged Care at Home Packages - Dementia are service packages for people living with dementia. These may include nursing and allied health services, personal care (assistance with bathing, dressing and eating), home help (assistance with housework, laundry and shopping), transport and social support

  • Respite care is short-term care that may be provided either at home, a day care centre or residential aged care home and provides the older person and their carer with a short break from care responsibilities

  • Day care offers care for part or all of a day, provided at day care centres.

Under upcoming Australian Government reforms, a four-level Home Care Package program will replace the three main care packages, complemented by a Dementia and Cognition Supplement across all four levels. A new veterans’ mental health supplement will be available to providers who care for eligible recipients.

Retirement living
Retirement villages or retirement communities are designed to facilitate independent living in individual premises that share common amenities, such as recreational facilities,

libraries, health and beauty services, food outlets, meeting spaces and medical services. Many retirement communities offer multiple levels of care at the same location, allowing residents to transition from independent units to serviced apartments and to higher-level care as their needs change.


Residential aged care
  • Low-level care consists of services designed to allow people to keep living independently while receiving assistance with meals, laundry, personal and nursing care

  • High-level care encompasses 24-hour nursing care, meals, laundry, cleaning and personal care

  • Palliative care involves residential care for people with life-limiting illness, where the primary aim is to maximise quality of life.

Industry strengths

The aged care system in Australia is one of the most thoroughly regulated in the world and is used as a model by many other countries.

Industry strengths

The aged care system in Australia is one of the most thoroughly regulated in the world and is used as a model by many other countries.

Regulation and quality standards

Australia led the world in establishing the role of Minister for Aged Care (now Minister for Ageing) and has had formal aged care legislation in place for over 60 years. Current legislation provides a national quality assurance framework for residential aged care, covering:

  • building certification
  • accommodation bonds, fees and charges, and the income and asset tests that are used to determine when they are applied
  • accreditation of facilities
  • reporting requirements.

Aged care sectors in other countries are benefiting from this depth of knowledge and experience in regulation and quality assurance, as Australian companies provide advice and practical support to many overseas health and aged care legislators and providers.

INFRASTRUCTURE

With wide-ranging capabilities in the design, construction, management and provision of support services to aged care facilities and retirement housing, Australia has the capacity

to meet the growing global demand for complete, fully integrated healthcare facilities and services. Specific areas of expertise offered by Australian companies include:

  • architecture and interior design of aged care facilities
  • cost management and quantity surveying
  • procurement
  • project management
  • engineering and construction
  • equipment
  • technology
  • fitout (including furniture, fixed items and equipment).

SERVICES

Australian companies are well-placed to advise and assist with a broad range of aged care services:

  • brief preparation
  • feasibility planning and design guidelines
  • aged care/health planning and briefing
  • project financing and financial modelling
  • aged care/health models or levels of care e.g. legislative frameworks, regulatory advice and funding models facility commissioning
  • aged care/healthcare operations and management
  • aged care/healthcare accreditation
  • facility standards/assessment/quality assurance
  • recruitment services.

While no formalised franchising services are available to organisations in other countries, a number of Australian aged care companies provide consulting and advisory services to overseas operators. Services range from organisational planning, architecture and design, through to a full suite of management contracts.

Contact your local Austrade representative for assistance with connecting with the Australian aged care providers that best suit your requirements.

Request a copy of Austrade's Medical Devices Industry Capability Report for further information.

Request a copy of Austrade's Health IT Industry Capability Report for further information.


medical devices and consumables

Products and technologies that help older people live at home rather than in residential care facilities can offer significant cost savings, as well as allowing the older people to retain their independence, and the benefits of living in familiar surroundings, for as long as possible.

Australia produces a wide range of aged care products and technologies, and is a leader in innovation in this area. Some of its current capabilities in medical devices, consumables and equipment include:

  • mobility aids (including wheelchairs, stretchers and lifts)
  • incontinence management solutions
  • medical furniture such as beds, mattress, pressure sore prevention products and care-related sheets
  • home and construction equipment including handrails, ramps and slopes, elevators and stair climbers
  • rehabilitation equipment, training materials and devices
  • hospital equipment, patient handling and ward equipment
  • hand-held ultrasound devices
  • daily living assistance devices such as positioning and stand-up aids, furniture, cooking, washing and clothes changing aids
  • medical consumables including bathing and toilet products
  • artificial limbs and orthopaedic products
  • prescription, over-the-counter and complementary medicines
  • home care services and equipment.

Healthcare information technology

Healthcare information (also known as e-health) technologies have great potential to improve the quality of aged care services while reducing costs. Australia has highly developed capabilities in hospital information management systems and communication equipment, such as facility management and briefing systems, emergency alarm and warning systems, nursing call systems, resident monitoring systems and aged care facility management software. New systems are being continuously developed and trialled in Australia.

Telehealth
Australia’s telehealth technologies and applications using mobile communications technology for aged care include:

  • applications that allow elderly people to have contact with healthcare professionals in their own home, or to access specialised services and advice without having to travel long distances.
  • technologies that allow general practitioners (GPs) treating patients in residential aged care facilities to refer patients to specialists in other locations via video conferencing. A GP or other health professional can also be with the patient during the telehealth consultation to provide clinical support. This is called a ‘supported’ consultation.
  • home-based cardiac rehabilitation programs that use mobile phones to measure physiological data and provide regular voice and video communications with specialists, encouraging patients to take an active role in managing their conditions.

Remote patient monitoring systems
Remote monitoring systems allow:

  • patients to upload test results, such as glucose levels, blood pressure or lung function, for review by their doctor
  • videoconferencing with the doctor
  • monitoring of implantable cardiac devices such as defibrillators and pacemakers to check device function and detect signs of worsening health.

Electronic medical records
The Australian Government has developed and is currently rolling out a national electronic health record to create better connected, faster and more efficient care between patients and health professionals.

The new system’s personally controlled electronic health record is likely to be of particular benefit to the aged care sector, given that elderly people are more likely to have multiple medical conditions that require complex care involving numerous providers.


research and development

Australia is well known for innovative and niche healthcare products, from the ‘bionic ear’ to continuous positive airway pressure (CPAP) devices to treat sleep apnoea. The availability of home assistance and medical services means that most of the older Australians who receive care are still in their own homes. Subsequently many new medical technologies, such as integrated remote monitoring capabilities, target this large and growing sector.

Some examples of recently developed products and therapeutic areas of research in the aged care sector include:

  • low-cost, portable infusion pumps
  • health monitors designed for use in aged care facilities or home-based care to measure and record patient data and send it to a central database for analysis and monitoring
  • self-inserted device for prevention of stress incontinence
  • topical wound-care cream for diabetic related ulcers, pressure sores and other wounds common in the ageing population
  • an antimicrobial hand gel for healthcare professionals that sanitises and moisturises
  • an injectable biomaterial that aids in the repair of cartilage
  • treatments aimed at slowing down cognitive decline in Alzheimers disease
  • advances in cancer diagnosis and treatment.

The Australian government is committed to finding cost-effective product and service solutions for the delivery of aged care, leveraging existing strengths in areas such as e-health and medical devices.

Many serious chronic diseases, such as heart disease, diabetes, stroke and cancer, are more common in the elderly.

The Australian government has funded a number of collaborative research projects to explore the areas of disease prevention, shortening periods of illness, maintaining economic and social participation, and approaches to care that support independence and quality of life. Some examples of aged care research centres are listed below.

The Western Australia Centre for Health and Ageing (WACHA) is a non-profit clinical research and education centre established with joint funding from the Department of Health of WA and The University of Western Australia, and partnered with the WA Institute of Medical Research. Its research comprises three core programs: the Healthy Ageing Program, the Clinical Research Program and the Health Service Research Program. Some of the Centre’s research achievements are:

  • demonstrating evidence of the benefit of memory clinics in reducing stress for older people with dementia and their caregivers
  • conducting Australia’s largest study of residential care residents, which demonstrated that vitamin D supplementation reduced rate of falls by 30 per cent for people in residential care
  • demonstrating that smoking is not a protective factor (as was commonly believed), but a risk factor for dementia
  • showing that physical activity reduces the rate of cognitive decline in later life
  • developing a culturally sensitive dementia assessing tool for remote and rural Indigenous communities.

Some current WACHA research projects are:

  • the Maintaining the Health in Men Study (HIMS), a large population-based study into the effects of various lifestyle factors on cardiovascular disease risk, cognition and mental health
  • the Promoting Healthy Ageing with Cognitive Exercise (PACE) study, which explores the role of stimulating mental activities in improving cognitive function and reducing the risk of dementia
  • studies on the effect of vitamins on mental health and cognitive function
  • studies of the effect of different drug therapies in stroke
  • examining the effect of heart failure on brain function and structure
  • developing tools for cognitive assessment in Indigenous people
  • the Student Training Project in Dementia (STRIDE), which aims to develop a new undergraduate medical curriculum in dementia. wacha.org.au/home.html

The National Ageing Research Institute (NARI) focuses on research into ageing and improving the quality of life and health of older people. It is recognised as a leading research institute in falls and balance, pain, dementia, physical activity, healthy ageing, public and preventive health, and health systems evaluation. NARI also conducts a broad range of other clinical and psycho-social research including research into cognitive decline and music therapy and older women's health. NARI is currently co-located with Melbourne Health on the University of Melbourne campus in Parkville, Victoria and teaches undergraduate and postgraduate students from the University of Melbourne. NARI’s current research projects include:

  • exploring tests and treatments to improve wound healing, blood supply and nerve function in people with diabetes
  • prevention of secondary strokes
  • falls prevention
  • interventions, such as music therapy and physical exercise, to help prevent or manage dementia
  • a blood test to measure the progression of osteoarthritis
  • improving pain management in residential aged care. mednwh.unimelb.edu.au

The Centre for Research on Ageing, Health and Wellbeing (CRAHW), established in January 2012, is comprised of academic staff, doctoral students, professional staff and visiting or adjunct fellows. The centre is based at the Australian National University in Canberra.

CRAHW also hosts a node of the Australian Research Council Centre of Excellence in Population Ageing Research and a National Health and Medical Research Council Dementia Collaborative Research Centre for Early Diagnosis and Prevention.

Its research projects currently include:

  • a screening tool to assess driving ability in older people
  • a self-report risk assessment tool to assess late-life Alzheimer’s disease risk
  • a social dancing program designed to reduce risk of falls
  • use of neuroimaging for early detection and prevention of dementia. crahw.anu.edu.au

The Centre for Research on Ageing (CRA) at Curtin University in Perth, Western Australia, aims to improve the health and wellbeing of older people through multidisciplinary research into aged care services, ageing and dementia. Some examples of its research are:

  • models of service delivery, approaches to care, issues for carers, workforce capacity and skills
  • physical and emotional health and wellbeing of older people, supportive environments, community engagement, and alternative family structures
  • services and support systems, alternative and innovative models of service delivery, quality of care issues, health workforce patterns and models, and the role of assistive technology. cra.curtin.edu.au

EDUCATION AND TRAINING

With steady growth in demand for medical staff at all levels, Australian educational institutions deliver general and specialist training for carers, nurses and doctors. Specialist postgraduate training in aged care for doctors is provided by Australian universities and overseen by the professional colleges.

Aged care providers are major employers of both registered and enrolled nurses. Registered nurses are trained at degree level with many universities also offering postgraduate diplomas in geriatric nursing. Enrolled nurses train in the Vocational Education and Training (VET) sector.

Nurse practitioners, who are registered nurses with specialist qualifications, are involved in the delivery of aged

care services in the community, particularly in rural and remote areas.

Care staff provide basic care services to residents and community clients but are not usually licensed to administer drugs. Training for carers is via graded industry courses provided by Registered Training Organisations.

The Community Services and Health Industry Skills Council (CSHISC) has developed numerous qualifications, competencies and skill sets that form the national VET standards for community services and health. These standards form the Community Services Training Package and the Health Training Package.

CSHISC has brokered a A$12 million package for major workforce development activities for the aged care sector, in response to rising demand for services.

Its Aged Care Innovation Project includes four separate aged care projects: the Workforce Innovation Networks, Aged Care Leadership for Change, Nursing Pathways and Securing Workforce Sustainability for Successful Reform. cshisc.com.au

FURTHER INFORMATION

The following organisations are some of the government and industry bodies involved in the Australian aged care sector.

Contact your local Austrade representative about connecting and partnering with the Australian aged care industry.

Further information

Government ORGANISATIONS

Department of Health and Ageing is the Australian Government department responsible for health and aged care. Its goal is ‘Better health and active ageing for all Australians’. health.gov.au

Australian Institute of Health and Welfare (AIHW) is a major national agency set up by the Australian Government under the Australian Institute of Health and Welfare Act as an independent statutory body to provide reliable, regular and relevant information and statistics on Australia's health and welfare. aihw.gov.au/aged-care

eHealth.gov.au is Australia’s personally controlled electronic health record system, linking patients to their health information and to the system itself. Electronic health records are designed to improve the sharing of clinical information between healthcare professionals, providing a more comprehensive and efficient health system. ehealth.gov.au

InduStrY ASSocIAtIonS

Australian Association of Gerontology (AAG) is Australia's main national body linking professionals working across the multidisciplinary fields of ageing. Its members include geriatricians, academics, researchers, nurses, policy makers, allied health professionals, social workers, consultants and other gerontology specialists. aag.asn.au

Australian Masters Aged Care Services (AMACS) is an Australian consortium of leading-edge aged care service providers and suppliers. amacs.org.au

Aged Care Standards and Accreditation Agency Ltd is the independent body responsible for managing the accreditation and ongoing supervision of Australian Government-funded aged care homes. accreditation.org.au

Aged Care Connect is a residential aged care placement service that helps families and carers select aged care accommodation. agedcareconnect.com.au

Aged and Community Services Australia (ACSA) is the national peak body for mission-based providers of aged and community care in Australia. agedcare.org.au

Alzheimers Australia is the peak body providing support and advocacy for Australians living with dementia. It administers national dementia programs and services funded by the Australian Government for people with dementia, their families and carers. fightdementia.org.au

Leading Age Services Australia (LASA) is a national organisation for providers of care, services and accommodation for older Australians. Its founding members include The Boards of Aged Care Association Australia (ACAA), Aged and Community Care Victoria (ACCV) and Aged Care Queensland (ACQ). lasa.asn.au

References

  1. United Nations. Global issues: ageing. Accessed from un.org/en/globalissues/ageing/ 10 July 2013
  2. Department of Health and Ageing. Ageing and Aged Care in Australia. July 2008. Accessed from health.gov.au
    4 April 2013
  3. Department of Health and Ageing. Aged Care Funding Instrument health.gov.au/acfi

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