To seek “respite” is to look for a break from strenuous effort to recharge and regroup. In the context of aged care, subsidised respite care provides temporary support to older people, which gives their carers a brief relief or “respite” from their caring responsibilities.
Carers look after a family member or friend who is frail or has a disability, mental illness, substance dependency, chronic condition, dementia, terminal or serious illness. Having access to respite services is crucial, as only one in five carers of an older person reports they can easily organise a friend or family member to help them out.
Access to respite can also improve a carer’s well-being, enable them to continue in their caring role, and postpone the need for an older person to move into permanent residential care.
However, in a recent survey, only 30.6% of carers reported accessing respite in the previous year, and just over half of those who did were satisfied with it.
What is respite care?
Respite care is a support service for older people designed to give their carers a short-term break from their caring responsibilities. It can be planned or used in an emergency, such as when a carer falls ill.
In Australia, respite occurs in a variety of settings. The more formal residential respite occurs when an older person stays temporarily in an aged-care home. However, there is also a range of community-based respite services. These include “day stays” in local community clubs, overnight stays in dedicated “respite cottages”, as well as options for care workers to provide support in people’s own homes.
In 2020–21, 67,775 people received residential respite care, and 46,527 received community-based respite care.
While this may seem like a lot, it is small compared with the 428,500 people who are the primary carer for a person aged 65 years or older. And formal respite services accounted for just 3.2% of all government expenditure on aged care.
Why don’t people use it?
Carers consistently report accessing respite care is difficult. The obstacles they face include:
not enough residential respite care beds
residential aged care facilities that do not routinely offer respite care
respite providers that can’t support people with dementia and high care needs
respite care that is not close to home
assessment delays that mean carers can’t access respite when they need it.
The royal commission heard evidence respite care can be risky for the care recipient due to poor communication in the transition process. For example, health and medical information about care recipients tends to be stored across multiple systems, some of them paper-based. This leaves scope for errors when care recipients move into a new care system.
Potential providers of respite care also face financial disincentives to offer short stays. The cost of the admission process is relatively high, so providing residential respite care for less than two weeks may not be financially viable.
A lack of appropriate respite care has significant consequences for both carers and the family or friends they look after. As one carer told the royal commission:
I have asked whether or not Betty can get respite care in Broome but I’m told that it is full. One time I had to go for a funeral out in the desert and I had to take Betty with me because I could not get her into respite care and I couldn’t leave her with other family. We drove over 1,000km to the funeral. Betty got sick and needed antibiotics. Having more access to respite care would make a difference, a big difference to me.
What needs to change?
From October 1, funding for residential respite care will change to better align with the funding provided for permanent residents. This aims to remove the financial disincentives for providers and improve respite availability in existing aged care homes.
But given the strong preference for respite in smaller cottage settings, further resources could be directed to expanding the availability of community respite. The royal commission noted that, while these services exist, they are limited, particularly in regional areas.
Improving the uptake of respite care will require more active and personal support for carers so they have the skills and confidence to organise respite care.
Perhaps most importantly, respite care needs to be understood as a service for the carer as much as for the older person they care for. We need to understand carers’ needs so we can design and match services for them.
This article is republished from The Conversation is the world's leading publisher of research-based news and analysis. A unique collaboration between academics and journalists.
Nicole Sutton is the current Treasurer of the Palliative Care Association of N.S.W.
Deborah Parker receives funding from a range of research grants including the Department of Health and Ageing, the Australian Research Council, SPHERE and integratedliving. She is a member of the executive committee of Palliative Care NSW, is on the Editorial Board of the Aged Care Sector Report and Board Director of Carrington Care.
Gillian McAllister does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.