Let’s say you’re starting to think about home care for your mother-in-law after she wrote off her car recently. You knew she had been declining, but that was your wake-up call that she needed more help. This is a common scenario; many families realise their loved one needs in-home care, but can be confused about what options are available and how to pay for their care.
As soon as you start thinking about getting help, you should gather your family members together and write down all the tasks you believe your elderly relative needs assistance with before you start your search, so you can find the right fit. It’s also a great idea to get an independent evaluation from a social worker. They can pick up on cognitive or physical decline that the family members may not notice and can guide you through the different levels of care.
Home-care agencies can send someone to do an in-home evaluation of your loved one’s personal situation. They might recommend having a support worker two afternoons a week to help with driving and shopping, and to provide conversation and companionship, for instance. Many people prefer to stay at home as a long as possible, so having in-home care is a great alternative to the likes of nursing homes.
Not to mention, hiring through an agency has many advantages. They will do all the background vetting of the candidate for you, make sure the worker is licensed (if necessary) and trained, and will handle tax filing and other paperwork. Hiring a support worker directly is also a good option, particularly for non-medical help. That way you can find someone who can grow with your family member’s needs. The support worker may start as a companion, and then take some training courses as the needs expand, so you can have continuity of care.
Here are your options for home care—from the least intensive to the most skilled levels of in-home care. Keep in mind that training and licensing requirements, as well as costs, may vary.
Non-medical care
Companion care
What they do: Companion caregivers provide friendship, conversation, and mental stimulation for their ageing clients. This can literally be a lifesaver for elderly people who live on their own. Loneliness in the elderly is a major underlying cause of poor health and even death. Human interaction and socialising are incredibly important, especially if family members don’t live nearby. The companion may also help with shopping, driving, light housework, watering plants, and cooking, but will not do any hands-on care or grooming.
Training: It’s possible to work as a companion carer without any formal qualifications or training, though some companion-care agencies may have their own training program. Agencies have a lot of really good workers who are often actors, artists, or writers, and who are used to working their schedule around the needs of the client—but most importantly, they enjoy working with older adults. You could also find a university student, a neighbour, or a member of your loved one’s religious community or a local community group who is a good fit for the job.
Cost: According to payscale, the national average wage in 2023 for companion care in Australia is $23.18 per hour (14 salaries reported).
Home care worker
What they do: A step up from simply being a companion, a home care worker also assists with the activities of daily living, including dressing, bathing/showering, assisting with mobility in and around the home, and administering medication. Home care workers may work part- or full-time, or can live with a patient who requires around-the-clock care.
Training: A vocational qualification in individual support is usually required in order to work in the field of home care, such as Certificate III in Individual Support. You may also be required to have first aid and CPR training.
Cost: According to payscale, the average rate for a home care worker is $24.37 per hour (263 salaries reported).
Medical care
Nurse
What they do: There are very few instances when a family needs a nurse in the home. In fact, nursing is usually only necessary after the patient has been discharged from hospital and is recovering from an illness or injury. In this case, the doctor will have determined that the patient is stable enough to go home but requires care for very specific medical tasks, such as wound care, tracheotomy, PICC lines, IV medications or infusions, or colostomy care.
Nursing care is ordered by a doctor, with a plan of care and with specific goals, usually for a 60-day time frame. Unless the patient needs constant infusions, for example, the nurse will usually visit for a few hours at a time, a few days a week. It is important to note that the nurse does not replace a companion or home care worker, but will work with the support worker (or family caregiver) on a plan of how to best care for the patient when the nurse isn’t there. Skilled nurses do not provide services such as housekeeping, food preparation, or shopping, though they may help bathe and dress patients and assist with other activities of daily life.
Training: There are two types of nurses in Australia: registered nurses and enrolled nurses, and which one you want to become will determine the level of training you need. Registered nurses are highly skilled in providing complex nursing care. They require a degree in nursing and must be registered with the Australian Health Practitioner Regulation Agency (AHPRA). Enrolled nurses, on the other hand, are usually supervised by registered nurses and tend to things such as patient comfort, safety, and hygiene. Enrolled nurses bear less responsibility than registered nurses. To become an enrolled nurse, you require a diploma of nursing rather than a bachelor’s degree, and must also be registered with AHPRA.
Cost: According to indeed, a home care nurse in Australia costs $30.96 an hour on average (152 salaries reported).
Palliative care
What they do: Palliative care, also known as end-of-life care, is specifically for patients who are terminally ill. To qualify for inpatient palliative care, you will usually have to provide a referral from a medical practitioner. Community-based services usually accept direct referrals. Once a patient is in palliative care, they agree to forego curative, or life-saving, therapies, and the focus shifts to making the patient as comfortable as possible in their final days. Palliative care covers medical and nursing care, such as managing pain and other symptoms. It’s possible to receive palliative care at home, in hospital, in a hospice, or in a residential aged care facility.
Training: Palliative care nurses are registered nurses with three years of experience at the clinical advanced nursing practice level. They must have postgraduate training in the specialisation and be registered with AHPRA.
Cost: According to payscale, registered nurses with palliative care training earn $35.85 per hour on average (22 salaries reported).
