My carer needs a break. What are my options for short term/temporary care?
The reasons for a carer taking a break are many and varied, as are the options. (See also the section at the bottom of this answer: "Forward planning advised")
Options for funded/subsidised services (assessment required) include:
1. Day Group. This is generally structured so that you leave home in the morning, have lunch and return home in the afternoon. (For further information see below.)
2. Carer Support. This may be taken in your own home (or other domestic home), a residential care facility (not offered in all District Health Board 2. [DHB] regions) or one of the newer short stay services (few of these). Carer Support is designed to give the carer a break from the care giving role and is allocated to the carer. The number of days allocated is based on your need at the time of assessment and may be adjusted if circumstances change. It may be broken into half day lots. (For further information see below.)
3. Respite Care or Carer Respite may be available for those with higher and/or more complex needs. This type of care is generally taken in a residential care facility. (For further information see below.)
4. Other localised programmes specific to your DHB region. (For further information see below.) Non subsidised options include:
Non-subsidised options include:
• informal solutions such as family members or friends who while they may not be able to offer full time support may be able to provide some short term support.
• privately paying for:
• extra help to come in to your home
• short term/temporary care in a residential care facility. An ? assessment is strongly advised before these services are accessed. You should be informed about this by the manager. What this means is that if for any reason you decide that you do not want to return home then it is very difficult to arrange assessment retrospectively. In circumstances such as this the public health funding bodies are under no obligation to provide a subsidy if it is ever required.
1. Day groups
Day groups are run in a variety of settings such as a local halls, purpose built facilities or residential care homes. The hours of operation vary however residential care facilities may be able to offer more flexible hours. DHB contracted day group
DHB contracted day group
The DHB may subsidise attendance at a day group in a ‘dedicated’ community day facility or rest home. Your assessment will establish whether you are eligible for funding. If you are, then you will be given an allocation of days (usually per year). Those who have funding eligibility are generally required to access a contracted service.
If you choose to go to a day group at a facility that does not have a contract for this then you may have to pay privately. Alternatively, you may be able to use other funding such as Carer Support if you meet the relevant eligibility criteria.
There are dementia day care/activity services in most urban areas for those who require this level of care. DHB contracted facilities should provide a midday meal. Transport to and from the facility is usually provided however in some instances you may have to pay for this, particularly if significant distances are involved.
Day group – alternatively or privately funded
If you want to attend either a community day group or a residential care facility for this purpose and you do not have DHB funding for it there are several other ways in which you may be able to fund this:
• Some services will offer day care/activity at the Carer Support half day rate.
• Alternatively you may be able to claim a ? Disability Allowance (you may not be eligible if you are entitled to subsidised carer relief) which can be applied for from ‘Work and Income New Zealand".
• You can pay privately.
• Some community based programmes may be free.
If you come to an arrangement with a residential care facility ask whether there is a day bed available should you need it e.g. become unwell or need to lie down.
Finally, ask whether the fee covers activities, meals, outings and transport as there may be additional costs. Check with your local service coordinator to see what applies in your region.
For more details about day groups in your area search on Eldernet under the “Support at Home” tab or contact your needs assessment/care/service coordination agency.
2. Carer Support
Carer Support funding is designed to give the carer a break from the care giving role and is allocated to the carer.
The days may be used for either formal or informal support. Carer Support is often taken in ‘block’ periods but it can also be divided into single days and half days.
Formal support (provided by GST registered agencies):
• An agency carer comes into your home. The care/? service coordinator will be able to advise you about organising this.
• Full or part days in a residential care facility i.e. day care/activity type of arrangement may be available in some DHB regions. If you use your Carer Support funding at a residential care facility it is possible that an additional ‘top up’ cost will be charged as there is often a shortfall between the funding and the cost of care. Check with your care/? service coordinator to see what applies in your region.
Informal and non family support (care by non GST registered carers):
• The caregiver can arrange for an alternative carer e.g. a friend or family member (who does not live in the same house) or other non GST registered carer to stay and provide care.
Carer Support funding - Eligibility
You (the client) must have a long term disability. Your carer must either live in the same house as you or live nearby and be providing frequent unpaid care. A determining factor is that you would be unable to live alone without the support of your carer. Other eligibility criteria may also apply.
Carer Support funding – Allocated days
The number of days you are allocated is based on the need at the time of your assessment and may be adjusted if circumstances change. You can increase your carer support days by paying for them yourself if you wish. Your service coordinator will discuss the use of your allocated days with you and your carer so that the best use can be made of them. Carer Support can also be taken in half day blocks (4-8 hours is equivalent to a half day).
Carer Support funding - Payment
If care is allocated under the Carer Support programme your carer manages the use of the allocated days. They need to make the necessary bookings and give the relevant form to those providing care so that they can be paid directly by the Payments Centre.
Occasionally you may have to make an ‘up front payment’ for the care, in which case you need to get a receipt from the person providing the relief care and claim reimbursement from the Payments Centre.
Seniorline provides some information on the rates which are paid for carer support. Rates vary slightly from region to region. A spouse or partner cannot be paid to provide care.
Reimbursement is made within ten working days of the correctly completed claim form being forwarded by the formal agency or the informal carer to the Payments Centre.
The carer will need to discuss with the service coordinator how the time is to be claimed as carer support days may be taken either as a series of half days or as whole days. Reimbursement forms or further information about Carer Support may be obtained by contacting the MOH’s Carer Support Line on 0800 281 222 (then select option one).
3. Respite Care or Carer Respite
Respite Care may be available for those who have a high level of need and whose situation it is determined will benefit from a short and often regular break in a residential care facility. It can also be used to give the full time carer a break from the caregiving role.
Respite Care is used in a variety of ways and how it is implemented varies from DHB region to DHB region. In some regions it may be allocated to those who live alone or it may be used during a social crisis or emergency. Where respite care is provided on a regular basis the purpose is for the residential facility to help you regain, maintain or improve your abilities and your independence in preparation for your return to your home.
Your care/service coordinator will advise whether you are eligible for this service and how it is implemented in your region. You/your carer will not be involved in the payment process as this is managed by the care/service coordination agency.
4. Other carefully managed block periods of care
All DHBs recognise that those receiving help at home may need extra support from time to time. The type of care described above usually meets most needs however in some situations other assistance will be needed. In some regions of the country there are support packages which provide for additional ‘block periods’ of care. Your assessment and care/service co-ordination service will be able to advise you about local policy, its implementation and give you information about what is available in your region (e.g. in some DHB regions there are residential care short stay options where there is a focus on rehabilitation; the aim being to return you to your own home as soon as possible). You will find that the use of short term care for emergencies and convalescence will be closely monitored, particularly if this is funded/subsidised.
Further information about short term programmes may be found on The Ministry of Health Website
Forward planning advised
For many people who are living at home and receiving care, short term breaks are a means of maintaining everyone’s ‘sanity’. When people spend intensive periods of time together a break is usually beneficial for everyone, especially you and your caregiver (if you have one). Plan to take routine breaks such as:
• providing an opportunity for the caregiver to have a break/holiday
• making a regular appointment to engage in activities that you can’t do at home
While it is understandable that a crisis can occur at any time and you might suddenly need to access short term care, anticipating and planning for the future is preferable wherever possible. A needs assessment is therefore recommended for all people who require support (whether they receive help from outside the home or not). Occasions when you might need unplanned access to short term care include:
• the prevention of admission to hospital by carefully managed early intervention
• covering emergency situations (a situation that needs close monitoring)
• convalescence (a situation that needs close monitoring)
Remember your first port of call regarding any enquiries is your local needs assessment care/service coordination agency.
Please note: If you want to trial residential care you must pay privately for this.
© Eldernet 2014