What is access to services?
Access to care includes how older people and their families engage with the aged care system at entry and how they continue to engage with aged care providers over time. This access is supported by the new Aged Care Act and easy access to services supports rights-based care. [1]
How is access to services a barrier to rights-based care?
Barriers to access include structures and systems designs that make accessing and navigating care difficult.
The lack of adequate services, information about eligibility and guidance on navigating the aged care system creates significant barriers for older people and families. Although consumer-directed care is intended to promote autonomy, the lack of information and the difficulty of navigating the system mean that older people and families rely on familiar care options for fear of change or additional financial costs. [2, 3]
Potential users become frustrated at the point of access when they lack the technology or infrastructure to access the system. Once inside, systems that are complex, inaccessible or poorly structured limit participation and informed choice. For example, older people seeking care might have difficulty navigating care options and processes online. [2-4]
Similarly, cultural, language and digital barriers at the system level restrict access for minority, rural and culturally and linguistically diverse populations. [2, 4, 5]
Funding constraints and economic pressures limit staffing, training, environmental quality and service availability, restricting older people's access to the care they need. [6-8]
How does access to services enable rights-based care?
Systems that enable rights-based care are easy to access and are provided in several formats that suit culturally and linguistically diverse people, those with varying levels of health literacy and provide flexibility over time.
Supporting older people’s care needs begins when a decision is made to seek aged care services. Factors that enable autonomy and choice in navigating information and care options include:
- Providing information in plain language, so it can be easily understood
- Curating the range of care options, so people navigating decisions do not become overwhelmed
- Allowing adequate time for older people and their supporters to make and consider decisions regarding care
- Providing culturally responsive care options and translation support
- Building in flexibility so older people can adjust their care services over time as their needs change. [2, 3]
What can be done?
Improve access to clear, inclusive information and navigation
Policy makers:
- Can work to provide accessible, multilingual and plain‑language information systems across entry points (e.g. My Aged Care) that improve older people’s access to these services.
- Through developing better system navigation and reducing administrative complexity for consumers, they can have better access.
Aged care leaders:
- By providing clear explanations of services, costs, and care options and actively checking understanding, older people will have better access to their services.
- Can try using care coordinators or navigators to support decision‑making and improve access to rights-based care.
The evidence:
- Lack of accessible, tailored information and time constraints limit participation in care planning. [5]
- Online entry systems and poor information formats create barriers to access and understanding of the aged care access points. [4]
- Clear communication, structured choice and support improve decision‑making and access for older people and their families. [2, 3]
Strengthen participation, autonomy and supported decision‑making
Policy makers:
- By embedding rights‑based participation and co‑design requirements in legislation and standards, access to rights-based care can be improved.
- Encourage the use of supported decision‑making approaches, especially for people with cognitive impairment, to improve their access to rights-based care.
Aged care leaders:
- By involving residents actively in care planning, goal setting and daily decisions, residents have better access to the types of care they desire.
- By shifting staff practices from “doing tasks” to enabling independence and autonomy, residents can enjoy access to rights-based care.
The evidence:
- Service users must be fully involved in their care, particularly for those with disabilities. [5]
- Task‑focused care limits independence and autonomy for older people. [5]
- Participation and autonomy are improved when residents are actively involved and supported in decision‑making. [4, 5]
Address inequity, discrimination and structural barriers to access
Policy makers:
- Can target funding and policy to reduce inequities for CALD, LGBTI, rural and cognitively impaired populations and as a result, improve their access to care.
- By strengthening workforce capacity, staffing levels and training, rights‑based care access to services can be improved.
Aged care leaders:
- Implement culturally responsive care, translation support and inclusive practices.
- Invest in workforce training, environmental improvements and flexible service models.
The evidence:
- Cultural, language and trust barriers limit access for minority groups. [4, 5]
- Workforce shortages, low literacy and provider control of information restrict access and choice. [2, 7]
- Addressing discrimination, improving training and culturally responsive communication support equitable access. [2, 9]
Want to learn more?
ARIIA provide a range of programs to support leaders and teams in solving problems and improving their skills.
The Provider guidance in the Quality Standards explains how to meet standards that embed rights, dignity and person-centred care. They also show what ‘good’ rights-based accessibility care looks like in practice.
This link provides more information about the timeline for accessing aged care services from the Australian Institute of Health and Welfare.