Older people living with disability make up a substantial proportion of the Australian community with 2.3 million Australians aged 65 years and over living with disability. This represents 41% of all Australians with disability; a rapidly growing cohort of older Australians, up from 1.9 million in 2018.Â
Older Australians with disability now make up the majority of the aged population and their needs are profound and complex. They require access to disability-specific supports to meet these needs.Â
The current aged care system does not cater to the needs of older Australians living with disability, especially those with fluctuating or episodic disability or health conditions. Older people living with MS need access to supports that meet their MS specific needs.Â
MS Australia is calling for the following action for people living with disability aged over 65:Â
MS Australia welcomes the new Aged Care Act being delayed to 1 November to ensure that providers, care recipients and the Department of Health, Disability and Ageing are appropriately prepared. Â
However, there are currently more than 80,000 Australians waiting for a home care package at their approved level, with wait times of up to 12 months. Under the aged care reforms 83,000 new Home Care packages were due to be rolled out from 1 July 2025 and this has now been postponed until November.
We join with the Older Persons Advocacy Network (OPAN) and Independent Members and Senators in calling for the government to release an additional 20,000 home care packages now. This will ensure that wait times do not blow out further and that the government can stay on track to match their commitment to reduce wait times under the new Support at Home Program to 3 months from 1 July by 2027Â
The longer that people wait for appropriate aged care, the higher risk of increased disability, hospitalisation and early entry into residential aged care.Â
For people living with MS, improvements in MS diagnosis, access to more effective Disease Modifying Treatments (DMTs), improvements in environmental exposures and health behaviours and improved management of health comorbidities have resulted in disability milestones being reached almost eight years later on average. Â
The prevalence of MS and the life expectancy and average age of people living with MS have increased significantly during the last two decades. This has led to an increasing number of older people living with MS.Â
People living with MS over the age of 65 are more likely to have a progressive form of MS, with 63% living with either primary progressive, secondary progressive or progressive relapsing MS. This leads to increased mobility issues, co-morbidities, psychological and cognitive problems, bowel and bladder dysfunction and limitations on undertaking activities of daily living. Â
As a result of these changes in the MS disease trajectory, people living with MS are increasingly accessing supports later in life (over the aged of 65), need more complex, disability specific supports and need them for a longer period. Â
It is critical that the new aged care system can meet the needs of older people with MS. People should have access to disability specific supports, regardless of their age and be supported to maintain their independence and remain in the accommodation of their choice. Â
The Royal Commission into Aged Care Quality and Safety (Aged Care Royal Commission) found that older people with disability receiving aged care do not have access to services and supports at the same level as those provided to people through the NDIS. The Aged Care Royal Commission recommended the new aged care system includes equity for people with disability (recommendation 72):Â Â
By 1 July 2024, every person receiving aged care who is living with disability, regardless of when acquired, should receive through the aged care program daily living supports and outcomes (including assistive technologies, aids and equipment) equivalent to those that would be available under the National Disability Insurance Scheme to a person under the age of 65 years with the same or substantially similar conditions.Â
The findings of the Royal Commission were supported by the NDIS Review which made the following recommendation:Â
The Australian Government should implement legislative change to allow participants once they turn 65 to receive supports in both the NDIS and the aged care system concurrently and clarify when aged care supports are reasonable and necessary (Action 2.11, NDIS Review Final Report).Â
The Final Report also notes that ‘People aged over 65 will likely benefit from foundational supports but should receive most of their supports from the aged care system’.  Â
The proposed Support at Home pricing will have significantly higher funding levels that the current home care packages. However, there is still a significant gap compared to the current levels of funding available to people living with MS under the NDIS. Â
The new Support at Home classifications will provide funding of between $11,000 and $78,000 per year. Even allowing for some additional funds from the new Assistive Technology and Home Modifications (AT-HM) program, there is still a significant disparity with NDIS funding. Outlined below are the average annual payments for NDIS participants with MS:Â
NDIS participants with MS | 6 months to 5 years | 5 to 18 years |
|---|---|---|
All participants | $104,200 | $134,000 |
Participants in Supported Independent Living (SIL) | $525,100 | $577,400 |
Participants not in SIL | $85,500 | $114,700 |
As outlined in the data above, there is a gap between the annual committed and annual spent budget for NDIS participants. Currently, participants face administrative and planning challenges that prevent them from spending their full budget. If the government implements the finding of the NDIS review, then participants will have greater opportunity to spend their full committed budget. This would make the gap between NDIS payments and the proposed aged care budgets even more significant. Â
This data also shows that participants who have access to SIL have significant budgets. Access to appropriate housing is crucial to people living with MS maintaining their independence. Older people with disability need access to housing that is driven by participant choice and control and that best meets their individual needs and long and short-term goals. Â
The aged care service list for the new Support at Home Program does not include all the disability supports available under the NDIS and has a strong emphasis on people moving to residential aged care when their needs increase.Â
Support to live independently, build skills, transition through life stages, train support workers, travel independently and engage fully in the community are not available under this new program. Further, many supports such as specialist behaviour support are only available in residential aged care.Â
A gap in suitable supports for olde people with disability will lead to quicker disease/disability progression, increased hospitalisation, loss of independence and choice and early entry to residential aged care.Â
MS Australia has provided a range of submissions on the aged care reforms. These submissions draw on the experiences and expertise of MS Australia’s Lived Experience Expert Panel (LEEP) and our state and territory Member OrganisationsÂ
Our State and Territory Member Organisations provide a range of aged care services. Â
Services vary across each organisation and may include home care packages, personal care, community services allied health and nursing. Â
You can find more information at the links below:Â
