How to find aged care even when your parents are reluctant

My mother Rosemary stubbornly refused help as she grew frail in her own home. But it reached a point where she wasn't eating properly or taking her medication. Housework and shopping were almost beyond her.

Some home help would keep her safe in her own home for longer, I told her, but she was very independent and had a million reasons why she didn't want help - she could do everything herself, it would cost money and she didn't want strangers in her home.

She never wanted to be a bother to anyone, so it was an all-consuming effort to get her to accept help.

The first step in getting aged care help is to book an assessment with an aged care assessment team (ACAT, or ACAS in Victoria). It can be a long wait to be assessed, in my case six months.

Eventually Rosemary joined the 500,000 older people around Australia in the Commonwealth home support program.

She received six hours of help per week spread over four days and she qualified for a low-cost package because she was on a part age pension.

The carers who saw Rosemary treated her respectfully but eventually her vascular dementia worsened. They said she needed 24-hour attention, which meant live-in care or moving into an aged care home.

Of course she wanted to stay in her home but 24-hour home care is expensive. A friend's family spent $250,000 a year for an at-home service, using an agency that provided three shifts of carer per day, so there were night and weekend rates.

Figures vary for nursing homes but I found that the most expensive in Sydney cost around $100,000 a year in fees on top of the bond.

Adamant that she could manage, Rosemary wouldn't hear about moving. It became a terrible battle.

Choosing a good nursing home is a bit like choosing a school for your kids. Just as the headmistress and quality of the teachers is key, so too are the manager and the staff.

Ask your friends and neighbours about their parents' aged care homes.

I asked my chemist, mum's doctors - the GP, the geriatrician - and the social worker at the hospital. You might get a crumb of advice that can turn out to be gold and save you a lot of time.

You should still meet the manager and see for yourself but it helps to narrow down the long list of choices.

Also pick an aged care home close to you so it easy to visit. If dementia is evident, my advice is to look at an aged care home with suitable care early on.

There are often no vacancies in good nursing homes so it is vital to get your parent's name on a waiting list.

If you don't and your parent ends up in hospital and can't go home, then they can be sent anywhere there is a bed even if it is a long way from where you live.

If you find a home you like but there is a waiting list, call up the manager regularly. Once you have found a spot, get to know the staff, especially if your parent is difficult.

Rosemary found a newish, low-care nursing home with a small number of rooms and a dynamic diversional therapist who ran plenty of activities. But when she fell and broke her hip and then later her shoulder, she needed high care so we had to go through the whole selection process again.

She grew quite fond of the home and the staff and was keen to return after a day out.

But adapting is stressful for old people, so it is best to choose a nursing home that offers the full range of care, or "aging in place", which is much more prevalent under the new rules for aged care homes introduced last year.

What to do

• Organise a meeting with an aged care assessment team. The waiting list can be long.
• Visit myagedcare.gov.au or phone 1800 200 422 and look at the nursing homes in your area. Make appointments to visit them. You need an assessment before they will see you.
• Discuss the cost of the bond and day rates so you know the costs. There are layers of fees and some are means-tested.
• Don't run yourself ragged. Use some of the carer services and seek carer counselling by phone. Contact Carers Australia on 1800 242 636 for more help.
• Submit applications to your preferred homes. Keep in contact about availability.
• Does it have a around-the-clock nursing care ? Remember to budget for equipment such as a wheelchair or a reclining day chair.

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