Dementia patients warned off seeking home care in case Australia’s aged care algorithm cuts funding

Exclusive: FoI documents show senior health officials were warned of concerns about assessment tool weeks after it launched

People with dementia were warned not to apply for home support because of fears their care would be downgraded by the government’s aged care algorithm.

Documents released to Guardian Australia under freedom of information (FoI) laws reveal the warnings came within weeks of the November rollout of the algorithm, which is used to determine funding packages and priority of need for older Australians requiring home support.

Home support packages are critical to help prevent avoidable hospital admissions, deterioration and early entry into residential care.

Days before the algorithm was rolled out, the government barred aged care assessors from overriding the Integrated Assessment Tool’s (IAT) decisions, even if the level of funding and priority allocated were wrong or inadequate.

Dementia Australia wrote to senior health department staff on 8 December to say that since the addition of the algorithm, “We remain very concerned about the feedback we are receiving”.

The organisation cited the example of a man caring for his wife with dementia who was on a level three home care package, entitling her to around eight hours of support each week.

But her dementia had progressed and she needed to be reassessed so she could access additional care.

The woman’s husband was “advised by his local assessment service not to pursue a reassessment as they have seen a number of people with dementia receiving less or no support following IAT assessment, even if their care needs are increasing”.

The Older Persons Advocacy Network (Opan) sent a paper to department officials in February warning of deaths occurring due to the failing assessment system, and people with “extreme needs” being left without adequate support before their deaths.

“The inability of clinicians to intervene” and “over-reliance on automated decision-making is contributing to preventable deterioration and in some cases, death,” the document said.

In one example given by Opan, the algorithm refused a funding upgrade for a rapidly deteriorating person, forcing them to pay for private care despite the assessor’s view their existing package was grossly inadequate.

A senior health department staff member shared concerns ahead of a meeting between the department and advocacy groups in late December, the FoI documents show.

“Assessment orgs are telling [people] not to get an assessment as there is no guarantee they will get more funding,” the internal email read, adding that assessors were telling advocacy groups they had not been properly trained on the IAT.