Aged-care providers are screening out older people with high-support needs and ending clients' services without warning because of debts they were unaware of.
The Older Persons Advocacy Network's Presenting Issues report has identified the top issues facing the $36 billion aged-care system as: poor communication, difficulties finding service providers and barriers to accessing assistive technology.
The network's chief executive Craig Gear said the report, released on Tuesday, "shines a light on the cracks in a system that's close to breaking point" and is "a stark reminder of how much work still needs to be done".
The report found issues raised last year had not been addressed "and older people continue to face challenges and breaches of human rights when accessing and receiving aged care", he said.
Drawing on more than 52,000 cases, the report noted that some aged-care homes now required a short respite stay before they would consider an application.
"Residential aged-care providers seemed to particularly focus on 'screening out' people with high behavioural support needs and complex interacting disabilities," the report said.
"These are the very people who end up falling through the cracks, having a poor quality of life and dying with pain that could have been managed, indignity and struggle at home, and/or in inappropriate longstay hospital settings."
The report cited a case study involving a person with long-term mental health issues, incontinence and poor mobility who had spent almost a year in hospital and had agreed to move to an aged-care facility.
But a team of hospital social workers that contacted 21 residential aged-care providers had all inquiries rejected and "it was implied that the older person's past suicidal ideation and complex care needs were deciding factors".
Older people's inability to access services they were entitled to was one of the top issues.
"This illustrates the human cost of the 120,000-plus people on the wait list for assessment or reassessment, and the 108,000-plus people on the wait list for a Home Care Package," the report said.
There were also reports that residential aged care "is effectively full, with an occupancy rate between 94 per cent and 98 per cent".
Significant issues around debt were caused by poor communication, with people experiencing stress and hardship because their services ended without warning or the were being pursued by debt collectors.
In one case, a provider demanded that the client pay 100 per cent of their age pension in order to settle the debt, or they would be evicted.
The government said on Tuesday it had delivered 6665 Home Care Packages of the extra 20,000 it had promised before the program transitions to the new Support at Home program on November 1.
It expected this number to reach 10,000 by the end of the week.
"Demand for in-home care has more than doubled in the last five years, with an anticipated 320,000 people to have a Home Care Package allocation by October 31, compared to around 155,000 in 2020," the government said.
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