Care navigators effective and important, report finds

Care navigators are a much-needed initiative to help older people engage with Australia’s complex aged care system, according to a government evaluation of the scheme.

A trial of the Aged Care System Navigator – which began in 2018 and was extended and refined through 2021-22 following positive evaluation findings – has tested various models of providing older people and their families with personalised information and support to help ease access to aged care services.

“Overwhelmingly, we found that the navigator services are providing much needed and much appreciated support for older people and their families,” say the evaluators in the 81-page report that examines the extension trial period.

Indeed, 95 per cent of customers agreed the support provided met their needs and 98 per cent indicated they would recommend the service to others.

“These high rates of satisfaction are in large part due to navigators’ commitment to taking the time to understand the customer and their needs,” say the evaluators.

Twenty-two partner organisations – coordinated by COTA Australia – were funded to deliver the care navigator (or care finder) services under the extension program, with 24 trials operating in 28 locations across all states and territories.

The trials revealed what we all know,” COTA Australia chief executive officer Patricia Sparrow told Australian Ageing Agenda. “That our aged care system can feel like a maze for many people, so ensuring people get clear education and support to help them is important. Crucially, they also demonstrated that people who had difficulty accessing and utilising aged care could, with the right support, be assisted to engage with the aged care system.”

She added: “It also highlighted the need for intensive face-to-face support for vulnerable hard-to-reach populations who may not be connected with support services or may need assistance in establishing those services in the way they want.” 

Between July 2021 and May 2022, the extension trials provided 8,164 older Australians with help and support.

Care finder staff assisted clients by talking to My Aged Care on their behalf, arranging assessments and appointments, attending and providing support at appointments, finding aged care providers and services in the client’s area, completing forms and providing assistance with understanding service agreements.

The care navigators also helped customers connect with other relevant supports in the community including health services, mental health services, social services, housing and homelessness services, drug and alcohol services and community groups.

“By adopting a person-centred approach, navigators were able to build trust and rapport with a diverse range of customers, including those who have had negative experiences of government services in the past,” say the evaluators.

Key learnings

Analysis of a range of data collected over the first 12 months of the extension program’s operation – which included consultation with navigators, their customers and intermediaries – offered the following lessons on how navigator services are designed and delivered in future:

• a flexible, person-centred approach to service delivery is critical
• effective promotion of navigator services requires a combination of localised and national approaches
• engaging intermediaries – who can identify and connect potential customers with their local navigator – is essential but can be resource intensive
• the boundaries of the navigator role are not always clear cut
• navigators require access to appropriate training and support
• navigators would benefit from improved access to My Aged Care functions
• navigator organisations require early clarity about their reporting obligations
• staffing services with an appropriate number of qualified and experienced navigators is important but difficult.

According to the evaluators, the shift towards a paid, experienced, and qualified navigator workforce has been “viewed positively” with partner organisations employing people with backgrounds in aged care or community services.

Recruitment of people with soft skills – such as problem-solving or an ability to work autonomously – are also important, say the evaluators.

Engaging intermediaries to meet with potential customers in places they frequent – such as RSLs, senior citizens’ centres and libraries – also proved effective.

Having received help to access aged care services, customers were found to be more confident about taking control of their own interactions with the system, say the evaluators.

While noting that the evaluation of the navigator trials was “largely positive”, Craig Gear – CEO of the Older Persons Advocacy Network – told AAA it identified a number of key areas where improvements could be made. 

“Organisations that are commissioned by primary health networks for care finders must have the adequate skill, cultural knowledge and independence to engage with hard-to-reach populations.”

Ms Sparrow, meanwhile, told AAA the wait for services was another problem highlighted during the trials. “Once assisted with service eligibility, people found they were navigating to nowhere because there were no services available in a timely manner in their local communities.”

Response times must be reduced, said Ms Sparrow: “If we’re serious about providing the quality support older Australians need, reform to home and community aged care needs to ensure that no one waits longer than 30 days between registering with My Aged Care and their services commencing.”

Rollout underway

In the 2021-22 budget, the Albanese Government committed $272.5 million over four years to expand the care navigator service and establish a network of community care finders – the rollout of which began in January.

Among the bodies coordinating the service is Eastern Melbourne PHN. It has appointed the following organisations to operate care finders in their local government areas:

• Care Connect for Knox, Manningham, Maroondah, Monash, and Yarra Ranges
• healthAbility for Banyule, Boroondara, Nillumbik, Whitehorse and Murrundindi
• DPV Health for Whittlesea and Mitchell
• Migrant Information Centre for Manningham, Monash, and Whitehorse (focussing on the culturally and linguistically diverse community).

Providers who previously delivered the Assistance with Care and Housing program will also transition to be care finders, predominantly with a focus on homelessness and people at risk of homelessness:

• Villa Maria Catholic Homes for Knox and Whitehorse
• Salvation Army for Boroondara, Manningham, Monash, and Whitehorse
• Merri Outreach Support Service for Banyule, Nillumbik, and Whittlesea
• Wintringham for Banyule, Knox, Maroondah, Monash, Nillumbik, Whitehorse, and Whittlesea
• Housing for the Aged Action Group providing intake services across the EMPHN catchment.

“OPAN supports former ACH providers becoming care finders due to their extensive experience and quality engagement with older people at risk of, or experiencing, homelessness,” Mr Gear told AAA.  

“However, given the recommendations from the first evaluation report of the navigators trial that services should, where possible, be independent of aged care service providers, we query the number of in-home and residential aged care service providers commissioned as care finders by PHNs.” 

Also delivering the care finder service is Bungree Aboriginal Association. Available to both Aboriginal and non-Aboriginal clients, the care finder service will be offered to residents in the Central Coast, Lake Macquarie, Cessnock and Maitland local government areas of New South Wales.

Bungree Aboriginal Association CEO Suzanne Naden said the care finder services were vital in supporting vulnerable people.  

“This could be an older person who has no trusted carer or support person, someone who has difficulty communicating, finds it difficult to understand information, is reluctant to engage with aged care or government or who will be in an unsafe situation if they do not receive services,” said Ms Naden

“I’m thrilled Bungree Aboriginal Association is able to launch this vital service to further assist vulnerable people within our community access the care they need,” she added.

Meanwhile, a care finder network has been established in Western Australia by the WA Primary Health Alliance – the operators of WA’s three PHNs.

The organisations participating include:

• WA Country Health Service 
• Australian Red Cross Society
• Amity Health
• Advocare Incorporated
• St Bartholomew’s House
• People Who Care
• Umbrella Multicultural Community Care Services
• Chung Wah Association
• Chorus Australia
• Dementia Australia
• South West Aboriginal Medical Service
• Tuart Place
• City of Stirling.

“There are some older Australians who, for a range of reasons, may experience significant barriers to understanding and gaining access to the aged care system,” said Mark Cockayne, WA Primary Health Alliance general manager commissioned services.

“The new care finder services are a welcomed response to the need for local, face-to-face support in the community for older people who require enhanced support to navigate the complexity of the aged care system.”

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