Carer resources · Waiting list and assessmentStandardised Assessment and Waiting List for Elderly Care Services
All subsidised long-term care services (subsidised places, day care and home care) are entered through the same door: the standardised care need assessment mechanism for elderly services. The most common misunderstanding is to think that the queue is something you register for yourself somewhere. In fact the assessment comes first and the waiting list second, and without an assessment the older person has never joined a queue. This page goes through the whole mechanism from application to waiting for a place.
The application process from start to finish
Apply through a referral pointIf the older person is still in hospital, the family can contact a medical social worker. If the older person is living in the community, they can ask the District Elderly Community Centre or an Integrated Family Service Centre for help. The social worker who handles the referral first gets an initial picture of the situation and then arranges for a recognised assessor to follow up.
Have the assessmentThe assessor uses standardised assessment tools to get a full picture of the older person's self-care ability, cognitive and behavioural state, health and nursing needs, and family support. The assessment is usually carried out at the older person's home or at a centre. It focuses on the older person's real ability in daily life, and not just on which illness the person has.
Receive the assessment resultThe result confirms which type of service the older person is suited to (for example community care or residential care) and the matching service level. This assessment result is the entry ticket for applying for all government-subsidised services later on.
Join the waiting listThe older person is placed in the matching queue according to the service type confirmed by the assessment, and can wait for more than one type of eligible service at the same time. Waiting times can be very different between service types and districts, and the actual time always follows the Social Welfare Department's latest announcements.
While waitingIf the older person's health changes clearly, the family can ask for a reassessment so that the service level can be adjusted. How care is arranged during this gap while waiting for the service is often the part that most families find hardest, and it is discussed in detail below.
In the whole application system, the assessment in the first step is what should be dealt with earliest. Waiting for a subsidised service often takes several months or even years, while the assessment itself is free, and passing it does not mean the service has to be used straight away. Completing the assessment early therefore means getting the entry ticket for the older person first. If the application is rushed only when the service is really needed, the family can only start queuing from the beginning.
Ways to fill the care gap while waiting
The assessment and waiting list system only handles the procedure of queuing. It does not solve the real question of who looks after the older person during the wait. In practice only three kinds of resource can fill this gap.
- Community services as support—Day care centres, residential respite and home care services: some of these are also applied for through the standardised assessment, and the wait is usually shorter than for a residential place. How they work is explained in day care centres and respite.
- Sharing the work with paid help—Escorts to appointments, hourly carers and live-in domestic helpers buy time with money. For the options and division of work, see escort to appointments and hiring help.
- Redividing the work within the family—In the gap while waiting for a service, the most common difficulty is that one carer carries all the work alone. Night care, covering holidays and escorting to appointments use up the most energy, and it is worth setting each of these out and dividing them among different family members. The parts that family members really cannot share are where paid help or community services are needed.
The two most common problems with assessment and waiting
The first is starting too late. Many families apply for an assessment only after the carer falls ill or the older person falls and is injured, and only then find a long queue ahead. It is better to apply for the assessment early, and especially when an older person has just been discharged from hospital and physical function has clearly declined. Contacting the hospital's medical social worker directly to start the assessment is the most natural moment.
The second is waiting in the wrong queue. After the older person's condition gets worse, the family goes on waiting in the queue for the original level and does not know that a reassessment can be requested. As long as the older person's condition changes clearly while waiting, the family should go back to the original referral point and ask for a reassessment, so that the queue they are in matches the real need.
Assessment and waiting are only one of six care gateways. For information on allowances, residential care homes, hiring help and respite services, see the full guide in the overview of carer resources.
Where do I apply for the standardised assessment?
The application does not go to the Social Welfare Department directly. It must be made through a recognised referral point. If the older person is still in hospital, contact a medical social worker. If the older person is living in the community, ask the District Elderly Community Centre for the area, an Integrated Family Service Centre or some Elderly Health Centres. The referral point then arranges for a recognised assessor to visit the home, or to carry out the assessment at the centre. Under this system, the first step in applying is always to contact a social worker, and not to look for an application form yourself.
What does the assessor actually assess?
The assessor uses standardised tools to review the older person's overall care needs. These cover self-care ability (eating, bathing, toileting and mobility), cognitive and behavioural state, health and nursing needs, and family care support. The result decides whether the older person is suited to community care services or residential care, and sets the service level. The assessment looks at the older person's real ability in daily self-care and not just the name of a medical diagnosis. At the assessment, family members must therefore describe honestly how the older person does on their worst days, and should not claim that everything can be managed out of concern for face.
Does waiting start automatically after the assessment?
Once the assessment confirms eligibility, the older person is placed on the waiting list for the approved type of service (for example a care-and-attention home place, a nursing home place or community care services), and can wait for more than one type of eligible service at the same time. If the older person's health changes clearly while waiting, the family can ask for a reassessment through the original referral point to adjust the service level. Many families do not know about this arrangement, and wait a long time in a queue that no longer matches the real need.
How long is the wait?
Waiting times differ greatly between service types and districts, and they change with policy, so this page does not give specific figures that would soon be out of date. Actual waiting times should follow the Social Welfare Department's announcements, and the referring social worker can also give the latest information when you apply. In planning care, a more useful principle is to understand that waiting is often counted in months or even years, so the assessment must be started early and not left until a care crisis breaks out. In fact the gap in care during the wait is the difficulty most families really have to face.
Disclaimer: This article is general health information and is not professional medical advice. If you have any health concerns, please consult a qualified healthcare professional.
