Blog 33: ACAT, HACC and EACHD to boot (pt 2)

Though I laugh at my initial encounter with the Department of Health and the Ageing, I have to admit that the assistance that it offered us, as a result of Bill’s ACAT assessments, proved to be a boon to us.

Bill’s first ACAT assessment was conducted on 28th April 2010. The resultant report, his ACCR  (c.f. BLOG 32), stated that Bill had:

A history of CVA  (2007) with aphasia, mini strokes, cognitive impairment, high cholesterol and duodenal and oesophageal ulcers and, as a result, was displaying gradual decline in functional level and ability to undertake ADLs independently.

The report went on to say that Bill had:

Cognitive impairment with short term memory loss, occasional disorientation to place, occasional verbal and physical aggression towards the carer and night time restlessness and wandering.

After that ACAT assessment, Bill became eligible for subsidised Respite Care at low level.  At first, I refused any help, not knowing how Bill would react to a strange person trying to get him into the shower.  I was happy that the report was on record and that, if ever I couldn’t look after Bill, he could go into a care facility and receive appropriate attention.

But, as the year went on and it became more and more difficult to keep Bill clean, I called in Blue Care for help, with the result that a Blue Care nurse began coming into the house twice, and then three times, a week to help with Bill’s hygiene needs.  It was not the magic bullet that I thought it was going to be, Bill being no more co-operative with the nurses than he was with me but, at least, now, there were two of us on the job and two of us taking responsibility for his cleanliness.  And, I didn’t have to continue to feel that ongoing, nagging worry that I was not looking after Bill properly.

Blue Care nurses came in to help us with hygiene care from January to November 2011.  As well, in the August of that year, much to my great delight, our respite time was increased and a nursing aide began to come each Monday morning to take Bill out in his car for a three-hour jaunt.  I had not expected it to be so, but that three-hour break turned out to be a blessing for me.  I soon found that I could go to the hairdresser, submit tax returns, talk on the phone and so on.  Once I even managed to go to a funeral.  I had worried that Bill would not behave well for a stranger but, right from the start, he enjoyed those trips.  The very interested carer would take Bill to look at things like building sites and boats on the Bay and would, each time that he took him out, take him for a walk in the park before they had their coffee.


In September 2011, Bill underwent his second ACAT assessment.  The report from that assessment noted that Bill displayed:

A marked deterioration in function and cognition ….. that he had very repetitive behaviours ….. that throughout the assessment he was lifting chairs off and on the table for much of the time  …… and that he needed to be asked numerous times to sit down as he was constantly on “the go”.

The report added that Bill:

no longer sleeps in his bed but prefers to sleep in the lounge chair, is unable to discern his own reflection, is resistive to personal care and can be obstructive to attempts to change his clothing and to sponge him.

It went on to say that:

Although he may respond well to single step commands after repeated instructions, Bill lacks comprehension of complex verbal commands and has significant expressive aphasia.

As a consequence of that ACAT assessment, Bill became eligible for an EACHD package which was much more generous than the HACC, entitling him to two hours subsidised care each day, seven days a week.  Since Blue Care had no EACHD packages available at the time, OzCare carers took on the job for us.  Though Bill remained unhappy with the hygiene requirements of the package, he continued to enjoy the drives.  And, each morning, when I opened the front door and he saw the OzCare car, he would urge:

Come on!  Come on!  He’s here!  He’s here!  Hurry up!

And he would pull me towards the car with all the strength that he could muster and beseech me to help him in.


Sometimes, when friends would come for afternoon tea and then prepare to depart, Bill would expect that he should get into their car with them, battering me around as I would try to stop him.  He thought that every car that came into our driveway transported an OzCare worker and that it was there to take him for a drive. In the end, friends and family, when they were leaving, had to sneak out by themselves and the custom of farewelling them with hand waving and horn honking, had to be abandoned.


I am, and always will be, eternally grateful to those Blue Care and OzCare workers who helped Bill and me through that very difficult year of 2011. And I am also thankful to the various Governments that funded that care.  Though the EACHD package cost us $118 a month, the Federal Government, over that year, gave me a fortnightly CarersAllowance of $114 so, in effect, all that care that Bill was given, cost me nothing.

I know that, today, there are carers who are struggling to cope and who need more hours of help. I know that dementia is about to become an epidemic in Australia and I know that a great deal more Government funding needs to be earmarked for dementia research.  But, at the same time, I cannot forget how much Governments are already doing for dementia patients and how much help the Government gave Bill and me over 2011, when we so desperately needed it.

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