What happens if my care needs change after my initial assessment?

What happens if my care needs change?

If your health, mobility, safety or ability to manage everyday activities changes, your services and support plan may need to be reviewed.

You do not need to wait for a scheduled review. You, your provider or your care partner can request a Support Plan Review when your current support plan no longer reflects your needs.

Speak with your care partner first

If you already have a Support at Home provider, your first step will usually be to speak with your care partner.

Your care partner should:

• discuss what has changed

• review your current care and services plan

• determine whether services can be adjusted within your existing approval and budget

• collect information about your new needs

• help obtain supporting information from health professionals where required

• request a Support Plan Review or reassessment on your behalf

• help maintain essential services while the review is being completed.

All Support at Home participants receive care management, and providers must allocate a care partner to help plan, coordinate and review their care. Helping a participant respond to changing needs is a key part of this role.

Can the provider change my services without a reassessment?

Sometimes.

Your provider may be able to change the timing, frequency or mix of services where:

• the services are already approved in your support plan

• the changes can be managed within your available funding

• the revised services continue to address your assessed needs and goals.

For example, your care partner may be able to reduce domestic assistance and use more of the available budget for personal care if both services are already approved and the change is appropriate.

A formal review may be required if you need:

• a service that is not currently approved

• a higher ongoing funding classification

• additional funding

• assistive technology or home modifications not covered by the current approval

• residential respite or permanent residential care

• substantially different support because your condition has changed.

What is a Support Plan Review?

A Support Plan Review considers whether your existing support plan should be updated.

It may be appropriate after:

• a fall or hospital admission

• a new diagnosis

• reduced mobility

• worsening pain or fatigue

• changes in memory or cognition

• increased difficulty with showering, dressing or meals

• medication or clinical concerns

• the loss of support previously provided by a family member

• increased stress or exhaustion for an unpaid carer

• a change in your living arrangements

• a noticeable improvement that means some services are no longer required.

The assessor may update the existing support plan or decide that a more complete reassessment is needed.

When is a full reassessment required?

A full reassessment may be needed where the changes are significant or your current funding and approvals are no longer adequate.

The assessor may consider whether you require:

• a different Support at Home classification

• a higher level of ongoing funding

• new clinical or allied health services

• additional personal or practical support

• short-term restorative support

• assistive technology or home modifications

• respite or residential aged care.

A request for more funding does not automatically result in a higher classification. The assessor considers your current abilities, risks, goals, health conditions and available informal support.

Can I contact My Aged Care myself?

Yes. You do not have to rely on your provider to make the request.

You can contact My Aged Care on 1800 200 422 and explain what has changed. You can also request a review through a Services Australia Aged Care Specialist Officer.

However, where you already have a provider, involving your care partner is usually helpful because they can provide service records, observations and other evidence supporting the request.

What happens after the review?

Depending on the outcome:

• your existing support plan may remain unchanged

• approved services may be added, removed or adjusted

• a reassessment may be arranged

• you may receive a different funding classification

• you may receive approval for additional types of care.

You should receive an updated support plan and, where a new approval decision is made, an updated Notice of Decision.

Your care partner should then update your provider care plan and budget with you, explain what has changed and organise the revised services.

What should I prepare?

It helps to provide practical examples of what has changed.

This could include:

• hospital discharge information

• reports from a GP, physiotherapist or occupational therapist

• details of falls or near falls

• changes in medication or medical conditions

• examples of tasks that have become difficult

• details of increased help being provided by family

• information about carer stress or reduced carer availability.

Do not simply say, “I need more funding.” Explain what has changed, what risks have developed and which activities you can no longer manage safely.

What if my income or assets change?

A change in income, assets or pension status may affect the contribution percentage you pay for some Support at Home services.

This is generally handled through Services Australia’s financial assessment process, rather than through a Support Plan Review. Tell Services Australia if your financial circumstances change so your contribution rate can be reassessed.

The simplest starting point is:

Tell your care partner as soon as your needs change. They should review what can be adjusted immediately and help arrange a formal review or reassessment when your current approval is no longer sufficient.

What should I do next?

Confirm the details with My Aged Care or the relevant provider, write down your questions and ask for important information in writing before making a decision.

Helpful Local Home Help resources

• Start with Liz

• Signs an older person may need help at home

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