C O M M U N I T Y S E R V I C E S C O M M I T T E E R E P O R T

Agenda Item 5.5

18 May 2006

LIFELONG MELBOURNE 2006 – 2016 DISCUSSION PAPER

Division Assets & Services

Presenter Michael O’Hanlon, Manager Community Development

Purpose

1. To seek endorsement of the City of Melbourne discussion paper, Lifelong Melbourne 2006 – 2016 Creating Opportunities for over 55s, for consultation.

Recommendation from Management

2. That the Community Services Committee endorse the discussion paper, Lifelong Melbourne 2006 – 2016 Creating Opportunities for over 55s, prior to the paper being distributed for community consultation with residents, visitors and service providers.

Key Issues

3. The current Aged Care Strategy, Baby Boomers and Beyond: Strategies for over 55s Forward Plan for Older People 2003 – 2006, expires at the end of 2006. A key part of the ongoing review of the strategy is community consultation regarding the current needs of older residents and visitors to the city.

4. The Lifelong Melbourne 2006 – 2016 Creating Opportunities for over 55s discussion paper (Attachment 1) will be used to inform further consultation with residents, service providers and peak aged care agencies about the needs of older residents over the next 10 years.

5. As a result of the consultation a Lifelong Melbourne 2006-2016 Aged Care Plan will be developed and include an action plan detailing key initiatives for the next three years and identifying relevant resource requirements.

6. The City of Melbourne has a 45 per cent forecast growth in resident numbers over the next 10 years. Over the same period the proportion of the municipality’s population aged over 55 years will increase by three per cent to 19 per cent, estimated at 18, 900 people in 2015. The proportion of the population over 65 years will increase from eight to 10 per cent during the same period.

7. The anticipated growth in residents aged 55 years and over will not be spread evenly across the municipality. The areas experiencing the greatest growth will be Docklands, CBD and Southbank. In 2015 the highest number of residents aged 55 years and over will live in the CBD, Docklands, Carlton and Southbank.

Page 1 of 54

2

8. In order to assist in the prioritisation of resource allocation the discussion paper provides a comprehensive analysis of the relative need of local areas within the municipality. The analysis draws on a range of indicators. While providing a consistent safety net of service to all areas, the paper suggests that priority in the first three years of the plan be directed towards Carlton, North Melbourne and Kensington. The paper suggests services should also develop new ways of supporting older people in the newer high rise communities.

9. The City of Melbourne provides a comprehensive range of home and community based services for older people. Over the past five years demand for services has remained constant with fluctuations in some service types determined by consumer need. The increase in the number of people aged 55 years and over and the anticipated generational change over the next 10 years will force a rethink of how older people are supported. The emerging generation of Melbourne’s older residents will have different expectations, with an increasing desire for new opportunities, preference and flexibility in their lifestyle choices.

10. There will be a 30 per cent increase in residents aged 80 years and over. This group is more likely to require higher levels of support, including access to residential care.

11. The most significant unmet need of older people in the municipality is for high care residential beds. The City of Melbourne is appreciably under the Commonwealth Government’s benchmark for high care residential beds as currently there are only 30 untargeted high care beds in the municipality. This puts Melbourne at risk of being unable to support its most frail resident who will be forced to seek care in neighbouring municipalities. A Residential Care Plan for Melbourne will be developed in the next phase of the Aged Care Plan and will form the basis for advocacy with the State and Commonwealth Governments.

Time Frame

12. The presentation and formal endorsement of this discussion paper to the Community Services Committee marks the end of Phase 1 of the Aged Services Plan process. It is anticipated that Phase 2, culminating in the development of Lifelong Melbourne 2006-2016, Aged Care Plan, will be presented to Committee in November 2006 for consideration.

Relation to Council Policy

13. Aged care planning sits within Council’s integrated planning framework and is informed by key Council policies and strategies including: Baby Boomers and Beyond: Strategies for over 55s Forward Plan for Older People 2003 – 2006; City Plan 2010; Council Plan 2005 – 2009; Disability Action Plan 2005-2009; Arts Strategy 2004 – 2007; Active Melbourne; Multicultural Policy 2005 – 2009 and the Municipal Public Health Plan.

Consultation

14. Internal and external consultations were conducted as part of the formation of this discussion paper. These consultations were conducted with three aims: to inform participants of Council’s current role in aged care planning and service provision; to seek advice on future directions for aged care; and, to establish strategic and service partnerships both internally and externally.

15. Public consultations on this discussion paper will utilise a range of methods to ensure that comment is received from all interested groups including people with disabilities and from CALD backgrounds. The paper will encourage informed debate on aged care challenges and will result in a combined commitment to improving opportunities for older residents.

Page 2 of 54

3

Government Relations

16. In Victoria, local government is the major provider of Home and Community Care Services. Funding and service agreements are in place with Federal and State Governments, with all levels of government contributing to the funding of municipal aged care services.

Finance

17. Consultation will occur within the existing recurrent budget. Capital and recurrent initiatives arising from the consultation will be costed and referred to the usual budget process.

Legal

18. There are no direct legal implications arising from the recommendation made in this report.

Sustainability

19. This discussion paper addresses the issue of sustainability in the following ways:

19.1. the decision to review the aged care service models at the City of Melbourne is aimed at implementing models of care that are both more appropriate to clients as well as more sustainable within an environment of increasing demand. During the consultation the concept of an environment volunteers group focused around older residents will be investigated.

Comments

20. The challenges for Council in responding to the needs of older people over the next 10 years include:

20.1. High Density Local Area Needs: The Docklands, CBD and Southbank will all experience the most rapid growth of residents aged 55 years and over. To respond to these neighbourhoods, strategies will need to take into account both the type of accommodation and the particular needs of these residents;

20.2. Creating Choice for Residents: the so-called baby boomer generation will expect a greater degree of choice and flexibility in the services provided to them by local governments;

20.3. Building Supportive Communities: in order to respond to the often unseen issue of isolation, neighbourhood services will become even more important;

20.4. Service and Infrastructure Requirements: many of the initiatives outlined in the discussion paper will require capital works. A Community Infrastructure Strategy is currently being developed by Community Services and will incorporate requirements for the provision of aged care services;

20.5. Technology Strategy: international trends support the utilisation of technological aids to support the independence of older people. This will be a significant area of development for action in the Aged Care Plan. Additionally, the provision of more health and service information through electronic processes has been identified as an emerging need; and

21. A range of possible responses to these challenges are canvassed in Section 8 of the report –Proposed Future Directions and will be further developed through community consultation.

Page 3 of 54

Attachment: 1. Lifelong Melbourne Aged Care Plan: 2006 – 2016

4

Background

22. The development of this discussion paper continues the City of Melbourne’s forward planning process for older people. Council has previously endorsed two aged care plans. The current aged care plan: Baby Boomers and Beyond, A Strategy for Over 55s, Forward Plan for Older People 2003-2006 initiated the discussion and planning for an ageing population.

23. The discussion paper presents a table of key aged care issues and responses from an international perspective; the research undertaken is based on an international literature review looking at political, economic, social, technological, environmental and legal viewpoints. The analysis highlights key international trends in aged care and the likely implication for aged care services at the City of Melbourne.

24. The discussion paper lists key policy papers ranging from international to local and provides a summary of key priorities.

Page 4 of 54

Attachment 1 Agenda Item 5.5

Community Services Committee 18 May 2006

Discussion Paper Lifelong Melbourne

Aged Care Plan: 2006 – 2016

Creating opportunities for people over 55 years in the City of Melbourne

Community Services City of Melbourne

May 2006

Contact: Michael O’Hanlon Telephone: (03) 9658 9907

Page 5 of 54

Contents Executive summary.......................................................................................................1 1. Introduction ............................................................................................................3

1.1 A new older generation..............................................................................3 2. Policy Framework..................................................................................................4

2.1 City of Melbourne.......................................................................................4 2.2 Council Plan 2005 - 2009 ..........................................................................4 2.3 Policy review ..............................................................................................5

3. Key facts and figures .............................................................................................5 3.1 Demographic and service profile and funding...........................................5

Chart 2: City of Melbourne residents 2001-2015 - aged 55 plus by year.....6 Chart 3: City of Melbourne residents aged 55 plus by neighbourhood........7 Chart 4: Residents aged 80 plus by year......................................................7

4. City of Melbourne aged care service delivery 2000 to 2005.................................8 4.1 Residential care .........................................................................................8

Map 1: City of Melbourne residential aged services and over 70s populations for 2005......................................................................................9

5. Funding ................................................................................................................10 Chart 5: City of Melbourne funding of aged services 2001/02 ...................10 Chart 7: City of Melbourne funding sources 2001 – 2005..........................11

6. Key indicators and determinants of need............................................................12 7. Establishing new principles and policies to meet emerging needs ....................12

7.1 Offering choice rather than one size fits all .............................................12 7.2 Fostering independence and self care ....................................................12 7.3 Providing older residents with information and services.........................12 7.4 Promoting active and supportive neighbourhoods..................................12 7.5 Building on our strengths .........................................................................13

8. Proposed key directions ......................................................................................13 Appendix 1 ...................................................................................................................15

City of Melbourne aged service provision ...........................................................15 Social Support Program ......................................................................................15 Home and Community Care Services.................................................................15 Home Care Program............................................................................................15 Respite Care Program.........................................................................................15 Personal Care Program.......................................................................................16 Home Maintenance Program ..............................................................................16 Delivered Meals Program....................................................................................16 Centre Based Meals Program.............................................................................16 Ethnic Meals Program .........................................................................................16 Community Bus Program ....................................................................................16 Adult Day and Support Services Program ..........................................................17 Community Aged Care Packages .......................................................................17 Linkages...............................................................................................................17

Appendix 2 ...................................................................................................................18 City of Melbourne neighbourhoods......................................................................18 Central Business District.....................................................................................18 Docklands ............................................................................................................19 Carlton..................................................................................................................19 East Melbourne....................................................................................................20 Kensington ...........................................................................................................20 North Melbourne ..................................................................................................21 Parkville................................................................................................................21

Page 6 of 54

Southbank............................................................................................................22 South Yarra – St. Kilda Road ..............................................................................22 West Melbourne (residential) ..............................................................................23

Appendix 3 – Key research and findings.....................................................................24 Political .................................................................................................................24 Economic..............................................................................................................26 Social....................................................................................................................27 Technological .......................................................................................................29 Environmental ......................................................................................................30 Legal.....................................................................................................................31

Appendix 4 Policy framework .................................................................................32 Local government ................................................................................................32 State government.................................................................................................34 Federal government.............................................................................................37 International organisations...................................................................................38

Appendix 5 Key indicators and determinants of need............................................39 Appendix 6 ...................................................................................................................41

Promoting choice - meals provision options........................................................41 Appendix 7 ...................................................................................................................42

Council’s role........................................................................................................42 References...................................................................................................................43

Page 7 of 54

1

Executive summary

Australia’s ageing population is a central social, political and economic issue for local, state and national governments. As increasing numbers of baby boomers join the 55 plus age group, a significant generational shift is taking place. Ideas about what it is to be ‘old’ are undergoing a transformation, along with the lifestyle choices, attitudes and expectations of the individuals who make up this emerging older generation.

The different lifestyle choices of this new generation of seniors are reflected in the City of Melbourne’s demographic forecasts. The key growth areas for people aged 55 and over will be the CBD, Docklands and Southbank. This presents a series of new challenges for the development and delivery of effective aged care programs and services.

So what are the implications of this changing demographic landscape for policy makers, service providers and the broader community? Can existing service delivery models and approaches to aged care adapt to the demands of an increasingly active, informed and sophisticated generation of seniors?

This discussion paper presents a broad overview of the key issues, implications and possible responses to these emerging questions. It is informed by extensive research, discussion and comprehensive consultation with service providers and staff from across Council.

The City of Melbourne takes an open approach to the provision and development of quality aged care services. Innovations ranging from the introduction of ethnic meals to door to door community buses reflect Council’s commitment to responding to seniors’ needs in a flexible and creative way.

Council can continue to respond to the changing demands of seniors through innovative programs that promote active, positive ageing and community participation. The concept of active ageing recognises that seniors have a great deal to contribute and much to gain by participating fully in recreational pursuits, cultural activities and broader community life.

Programs like local meal groups and organised intergenerational and volunteering activities can play a crucial role in supporting and engaging seniors. A focus on neighbourhood activities and fostering a sense of strong local community can provide a sense of belonging. Reshaping the delivery of aged care services will involve a greater emphasis on active living programs, other responses could include placing a new emphasis on assisting people through better assessment and practical home alterations.

Technology plays an important role in developing and delivering new programs and services to meet the needs of seniors. Technological advances are opening up new opportunities for seniors’ health and social inclusion. Practical examples include aids to monitor medication levels, personal alarms, and the ability to link in real time to relatives and carers.

At the same time as the discussion paper is being considered Council will be finalising its Community Infrastructure Plan. Information from both processes will identify current gaps in infrastructure and services and develop new strategies to address these shortages with the State and Commonwealth Governments and the community for Council consideration.

Page 8 of 54

2

A series of workshops will be held over the next few months and a final Lifelong Melbourne Plan will be presented to Council for consideration in November 2006.

To provide feedback on this plan, email lifelongmelbourne@melbourne.vic.gov.au or contact Council’s Aged Services Policy Officer on 9658 9769.

Page 9 of 54

3

1. Introduction

This paper provides an overview of current thinking, research and demographic data from local, national and international sources. The material supports and informs the proposed principles and policies presented in section eight. These principles and policies propose new directions for aged care in the City of Melbourne for debate and refinement and detail the emerging needs for Council’s consideration.

In developing the discussion paper, the City of Melbourne undertook the following activities:

• established a project plan listing key documents, plans, strategies and reports;

• identified and consulted internal and external stakeholders; and

• sourced and reviewed relevant literature, models and data from various local, national and international sources to support the recommendations made.

1.1 A new older generation

The worldwide trend towards population ageing will dominate the political landscape over the next 50 years, affecting the health and socioeconomic development of all nations. In Australia, the baby boomer generation will increase the over 65 age group by 50 per cent over the next 10 to 15 years. At the same time, a dramatic increase in life expectancy is increasing the number of people aged 80 and over. The number of people aged 80 and over in Australia will double over the next 20 years. Women will constitute the majority of the aged community.

Melbourne will experience a 75 per cent increase of in the city’s aged population within the next 10 years (from 10,800 in 2005 to 18,906 in 2015). This issue will impact directly on the City of Melbourne and the provision of aged services.

As outlined earlier, the baby boomer generation will age differently from previous generations and bring with them high expectations of the service system, forcing a shift from a needs-based approach to a rights-based approach. Planning for the ageing of the population at national and state levels has so far focused on developing a highly integrated service system and strategies to deal with rising health costs. In Victoria, community-based health reforms over the next couple of years will enhance the role of local government in local area planning and partnerships.

Promoting active ageing is widely identified as an essential response to the ageing of the population. Active ageing assists in delaying or preventing age related diseases and is therefore economically beneficial both for individuals and for society at large. For ageing populations, priorities at the individual and community levels will be to maintain physical and mental functioning and to promote independence, social and civic participation, dignity, care, and active engagement with life.

The City of Melbourne is experiencing a substantial increase in new residents who are attracted to the culture of the central city and its surrounds. This group is tertiary educated, affluent, well informed about health and wellbeing issues and lead active lives. Delays in the onset of chronic illnesses associated with ageing will see a rise in the number of healthy, active aged people, enabling people to engage in collective, community activities such as volunteering and other civic opportunities.

Page 10 of 54

4

Despite the affluence of new residents, research shows that social disadvantage within Melbourne is more concentrated within neighbourhoods in Carlton, North Melbourne and Kensington. Those who do not own their own homes are vulnerable to insecure housing as they age. Women are more likely than men to experience poverty in old age and an increasing number of people will live alone. Research indicates that socially isolated people die at two to three times the rate of people who have regular social opportunities. It is evident that aged and isolated residents will require a range of social support services.

There is a global movement towards promoting healthy cities to improve health outcomes for residents. This encompasses aspects such as the capacity to walk easily in the city, personal safety, accessible public transport and air quality. Having the opportunity to connect with the environment through parks, gardens, animals and pets is also important, and is known to reduce the number of visits to doctors and increase feelings of safety and community belonging.

Buildings also impact on health and are of particular importance in our community, with Australians reportedly spending 90 per cent of their time indoors. Building design is a key factor in maintaining older people in their own homes, and is best done at planning stages to avoid the cost of retrofitting. In the United States, strategies to support ageing in place include naturally occurring retirement communities in apartments or building complexes. Communities become eligible when at least half of the households are headed by a person aged 60 years or older. Support services are invested within the community to enable residents to continue living in their homes.

Legal issues raised by the ageing of the population include those of age discrimination in the workplace as well as provision of services, elder abuse, standards of care for service provision, duty of care responsibilities and occupational health and safety issues for the workforce, such as lifting and working in isolated home environments.

This discussion paper is the first part of a comprehensive review and response to this broad range of issues. The particular issues outlined in this section are explored further in Appendix 3.

2. Policy Framework

2.1 City of Melbourne

Council has developed an integrated planning framework to ensure that the actions undertaken and the policies and strategies developed work towards the achievement of the vision expressed for the city. City Plan 2010 Council’s primary planning strategy sets out what must happen over the next 10 years.

2.2 Council Plan 2005 - 2009

The Council Plan is the key document that guides Council’s strategic direction over the next four years. It outlines the strategies that will be undertaken to ensure Melbourne achieves the visions outlined in City Plan 2010.

Council Plan commits the City of Melbourne to undertake and action the appropriate planning for aged services in the City of Melbourne.

3.3.07 Investigate the current and future service needs of aged people and their carers, including home and community care. Identify gaps and develop and implement a new long-term strategy for the city. (Council Plan 2005-2009)

Page 11 of 54

5

2.3 Policy review

Key aged care policy and planning documents from local to international forums have been reviewed as part of the research for this discussion paper. The importance of planning for ageing populations is a consistent message from the research to assist people to maintain independence and social connection.

Actions seen as supporting these outcomes include: the use of assistive technologies for monitoring at risk people and aiding frail people with tasks of daily living; ensuring greater service flexibility to meet the needs of emerging community needs; and ensuring the design of buildings takes into account the safety and accessibility for older people.

A complete list of the policy documents reviewed for this discussion paper is contained in Appendix 4.

3. Key facts and figures

This section provides detailed demographic information about the number of older people in the City of Melbourne.

3.1 Demographic and service profile and funding

The City of Melbourne’s population is forecast to grow by 45 per cent from 2005 to 2015.

The Australian population is ageing, fertility rates are falling and life expectancy is increasing. This means that by 2015 approximately 16 per cent of the Australian population will be aged 65 and over. This number will rise to 25 per cent in 2050. Over the same period, the City of Melbourne’s population of people aged 65 years and over is forecast to increase only slightly from 8 per cent of the total population in 2001 and 2005, to 9 per cent of the total in 2010 and 10 per cent in 2015.

The City of Melbourne’s proportion of people aged 55 and over will remain fairly constant over the next 5 to 10 years. Forecasts show that there will be significant increases in both the overall number of residents and the number of residents aged 55 and over in Melbourne.

Page 12 of 54

6

18,906 14,760 10,800 7,586

0 2000

4000 6000 8000

10000 12000 14000 16000 18000 20000

2010

2015

2005

2001

Chart 1: City of Melbourne residents 2001-2015 - population by age group

2001

2005 2010

2015

0

20,000

40,000

60,000

80,000

100,000

Res

iden

ts

50,675 67,300 83,460 98,220

The increased number of residents aged 55 plus will not be spread evenly across the City of Melbourne. The Docklands, CBD and Southbank will experience rapid growth between the years 2005 to 2015.

In 2015 the neighbourhoods with the highest number of residents aged 55 and over will be the CBD, Docklands, Carlton and Southbank.

Chart 2: City of Melbourne residents 2001-2015 - aged 55 plus by year

Page 13 of 54

7

2001 2005

2010 2015

0

500

1,000

1,500

2,000

2,500

1,088 1,416 1,761 2,016

Po

pu

lati

on

Chart 3: City of Melbourne residents aged 55 plus by neighbourhood

Chart 4: Residents aged 80 plus by year

People aged 80 and over are far more likely to require support to maintain independence in their daily lives. This chart shows a 30 per cent increase in people aged 80 and over from 2005-2015.

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

Po

pu

lati

on

2001 2005 2010 2015

2001 1,212 21 858 561 890 1,124 775 1,497 409 239

2005 1,488 827 1,043 648 1,702 1,257 945 1,589 930 369

2010 2,000 1,889 1,206 824 2,565 1,443 1,208 1,661 1,441 519

2015 2,213 3,476 1,355 951 3,499 1,554 1,418 1,735 2,037 669

Carlton DocklandsEast

MelbourneKensington Melbourne

North Melbourne

ParkvilleSouth Yarra

-St Kilda Road

SouthbankWest

Melbourne

Page 14 of 54

8

4. City of Melbourne aged care service delivery 2000 to 2005

The City of Melbourne provides a comprehensive range of home and community based services for older people. These services include:

• assessment;

• case management;

• home care;

• personal care;

• respite care;

• planned activity groups;

• community transport;

• community meals;

• delivered meals; and

• home maintenance.

Demand for home care services has remained constant between 2000 and 2005, with rises and falls for individual services determined by client requirements.

The City of Melbourne’s home care services are currently provided under contract by Southern Cross Care (VIC).

Council has retained responsibility for assessment and case management and ensures that the services provided to older residents are reliable and of a consistently high quality. Council manages the demand for, provision of and overall coordination of home and community services for older people. There are currently no waiting lists for essential services.

4.1 Residential care

The most significant unmet need of older people in the City of Melbourne is for high care residential beds. The closure of a 180 bed high care facility in Parkville in 1998 marked the beginning of serious shortfall in high care beds in the City of Melbourne. Currently there are only 30 high care beds available to the community however, these are dementia specific beds. A number of small providers have maintained facilities in the municipality, along with some larger providers who provide hostel care beds.

Based on Commonwealth Government planning benchmarks (40 high care beds per 1000 people over 70), Melbourne requires 120 beds for its current 70 plus population of 3,775 (ABS Census 2001). This indicates a shortfall of 90 high care beds. Unless action is taken to establish new beds in the City of Melbourne, this shortage will become chronic as the number of older people living in the municipality grows.

Page 15 of 54

9

There is a range of difficulties facing existing providers of residential aged care in the inner city area, including increased regulation of nursing homes which can be difficult for small providers to comply with within current resources. Similarly, new providers have so far found the land cost within the City of Melbourne to be prohibitive, with the consequence that new facilities are usually established in the outer areas of the Melbourne metropolitan area. If this trend continues, the City of Melbourne will be at considerable risk of being able to support only a healthy, younger population, with older people having to leave the city if they require nursing home support.

The map below illustrates the current distributions of residents aged 70 years and over. It also highlights current availability of residential aged care. There are approximately 190 low care beds available and only 30 untargeted high care beds, which is an inadequate number to meet current demand in the municipality.

Map 1: City of Melbourne residential aged services and over 70s populations for 2005

Page 16 of 54

10

5. Funding

The City of Melbourne’s aged care services are funded through a diversified funding stream that includes all levels of government, as well as user contributions. Council is a major financial contributor for aged care services to its residents. Services are offered through a variety of specialised programs including Community Aged Care Packages, Linkages, the Home and Community Care program, the Department of Veterans Affairs Home Care and the National Respite for Carers Program.

The available information would indicate that Council is increasing its proportion of total funding for services, while state and federal government efforts have reduced in comparison, as has income from service fees.

The charts below show the proportion of funding contributed by all levels of government and client fees for aged services in the municipality for the period 2001-2005. Council funding has increased by five per cent as a proportion of total costs. Client contributions have decreased over the same period and may require a review.

The proportion of federal and state funding has also fallen. This highlights the need for Council to advocate with federal and state governments to increase their funding contributions for aged care services.

Chart 5: City of Melbourne funding of aged services 2001/02

State42%

Federal5%

Fees10%

Council43%

`

Page 17 of 54

11

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

2001 2002 2003 2004 2005

$

Cost to Council Other Fees Federal grants Other state grants

Home & Community Care grant

Chart 6: City of Melbourne funding of aged services 2004/05

Chart 7: City of Melbourne funding sources 2001 – 2005

Council48%

Fees8%

Federal4%

State40%

–

Page 18 of 54

12

6. Key indicators and determinants of need

In order to assist Council to prioritize resource allocation a comprehensive statistical analysis of the relative need of local areas within the municipality has been conducted. The analysis draws on a range of indicators. While providing a consistent safety net of service to all areas, evidence would suggest that priority in the first three years of the plan be directed towards Carlton, North Melbourne and Kensington. The paper suggests services should also develop new ways of supporting older people in the newer high rise communities (Appendix 5).

7. Establishing new principles and policies to meet emerging needs

As the baby boomer generation ages, the City of Melbourne will increasingly be faced with different demands and expectations in relation to aged care services and support that Council provides. This emerging generation of seniors does not necessarily see themselves as having entered old age, but prefers to see retirement as a time to reinvent themselves and explore new aspects of life.

7.1 Offering choice rather than one size fits all

The baby boomer generation has higher expectations of service systems. It is likely that these expectations will expose shortcomings of the existing Home and Community Care model and general aged care service provision. A review of Council’s tendering strategy of services is needed to address these implications.

7.2 Fostering independence and self care

Reshaping the delivery of Council’s services will entail a greater emphasis on active living programs, a tighter ceiling on low level in home care and an extension to medium and higher end care. To complement these initiatives, a new emphasis will be placed on assisting people through an occupational therapist assessment of their homes and activities. There will also be a greater focus on aids and equipment that can provide assistance to older people in managing tasks that might otherwise put the person at risk.

7.3 Providing older residents with information and services

The emerging generation of older people will require more immediate modes of access to health and information services. This can be achieved through improvements in technology and planned access to mainstream services.

7.4 Promoting active and supportive neighbourhoods

Council will investigate neighbourhood based models of care to respond to community desire for choice and flexibility in service delivery. The aim of these models is to increase community connections and provide a broader range of choices for residents. For example, Council may establish neighbourhood meal groups and investigate partnering with existing volunteer organisations to create intergenerational programs.

Page 19 of 54

13

7.5 Building on our strengths

This plan builds on the City of Melbourne’s rich history of leadership and innovation in aged care. Ethnic Meals, Arts and Culture programs and the Community Bus are examples of Council’s lead in innovation.

Appendix 6 contains an example of how these principles could be used to promote choice for residents requiring assistance with meals and social support.

8. Proposed key directions

The following table details a range of proposed key directions for the City of Melbourne. These directions will be explored further through the community consultations in the development of the final Aged Care Plan.

Issue Proposed response

More choice § review service tendering strategies

§ provide residents with more options in home care and meals services.

Increase demand for home care

§ delay need for home care program through increased use of technology, social support and recreation programs.

Review information strategies required for emerging older groups

§ provide aged care and support in combination with mainstream services such as libraries and community centres

§ develop effective and innovative information technology strategies

Increased isolation of frail older residents

§ develop gender specific social support programs, for example, men’s shed, women’s network

§ improved community transport across the municipality.

Contain demand for aged care § expand successful Parks and Recreation and Arts and Culture programs

§ adapt homes to encourage independence § establish and expand social support programs in

priority neighbourhoods

§ develop new models of social support in high rise communities

Limited use of home care services by culturally and linguistically diverse groups

§ develop new service models with Culturally and Linguistically Diverse organisations.

§ facilitate older culturally and linguistically diverse groups access to Council premises

Increasing numbers of 55 plus living in the City of Melbourne

§ apply for Extended Aged Care at Home packages of care from the Commonwealth Government.

Page 20 of 54

14

Gaps in community facilities. § review existing senior citizens’ centres in Carlton

and South Yarra § develop new models for facilities and

mainstream services such as libraries and community centres

§ purpose built day care facility within municipality

§ develop facilities in high rise estates.

Shortage of residential care beds

§ support provision of residential care beds in Docklands

§ develop a residential care plan for Melbourne

§ advocate with federal and state governments to identify land and capital.

Page 21 of 54

15

Appendix 1

City of Melbourne aged service provision

This section provides an overview of services and programs run through the aged and disability services area.

Social Support Program

The Social Support Program offers community based activities and support for older people. The provision of this service is based on the principles of positive ageing. Positive ageing programs aim to counter some of the negative aspects of ageing, such as deteriorating health, reduced mobility and social isolation.

The Social Support team directly run or contribute to the following activities:

• ethnic meals subsidy;

• the organisation of the annual Seniors’ Christmas Festival;

• the quarterly City of Melbourne seniors’ newsletter, Out and About;

• day trips to parks, gardens and attractions in Melbourne and regional Victoria;

• tickets to musicals and theatre productions;

• guest speakers; and

• Victorian Seniors Week.

Home and Community Care Services

Home and Community Care (HACC) Services are jointly funded by all levels of government through service agreements with the Department of Human Services. These services are commonly referred to as Home and Community Care services and comprise a suite of services aimed at assisting people to retain an independent lifestyle within their community and home.

Home Care Program

The Home Care Program provides people with basic cleaning and domestic services. In 2004/2005, 413 individuals were assisted by this service through the provision of 19,949 hours of home care. Home Care Escorts are also provided under this service. These escorts are provided to people to assist with shopping and administrative tasks when it is not possible for individuals to use the community bus service. In 2004/2005, 136 individuals used the Home Care Escort Service and 5,693 hours of service were provided.

Respite Care Program

The Respite Care Program provides carers of older people or people with a disability with an opportunity to take a break from their caring role. In 2004/2005, 50 individuals were assisted with this service and 3,708 hours of service were provided.

Page 22 of 54

16

Personal Care Program

The Personal Care Program provides people with assistance in daily personal hygiene, including showering, grooming and toileting. In 2004/2005, 146 individuals used this service, and 17,274 hours of Personal Care were provided.

Personal Care Escort services are offered as part of the Personal Care Program. These escorts are provided to people for medical appointments such as dialysis or chemotherapy. In 2004/2005, 29 individuals used this service, and 758 hours of service were provided.

Home Maintenance Program

The Home Maintenance Program assists people with minor maintenance tasks around the home and aims to ensure health and safety are met. Services include the installation of rails, clearing gutters, replacing locks and gardening. In 2004/2005, 133 individuals used this service and 325 hours of service were provided.

Delivered Meals Program

The Delivered Meals Program is aimed at people whose health is at risk because they are unable to prepare all of their own meals. A delivered meal consists of fruit juice, soup, a hot main meal with vegetables and a hot or chilled desert. Meals are delivered to a client’s home five days a week, with weekend meals being provided chilled on Fridays. The meals delivery staff provide a daily monitoring and feedback on the client’s wellbeing. In 2004/2005, 31,295 meals were provided to 208 individuals.

Centre Based Meals Program

The aim of the Centre Based Meals Program is similar to the general meals program, with the additional aspect of providing the meals in a community setting such as the East Melbourne Neighbourhood Group or senior citizens’ centres. Meals are available five days a week. In 2004/2005, 11,400 meals were provided to 215 individuals through this program.

Ethnic Meals Program

The Ethnic Meals Program is funded through the Community Services Annual Grants Program. This program supports older people’s culturally and linguistically diverse community groups to assist their members through the provision of lunches. Grants can be used to subsidise the preparation of their own meals or to purchase meals. Priority is given to groups of 20 or more who meet in the City of Melbourne, are from a non-English speaking background and who are not able to source alternative funding. In 2004/05 more than $65,000 was provided by Council for this program, which subsidised 22,000 meals.

Community Bus Program

The Community Bus assists aged and frail people to maintain their links with the community by providing a series of trips to shopping and recreation centres, including the City and Carlton Baths, day centres, the Prahran Market and Barkly Square Shopping centre. This service is wholly Council funded. In 2004/2005, 18,037 Community Bus trips were provided.

Page 23 of 54

17

Adult Day and Support Services Program

The Adult Day and Support Services Program, also known as Planned Activity Group, aims to provide stimulating, recreational support services and outings for older frail people, including people with dementia. The service offers isolated people a chance to be involved in enjoyable activities and outings with other people in their community. The service also assists carers of older people by providing them with respite from their caring duties while their friend or family member attends day centre. The day centre services are currently run from Council owned premises in Canning Street. In 2004/2005, 62 individuals attended the day centre and 14,290 hours of service were provided.

Community Aged Care Packages

Council currently receives funding from the Australian Government for 12 Community Aged Care Packages. These packages are designed for people with more complex needs and are the equivalent of low care in a residential setting. The role of the case manager is to establish the suite of services required by the client and then provide ongoing support, coordination and management of the client’s care needs.

Linkages

Currently the City of Melbourne receives state government funding for 25 Linkages packages. These packages are aimed at providing clients with complex needs with in-home support, community support, the provision of aids and equipment and case management.

Page 24 of 54

18

Appendix 2

City of Melbourne neighbourhoods

Central Business District

The population of the Central Business District (CBD) of Melbourne was 11,678 in 2004.1

The demographic characteristics of the CBD relevant to social support planning are set out below:

• there has been a 26 per cent annual increase in the population of the CBD in the years since 2001;

• the strongest growth in CBD residents to the year 2021 is expected to be in the 65-69 year old cohort;

• people aged 60 years and over compromise 8 per cent (934) of the CBD population compared to 11 per cent in the City of Melbourne;

• People aged 75 plus was the only age bracket to decrease in population size between 1996 and 2001 (3 per cent);

• the most prominent household structure in the CBD is group households (25 per cent), followed by lone households (18 per cent);

• the majority of families in the CBD are couples without children;

• forty nine per cent of residents in the CBD were born overseas, with the most common language other than English being Indonesian;

• fewer Australian born residents live in the CBD than in any other suburbs of the City of Melbourne;

• household income appears to be lower than in other parts of the City of Melbourne*;

• CBD residents received on average only 8 per cent of all pensions and benefits in the City of Melbourne in 2004. Of these, 188 were in receipt of the Aged Pension, 188 were in receipt of the Disability Support Pension, and 508 received Rent Assistance;

• sixty per cent of residents in the CBD accessed the internet in the week prior to the ABS 2001 Census, with 70 per cent accessing it at home;

• seventy per cent of all dwellings in the CBD are residential apartments;

• fifty four per cent of all dwellings in the CBD are rented*; and

• there was a high non-response rate to these questions in the ABS 2001 Census.

1 Melbourne City Research Branch, City of Melbourne Population Estimates

Page 25 of 54

19

Docklands

Docklands is the newest and fastest developing suburb in the City of Melbourne. It had a population of 2,818 in 2004 and is expected to grow to 15,000 in 2021. The demographic characteristics of the Docklands precinct relevant to social support planning are set out below:

• Docklands has experienced high levels of growth since 2001;

• people aged 60 and over years make up 4.2 per cent (fewer than 180) of the population compared to 11 per cent in the City of Melbourne;

• the strongest growth in population in the Docklands area to the year 2021 is expected to be in the 75-79 year old age bracket;

• around 52.9 per cent of households in the Docklands area are comprised of couple only families;

• all dwellings in Docklands are residential apartments;

• only 17 per cent of Docklands residents were born outside of Australia, and of those, only 9 per cent speak a language other than English – the highest being Mandarin at 3 per cent;

• approximately 80.4 per cent of residents have internet access at home; and

• Docklands is one of the more affluent suburbs in the City of Melbourne with 62 per cent of residents earning over $800 per week and accounting for only 0.4 per cent of all pensions and benefits in the City of Melbourne.

Carlton

The population of Carlton was 11,047 in 2004.2 The demographic characteristics of Carlton relevant to social support planning are set out below:

• the residential population of Carlton is expected to grow by up to 6,500 by 2021, with the strongest growth in the 35-39 year age group;

• ten per cent of the suburb’s population is aged 60 and over;

• a greater percentage of Carlton residents (49 per cent) were born overseas compared to the City of Melbourne average of 38 per cent -the most common languages other than English being spoken at home being Mandarin (9 per cent), Cantonese (8 per cent), Arabic (4 per cent), Vietnamese, Somali and Italian (all per cent);

• group households comprise 25 per cent of household types, and lone households comprise 18 per cent;

• the most common family type in Carlton is couple only families (39 per cent);

• Around 61 per cent of Carlton residents accessed the internet in the week prior to the ABS 2001 Census, which is very close to the City of Melbourne average of 62 per cent;

2 Sustainable City Research Branch, City of Melbourne Population Estimates

Page 26 of 54

20

• a higher percentage of Carlton residents (32 per cent) compared to the City of Melbourne as a whole (24 per cent) earn less than $200 a week;

• approximately 15 per cent of all pensions and benefits received by City of Melbourne residents were received by residents of Carlton in 2004 - including Aged Pension (479), Disability Support Pension (340) and Rent Assistance (524); and

• around 59 per cent of the dwellings in Carlton are flats, units or apartments and 69 per cent of all dwellings are rented, which is higher than the City of Melbourne average of 58 per cent.

East Melbourne

The population of East Melbourne was 3,939 in 2004 and is expected to reach 5,681 in the year 2021. The demographic characteristics of East Melbourne relevant to social support planning are set out below:

• twenty one per cent of the suburb’s population is currently aged 60 years or older;

• the greatest rate of population growth to the year 2021 is expected to be in the 70- 74 year old age group;

• overseas born residents comprise only 21 per cent of the population, Italian being the most common language (2 per cent) other than English to be spoken at home;

• East Melbourne has a low proportion of group homes, with households predominantly being made up of couples without children (64 per cent);

• residents of East Melbourne have high levels of tertiary qualifications and 59 per cent reported having used the internet in the week prior to the ABS 2001 Census;

• this suburb is one of the most affluent in the City of Melbourne, with 29 per cent of residents earning more that $1000 per week;

• East Melbourne residents received on average only 4 per cent of all pensions and benefits for the City of Melbourne, with the Aged Pension accounting for 40 per cent of that figure;

• the most common dwelling type is residential apartments and compared with the City of Melbourne as a whole, the suburb has a relatively low proportion of rented accommodation; and

• East Melbourne is home to a significant number of public and private hospital and clinics providing both metropolitan and statewide services.

Kensington

Kensington’s population in 2004 was 4,312 and is expected to grow to 6,442 in 2021.

The demographic characteristics of Kensington relevant to social support planning are set out below:

• currently Kensington’s population of people aged 60 years and over is only 15 per cent of its total. The greatest growth to 2021 is expected in the 65-69 year old age group;

Page 27 of 54

21

• 31 per cent of the suburb’s residents were born overseas, with Vietnamese being the most common language after English, to be spoken at home (6);

• Lone households comprise 14 per cent of those in the area;

• Kensington had the lowest proportion of residents accessing the internet prior to the ABS 2001 Census;

• the proportion of residents earning more than $1000 per week increased significantly between the 1996 and 2001 Census;

• Kensington residents received 30 per cent of all City of Melbourne pensions and benefits in 2004 – the most common being the Age Pension (28 per cent); and

• a higher percentage of Kensington residents either own or are purchasing their homes (47 per cent) compared with the City of Melbourne average.

North Melbourne

North Melbourne’s population was 7,635 in 2004 and is expected to grow to 9,508 residents in 2021. The demographic characteristics of North Melbourne relevant to social support planning are set out below:

• currently the 60 plus population accounts for 23 per cent of North Melbourne’s total population and the strongest growth to 2021 is expected in the 60-69 year old age group;

• overseas born residents account for 40 per cent of the population and 35 per cent do not speak English at home. Cantonese is the most common language after English at 7 per cent;

• lone person households comprise 17 per cent of households in North Melbourne;

• around 62 per cent of residents reported having used the internet in the week prior to the ABS 2001 Census;

• income levels in North Melbourne are at the lower end with 26 per cent earning less than $200 week and a further 20 per cent earning between $200-400 per week;

• North Melbourne residents received 18 per cent of all City of Melbourne pensions and benefits (accounting for 12 per cent of the total population of the LGA). The most common being Rent Assistance (642), the Age Pension (637), Newstart Allowance (522) and the Disability Support Pension (480); and

• the majority of houses in North Melbourne are rental properties (56 per cent).

Parkville

The population in Parkville in 2004 was 5,282 and is expected to grow to 7,749 residents in 2021. The demographic characteristics of North Melbourne relevant to social support planning are set out below:

• twenty three per cent of the suburb’s population is aged 60 years and over and the greatest growth to 2021 is expected to be in the 65-74 age group;

Page 28 of 54

22

• 27 per cent of residents were born overseas and 25 per cent speak a language other than English at home - Mandarin and Cantonese being the most common (4 per cent);

• lone households comprise only 16 per cent of all households in Parkville;

• the highest number of City of Melbourne residents accessing the internet prior to the 2001 Census lived in Parkville - a reflection of the high number of tertiary students in the suburb;

• thirty nine per cent Parkville residents earn less than $200 per week – again a refection of the high number of university students in the area;

• only 16.7 per cent of pensions received were the Age Pension; and

• fifty two per cent of all dwellings in Parkville are rental properties.

Southbank

The population in Southbank was 6,745 in 2004 and is expected to more than double to 15,316 residents in 2021. The demographic characteristics of North Melbourne relevant to social support planning are set out below:

• just 8 per cent of the Southbank population is currently aged 60 or older, although the expected growth to 2021 is anticipated predominantly in the 60-74 year old age group;

• forty four per cent of Southbank residents were born overseas – the City of Melbourne average is 38 per cent;

• around 39 per cent of these residents report speaking a language other than English at home, with Indonesian being the most prominent (27 per cent );

• the most common household type in Southbank are couples without children (60 per cent), and lone households comprise 14 per cent;

• seventy per cent of Southbank residents reported having accessed the internet in the week prior to the ABS 2001 Census;

• twenty six per cent of residents earn more than $1000 per week and 17 per cent earn less than $200 per week;

• Southbank residents were in receipt of only 2 per cent of all City of Melbourne pensions and benefits, with Rent Assistance making up nearly half of those benefits; and

• around 54 per cent of the apartments in Southbank are rented.

South Yarra – St. Kilda Road

The population in the South Yarra – St. Kilda Rd. precinct in 2004 was 5,415 and is expected to rise to 6,341 residents in 2021. The demographic characteristics of South Yarra – St. Kilda Road relevant to social support planning are set out below:

• the 60 plus cohort accounts for 16 per cent of the suburb’s population currently;

• the greatest area of population growth to 2021 is expected in the 70 -74 year old age group;

Page 29 of 54

23

• twenty six per cent of the population nominate were been born overseas, and the majority are from English speaking countries;

• residents living alone account for 26 per cent of the household types in South Yarra – St. Kilda Road and 15 per cent of the City of Melbourne’s lone person households;

• Nearly 30 per cent of residents earn more than $1000 per week with only 15 per cent of residents earning less than $200 per week;

• South Yarra- St Kilda Road residents receive 10 per cent of all City of Melbourne benefits, with 30 per cent being in receipt of the Age Pension; and

• around 46 per cent of dwellings (83 per cent are residential apartments) are rented.

West Melbourne (residential)

The population in West Melbourne was 2,799 in 2004 and is expected to rise to 5,290 residents in 2021. The demographic characteristics of West Melbourne relevant to social support planning are set out below:

• six per cent of the population is aged 60 years or older;

• the greatest area of population growth to 2021 is expected in the 75-84 age groups;

• thirty five per cent of residents were born overseas and 40 per cent speak a language other than English at home – Cantonese (15 per cent), followed by Mandarin (12 per cent) and Indonesian (8 per cent);

• 10 per cent of residents in West Melbourne live alone;

• only 54 per cent of residents had accessed the internet in the week prior to the ABS 2001 census (the City of Melbourne average is 62 per cent);

• it is difficult to draw a conclusion about income levels in West Melbourne due to a low rate of response to income related questions in the ABS 2001 Census;

• residents of West Melbourne are in receipt of 4 per cent of all pensions and benefits - 33 per cent being for the Disability Support Pension and 26 per cent for Rent Assistance; and

• around 49 per cent of dwellings in West Melbourne are rented.

Page 30 of 54

24

Appendix 3 – Key research and findings The following tables present key aged care issues and responses from an international perspective covering a broad range of political, economic, social, technological and legal matters. The analysis highlights key international trends in aged care and outlines the possible implications for aged services at the City of Melbourne.

Political

Factors Implications for the City of Melbourne Aged Services

International The ageing population is a global trend, across developed and developing nations. This demographic transformation will affect the health and socioeconomic development of all nations. (Kinsella and Phillips, 2005). Gender differences are evident in ageing populations. Women constitute a majority of the older population in almost every country (Kinsella and Phillips, 2005). Emergence of concepts of ‘successful ageing’, ‘active ageing’ and ‘positive ageing’ (WHO, 2005, Kinsella and Phillips, 2005). Prevalence towards ‘care in the community’ ‘ageing in place’ and ‘joined up services’ (Olsberg and Winters, 2005).

§ leadership opportunity to develop new models of service delivery tailored

to the expectations of the “baby boomer” generation for aged care/community services

§ need to meet baby boomer expectations for flexibility, choice and sophisticated health literacy

§ civic engagement will be both an expectation and a skill of baby boomers. Planning will need to include strategies for civic engagement. It is reasonable to expect increased lobbying to address needs of the aged and ageing in the community.

National The baby boomer generation will increase the over 65 age group by 50 per cent over the next 10 to 15 years (National Strategy for an Ageing Australia, 2002). Numbers of people aged 80 years and over will double during the next two decades (National Strategy for an Ageing Australia, 2002). The political power of the aged will increase in the near future (Banks, 2004).

There is the potential for a funding ‘squeeze’ between services for the aged and those directed to other demographics (Productivity Commission, 2004). There are strong indications that experiences of ageing will change radically as the massive baby boom cohort advances through middle age into later life. The baby boomer generation will bring their experiences of political

§ critical role of demographic, service and service mix planning tailored to

the needs of the new ageing demographic and balanced against other needs in the community

§ aged services will need to support key planks of care in the community and ageing in place

§ the baby boomer generation will have higher expectations of the service system. It is likely that these will expose shortcomings of the current model of Home and Community Care and aged care service provision for the new generation of ageing.

Page 31 of 54

25

Factors Implications for the City of Melbourne Aged Services

activism and involvement to their approach to aging (Kendig, 2005).

The baby boomer generation is likely to spearhead a shift from a ‘needs based’ approach of previous generations to a ‘rights based’ approach (Kinsella and Phillips, 2005). The baby boomer generation will have higher expectations of the service system. It is likely that these will expose shortcomings of the current model of Home and Community Care and aged care service provision for the new generation of ageing.

State Victorian policies for communities and health services emphasise a linked service approach, including integration and coordination of health services and care for the aged (Department of Human Services, 2006). Significant investment in service coordination, currently being implemented across the state (Department of Human Services, 2003). Reforms in ambulatory care and Home and Community Care assessment (Department of Human Services, 2006).

§ need for active partnerships across the service spectrum of acute care,

residential care, community health and community services. § continued and active participation in Primary Care Partnership will be a

state government expectation

§ gaps in City of Melbourne evident in residential care and community health. Advocacy / lobbying role for City of Melbourne to ensure needs of residents are met in terms of these services. Expect counter arguments which emphasise the concentration of acute care services and other community-based services in the Local Government Area [NB: Melbourne Extended Care to be redeveloped as Centre Promoting Health Independence, Department of Human Services, 2006)

§ need to monitor reforms to the Home and Community Care service system.

Local There is significant variation in socio-economic status and levels of relative need across the suburbs and neighbourhood of the City of Melbourne.

§ Need to ensure that services are planned to address areas of social

disadvantage as well as catering to needs according to size of the population.

Page 32 of 54

26

Economic

Factors Implications for the City of Melbourne Aged Services

The ageing of the Australian population will not have a major impact on the Commonwealth budget for another 10 years (Treasury, 2002). Drivers of rising costs will include technological advancement, health care costs, community expectations as well as the structural ageing of the population (Health and Ageing, 2002).

§ City of Melbourne Home and Community Care funding likely to decrease in relative terms in the medium to long term. Offset in short to medium term by increase in rate revenue base as other areas will have higher growth in aged care.

§ financial support for aged services will be affected by rising cost of technology and community expectations

§ need to plan for potential relative reductions in funding.

Declining labour force participation and changes in patterns of participation. Federal and state policy responses have canvassed longer participation in the workforce to address the ageing population (productive ageing) (Productivity Commission, 2004, Treasury, 2002, Victorian State Government, 2004).

§ the retired (recently retired, active retired); those moving to retirement and older workers will all be more prevalent in the City of Melbourne. Services which address employment issues for an ageing workforce will be required in Melbourne.

§ City of Melbourne well positioned to advocate for older employees with employers.

Potential to accrue social capital benefits through attracting and engaging the active aged in volunteering roles. Volunteering strategies will need to appeal to baby boomer skills and life experiences and interests (Hanlon, 2002).

§ volunteer activities can include: social monitoring for depression, aged service support role in apartment dwellings, support to access public transport and maintain independence, information provision, sharing professional expertise / skills with community based organisations, support from apartment dwellers to aged residents in houses – e.g. gardening, dog walking; and ambassador roles for City of Melbourne/partnership organisations.

§ potential to broker volunteers for partnerships organisations based in the City of Melbourne (e.g. health and community services; cultural and leisure; sport and recreation) with City of Melbourne as the gateway to volunteering opportunities, rather than the coordinator of these activities.

§ a productive/active ageing approach will have dual benefits for both volunteers and recipients of the volunteering service.

Investments in good health and healthy ageing make good economic sense. Health gains on individual levels translate to cost savings at a community level (VicHealth, 2006, 2005).

§ healthy ageing/active ageing focus of services

§ active ageing approach keeps people out of the funded service sector longer and reduces financial burden on health services

§ opportunity to partner with VicHealth/access VicHealth funding to implement innovative health promotion strategies.

Page 33 of 54

27

Factors Implications for the City of Melbourne Aged Services

Variations in financial security will affect ageing experience and quality of life (Morris, Judd and Kavanagh, 2005). Women are more vulnerable than men to experiencing of poverty in old age (World Health Organisation, 2005, Kinsella and Phillips, 2005).

§ potential for economic polarisation/increasing social unrest and disconnection

§ aged population will be sensitive to external changes in stock market and housing market

§ extended periods of ageing may deplete residents’ capacity to access services privately and place additional demand on the City of Melbourne

§ accessing financial information will be a key interest for the aged

§ target services to meet the needs of older women.

Infrastructure issues § as a service provider, some aged service facilities across the Local Government Area are below industry standards

§ new developments, e.g. Docklands lacks facilities for aged services. Issue of age-specific or community/neighbourhood facility will need to be addressed and community consulted.

Ageing of the population will also affect workforces in health and Home and Community Care (Department of Health and Ageing, 2003).

§ need to monitor recruitment and retention patterns to identify potential workforce shortfalls.

Social

Factors Implications for the City of Melbourne Aged Services

Life expectancy is increasing and will continue to increase.

The ‘old’ old as a group are increasing. Life expectancies are longer for women than men. Increases in male life expectancy are anticipated.

‘Compression of morbidity’ – delays in the onset of chronic illness associated with ageing (Kinsella and Phillips, 2005, WHO, 2005).

§ one size fits all approach no longer appropriate - tailor programs to life stage/situational needs of the aged

§ gender differences in ageing: require gender sensitive strategies, impact on the availability of carers in the community and needs of active aged are different to the frail aged.

§ levels of mobility and functioning not dictated by age - active aged can be 80 plus, frail aged can be 55 plus

§ longer life expectancies potentially extend the length of time service is provided. Important to encourage independence/avoid extended, and inappropriate periods of service dependence

§ longer life expectancy will increase the prevalence of age-related diseases and conditions, e.g. dementia

Page 34 of 54

28

Factors Implications for the City of Melbourne Aged Services

§ longer life expectancy and current shortage of residential aged care beds in the Local Government Area will place considerable pressures on services providers.

Social inclusion is one of the key determinants of health (VicHealth, 2005).

Friendship, good social relations and strong supportive networks improve health at home, at work and in the community (Marmot 1999). The aged are vulnerable to social isolation due to factors such as failing health, reduced mobility, personal safety fears, depression, and isolation from family and social networks, death of spouse, neighbourhood changes, inability to drive or access public transport, built environment (VicHealth).

§ social programs and services for the aged can have significant health benefits

§ develop strategies which address social isolation within the context of a fresh approach to service delivery

§ develop strategies which target or promote ‘communities of interest’ § adopt holistic approach to social inclusion strategies - work in conjunction

with internal and external partners.

The drivers for health lie outside the health sector (VicHealth, 2005). § need for internal (e.g. culture, recreation, parks) and external partnerships to affect positive health outcomes.

The baby boomer generation has generally shared in wealth accumulation of recent years. However, those who do not own their own homes are vulnerable to insecure housing as they age (Brotherhood of St Laurance).

§ need to target strategies to public and private tenants

§ need to work in partnership with tenancy and other relevant peak organisations.

Inner cities, including Melbourne, have seen and are seeing an influx of ‘lifestyle migration’, particularly of empty nesters drawn to the ‘creative city’ (City of Melbourne, 2005).

§ target strategies which appeal to the lifestyle considerations/motivators.

The combination of relative social advantage (health, education, economic status) and health status results in the growth of reserve of social capital, e.g. volunteering reserves (Department of Human Services, 2005, Office of Senior Victorians).

§ target strategies which appeal to the lifestyle considerations/motivators.

Family structures and patterns/intergenerational issues have changed significantly over the last 20 years. These changes include patterns of divorce and remarriage, increases in blended families and single parent households, caring for elderly relatives and boomerang children (adult children who leave and then return to the family home). Fertility rates are steadily rising (Kinsella and Phillips, 2005).

§ establish partnerships with service providers who work with people from different lifestyle stages, e.g. youth and family services

§ need to develop targeted strategies to engage people

§ provide transport or other assistance as required to enable people to attend programs or services with a social focus.

Page 35 of 54

29

Technological

Factors Implications for the City of Melbourne Aged Services

Significant advances in medical technology have been made over the last 10 to 15 years, and this trend will continue. The impacts include improved results in terms of treating disease. Medical technological advances however consume significant proportions of health funding (Fett, 2000).

§ contributes to trends for extended ageing § increased competition for health funding.

Technology will increase the opportunities for health service providers to coordinate care through sharing of medical records and information. In Australia, these trends are impacting at both the federal and state levels. In Victoria, coordination of care includes providers of Home and Community Care (Richards, 2005).

§ actively participate in service coordination initiatives (as is the case currently)

§ significant infrastructure funding will be required.

Technological advances can connect specialist health service providers (Fett, 2005).

§ infrastructure funding will be required.

Technological advances are opening up new opportunities for social and health monitoring of older people by others and/or by self. These include, e.g. aids which can prompt/monitor taking of medication; capacity to link in real time with relatives/carers; monitoring vital signs; personal alarms; use of television as an interface (Pollack, 2005, Rodriguez et al 2005).

§ could be significant as technology advances

§ generalised health monitoring role of Home and Community Care services may be less important, while socialisation goals may increase

§ could have cost implications.

Technological advances are opening up new opportunities for individuals to access information – both at the community level (e.g. services provided) and individual level (e.g. health and wellbeing information).

§ provision of online information § recruitment strategies should include staff with IT development skills.

There are high levels of computer ownership and internet access amongst the “baby boomer” generation and more specifically in the City of Melbourne (City of Melbourne, 2005) Education and income are key predictors of use of the internet. In the US, the elderly are the fastest growing demographic group accessing the internet. Most common uses include personal correspondence with friends and family and to research health topics and topics of interest (Eastman and Iyer, 2004).

§ City of Melbourne will need to develop an online information strategy.

Technological advances are opening up new opportunities for smart gadgets which assist older people remain in their own homes, e.g. smart cards to improve feelings of safety (Hoffman, 2006, The Economist 2005).

§ implications for service provision, service delivery – social monitoring, assessment and care management

§ affordability for technology will be an issue.

Page 36 of 54

30

Factors Implications for the City of Melbourne Aged Services

Technological advances can assist in compensating for decline in cognitive functioning (e.g. memory prompts; navigational support; schedule management; activity guidance systems) (Pollack, 2005).

§ implications for service provision, service delivery – social monitoring, assessment and care management

§ affordability for technology will be an issue.

Environmental

Factors Implications for the City of Melbourne Aged Services

There is global movement to promoting healthy cities (Department of Human Services, 2001).

§ need for integrated approach across Council, with opportunities for Aged Services’ input into built environment planning and strategies.

The environment has a direct impact on health and health outcomes (Department of Human Services, 2001).

§ older residents to work with Council to improve the quality of the environment.

The design of built environments influences lifestyle. There are significant health benefits to living in compact neighbourhoods which encourage walking and use of public transport. These include benefits to individuals and benefits to communities through reductions in the amounts of energy consumed (VicHealth, 2006).

§ design and planning areas of Council will need to provide guidelines for the built form which are user friendly and environmentally sustainable.

Building design should include planning for aged residents to avoid costs of retrospective fitting, e.g. ramps (Kinsella and Phillips, 2005).

§ need for Aged Services’ input into building design/planning to ensure the needs of an ageing population are considered.

Australians spend 90 per cent of their time indoors (Clean Air Society of Australia and New Zealand, 2002) This raises the importance of building design in order to overcome sick building syndrome when the air inside can be more polluted than the air outside(VicHealth, 2006).

§ provide advice to residents on minimising potentially harmful airborne pollutants and use of appropriate indoor plants.

People who connect with nature be that through parks, gardens or animals and pets visit doctors less frequently, feel safer and have a higher sense of community belonging (VicHealth, 2006).

§ Parks and Recreation to continue to develop programs.

Access to fresh and affordable local produce promotes health, particularly for the aged (VicHealth, 2006).

§ focus on low income groups and community gardens.

Older people tend to exhibit a fear of crime, disproportionate to their experience of it. However, this leads to a fear of leaving their house, and increased social isolation (Wicks, 2003).

§ emphasis the importance of crime reduction/safe city approaches.

Page 37 of 54

31

Factors Implications for the City of Melbourne Aged Services

Capital city infrastructure provides access to many of the key environmental resources which support active and healthy ageing. These include access to public transport; libraries and internet use; hospitals; parks and gardens; entertainment.

§ need for Aged Services to actively collaborate with other departments, in particular, Arts and Culture and Parks and Recreation

§ need to actively promote cohesive neighbourhoods, especially in newly established neighbourhoods.

Negative features of capital cities include fear of crime, safety concerns, levels of air quality and pollution, absence of sense of neighbourhood or community.

§ provide opportunities for older residents to work together to improve the environment.

International trends: NY - range of programs designed for vertical living, and US - Naturally Occurring Retirement Communities (Mallion).

§ develop aged service models for vertical living.

Legal

Factors Implications for the City of Melbourne Aged Services

Age discrimination § opportunity to promote City of Melbourne as an active employer of mature aged workers

§ opportunities to promote mature-aged friendly strategies to the business community of Melbourne.

Elder abuse § need to develop guidelines on prevention of elder abuse/monitoring of elder abuse for Aged Services

§ monitor the legislative developments in relation to elder abuse.

Standards of care for provision of services. § need to ensure that the advance in technological aids, e.g. for in-home monitoring, do not breach privacy regulations.

Privacy § monitor standards.

Duty of care responsibilities to clients. § monitor standards and legal requirements.

Laws affecting the workforce – OHS (e.g. lifting weights, working in isolated home environments) discrimination.

§ additional resources may be required to meet local expectations § monitor workforce trends in Aged Services and if required, develop

tailored recruitment and retention strategies.

Page 38 of 54

32

Appendix 4 Policy framework

Ageing populations and the emerging social, economic and medical needs of older demographics are now a significant focus for local, national and international governments. This discussion paper draws on a broad range of research and contemporary policy debates. The following table highlights key aged care policy documents from the national and international arena. It identifies key priorities and issues from each policy document

Local government

Date Document Name Prepared by Key issues

1989 Local Government Act Victorian State Government

§ providing leadership by establishing strategic objectives and monitoring their achievement

§ advocating the interests of the local community to other communities and governments

§ planning for and providing services and facilities for the local community

§ providing and maintaining community infrastructure in the municipal district

2005 City Plan 2010 City of Melbourne § connected and accessible city § innovative and vital business city

§ inclusive and engaging city.

2005 Council Plan 2005 - 2009 City of Melbourne § developing improved approaches for child and aged care

§ creating and improving the city’s public spaces

§ encouraging community uptake of renewable energy.

2004 City of Melbourne Annual Plan City of Melbourne § connected and accessible city § innovative and vital business city § inclusive and engaging city § environmentally responsible city

§ well managed and leading corporation § financially responsible corporation.

Page 39 of 54

33

Date Document Name Prepared by Key issues

2005 City Health 2005 - 2009 City of Melbourne § environmental health § amenity

§ life opportunity and choices § inclusion and participation § transport

§ urban planning § governance.

2005 Disability Action Plan 2005 - 2009 City of Melbourne § equity of access and participation opportunities § reduced discrimination due to disability

§ increased life choices for people with disabilities § an inclusive community § fair and socially just society.

2005 A City of Opportunity - A Multicultural Strategy for the City of Melbourne 2005 - 2009

City of Melbourne § improved participation in a broad range of activities by people from different cultural, religious and linguistic backgrounds

§ celebrate and showcase stories, festivals and the contributions of people from different cultural, religious and linguistic backgrounds

§ provide appropriate and accessible support to people from different cultural, religious and linguistic backgrounds

§ provide leadership promoting the benefits of cultural, religious and linguistic diversity within the City of Melbourne.

2004 Healthy by Design: A Planners Guide to Environments for Active Living

National Heart Foundation § well planned networks of walking and cycling routes § streets with direct, safe and convenient access

§ local destinations within walking distance from homes § accessible open spaces for recreation and leisure § conveniently located public transport stops

§ local neighbourhoods fostering community spirit.

Page 40 of 54

34

Date Document Name Prepared by Key issues

2003 Population Ageing Action Plan 2004 - 2008

Australian Local Government Association

§ building awareness § encouraging local government action

§ fostering partnerships § improving information access.

2002 Baby Boomers and Beyond: Strategies for Over 55s. Forward Plan for Older People 2003 - 2006

City of Melbourne § welcome and support older people’s experience and contributions

§ promote positive, healthy and independent experiences of ageing

§ city amenity, neighbourhood liveability and availability of a broad range of social, recreational and cultural opportunities for over 55s

§ ensure that appropriate and relevant services are available to support ageing at home and in the community

§ engage people in planning for their care.

State government

Date Document Name Prepared by Key priorities

2006 Care in your Community - A Planning Framework for Ambulatory Health Care

The Victorian Department of Human Services

Integrated, community-based health care, including:

§ a single set of area-based planning catchments § a single set of planning principles § area-based planning networks

§ three high level areas of need - chronic disease management, streamlined care and integrated health promotion

§ defined modes, settings and levels of care

Specific actions in the next two to three years in: § funding models § workforce

§ integration tools

Page 41 of 54

35

Date Document Name Prepared by Key priorities

§ information, communication and technology developments

§ partnering arrangements. Local planning networks will be established in 2006.

2006 Home and Community Care 2006 - 2009 Expenditure Priorities in Victoria - Consultation Paper

The Victorian Department of Human Services

Maintain current dollar per capita funding in all regions Achieve approximate parity in dollar per capita funding between rural regions and between metro regions. Home and Community Care Basic activities focusing on: § national redevelopment agenda

§ assessment framework § more active model of service § person centred and capacity building approaches to

service delivery § redevelopment of food services more targeted to

respond to variation in clients’ needs

§ research on respite and social support § five per cent of growth funding to expand day care for

the frail aged.

§ enhancing access to Home and Community Care services including day care for the frail aged

§ increase quantity and quality of Home and Community Care Basic services for people from culturally and linguistically diverse backgrounds

§ evaluate Cultural Equitable Gateways Strategy and other strategies

§ seek state funds for expanded Planned Activity Group Programs where need is demonstrated (e.g. growing ageing population).

Enhance access to Home and Community Care services for Indigenous people.

2005 Strategic Directions in Assessment for the Victorian Home and Community

The Victorian Department of Human Services

§ closer integration of Home and Community Care and primary care sectors

Page 42 of 54

36

Date Document Name Prepared by Key priorities

Care Program § three year plan for assessment § new policy guidelines

§ designated Home and Community Care assessment agencies

§ demand management

§ carer assessment.

2005 A Plan of Action 2005 - 2007 Promoting Mental Health and Wellbeing

Victorian Health Promotion Foundation

§ innovation § building and sharing health promotion knowledge § working across many sectors

§ improving the health of all people in Victoria § reducing the differences in health status between

different population groups

§ leadership and skills in public health § strategic alliances with national and global public health

organisations.

2004 Preparing for Victoria’s Future - Challenges and Opportunities in an Ageing Population

Victorian Government. * § boosting productivity

§ increasing workforce participation § increasing skilled migration § containing future health priorities.

2004 Culturally Equitable Gateways Strategy

The Victorian Department of Human Services

§ capacity building in ethno-specific services to provide support to local councils to offer culturally appropriate services and enhance service linkage

§ funding for flexible service responses by small and emerging ethnic services

§ leadership and sectoral development within and across ethno-specific, multicultural and local government sectors to improve service provision

§ bilingual/multicultural staff recruitment project in Home and Community Care.

2003 Better Planning and Funding Allocation for Home and Community Care in

The Victorian Department of Human Services

§ equitable distribution of Home and Community Care funding.

Page 43 of 54

37

Date Document Name Prepared by Key priorities

Victoria

2002 Making this the Age to be in Victoria – A Forward Agenda for Senior Victorians

The Victorian Department of Human Services

§ access to services § enabling independence

§ encouraging participation § upgrading residential homes.

Federal government

Date Document Name Prepared by Key priorities

2004 The Way Forward – A New Strategy for Community Care

The Department of Health and Ageing

§ overlaps and gaps in service delivery § easier access to services

§ enhanced service management § streamlining programs § partnerships.

2004 Economic Implications of an Ageing Australia

Productivity Commission Range of policy measures needed to reduce the fiscal pressure from ageing, for example: § increases in fertility and net migration - little impact § measures to raise productivity and participation would

enhance income growth and the capacity to pay for the costs of ageing, however, this depends on the extent to which service demands and costs continue to rise with growth;

§ more cost-effective service provision, especially in health care

§ timely action.

2002 Intergenerational Report Treasury § achieving budget balance

§ maintaining an efficient and effective medical health system

§ containing growth in Pharmaceutical Benefits Scheme

§ affordable and effective residential aged care system to

Page 44 of 54

38

Date Document Name Prepared by Key priorities

meet high growth in the numbers of very old (85 plus) § social safety net

§ encouraging mature age participation in the labour force

§ maintaining a retirement incomes policy.

2001, 2002

An Older Australia – Challenges and Opportunities for All

National Strategy for an Ageing Australia

§ independence and self-provision

§ attitude, lifestyle and community support § healthy ageing § world class care.

International organisations

Date Document Name Prepared by Key priorities

2005 Active Ageing: A Policy Framework World Health Organisation § intersectoral action

§ health § participation § security.

2004 The Macau Plan of Action on Ageing for Asia and the Pacific

United Nations § older people and economic development

§ advancing health and well-being into old age § ensuring enabling and supportive environments.

2002 Madrid International Plan of Action on Ageing

United Nations § older people and economic development § advancing health and wellbeing into old age

§ ensuring and enabling supportive environments.

2000 Reforms for an Ageing Society Organisation for Economic Co-operation and Development

§ employment and economic participation of aged population.

Page 45 of 54

39

Appendix 5 Key indicators and determinants of need

The following table details statistical measures which rank the relative service needs of older residents in the City of Melbourne.

The area with the greatest relative need is ranked 1 and the area with the lowest relative need is ranked 10.

The purpose of this study is to assist Council to prioritise its actions in aged care for each area.

Key indicators CBD Docklands Carlton East Melbourne

Kensington North Melbourne

Parkville Southbank South

Yarra – St. Kilda Road

West Melbourne

Total City of

Melbourne

Population 60+ Relative need

484 4

15 10

668 1

431 5

281 7

512 3

322 6

192 8

586 2

137 9

3628

Population 75+

Relative need

120

5

3

9

184

3

123

4

97

6

220

2

153

4

49

7

292

1

27

8 1268

Population 85+

Relative need

39

7

0

9

59

3

41

5

40

6

48

4

104

2

12

8

192

1

12

8 547

CALD pop. 55-693

Relative need

105

2

3

10

157

1

29

9

68

4

102

3

34

7

31

8

38

6

41

5 608

CALD pop. 70-84

Relative need

29

6

0

8

112

2

15

7

39

4

121

1

23

6

15

7

40

3

31

5 425

CALD pop. 85+

Relative need

3

5

0

6

12

1

0

6

6

4

10

3

6

4

0

6

11

2

6

4 54

# and % of pop in receipt of Disability Support Pension Relative need

188 (8% of CoM)

6

20 (9% of CoM)

9

340 (15% of CoM)

3

45 (2% of CoM)

8

788 (34% of CoM)

1

480 (20% of CoM)

2

71 (3% of CoM)

7

20 (1% of CoM)

9

193 (8% of CoM)

5

199 (8% of CoM)

4

2344

3 Residents born in non-English speaking country (excludes ‘other country’)

Page 46 of 54

40

Key indicators CBD Docklands Carlton East Melbourne Kensington North

Melbourne Parkville Southbank South

Yarra – St. Kilda Road

West Melbourne

Total City of

Melbourne # and % of pop in receipt of Age Pension Relative need

188 (5% of CoM)

6

<20

10

479 (12% of CoM)

4

257 (7% of CoM)

5

1402 (36% of CoM)

1

637 (16% of CoM)

2

187 (5% of CoM)

7

58 (1% of CoM)

9

614 (16% of CoM)

3

64 (2% of CoM)

8

3885

% of residents earning less than $200/week Relative need

21%

5

9.3%

10

32%

2

12%

9

23%

4

26%

3

39%

1

17%

7

15%

8

19% 4

6 24%

% of lone person households Relative need

18%

4

25.9%

2

18%

4

21%

3

14%

7

17%

5

16%

6

14%

7

26%

1

10%

8 -

# and % of pop in receipt of ‘Rental Assistance’ Relative need

508 (13% of CoM)

4

41 (1.1% of

CoM)

11

524 (14% of CoM)

3

165 (4% of CoM)

8

771 (20% of CoM)

1

642 (17% of CoM)

2

501 (13% of CoM)

6

127 (3% of CoM)

10

420 (11% of CoM)

7

160 (4% of CoM)

9

3858

% rented dwellings Relative need

54%

3

38%

8

69%

1

48%

6

46%

7

56%

2

52%

4

54%

3

46%

7

49%

5 58%

Carer Allowance Relative need

<20 (0% of CoM)

4

<20

4

25 (19% of CoM)

2

<20

4

87 (66% of CoM)

1

20 (15% of CoM)

3

<20

4

<20

4

<20

4

<20

4

132

Level of social disadvantage Relative need

1033.92

4 n/a

950.24

1

1154.24

9

983.36

2

1029.36

3

1055.36

6

1103.52

7

1134.56

8

1038.08

5 -

Total 65 106 31 88 55 38 70 100 58 88 Rank 5 9 1 7 3 2 6 8 4 7

4 high rate of non-response to the income qu. in the 2001 ABS Census does not allow for meaningful comparison with the municipal average

Page 47 of 54

41

Appendix 6

Promoting choice - meals provision options

There are a number of innovations that can benefit aged care clients. The following example provides information on one such innovation that illustrates the principles of choice, culturally adaptability and social opportunity.

The next aged care plan will introduce more flexible and diverse meal options for older residents. Some of these opportunities are already on offer, some alternative meal services are currently provided through pilot programs and others will be introduced after the aged care plan is completed in November 2006. As the provision of meals is further diversified, a new assessment tool called Chart of choice will be introduced to integrate the range of meal choices available to clients. An example chart is illustrated below.

The chart would be used at the initial assessment of a client’s needs, and functions in two ways. The chart ensures the Council Assessment Officer identifies the potential areas of need in relation to a client’s nutritional needs, and illustrates the range of options available to the client, who is able to choose the most suitable options.

Chart 8: Promoting Choice – Community Meals Programs

Individually With staff member

As a group

Voucher ü ü ü

To restaurant ü ü ü

To restaurant by community of interest ü ü

Local neighbourhood ü ü

Staff member goes in and prepares ü ü

Culturally Specific Needs: sourced from Specialist providers

ü

Examples of different types of meal provision include:

§ small neighbourhood groups;

§ cooking in the client’s home;

§ a voucher system for meals in cafes;

§ group meals in restaurants; and

§ ethno-specific meals from specialist providers.

Page 48 of 54

42

Appendix 7

Council’s role

Local governments in Victoria have a played a significant role in providing aged care services to residents since the 1950s. The funding, coordination and provision of these support services was formalised through the Home and Community Care Act 1985. These services are funded jointly by federal, state and local governments in conjunction with client contributions.

The City of Melbourne provides an extensive range of aged care services (see Appendix 1). Most of these services are provided in partnership with Council’s contracted service providers - Southern Cross Care (VIC) and Ballarat Health Services.

The table below shows the main areas of Council’s current role in aged care, from planning to service delivery. Currently Council’s main activities are centred on the planning and coordination of service delivery. The main areas of responsibility are:

§ social support activities;

§ meeting space provision;

§ information provision; and

§ infrastructure.

Council’s aged care services

Service Planning Local Coordination

Service Delivery

Key partners

Community meals v v x Community groups

Planned activity group v v x Contractor

Community bus v v x Contractor

In home care v v x State and federal governments, Contractor

Home maintenance v v x Contractor

Delivered meals v v x Contractor

Home delivered library v x x Rotary and Yarra Melbourne Regional Library Corporation

Residential care v x x Various

Assessment service v v v State government

Case management v v v Federal government

Senior citizens’ centres v v Committees of management

Social support activities v v v Community groups, other areas of Council

Meeting space provision

v v v -

Information provision v v v Various

Infrastructure provision v v v State and federal governments

Page 49 of 54

43

References

Australian Local Government Association (ALGA), 2003 Population Ageing Action Plan 2004 – 2008

Banks, 2004 Policy Implications of an ageing Australia: an illustrated guide

Berkman LF and Glass T. Social integration, social networks, social support and health. In: Berkman LF, Kawachi I. eds Social Epidemiology, New York: Oxford University Press

Brunner 1997, Stress and the Biology of Inequality, British Medical Journal

Bunker et al 2003, “Stress and coronary heart disease: psychosocial risk factors.” National Heart Foundation.

City of Melbourne, 2005 Inner City Apartment Residents’ Survey

City of Melbourne, 2005 City Plan 2010

City of Melbourne, 2005 Council Plan 2005 – 2009

City of Melbourne, 2003 City of Melbourne Annual Plan 2003-2004

City of Melbourne, 2005 City Health 2005 - 2009

City of Melbourne, 2005 Disability Action Plan 2005 – 2009

City of Melbourne, 2005 A City of Opportunity – A Multicultural strategy for the City of Melbourne 2005 – 2009

City of Melbourne, 2004 City & Suburb Profile A community profile of cultural, religious and linguistic diversity

City of Melbourne, 2002 Baby Boomers and Beyond: Strategies for Over 55s

Clean Air Society of Australia and New Zealand, 2002 Indoor Air Quality in Australia: a strategy for action

Commonwealth Department of the Treasury, 2002 Intergenerational Report Budget Paper No. 5 May 2002

Cummins et al, 2002 Australian Unity Wellbeing Index , Survey 4, Report 4.0 Executive Summary

Department of Health and Ageing, 2004 The Way Forward – A New Strategy for Community Care

Department of Health and Ageing, 2002 Submission to the House of Representatives Standing Committee on Ageing: To inquire into and report on long term strategies to address the ageing of the Australian population over the next 40 years, 2002

Department of Human Services 2006, Care in your Community – A planning framework for ambulatory health care

Department of Human Services 2006, Home and Community Care 2006-2009 Expenditure Priorities in Victoria – Consultation Paper

Department of Human Services 2005, Your health - A report on the health of Victorians 2005

Department of Human Services 2005, Strategic Directions in Assessment for the Victorian Home and Community Care Program

Department of Human Services, 2003 Better Planning and Funding Allocation for Home and Community Care in Victoria

Page 50 of 54

44

Department of Human Services, 2002 Making this the Age to be in Victoria – A Forward Agenda for Senior Victorians

Department of Human Services Culturally Equitable Gateways Strategy www.dhs.vic.gov.au

Department of Human Services, 2001 Environments for Health: Municipal Public Health Planning Framework

Department of Victorian Communities 2005 Indicators of community strength at the Local Government Area level in Victoria

Eastman J and Iyer R, 2004 The elderly’s uses and attitudes towards the Internet The Journal of Consumer Marketing, Santa Barbara 2004 Vol 21, Issue 2/3

Fett M 2000 Technology, Health and Health Care Occasional Papers: Health Financing Series Volume 5 Commonwealth Department of Health and Aged Care

Hoffman, 2006 Smart Gadgets for Seniors Business Week, New York, Jan 2006, Issue 3969

Kendig H, Andrews G, Browning C, Quine S, Parsons A 2000 A review of healthy ageing research in Australia - Report prepared for the Community Services Ministers’ Advisory Council

Kinsella K and Phillips D, 2005 Global Ageing: The Challenge of Success Population Bulletin, March 2005 Vol. 60, Issue 1

Marmot, M G and Wilkinson, RG (eds), 1999 Social determinants of health New York: Oxford University Press

McCallion, P 2006 Naturally Occurring Retirement Communities www.albany.edu/aging

Morris, Judd and Kavanagh, 2005 Marginality amidst plenty: Pathways into Homelessness for older Australians, Australian Journal of Social Issues, 40, (2).

National Strategy for an Ageing Australia, 2002 An Older Australia – Challenges and Opportunities for All

New York City Housing Authority Community Programs and Services www.nyc.gov

OECD 2000 Reforms for an Ageing Society

Olsberg and Winters, 2005, Ageing In Place: Intergenerational and Intrafamilial Housing Transfers and Shifts in Later Life. Australian Housing and Urban Research Institute

Pollack M, 2005 Intelligent Technology for an Aging Population: The Use of AI to Assist Elders with Cognitive Impairment AI Magazine, La Canada, Summer 2005 Vol 26 Iss 2

Productivity Commission, 2004 Economic Implications of an Ageing Australia

Richards B, 2005 Australian Health Information Council Stakeholder Forum Australian Government Department of Health and Ageing

Rodriguez T, Fischer K and Kingston J Intelligent Services for the Elderly Over the TV Journal of Intelligent Information Systems, Boston Sept 2005 Vol 25 Issue 2

Stewart –Brown 1998, ‘Emotional wellbeing and its relation to health,’ British Medical Journal, Vol. 317. No. 7173, p. 1608

The Economist Home Alone The Economist, London June 11 2005 Vol 375 Issue 8430

United Nations 2004 The Macau Plan of Action on Ageing for Asia and the Pacific

United Nations 2002 Madrid International Plan of Action on Ageing

Victorian Government, 2004 Preparing for Victoria’s Future – Challenges and Opportunities in an Ageing Population

Page 51 of 54

45

Victorian Health Promotion Foundation, 2005 A Plan of Action 2005 – 2007 Promoting Mental Health and Wellbeing

VicHealth Newsletter, Winter 2005

VicHealth Newsletter Summer, 2006

Victorian State Government Response to Productivity Commission Research Report Nov 2004

Waterhouse C and Angley P, 2005 Social exclusion among older people

World Health Organisation, 2005 Active Ageing: A Policy Framework

Wicks M 2003 Economic and Social Research Council Growing Older Program Conference

Page 52 of 54

Agenda Item 5.5 Community Services Committee

18 May 2006

FINANCE ATTACHMENT

LIFELONG MELBOURNE 2006 – 2016 DISCUSSION PAPER

Funding of $2,433,801 has been provided in the 2005/06 Budget for community services for older people and people with a disability. Ongoing and additional funding will be subject to the normal budget processes.

Joe Groher Manager Financial Services

Page 53 of 54

Agenda Item 5.5 Community Services Committee

18 May 2006

LEGAL ATTACHMENT

LIFELONG MELBOURNE 2006 – 2016 DISCUSSION PAPER

The recommendation made in this report is consistent with the powers and functions of Council.

Section 3C (1) of the Local Government Act 1989 (“the Act”) provides that:

“The primary objective of a Council is to endeavour to achieve the best outcomes for the local community having regard to the long term and cumulative effects of decision.”

Section 3C (2) of the Act provides that in seeking to achieve its primary objective the Council must have regard to facilitating objectives including:

“(c) to improve the overall quality of life of people in the local community;

(e) to ensure the services and facilities provided by the Council are accessible and equitable;”

Section 3E of the Act provides that the functions of a Council include:

“(a) advocating and promoting proposals which are in the best interests of the local community;

(b) planning for and providing services and facilities for the local community;

(c) providing and maintaining community infrastructure in the municipal district;”

Instrument of Delegation

On 28 February 2006 the Council resolved to delegate to the Community Services Committee the power, duties and functions directly relating or ancillary to Social Policy and Children’s, Family, Aged, Youth, Disabled and Ethnic Services.

Kim Wood Manager Legal Services

Page 54 of 54