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Discussion of the role of migrant care workers in long-term care (LTC) that has gained increasing attention in the United States and other developed countries in recent years is of particular relevance to Australia, where 24% of the total population is overseas-born, two-thirds of them coming from countries where English is not the primary language. Issues of interest arise regarding meeting LTC workforce demands in general and responding to the particular cultural and linguistic needs of postwar immigrants who are now reaching old age in increasing numbers. This review begins with an account of the overseas-born components of the aged care workforce and then examines this representation with reference to the four factors identified as shaping international flows of care workers in the comparative study carried out for the AARP Public Policy Institute in 2005: migration policies, LTC financing arrangements, worker recruitment and training, and credentialing. The ways in which these factors play out in Australia mean that while overseas-born workers are overrepresented in the LTC workforce, migrant care workers are not identifiable as a marginalized group experiencing disadvantage in employment conditions, nor do they offer a solution to workforce shortages. The Australian experience is different from those of other countries in many respects, but it does show that the experience of migrant care workers is not unique to LTC and points to the need to extend the search for solutions to workforce shortages and improving conditions of all care workers well beyond L TC systems to wider policy settings. KEYWORDS Australia, immigration, long-term care, overseas workers, workforce DOI: 10.1080/08959420903167140

Retirement incomes and aged care have both received considerable policy attention in Australia over the last three decades, but as in other countries, the two financing systems have remained largely separate in policy and practice. The problem is located at the intersection of wider policy debates about shifts from public to private welfare and concerns over intergenerational equity. This paper aims to integrate these related debates by incorporating aged care into the "pillars" framework used to understand retirement incomes. We propose an Aged Care Superannuation Levy applied to superannuation fund earnings, winding back the large and growing public tax concessions that support this pillar of private defined contribution pensions in Australia's retirement income system. This revenue would create a social insurance pillar for aged care to stand alongside the four other pillars of retirement incomes that interact variously with aged care financing. Interest in a social insurance pillar of aged care financing is renewed in the light of the Royal Commission into quality and safety of aged care that reported in February 2021. As the Royal Commission recommendations on financing were divided and not taken up in government policy, the way remains opens for further consideration of the alternative approach proposed here. [ABSTRACT FROM AUTHOR]

A series of major reforms implemented through the mid 1980s sought to contain residential care and expand community care in Australia's long-term care system. While this goal has been maintained, a number of new policy initiatives followed the change of federal government in 1996. This article presents a systematic account of current policy objectives, implementation measures, and outcomes in three major policy areas: changing the balance between residential and community care, targeting in community care, and support for family caregivers. This analysis shows that while there have been shifts in emphasis from time to time, concerted policy efforts over the last 20 years have contained the growth of expenditure on long-term care and realized significant change in the service system. KEYWORDS. Assessment, Australia, caregivers, community care, targeting, planning

Raising the floor of community care, which refers to providing a basic level of service to all disabled and aged people, can help caregivers and better the day-to-day-living standards of the older people. In comparison the raising the ceiling option, which provides increased services to a targeted and needy group, does not have the advantage of covering many people. It is important to provide the basic care as a foundation and then to build on it with the advanced care idea.

The diversity of terms and meanings relating to housing with services for older people confounds systematic analysis, especially in international comparative research. This paper presents an analysis of over 90 terms identified in literature from the United Kingdom, the United States of America, Canada, Australia and New Zealand reporting types of housing with services under the umbrella of ‘service integrated housing’ (SIH), defined as all forms of accommodation built specifically for older people in which the housing provider takes responsibility for delivery of one or more types of support and care services. A small number of generic terms covering housing for people in later life, home and community care, and institutional care are reviewed first to define the scope of SIH. Review of the remainder identifies different terms applied to similar types of SIH, similar terms applied to different types, and different terms that distinguish different types. Terms are grouped into those covering SIH focused on lifestyle and recreation, those offering only support services, and those offering care as well as support. Considerable commonality is found in underlying forms of SIH, and common themes emerge in discussion of drivers of growth and diversification, formal policies and programmes, and symbolic meanings. In establishing more commonality than difference, clarification of terminology advances policy debate, programme development, research and knowledge transfer within and between countries. [ABSTRACT FROM PUBLISHER]

Shares assessments and reflections from articles about long-term care in the Asia-Pacific Rim in the 21st century. Practice perspectives and lessons learned; Practice perspectives and questions asked; Policy perspectives.