Aged Care Issues
Special needs status under the Aged Care Act
In 2001 veterans were assigned special needs status under the Department of Health and Ageing’s Aged Care Act 1997. The effect of this is that aged care providers need to consider the 'special needs' of the veteran community in the provision of care, and planning authorities must consider the aged care requirements of the ex-service community.
The assigning of special needs status was based on:
- the rapid ageing of the veteran population
- their service, sacrifice and hardship
- their unique cultural identity.
See factsheets:
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What is the veteran community?
Three generations of Australians had their lives substantially shaped by the experience of Australia’s involvement in two world wars. In the decades since, Australians have participated in over 50 wars, conflicts or peacekeeping activities, or been members of the Australian Defence Forces.
The meaning of the word 'veteran' depends both on the individual and the context of the term. For DVA, a veteran holds a health entitlement card and/or a pension card, or is a war widow/er or dependent holding such cards. Under the Aged Care Act 1997, a member of the veteran community is more broadly defined as '…a veteran of the Australian or allied defence force; or a spouse or widow/er of a person mentioned above'.
Veteran demographics
The DVA veteran population is old and ageing faster than the general population. There are approximately 300,000 veterans and war widow/ers with health cards (treatment population), and an additional 150,000 receiving pensions or benefits without DVA treatment entitlement. Approximately three quarters of veterans and war widow/ers with health cards are aged 75 or older.
Over the next decade the proportion of DVA clients over 90 will more than quadruple, to make up one quarter of DVA’s treatment population. Given the number of people involved in WW2, it is not surprising that the veteran population makes up around a quarter of the residents of aged care facilities. While nearly half the Australian male population over 80 are veterans, most people would be unaware that female gold card holders will outnumber their male counterparts within five years.
See: State specific demographic information
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Veteran culture
During World War 2, one in seven of the total Australian population enlisted.
Whether serving overseas or in Australia, taking on new occupational roles in the absence of so many, or knowing family and friends were at risk, the experience of war was a defining experience for today’s older Australians. For many, this shared history and hardship has lead to identification with a distinctive cultural group.
Cultural attributes often seen in the veteran community include:
- bonds of mateship formed in times of danger
- commemoration of sacrifice of the fallen
- provision of welfare support for their mates and the wives and dependants of deceased comrades
- high membership of ex-service organisations and other social groups
- participation in commemorative activities, such as Anzac Day and Remembrance Day.
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Veteran health
Veterans have higher rates of health risk factors compared to their non-veteran counterparts, including lack of exercise, obesity and long term use of cigarettes and alcohol. Veterans are more likely to experience a short or long term illness, develop cancer or suffer from diseases of the digestive, nervous, circulatory and musculoskeletal systems. Veterans are also prescribed more medications than non-veterans, even allowing for disabilities.
Increased rates of mental health problems are apparent in the veteran community. More than a quarter of the treatment population have mental health conditions, about half of which are accepted as being due to military service. Veterans have much higher rates of conditions such as posttraumatic stress disorder, although this diagnosis might not have been made in older veterans. War-related memories may have a negative affect on those with dementia, and this issue should be considered in care planning for older veterans.
Three types of health cards are issued by DVA:
- Gold cards are issued to eligible veterans or their war widow/ers, and cover all medical conditions.
- White cards are issued to eligible veterans, and cover specific service-related disabilities.
- Orange cards are issued to eligible Commonwealth and Allied veterans, and cover pharmaceutical benefits only.
See factsheets:
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Special needs of the veteran community
Aged care services can contribute to better care of veterans by considering issues related to their special needs:
- Identify all veterans and their widow/ers (regardless of cards or entitlements) on admission.
- Ensure the veteran or war widow/er is aware of their DVA entitlements.
- Provide DVA contact information for the resident or family members.
- Contact DVA to check entitlements.
- Collect a detailed service and cultural history soon after admission.
- Ensure ongoing contact with ex-service organisations as desired.
- Help the veteran and/or family members to observe commemorative days of national and individual significance.
- Consider the veteran’s service and subsequent history when managing challenging behaviours and potential triggers.
- Look for mental health issues in veterans and link to appropriate psycho-geriatric services.
- Ensure health providers are aware of the resident’s entitlements, status and history.
- Identify staff training opportunities in veteran issues and services.
See factsheet: Who to contact (DVA07) (PDF kB)
Ex-service organisations (ESOs)
Many in the veteran community associate closely with ex-service organisations.
ESOs in various states and regions have differing levels of involvement in aged care and some may be able to help veterans in your facility. They may be able to provide advocacy, advice or assistance to them, or in some cases visit them. Further, ESOs may be able to assist providers by advising on commemorative activities in which veteran residents might like to participate.
See factsheet: Ex-service organisations (ESO01) (PDF kB)
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