Overview
Create Allied Health provides specialist social work services for complex aged care transitions, including residential placement, ACAT processes, and family mediation. Our clinical director's PhD research in aged care social work, combined with her membership of the AASW Aged Care Working Group, ensures our practice is grounded in the latest evidence and best practice frameworks.
Hospital-to-Aged-Care Transitions
We support patients and families through the often-difficult transition from hospital to aged care, ensuring decisions are informed, timely, and person-centred.
- Comprehensive assessment — Psychosocial assessment of the person's needs, preferences, and circumstances
- ACAT liaison — Coordinating with Aged Care Assessment Teams to ensure timely and accurate assessments
- Provider matching — Researching and recommending aged care providers that align with the person's needs and values
- Family support — Facilitating family discussions and providing emotional support through the transition process
- Discharge coordination — Working with hospital teams to ensure seamless discharge planning and handover
NDIS-to-Aged-Care Pathways
For NDIS participants approaching or turning 65, we provide specialist support to navigate the transition from disability services to the aged care system.
- Transition planning — Developing comprehensive transition plans well ahead of the participant's 65th birthday
- Funding coordination — Navigating the interface between NDIS and aged care funding to minimise service disruption
Young People in Aged Care
We advocate for young people who find themselves in residential aged care, working to identify and facilitate transitions to more age-appropriate settings.
- Transition planning — Developing individualised plans to move young people out of aged care into suitable alternatives
- Alternative options assessment — Identifying SDA, SIL, and community-based living options that better meet the person's needs
Residential Placement
Finding the right aged care facility is one of the most significant decisions a family can face. We provide expert guidance throughout the process.
- Provider research — Comprehensive evaluation of residential aged care facilities based on quality indicators, specialisations, and location
- Family decision support — Facilitating informed decision-making with transparent information and clinical guidance
- Respite-to-permanent transitions — Supporting the pathway from respite care to permanent residential placement when needed
Family Mediation
Aged care decisions can cause significant family conflict. Our clinical social workers provide therapeutic intervention to help families reach consensus.
- Therapeutic intervention — Addressing the emotional and relational dynamics underlying family conflict about care decisions
- Facilitated family meetings — Structured, professionally facilitated meetings to discuss options and reach agreement
- Conflict resolution — Evidence-based mediation strategies tailored to the unique dynamics of each family
ACAT Assessment Support
We help clients and families prepare for and navigate the ACAT assessment process, ensuring the person's needs are accurately captured.
- Preparation — Helping individuals and families understand the process and gather relevant information
- Advocacy — Attending assessments to advocate for the person's needs and preferences
- Documentation — Preparing supporting documentation and clinical reports to inform the assessment
Capacity Assessment
When questions arise about a person's capacity to make decisions regarding their care, we provide thorough clinical assessment and support.
- Clinical assessment — Comprehensive psychosocial assessment of decision-making capacity
- NCAT support — If guardianship proceedings are necessary, we provide seamless referral to our Guardianship & NCAT services
End-of-Life Planning
We support individuals and families through sensitive end-of-life discussions and planning.
- Advanced care planning — Facilitating conversations and documentation of wishes for future care
- Palliative care coordination — Working with palliative care teams to ensure holistic, compassionate end-of-life support
Our Expertise
Our aged care transition services are led by practitioners with deep clinical and research expertise:
- PhD research examining social work roles in aged care settings
- Active membership of the AASW Aged Care Working Group
- Extensive experience in complex case management across acute, subacute, and community settings
When to Refer
Consider referring a client to our aged care transitions services when:
- A hospital patient requires aged care placement and the family needs support navigating the process
- An NDIS participant is approaching 65 and needs transition planning
- A young person is living in residential aged care and alternatives should be explored
- Family conflict is impeding aged care decision-making
- Capacity concerns are affecting care decisions for an older person
- ACAT assessment navigation and advocacy is needed
- End-of-life planning support is required
- Home care package navigation and optimisation is needed
Funding
- iCare — For clients with work-related injuries requiring aged care support
- NDIS — For participants transitioning to aged care or requiring aged care-related support
- Hospital discharge budgets — Direct engagement by hospital social work departments
- Private — Self-funded engagement for families and individuals
Response Times
We aim to respond to all referrals within 48–72 hours.