Australia's peak aged care body is calling on the government to mandate a maximum home care package waiting period of 90 days, which it says would reduce the risks to older people as well as the strain on their caregivers.
Leading Age Services Australia chief executive Sean Rooney says it would take three years to get wait lists down to that "reasonable" level, at a cost of about $500 million a year.
The Aged Care Royal Commission heard again this week that more than 16,000 people died waiting for a home care package in 2017-18. Unpaid and informal carers at the Mildura hearing said the respite system was flawed and they were not getting enough support.
"In the absence of having a home care package, family members or volunteers are having to provide that additional care," Mr Rooney said.
"That's quite a significant issue in terms of all the unpaid hours of care, but it can also take a physical, emotional, and financial toll on those individuals."
Mr Rooney wanted those already on the wait list to be prioritised based on their means.
Minister for Aged Care and Senior Australians, Richard Colbeck, did not answer The Sunday Times' question about whether he would consider a 90-day maximum wait list period.
The median wait time from when a person in the ACT was approved for a home care package and received it in 2017-18 was 164 days.
The My Aged Care website states the expected wait time for a level one package is between three and six months, while the wait time for levels two, three, and four is 12 months or more.
"In the year to December 2018 there has been a 20 per cent increase in the number of people receiving a home care package, now up to 93,331 people," Mr Colbeck said.
"We have since released another 20,000 home care packages and indications are that this has significantly reduced demand pressures for home care packages.
"I acknowledge that there is even more work to do and I am focused on delivering practical solutions to support choice in aged care."
While interim support was available for people on the wait list through the Commonwealth Home Support Program - and in some cases, a lower-level home care package - it still left a significant gap between services and needs, Mr Rooney said.
As of March 31, 2019, there were 1690 people in the ACT waiting on a home care package at their approved level. More than 95 per cent had been approved for Commonwealth home support, a spokesman for the Department of Health said.
Of the 1690 people, 922 had not been offered a lower level home care package, while 10 people had not been offered any assistance. There were 1332 people living in the ACT who had an active home care package as of December 31, 2018.
"There are some Australians who are fortunate enough to fund [the] gap themselves, or who have [loved ones] that they can rely on to fund it or provide that additional care and support," Mr Rooney said.
"But there's also large numbers of older Australians that don't have those resources.
"They are at significant risk with regards to health issues, social isolation, and indeed, mortality."
Mervyn Knowles, 97, and Beth Knowles, 92, are at the more fortunate end of the spectrum. The couple live independently in their Forrest home of 55 years, and manage with Mrs Knowles' level two home care package and additional support from their son, Jeff Knowles.
Mrs Knowles was approved to transition to a level three package some 13 months ago, while Mr Knowles was approved for a level two. The couple are yet to receive either, but are in reasonable health and "well-settled, to say the least".
They agree the same wait period would be "absolutely" problematic under different circumstances.
"One of the things the lady from [the home care provider] said to me is be the son, don't be the carer," Jeff Knowles said.
"So understand how to give them their independence, and each time they get a little bit less independent, just put something in place."
Barton resident Rebecca Scouller struggles to strike that balance, given that she spends a large portion of her week managing different services to support her mum.
Charlotte Scouller has dementia and lives in an independent over-50s community. She was approved for a level three home care package a month ago, and aged care assessors indicated it would likely be 12 months before she receives it.
"These people have worked all their lives, paid taxes, volunteered numerous hours, raised children, given to Australia, to the community and the economy, and yet they get to the point where they finally say, 'Hey, I actually need a hand', and ... they're told that they need to wait 12 to 18 months," Rebecca Scouller said.
"I'm not sure why the community outrage isn't there."
Mrs Scouller is receiving Commonwealth home support assistance while she waits for a home care package, and uses a private transport service once a week.