Abstract
BackgroundOur study explored client experience of Australian Consumer Directed Care. This evolving funding model enables consumer autonomy and choice, allowing older people to remain in their community as they age and need support through the creation of a personalised support service. Consumer Directed Care focuses on providing services that the consumer self-determines to meeting their needs including identifying their types of services, from whom, when and how these services are delivered.MethodsSemi-structured in-depth interviews were conducted in two Australian states between August 2015 and April 2016 with 14 participants, preferably in receipt of CDC services for at least the previous 12 months. Questions explored how the participant first learned about this service; the types of services they received; whether services met their needs; and any additional support services they personally purchased. Interviews were transcribed, coded and thematically analysed.ResultsFour main themes related to consumer experience emerged. Knowledge: Unsure what Consumer Directed Care Means. Acceptance: Happily taking any prescriptive service that is offered. Compliance: Unhappily acceding to the prescriptive service that is offered. External Influences: Previous aged care service experience, financial position, and cultural differences.ConclusionOur results suggest that the anticipated outcomes of Consumer Directed Care providing a better service experience were limited by existing client knowledge of these services, how best to utilise their funding allocation, and their acceptance or compliance with what was offered, even if this was not personalised or sufficient. External influences, such as service experience, finances, cultural difference, impacted the way clients managed their allocation. Our study identified that ongoing engagement and discussion with the client is required to ensure that services are specific, directly relevant and effective to achieving a consumer directed care service.
Highlights
Our study explored client experience of Australian Consumer Directed Care
Our findings are consistent with other investigations that have identified a number of areas of concern to consumers receiving home care services (CDC) including: costs related to administrative fees and brokerage; issues with accuracy and complexity of information; limited choice and flexibility in the service and who provides it; issues with goals not being reflected in care plans; and inequities in access and service availability
Whilst the issues identified in this paper are not unexpected for a policy change in its infancy in Australia, the uniqueness of this study is that it provides some insight into the management and use of Consumer Directed Care (CDC) services from a CDC client perspective rather than a policy or service provider perspective
Summary
Our study explored client experience of Australian Consumer Directed Care This evolving funding model enables consumer autonomy and choice, allowing older people to remain in their community as they age and need support through the creation of a personalised support service. Government Productivity Commission Report on Caring for Older Australians [8] which led to a ten-year program of reform called Living Longer, Living Better, due for completion in 2022 [9]. These reforms were acknowledged as needed because of the demographic bulge of the Baby Boomers entering older age [9]. In 2018 all home care packages are required to be of the CDC type [10]
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