Aged care refers to the living as well as nursing care amenities for older Australians who can no longer live self-sufficiently or those who need help to sojourn in their homes. These services include both residential aged care in nursing home and home care services. The Commonwealth Government under the Health Department is responsible for the Australian Aged Care System. It provides the funds needed for the sustenance of aged care services while regulating expenses and overseeing legislation for aged care. Home care services aim to maintain an aged individual’s quality of life while still in their homes by assisting them with their physical requirements and day-to-day activities (Day et al, 2017). Home care embraces two forms of government-funded services for home-based persons. These are the Home Care Packages Program, which can deliver a greater array of services as compared to the Commonwealth Home Support Program that offers certain help with daily tasks.
Residential aged care also simply known as residential care, on the other hand, entails the kind of care and clinical services provided to aged people living in nursing homes. It can be offered as letup care that is for short periods of time or on a long-lasting basis. The Federal Government of Australia, under the Aged Care Act 1997, is accountable for residential aged care comprising of the control of the standards and principles of care as well as its funding (Fay & Owen 2012). This essay dwells on the Home Care Packages Program in Australia, bringing to light its reorganization to Consumer Directed Care (Ottmann et al, 2013). It clearly discusses the rationale, the future of CDC as well as pros and cons of this model. Moreover, it explains the ethical issues that are associated with the consumer-directed care system and mentions its foundation which is mostly based on political matters.
Consumer-directed care is an aged care system designated to give the consumers more choice, flexibility, and control regarding the services delivered to them(McCaffrey et al, 2015). This means that the older people can regulate the types of services and care they are provided with including who delivers these services, their conveyance and the time of delivery (Wilberforce et al, 2017). Together with their service providers, the aged come up with a care plan, decide the level of their immersion in the management of the services provided to them. This consumer model also provides them with their financial statements, that is, their monthly income and expenses report that enable them to find out how their funding is distributed among their various needs and that it is not being wasted. Reviews of these statements allow for adjustments in case the needs of a particular person have changed. The financial reports also indicate whether a certain individual is eligible for higher levels of services or if they need to use their own finances to meet their own prerequisites (Boelsma et al, 2014). Additionally, the system ensures that their caregivers make monitor all the kinds of care needed as they have to make formal assessments to this effect (Lowthian et al, 2018).
The Aged Care Act 1997 provides for the funding and regulation of aged care services. The approved care providers, that is, individuals who are permitted under the Act to give care services to the aged can be entitled to collect subsidy payments in respect of the devotion they offer to the ratified care recipients. The aged care providers are obligated to issue the maximum sum they charge for their accommodation and additional services. The User Rights Principles lay out the duties of approved providers in giving home or residential care services. The User Rights Principles were amended in 2015 to accommodate the Consumer Directed Care model. Despite being piloted in the Commonwealth funded Home Care Packages since the year 2010, CDC has only been fully effective from 1 July 2015 when it was mandatory for all Home Care Packages to be supplied on a CDC basis (Laragy & Allen, 2015). This is mainly due to its success as a pilot program (Low et al, 2012). During this period an improved capping arrangement was also established to advance the affordability of the aged care. The high and low care distinction, which was previously used was removed by the government to increase the elasticity of the care engagements between care providers and the aged.
The Department of Social Services was the section that was mostly responsible for the amendment. Throughout early 2015, it held briefing conferences with stakeholders in Port Macquarie, Sydney, Darwin, Shepparton, Hobart, Melbourne, Launceston, Bunbury, Perth, Adelaide, Brisbane, Port Augusta, Townsville, Canberra and Alice Springs. An Exposure Draft of the Amending Principles and a Home Care Packages Programme Consultation Paper were published by the department in April the same year and both the public and the stakeholders strongly supported the new provisions proposed. Some useful suggestions were also put forward to enhance the tractability and further reinforce the relationship between the care providers and the aged. For this system to become officially operative, it was vital for the Amending Principles and all the stakeholder comments to be reviewed by the National Aged Care Alliance’s Home Care Packages Advisory Group. This association comprises peak provider groups, care recipient representatives, carers’ legislatures as well as allied health professionals (Petriwskyj et al, 2014).
The Department of Health’s Home Care Packages Program Guidelines, in 2013, gave out certain policies that were meant to guide the delivery of home packages on a CDC basis. These principles include:
Greater Control for the Elders: earlier on, providers owned the consumers’ packages whereby the latter were assigned to them by the government via the bidding process. The aged were individualistically assessed through the Automated Customer Account Transfer Service (ACATS) and indicated to the level (1 to 4) of the package they qualify for. They then had to look for a provider who had matching packages (Jowsey et al, 2016). This process was vastly unorganized as some of the elders ended up in a partnership with care providers they did not necessarily want to use while sometimes ending up with lower level packages (Gill et al, 2017). The CDC system, however, gives the elders and their families better control of their lives as they have an opinion on how their package is spent (Stones & Gullifer, 2016). It allows them not only to pick the kind of care that preeminently suits them and decide on how it is distributed but also choose the best care providers for their individual requirements. If the consumers have special care needs like dementia, for instance, they have a right to choose specialists in this area as their care providers.
Saves the Aged Money: The clients can negotiate with a specified caregiver if he or she charges very high fees leaving more cash for actual care. In addition, they are involved in all the transactions handled and provided with monthly financial statements indicating their expenditures and their total monthly income. This facilitates their savings as they have an idea of how much cash is needed for what and consequently the remainder. Money is also saved by the purchase of cheaper services. The currency saved can then be used to fund other services required.
Maximum satisfaction: It is normal for people to feel more contented when they make their own decisions entailing money issues. The elders, by being involved in the decisions concerning their assets identify how their cash is being spent and therefore are making better-informed resolutions concerning it (Bulamu et al, 2017).
Safety of the Package: once a package has been allocated to a specific individual, they cannot lose it as they are eligible for it. It cannot also be allotted to another person, meaning that the elder is free to use as he or she wishes.
Changing of providers does not incur any financial penalty: the aged are certified to take up another service provider and lose the previous one if they are not well serviced. This does not incur any financial losses to the elder since any amount required by the provider for exiting can only be deducted from the package if there is a surplus (Cash et al, 2017). All the older person needs to do is check the statement for their package to find out if there is a surplus and their Home Care Agreement to ascertain the provision for exit fee. If this is not provided for, then changing of care providers can be achieved without any financial drawback (Yeandle et al, 2012).
Lower Levels of Assistance: sometimes the prevailing home care packages are simply not intensive satisfactory in providing support to those who need supplementary hours of help every week. In order to offer more assistance, the service provider may decide to increase the number of care workers attending each visit. This would, however, mean reducing the amount of time they spend with the aged as well as the total visits. This would subsequently lead to these elders inability to stay at home further due to the poor quality of the services they receive (Jowsey et al, 2016). These elders need more than level 4 packages which are not available. Furthermore, there may be a shortage of workers mainly due to the low wages and deficiency of benefits that are likely to be associated with this field.
A limited number of providers: CDC permits one to choose their own products and service providers. This means that the consumer should exit and try to find another provider. This can be, however, difficult or even impossible in many regions in Australia due to a narrow choice of care providers. This is also a challenge to the state as they may have to use independent care providers sometimes. This increases the potentiality of fraud and abuse that may exist as a result of lack of constant monitoring by the government.
Inability by some users to manage their own care: this list may include people with cognitive impairment, who may not realize what they need or deserve. Some frail elders also may simply not want to be completely accountable for their own care.
The study of ethics is majorly concerned with making decisions that advance autonomy and fairness. In the case of CDC, the cost of providing services would have to be included in order to promote equality and the independence of the aged. For an operational cost control mechanism, the consumers must clearly comprehend the economic exchanges needed to make conversant allocation decisions. In this scenario, the concept of unlimited wants to be satisfied with limited resources is applied. Basing on this concept, rationing of the available assets is unavoidable. Nevertheless, it can be structured in a manner in which it provides a certain level of self-sufficiency and equity among the consumers.
The core ethical principles for service providers are non-maleficence and beneficence. This means that the care providers have an obligation to take care of those in need and not to abandon the consumer (Prgomet et al, 2017). Moreover, they should honor the client’s requests and denials but may refuse unreasonable demands that could harm their own values.
Whilst the federal government is anticipated to introduce consumer-directed residential aged care in the very near future, this is not available currently. This is due to lack of the necessary enactment costs, strategies, and approaches (Dybvik et al, 2014). Some residential facilities have already acquired certain aspects of the consumer-directed care in particular areas such as food. However, there has not been a full implementation of all elements of lifestyle and care allied with this model in residential homes.
Aged care is in evolution. It is progressing into a structure that better supports the welfare of older people and the provision of care in means that esteem their dignity and maintain their independence. As aforementioned, there is an amplified focus on consumer control and choice. Similarly, the population of Australia is increasing and the proportion of older people will continue to upsurge in the near-term decades. In fact, studies show that by 2096, about 22 percent of Australia’s populace will be 65 years old and above. This growing population will demand fundamentally reimagined aged care systems and solutions. Preparation for this growth is one of the key challenges of the aged care policy.
In order to solve these continually arises problems, both the government and other interested parties (stakeholders) agree on the need for an additional reform for aged care to become even more of a consumer-centered system. This necessitates orienting the supply of diverse care types around the demands of users and giving consumers superior choice and control (Gill &Cameron, 2015). This means establishing a demand-driven system, that is, a system that has little regulatory control. Nonetheless, for this to become operative, some conditions have to be met. These include:
Comprehending the nature of the demand for aged care is crucial so as to determine the best way to satisfy the consumer. The right amount and mix of services should be provided to each user justifiably. With the persistently growing population of the aged, better-aged care services should be are continually sort after to accommodate all the elders (Khaksar et al, 2017). Technology should, therefore, be employed in this area (Douglas et al, 2017). Also, attempts should be made to increase the number of workers for the aged care as this is one area that id faced with a huge shortage of workers.
Conclusion
In conclusion, it is evident that the Consumer Directed Care (CDC) for the aged in Australia has brought about more good than bad. Ranging from independence and greater satisfaction for the user to utilize the available resources (funds) in a more cognizant manner and safety of the consumers’ packages, CDC has led to more organization in aged care. This system has also improved the lives of the older Australians by giving them more freedom which enhances happiness. CDC also ensures that the ethical considerations put in place are adhered to as it offers clear principles to be followed by both the consumer and the aged care provider. With a continuously growing population of the aged Australians, even better systems for aged care that are more user-friendly are required in the future.
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