Discuss about the Health and Socio-Political Issues in Aged Care.
Consumer-directed care can be described as the aged care that involves choice, control, and management of clients that are offered. The government of Australia developed care policies that were named Living Longer Living Better (LLLB). The care is enjoyable since that client enrolled in the service are allowed to make the decision independently on the provider, type of service and funds usage. The preference of a client is important for decision-making process and clients are also involved in continuous assessment or monitor of the progress. The piloting stage was completed in 2011 and showed a success. The government, therefore, rebranded all the Home Care Packages to follow the consumer-directed care model. Since its official implementation in 2012, the government has provided the funding solution for the consumer-directed care upon approval of the budget for the care. There are some laws that provide the basis of the consumer-directed care developed to foster or provide guidelines. An example of the laws that assist in the provision of guidelines during the implementation of the consumer-directed care is User Guide that was amended in 2015. Moreover, the government partners with caregivers through the department of health and the department of social service. The care provider together with the consumer is both involved in the development of a plan of activities, budget and monitoring or management of the service delivery. The following paper critique and discuss the consumer-directed care analyzing positives and negatives of the care.
Consumer-directed care refers to the care offered within at home to aged people in Australia with the aim of making the life of elderly people better. The consumer-directed care is based on the principle of choice, flexibility, and autonomy. The consumer is given chance to make choice on the type of service provider and the type of care they receive from service providers. In addition, the consumer and the provider discuss, plan and develop a plan for the care. The government of Australia, therefore, recommended all Home Care Packages to offer the care on consumer-directed care basis (Bradley, 2017).
The consumer-directed care was developed on four main principles and these are legal, ethical, political and philosophical principles. These factors determine the development, adoption, and implementation of the consumer-directed care. Firstly, the legal principles that provide the foundation for the consumer-directed care are based on the consumer right to better, quality and accessible care (Singh, Douglas & Shi, 2015). The government has develops various laws that guide the adoption and implementation of consumer-directed care. Some of these laws are Aged Care laws, User Right Amendments and Living Longer Living Better bill. Firstly, aged care laws were first developed in 1997 that improved care for the aged people within the country and this law give background for implementation of consumer-directed care within Home Care Package. Secondly, User Right Amendments of 2015 also gave the consumer-directed care upper hand since the law provides guidelines for implementation of the care within the community. Thirdly, before the amendment of 2015, the bill named as Living Longer Living Better Bill of 2013 is an important legal instrument that provided the ground for life improvement within Australia among aged people (Australian Government, 2015).
The political foundation is based on the health policy developed by the Australian government that was commonly called Living Longer Living Better. The policy was developed in 2012 that aim to make lives of aged people better and live longer due to improved care (Government, 2013). This necessitated the consumer-directed care that allows consumers to be part of the care program. The government, in order to fulfill its political promise to the people of Australia, developed this care model to improve the life of aged people. In addition, the policies of the government of Australia are linked to the consumer-directed care through the development of various guidelines to aid in the implementation of the care. The success of the consumer-directed care is therefore attributed to the success of the political strategy of the government (Delp & Muntaner, 2011).
The ethical foundation of the consumer-directed care is based on the human choice, preference, and independence that define the quality of care. Western countries value the autonomy of humans and attribute this to the quality of healthcare given to these people. Likewise, the consumer-directed care is developed in order to upload the need for independent decision making that allows people with cognitive sound judgment to make their own choice on the care providers and the type of care offered to them. Management of consumer-directed care, therefore, considers the client or their representative. For those clients unable to make the right decision, their designated representatives are allowed to manage the care on their behalf. In addition, the client together with their provider discusses and developed a plan of the care. The planning of the care also involves the development of a budget that upon approval, the government offers funding (iCareHealth Blog, 2013).
The philosophical basis of consumer-directed care rests on the choice, preference, and flexibility. The theoretical aspect of the CDC was coined based the need for a more flexible care model that improve the ability of consumers to have a say on the service offered to them within home care. In order to give clients more desirable care, giving client opportunity to control their care was seen as the best way to make the whole model applicable in Australia. Preference of clients within the mode plays the part of the system and means more to providers as they have to incorporate the desire of consumers in care. The flexibility of the care is another aspect that forms the philosophical background since consumers are given priority to decide on their own. Moreover, the choice that consumers make is used for decision-making process to implement the consumer-directed care (Ashley, Hester & Leslie, 2017).
The management of the consumer-directed care is based on three key players and these include consumer or the designated representative, Provider and the government. Firstly, the government is involved in the management of the operation and progress of the care and this is mainly done through continuous assessment of the program. In addition, the government before approving funds requires a proper commitment shown by parties involved in the care (Department of Social Services, 2014). The government also monitors the service delivery to ensure that all are according to the required standards of care. Secondly, the consumer can directly involve the management of the care program since they are involved in planning, budgeting, and assessment of the program. Those consumers without the ability to provide their opinion on management are given chance to provide their representative. Thirdly, the representatives of the client are part management and control of activities that take place during the care service. Where the consumer is unable to make their own decision due to cognitive problems their representative is involved in the management of the care. Lastly, providers are other case management factor that can either be directly involved to clients or through the Home Care Package organization. Providers discuss, plan and budget with a client or their representative on the care service. Care providers can also be in form of the organization that manages various care professionals that are then directly involved in consumer-directed care (Kijong & Rania, 2011).
The mode of offering consumer-directed care is residential aged care through which the government implemented the Living Longer Living Better (LLLB). The government through the department of health and social services incorporated the consumer-directed care into Home Care Packages. Previously, the government has been fostering the high-quality care within the residential homes and this has been strengthening through the adoption of consumer-directed care. CDC, therefore, took Home Care Packages to the next level especially through funding by the government has also improved the quality of care (Chuanmei, Dunt & Doyle, 2014).
Consumer-directed care can also be analyzed based on the perspective of the care provider being an important player in the model of care. Providers need to show the professionalism and high quality of service delivery that meet both set objectives and goals of the client (Moorman & Macdonald, 2013). Providers together with clients are expected to discuss the goals of the care, plan of activities and the expected budgets for the whole program. This enables the government to fund the approved budget for the service delivery. Caregiver and the client collaborate to continuously assess the care program and give the progress report to the ministry officials. The level of engagement is another issue that both client and the care provider discuss to ensure they are successful. Analysis of the consumer-directed care shows that the government requires clear developed rules of engagement as this prevent continuous concerns of the provider of overtime care. The level of involvement, therefore, needs to be an asset to the user guide for the consumer-directed care (Beeuwkes, Haviland, McDevitt & Sood, 2011).
Consumer-directed care involves collaboration between consumers and their care providers. The collaboration brings together various patients that are involved in the care through personal expression. The relationship between client and provider can also be described as a partnership where both partners have to say and choice. This implies that all those people that are involved in consumer-directed care have their choice and opinion used in the decision-making process. This kind of partnership during care is enabling the government to meet its goal of providing better care to senior citizens. In addition, since the pilot stage of the care conducted in 2010-2011, the consumer-directed care has been proved to be successful in meeting this objective of the government of Australia (McStay, 2015).
The consumer-directed care has some traits that make the care model unique and appropriate for the people of Australia. Firstly, the model brings together various stakeholders within the residential care for better service. The care brings together government particularly department of health and department of social services, care providers and clients that are mostly aged people. Secondly, the opinion of consumers forms part of the decision making regardless of their background or cognitive ability (Productivity Commission, 2011). The client within the consumer-directed care has a choice and this can be expressed either directly or through representation. For instance, those consumers without the capability of directly expressing themselves due cognitive impairment are also given chance to share their opinion through a designated representative. Thirdly, funding for the program is offered by the government of Australia upon approval of the budget and plan of activities. The commitment and the height of interest determine the funding capability of the government. The consumer has rights to access the funds available that the spending rate of the funds so as to control the fund’s usage. Fourthly, another characteristic of the consumer-directed care is the determination of the engagement between the consumer and their service providers. Discussing the period of engagement is important as it prevents complains of most caregivers showing overtime working without payment (Net Industries and its Licensors, 2018).
Partners within the consumer-directed care include the government, the home care providers, and clients or their representatives. Firstly, consumers are important partners within the model and can take part in decision-making process either directly or through their representatives. Consumers without capabilities to discuss care or provide their opinions are represented during the collaborative meetings (Paraprofessional Healthcare Institute, 2015). Secondly, the government of Australia is another partner or stakeholder in the implementation of consumer-directed care. The government involvement in the care is through two departments of health and social services. The government come in to fund the care and also provides lows that are used to plan activities hence the political objective of the government is realized. Thirdly, the care service provider is another stakeholder or partner that also takes part in the provision of aged care in a professional manner. Service providers are involved in consumer-directed care through professionals and organization. There are many different organizations that provide Home Care Packages that are spread throughout Australia (COTA Australia, 2017).
Financing of the consumer-directed care is mainly done through three main solutions. Firstly, previously the home aged care has been funded by the users themselves and this enables various clients to enroll in Home Care Packages. Users or clients enroll within the aged care service provision in order to access various services offered within the care package. Secondly, the pilot form of the consumer-directed care was majorly funded by the commonwealth. The pilot consumer-directed care was mainly offered during the periods of 2010 and 2011 and proved that the program was successful (Kristen, 2015). After the testing of the pilot form of the consumer-directed care the commonwealth funding ended and the government took over through the implemented program. Thirdly, the government is another financial agency that mainly touches those home care services that have been incorporated into the consumer-directed care. The government has been fostering its better living, living longer policies that aim to improve the service delivery or aged live improvement. In order to fund the consumer-directed care, the government assesses the budget and the commitment shown by parties involved in the care as this assist the government to periodically monitor the care (Department of Health, 2016).
The financial issues have been observed and this follows a process that needs a clear understanding. The government normally finances those care that is already operating and this is based on the level of the commitments shown during the service provision. One of the key issues that affect the consumer-directed care is the transfer of consumer from one service provider to another. It is good to note that funds that are used by the consumer sometimes becomes difficult to transfer in case of changing service provider. Moreover, the legal framework provides a window period of 28 days during which consumer is expected to return to the provider. After this period the funds can be used for other consumers within the same service providers. The stipulated amount that is given to each client for care is normally $12,000 annually and can be given in bit by bit. Sometimes the client may require wheelchair that is also incurred as expenses also funded by the government (Myagedcare, 2016).
Positives of the consumer-directed care
The analysis of the adoption and implementation of the consumer-directed care shows high relevance and positives of the model. Firstly, the consumer-directed care gives the clients the best flexibility that is also connected to the quality of the service that is expected. The consumer-directed care is based on making care flexible according to the foundation principles used to develop the consumer-directed care (Iecovich, 2011). Secondly, the consumer-directed care improves the lives of aged people since they are given the opportunity to express themselves. This makes the life enjoyable hence meeting the intended purpose of service that is meant to make client Live Longer Living Better (LLLB). Thirdly, analysis of the cost and benefits show that the consumer-directed care is cost-effective making the care appropriate for current community health. The model of care is cost-effective that show more improvement in the outcome that is attributed to longer and better health of aged people in Australia. Lastly, consumer-directed care has been proved to offer satisfactory care that enables the consumers to express their better health. The flexibility and control that is given to consumer make them feel part of the care hence are satisfied with the service offered to them. In addition, consumers are also involved in planning and this makes them feel valued and part of the whole model of care (Huang, Thang & Toyota, 2012).
Negative of consumer-directed care
There are some negatives that are involved with consumers directed care that needs improvement. Firstly, balancing of duty of care and consumer’s right is the key challenge that affects the providers under consumer-directed care (Jenay, McBride, Tracy & Wendy, 2014). The provider normally offers care to consumers based on their duty to the consumer is mostly connected based on their rights. Secondly, the consumer-directed care requires high involvement that makes the whole care model stressful. Many care providers have expressed their dissatisfaction with the consumer-directed care as this expose them to overtime working conditions (Delp, Steven, Jeanne & Muntaner, 2010). The worst is the unpaid overtime working that makes the providers feel exhausted. Thirdly, balancing the consumer choice and professionalism is another aspect of the consumer-directed care that makes need improvement. Some consumers are reported to give unrealistic choice and this is mainly based on their cognitive reasoning. For instance, those consumers with impaired cognitive abilities need assistance to express them. Fourthly, making the budget that is well balanced to meet all the consumer needs as this also requires the consumer’s choice and planning (Edward, Louise & Sara, 2015).
Conclusion
In conclusion, the consumer-directed care analysis show various principles that were used to develop, adopt and implement the care. The analysis identifies some factors that form the main foundation of the consumer-directed care and these include legal, philosophical, ethical and political factors. In addition, the funding of the consumer-directed care is mainly the government though formerly funded by users within the home aged care services. For the Home Care Package to receive the financial support from the government, the service must be approved by the government. The analysis also shows that the consumer-directed care has positive and negative that can be improved for the care to be better than currently offered. Some of the negatives of the consumer-directed care include high involving leading to job dissatisfaction among providers, cognitive impairment may lead to wrong decision or choice by consumers, funds management and balancing between professionalism and client choice is challenging. Therefore, the positives and benefits of the consumer-directed care are numerous indicating the importance of the care as sued in Australia to improve lives of aged people.
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