Consumer Directed Care in Aged Care Sector
The term consumer directed care (CDC) is used in the sector of aged care. It explains a novel way of service providing that allows the older people to receive the services according to their choice of the expert and the type of service they want. This model of consumer directed care is designed to deliver services to the people who belong to aged community and gives them the freedom of choice and allows the consumers to be flexible according to their need. When older people opt for the CDC services, they have the complete control over the type of care and services they want to access, the way those services are to be delivered, the choice of the service provider and also the time of taking the care. The service provider organizations and the case managers tend to lose power over the management of their clients’ budgets (Ruggiano & Edvardsson, 2013). Although, CDC has made the entire process more transparent than before.
In Australia, all the aged care facilities that are funded by the government, follow the consumer directed method. This approach is used to encourage the older consumers so that they can be able to take the decision for the type of the care service they want to be delivered, along with how and when they want to access the services (Purcal, Fisher & Laragy, 2014). Previously the care facilities used to be directed by the provider, following a person-centered approach to aged care. This new consumer directed approach has been a revolutionary change in this industry, and has become an essentially compulsory element of the aged community and aims to provide much better residential care services in Australia.
The term consumer directed care is used in aged care sector as a way to explain the service giving process that allows the aged people to make their own choices regarding the types of service they want and who should be there to provide the services. This Consumer directed care approach allows the older consumers to shop around to access the services of their choice and also to choose who they want to provide those services. They are able to select the price that suits them best and thereby make their own funding go further. The people belonging to the aged community may ask for hiring their choice of the service provider from the organization. If they want to avoid most of the excess charges, the older community can also ask for a local care giver from the service provider. This helps them to avoid the overhead charges as well as makes their funded package more sustainable (Harrison et al., 2014).
Benefits and Challenges of Consumer Directed Care
The consumer directed care is entirely about the two phrases: choice and control. Compared to the traditional provider directed approach, this new method gives the patient and the care-givers the flexibility to choose the type of services they require in order to support them at home and also they are capable of choosing the care giver who will provide these services. The care givers work together with the aged people in order to determine their needs and individual requirements and expected outcomes. CDC also gives complete flexibility to the older people in managing the packages and the service costs and gives them freedom to choose how much money they want to spend (Schwartz, 2013). Their involvement is not compulsory. Extra attention are given so that the financial aspects of the services are done with absolute transparency.
Most of the aged care facilities are funded by the Australian government. Only a few are privately paid by the people and these services are provided by volunteers (Bradley, 2017). The followings include the government funded initiatives:
- Commonwealth home and community care (provides high level of assistance)
- Home care packages (provides low level of assistance)
- Residential care (provides care in aged care homes or in nursing homes)
This revolutionary reform of consumer directed care in the aged home care industry, started on 1st July of 2015 and developed into being fully operational since 27th February of 2017. It provides the older citizens of Australia with nine new rights that enables them to possess more strength than ever before (McCaffrey et al., 2015). Although the consumers must possess the required knowledge about the rights and always be assertive to receive the true Consumer Directed Care even if the service providers still wants to impose the traditional provider directed care on them. The older Australians must therefore acknowledge the difference between the old and the new rights in order to receive the best care facilities.
In Australia the consumer directed care allowed frail senior citizens to possess the choice of services and control on their life. In January 2012, the outcomes of consumer directed care showed major improvements in the choices, control and level of satisfaction and contentment among the clients who have dementia or higher care needs. The cost-effectiveness of this care has also been proven to be quite impressive (Laragy & Allen, 2015).
Positive aspects of CDC:
- The consumer directed care approach provides the chance to close the gap among different levels of care packages. Thereby the CDC approach benefits the borderline consumers by making their transfer of between various levels of funding streams much more easy.
- When the clients start accessing the CDC care packages they become more conscious and responsible for the service they get and usually do not make any unreasonable expectations from the care givers (Mittler et al., 2013).
- The efficiency of CDC is much more developed regarding its individual budget control capability. The consumers who have the same requirements possess the same amount of individual budgets.
- Through this modern care approach the consumer’s actual needs are met rather than what the providers assess about their requirements. Thereby, this greatly promotes the customer satisfaction.
- Each of the care levels consist of a “Dementia care” component. This hugely benefits the clients, as they do not need to apply for the high care packages to get the special care for dementia anymore.
Challenges and concerns of CDC:
- Sometimes the care givers are unable to fulfil the client’s requirements and thereby lose the creativity and flexibility which are essential to meet the consumer’s special needs.
- The Consumer directed care requires the aged clients to make the co-payment individually. This is not an easy task for most of the older citizens. In order to access services the clients need to access the services otherwise their health would deteriorate (Crozier et al., 2013).
- A decline in the hands-on case management support technique may result in some difficulties for the clients to access the services themselves. This results in a decreased quality of services.
- Also, a major criteria of properly using the money is a prerequisite to access uninterrupted services. Clients who fail to meet this requirement may have to face the financial burden.
- A major lack of the whole consumer directed care approach is that even though it benefits the older people belonging to the mainstream population, it does not address the needs of the groups of clients who are mostly financially disadvantaged or homeless or belong from indigenous or culturally and linguistically diverse (CALD) backgrounds (Haviland et al., 2016).
The responsibilities of the organizations that provide the services to the older people include:
- The organizations that provide the consumer directed care services to the aged community, needs to change their care models such as separating the case managements from the coordinated care approaches.
- The organizations are also required to review their current policies, prepare the staff members by thorough training, guiding, providing education and thus making them more skilled professionals (Kaambwa et al., 2015).
- Also the organizations may consider adding a modern information technology system which will help them to guide through the processes more easily.
- The workforce policies and the policies of the payment are affected due to the changes in the model of care delivery and changes in the positions of the case managers (Ottmann, Allen & Feldman, 2013).
- It may be difficult for the organizations to maintain the contracts with a wide range of service providers and monitoring if their delivery actions are meeting the client’s requirements. Since the consumers choose from a wide variety of services, it is often hard to follow through each of their needs are being addressed.
Conclusion
The people receiving the care addressed this approach of consumer directed care as a person-centered care which emphasizes and enables the consumers by giving them much more power, more options to choose from, and control on their needs. This consumer directed approach also entails the clients to have the entire responsibility for their money and choice of care. Although it has been mentioned by some consumers that the word “choice” mentioned in the approach is more of a superficial term. Under many circumstances choosing the preferred mode of care was not possible and that it turned into the traditional approach of non-negotiable provider directed care. The organizations that provide these services need to improve their quality of care in order to satisfy and maintain the customers and increase the number of clients. Although, the consumer directed care approach has given back the strength to older people by making their voices heard.
References
Bradley, S. (2017). Consumer directed care. Australian Nursing and Midwifery Journal, 24(11), 33. Retrieved from: https://search.informit.com.au/documentSummary;dn=839749192424493;res=IELHEA
Crozier, M., Muenchberger, H., Colley, J., & Ehrlich, C. (2013). The disability self?direction movement: Considering the benefits and challenges for an Australian response. Australian Journal of Social Issues, 48(4), 455-472. doi: https://doi.org/10.1002/j.1839-4655.2013.tb00293.x
Harrison, F., Low, L. F., Barnett, A., Gresham, M., & Brodaty, H. (2014). What do clients expect of community care and what are their needs? The community care for the elderly: needs and service use study (CENSUS). Australasian journal on ageing, 33(3), 208-213. doi: 10.1111/ajag.12118.
Haviland, A. M., Eisenberg, M. D., Mehrotra, A., Huckfeldt, P. J., & Sood, N. (2016). Do “consumer-directed” health plans bend the cost curve over time?. Journal of health economics, 46, 33-51. doi: 10.1016/j.jhealeco.2016.01.001.
Kaambwa, B., Lancsar, E., McCaffrey, N., Chen, G., Gill, L., Cameron, I. D., … & Ratcliffe, J. (2015). Investigating consumers’ and informal carers’ views and preferences for consumer directed care: A discrete choice experiment. Social Science & Medicine, 140, 81-94. doi: 10.1016/j.socscimed.2015.06.034.
Laragy, C., & Allen, J. (2015). Community aged care case managers transitioning to consumer directed care: More than procedural change required. Australian Social Work, 68(2), 212-227. doi: https://doi.org/10.1080/0312407X.2014.991337
McCaffrey, N., Gill, L., Kaambwa, B., Cameron, I. D., Patterson, J., Crotty, M., & Ratcliffe, J. (2015). Important features of home?based support services for older Australians and their informal carers. Health & Social Care in the Community, 23(6), 654-664. doi: https://doi.org/10.1111/hsc.12185
Mittler, J. N., Martsolf, G. R., Telenko, S. J., & Scanlon, D. P. (2013). Making sense of “consumer engagement” initiatives to improve health and health care: a conceptual framework to guide policy and practice. The Milbank Quarterly, 91(1), 37-77. doi: 10.1111/milq.
Ottmann, G., Allen, J., & Feldman, P. (2013). A systematic narrative review of consumer?directed care for older people: implications for model development. Health & social care in the community, 21(6), 563-581. doi: 10.1111/hsc.12025.
Purcal, C., Fisher, K. R., & Laragy, C. (2014). Analysing choice in Australian individual funding disability policies. Australian Journal of Public Administration, 73(1), 88-102. doi: https://doi.org/10.1111/1467-8500.12063
Ruggiano, N., & Edvardsson, D. (2013). Person-centeredness in home-and community-based long-term care: current challenges and new directions. Social work in health care, 52(9), 846-861. doi: 10.1080/00981389.2013.827145.
Schwartz, R. L. (2013). Health law: cases, materials and problems. West Academic Publishing. Retrieved from: https://digitalrepository.unm.edu/law_facbookdisplay/167/
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