The Consumer Directed Care model in Aged Care
Discuss about the Health and Socio-Political Issues in Aged Care.
The population of the aged in Australia is high, and the government has started to show concern for this. The aged in the country are faced with challenges of care, and the government wants to make sure that they can sustain the care system for them in the coming years. As the population is increasing, the concern for the overall care and safety of the old is rising as well. The Australian government is concerned with ensuring that this population is taken care of in terms of wellness, safety, and aged care. According to research, the elderly population is expected to be twice what it is now in the year 2050.
In the past Australia has been using other models for care of the elderly such as the Community based services as well as the traditional provider-directed care. The government, however, decided to change this as they wanted to ensure that the elderly population was receiving the optimal care that they deserved. This made way for the Consumer Directed model. In this model, the Australian government pays for most of the services offered while the rest is catered for by the consumer out of pocket.
The Consumer Directed Care model also referred to as the CDC is a care model that aims at achieving flexibility between both the aged care provider and the elderly who is also the consumer. The CDC is a service delivery that ensures the consumer has total control of managing their care plan. The consumer also has a choice in whether they want to manage their care plan or not.
The sole focus of the model is on choice where the consumer dictates the services they want to be rendered as well as the person to provide the services and on control where the consumer again has complete control over their care. By using this model, the Australian Government wanted to ensure that their elderly were able to make decisions on their own therefore giving them a sense of independence. Research showed that most older adults do not like the idea of being stereotyped as being helpless. The government consequently wanted to ensure that they were able to get a piece of their independence back (Australia, 2017).
The CDC allows for this independence as the consumer can direct the caregiver on the type of services they want and how they want it as well. This also includes who can deliver the care. The CDC model mostly works for the aged with the Home Care Package system, and it allows them to manage their package. This model has proven to be useful as the consumer is taken care off in accordance with their needs. Once the elderly states what they need and want and what they hope to achieve, the care provider follows suit. This leads to customer satisfaction as the consumer gets everything that they wish to (Baldwin, Chenoweth & dela Rama, 2015).
The political view of the CDC model
Most of the elderly population especially those with the home care package have adopted this model as it allows them to take care of themselves as they have throughout their lives. The consumer in the case of the CDC model has the ability to:
- State what they want in terms of services, who delivers it and how they provide it.
- Creating a care plan with their aged care provider.
- Choose whether they want to manage their package or not.
- Know the payments involved in the care as well as how the money will be spent.
- Monitor their home care package to establish whether it works for them or not.
- The provider, on the other hand, is supposed to accomplish the following:
Listen and communicate continuously with their consumer to be aware of their goals and their needs.
- Come up with care plans that suit the consumer (co-produce it).
- Give all the information to their consumers about the payment involved and how it will be spent. This creates room for transparency.
- Discuss with the consumer on how much they want them to be involved in managing the home care package.
From the above, we see that if applied correctly, the CDC model can be useful in providing the aged with the care that they need (Cash, Moyle & O’dwyer, 2017).
The Australian citizens are responsible for the funding of the aged care system, through the taxes that they pay. The government allocates part of these taxes to the aged care system so that they can provide the financial help to them as most of them are not able to afford it. However they only pay part of it and the rest, the consumer has to pay for themselves. The Australian government made this a priority when allocating taxes money as they wanted to be able to sustain the aged population and their care well into the future (Hume et al., 2015).
The Department of Health in the country ensures that the elderly can receive the care that they need by appropriately using the funds to provide care of all. However, there have been claims that the government does not take into account the elderly population living in the remote areas of the country. There have been claims that these funds are not able to reach such audiences due to their location. The people living in the remote areas are therefore not able to receive care under the CDC model as they cannot be accessed quickly (Temple, Jukic & Dow, 2017).
As some claim that the funding is enough, others claim that it is too little and therefore not everyone will be able to receive the CDC care. For everyone to receive care based on the CDC model, the government will have to increase funding which means that the tax rate will have to increase, unless the Australian government decides to cut the funds allocated to other sectors so that they can fully support the aged care sector (Hutchinson et al., 2016).
The CDC model is best suited for the home care packages where the elderly can receive the care they need at the comfort of their home. Most people in Australia own homes and the government is encouraged to use this to their advantage. This way instead of spending taxes on building homes for the elderly or community facilities, they will solely focus on providing consumer-directed care.
Legal and ethical considerations in the CDC model
The CDC model also requires for the aged care workers to work more extensively and be flexible than the other models that the country has used. This means that more aged care providers need to be employed to maintain the work efficiency. The Australian government will have to increase the number of care providers so that each consumer can get the attention they need. With the numbers of the elderly spiking in the coming years, the government has to re-strategize on how they will ensure that each will get the help that they need (Macdonald & Charlesworth, 2016).
If the government does not take this action, it will find that the aged care providers will have to stretch to unreasonable limits to provide care. The CDC model especially requires an aged care provider to attend to one consumer at a time so that they can provide sufficient care. Therefore, the government needs to consider this when making plans for implementing the CDC model fully. Also, the Australian government will need to make sure that by the year 2050 when the spike in the elderly population is forecast, the care providers will as well have to increase (Warburton & Mahoney, 2016).
The aged care providers must be professionals that have the training in the CDC model and can deliver the care that the CDC model requires the workers to deliver. This means investing in training programmes as well as workshops and seminars for these people (Redfern et al., 2014).
The Minister in charge of the aged care system in the country promises its citizens that they will find the solutions to the challenges that the aged care system faces especially when providing care to people in remote areas or those that do not use the home care package. The Minister says that they want the model to be used by all elderly persons in the country because as for now, it is the most effective in accomplishing their strategies of sustaining the sector in the future (Layton, 2015).
The Minister also assures the citizens that the aged care providers will increase especially so that they can reach the community-based services in the distant locations. The aged care providers will be professionally trained to provide care in regards to the CDC model. The Minister hopes that in the coming future, they will be able to provide consumer-directed care without any challenges.
The Australian constitution outlines the laws that are to be met when providing the care for the elderly. These laws are contained in the Aged Care Act of 1997 and clearly, state the guidelines and rules that care providers need to follow as they provide the care. It is ethical that care providers abide by these rules and any aged care provider that does not is considered as unethical as it is not part of their scope of practice. Therefore when providing care based on the CDC model, the provider needs to ensure that they follow the guidelines of the model as well as keep the law (Low, Fletcher, Gresham & Brodaty, 2015).
Some of the principles that a caregiver needs to abide by are Allocation Principles 2014, Quality of Care Principles 2014 and the Sanctions Principles 2014. When providing care the aged care provider needs to ensure that the services being delivered meet the above principles. For example, the services need to ensure the safety of both the provider and the consumer and also that everyone involved in the care has a right to their privacy. Therefore in no instance is the aged care provider supposed to interfere with one’s privacy when providing care (Prgomet et al., 2017).
One significant right in the act that protects the users is that of negligence. An aged care provider must provide reasonable care to a consumer and at the same time prevent injury to them as well as loss. Aged care providers that show negligence can be sued and this can cause them to lose their license. For example, when using the CDC model, the aged care provider is supposed to ensure that they perform services as asked for by the consumer. However if the aged care consumer neglects the risks that a service will cause simply because the consumer asked for it, then this can be termed as negligence (Macleod, Tatangelo, McCabe & You, 2017).
This is because the law states that the aged care provider has the capability of guiding the consumer in the right direction as they can assess the risks. While respecting the request of the consumer they also need to ensure that they are not breaking the law by being negligent. Therefore the aged care provider needs to ensure that they maintain the CDC model while abiding by the law (Goeman, King & Koch, 2016).
Ethically, the consumer care provider is supposed to provide care to the consumer as expected of them. In the CDC model, the consumer states what type of treatment they need. In this instance, we can argue that ethically the care provider will be required to follow suit with the request as his profession requires them to. But also ethically, they can decide to advise the consumer in the case where the service is chosen is not suited for the consumer as they will incur risks.
Therefore an aged care provider using the CDC model needs always to do the right thing regardless of the circumstances while at the same time, maintain the respect between them and the consumer. This built trust between the aged caregiver and the consumer and they can work together for adequate care. As much as the Australian government wants to use the CDC model in providing proper care, then they need to ensure that their aged care providers are also acting ethically and in accordance with the law (Willis, Reynolds & Keleher, 2016).
The CDC model has proven to be very useful in providing aged care for the elderly in Australia. Some of its benefits are:
The model allows the consumer to choose and control the services they want to receive. The CDC model is solely focused on attending to the needs of the consumer. Therefore it gives them the option to choose as well as control these services. This way, aged care providers are entirely able to focus on providing the services rather than identifying.
The model allows for transparency among all the participants in the care plan. This is because, in the CDC model, the aged care provider is supposed to share with the consumer about the payments made for the care package as well as how the money will be spent. This also builds trust between them.
The CDC model also allows the elderly to be independent just as they have been throughout their life. This is because the elderly have a choice to manage their plans as well as create the plans and therefore have a say in their care (Meagher, Szebehely & Mears, 2016).
The model ensures that the needs and the wants of the consumer are met. This is because in the model the elderly is the one who dictates the services they will receive based on their needs.
The CDC model cannot be used by all the elderly persons in Australia as the funding from the taxpayer money is not enough. This has been caused by the rise in the population of the elderly, and therefore not everyone can receive it causing others to pay on their own (Fine & Davidson, 2018).
The model does not take into account all cases of the aged as not all can make choices of their own. For example, the elderly with conditions such as dementia and disability are unable to use the model (Meissner & Radford, 2015).
Lastly, the model does not take into account the risks that are involved in letting the consumer create their care plan. The services that the consumer wants to be delivered may have risks and may also not be effective.
The CDC model requires the aged care providers to focus their attention and energy on one patient and the Australian government does not have this amount of workforce at the moment. For the country to achieve the use of this model, they need to consider increasing their workforce so that consumer-directed care can be effectively applied. The government also needs to consider the increasing elderly population meaning the workforce also has to increase if they want to provide CDC.
The CDC model only suits consumers that have the home care package. The model will most effectively work when it’s elderly choose the home care package. This is because their homes are easily accessible and the services they want can be comfortably done at home when they cannot be done in a community facility (Radford & Chapman, 2015).
Also in the country, the CDC services do not reach the elderly in the remote areas, and this is an issue of the model. The model requires easy access so that the aged care providers can work to and fro without any difficulties. Therefore it is impossible to provide CDC care to citizens living in the remote areas of the country.
The CDC model puts a strain on the aged care providers primarily in the country as the workforce is not sufficient. The aged care providers will be overworked as the model requires close attention and constant care (Kelly, Sampson & Kelly, 2015).
Also, the model does not consider the different ways of aging. How one person will age is not the same as another, and this will determine how independent they can be. For instance, if a consumer ages and had Alzheimer’s or dementia then they are not able to apply the model to their care as they are not physically or mentally able to make the choices on their own (Meyer et al., 2018).
This gives rise to another issue where the model only allows the consumer to have choice and control. The model needs to be more flexible by extending this choice to family members or person’s close to the consumer. This way when they are incapable of identifying their needs or the goals they want to achieve due to aging conditions such as dementia, the decision can be made for them (Davis, Morgans & Burgess, 2016).
The CDC model has a lot of grey areas, and this is another issue. The model solely focuses on flexibility for the consumer as well as the aged care provider but does not put into perspective other factors. Some of these factors include the condition of the consumer, the risks that might occur and the environmental situations of the elderly. This, therefore, means that the model can only be applied under circumstances that it can relate with and ignores all the other (Andrew et al., 2016).
Lastly, the CDC model allows the consumers to make choices of their care plans and services, and at times the choices are not practical. Also, the choices may involve a lot of risks, and the care provider may find it difficult to communicate this with their consumers. The CDC needs to address this issue so that the requests that are made are practical and can be easily accomplished to provide care (Armstrong et al., 2017).
Conclusion
The Australian government has adopted the use of the consumer-directed care model so that they can sustain their aged care sector. The government pays for most of the care, but the elderly pay for the rest on their own. The Australian government aims at doubling their aged care providers to meet the increasing population of the elderly. They hope that this will help in providing adequate care for the elderly. In conclusion, the hope that with the adoption of the CDC model the aged care sector will improve and be sustained.
References
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