Consumer-directed care (CDC) refers to the care developed for aged people living in Australia where consumers are given choice and control of the service they receive. The CDC model takes into account choice, control, independence and flexibility to better the service delivery of home care. The government of Australia incorporated the consumer-directed care into all the Home Care Packages throughout the country to be given on the CDC basis. The whole care model employs a collaborative approach that enables both client and Provider to develop a plan and manage the plan together. Approved Home Care Package that offers consumer-directed care receives funding from the government. The provider and consumer develop a budget that is continuously monitored and re-assessed to ensure that the goals of the care are met. There are some other principles that foster the consumer-directed care and these include legal principles, ethical principles and political basis of the CDC. For instance, the government through the policy of better living develops the consumer-directed care that is also incorporated into all the Home Care Packages. The consumer-directed care is also supported by the Aged Care Laws that emphasis on the consumer right protection. The following analytical paper provides that critique and analysis of the consumer-directed care (CDC) as offered in aged care.
Critique consumer-directed care
Consumer-directed care (CDC) can be described as a health care model that involves giving consumers opportunity to choose caregiver, control or manages the type of care given to them. CDC model emphasis on the flexibility and choice of the care hence consumers feels the sense of independence and flexibility. The elderly people are given the opportunity to choose the caregiver and type of care with flexibility. The CDC has been incorporated into various care models such as home care to improve the care services given to aged people within the community. The government developed a policy to improve the lives of citizen with more focus on aged people in the society (Bradley, 2017).
Understanding the consumer-directed care require a more understanding of the underlying principles of political, legal and ethical principles. Firstly, the CDC has political background since the Australia government developed the policy of better living aim to improve the care for older people in the country. Since 2012, the government through the ministry of health has come up the service delivery model that allows the consumer to have choice and flexibility. The ministry first commences the CDC within the year 2010 to 2011 showing the success that enables the model to be used since 2013. The political nature of the care is also the promoting factor that influences the funding of the service that is delivered within the Home Care Packages (Delp & Muntaner, 2011).
Secondly, the CDC is baked by legal principles that are majorly engraved on the Aged Care laws (User Rights Principles 2014). The legal basis of the care is based on the client's rights and freedom to make choice. Within the Aged Care laws people rights are used to design or plan care with a view to better the care or living condition of these people. Respecting the rights of aged people is an important factor when giving service to these people. Moreover, the ability of the client to make their choice when it comes to the caregiver and the type of care is a fundamental aspect of CDC. The legal basis of the care is also a contributing factor that has to enable the care to be embraced within the health system of Australia (Department of Social Services, 2014).
Thirdly, the ethical principles that are used in the consumer-directed care include the independence of human and the need for choice. Within the ethical framework choice and autonomy are two important factors that are used in the determination of the service delivery. In addition, elderly people being mentally impaired do not make them lesser people and need independence. This implies that there is a need for respect for people's choice is an important determinant of the quality of care and is used to drive the basic model of CDC. Moreover, the flexibility is also part of the ethical consideration that fosters normal working of the CDC. A quality health care system requires high regard for human autonomy and this is an important factor used to develop the consumer-directed care (Gunn & Rolf, 2013).
Philosophical background of the consumer-directed care lies on the principle of choice, control, and preference of consumers. Consumer’s choice is paramount for effective and quality service and this enable provision of care to aged people in the community. Consumers are also given chance and opportunities express themselves in the care management service. Preference of customers remains the most important aspect of the consumer-directed care and also forms the core philosophy of the care model. Moreover, the consumers that are mostly elderly people are given chance to determine the type of service and the kind of service delivered to them in home care. Home care packages were rebranded to include these aspects of the consumer-directed care so as to improve the care offered to aged people in the community. Consumers are also given a part in the management of the care given or provided in the home care (Department of Health, 2016).
The Home Care Package was redesigned with the CDC model to help better the care given to aged people in homes. Consumer-directed care was first incorporated into home care packages in 2015 and this was used to ensure that all the Home Care Package is given on the CDC basis. Various principles of the CDC have been used in home care packages and this makes the lives of aged people better. The first principle of CDC that has been used in Home Care Package is more choice and flexibility that give a more flexible care service to homes (iCareHealth Blog, 2013). Secondly, consumers are given support to decide on care given to them and the information on the care hence consumers can make a decision the type of care. Thirdly, the partnership is also part of the model enabling a better quality of participation among parties involved in the consumer-directed care. Fourthly, consumer-directed care enables a high level of transparency since consumers are involved at various levels. The last principle that is applied to Home Care Package is wellness and reablement adds more value to the care making the care better as compared the previous home care (COTA Australia 2017).
Consumer-directed care enables the care providers to fulfill certain obligations and these also include influence service delivery. Firstly, service providers discuss the care service with their client based on the consumer needs and goals. Goals and needs enable both caregiver and the client to develop the plan of activities. Secondly, caregivers are expected to show transparency to clients on the funding and the amount of the funds that are available to the Home Care Package. Thirdly, care providers will agree on the level of involvement that caregiver and the client are expected to show. Lastly, the service provider is also expected to assess the Home Care Package and monitor the whole program to ensure that the service is appropriate to clients. The service providers are therefore expected to play an important role in the care with the help of their clients that form part of care service (Shinan-Altman & Liat, 2017).
The case management of the consumer-directed care can be divided into individual direct management or representative management. Firstly, the individual consumer is directly involved in management or control of care service in collaboration with the service provider (Net Industries and its Licensors, 2018). Consumers within this care program are also given sole responsibility to manage the care they receive from care providers. Secondly, the consumer can be involved in the management of the service delivery through a representative. Since the consumer-directed care requires consumer consent and their preference, this can be through a designated representative. Lastly, the consumer-directed care program also involves many different types of case managers that are supposed to arrange and monitor the CDC within the community (Chuanmei, Dunt & Doyle, 2014).
Critically discuss consumer-directed care
Consumer Directed Care (CDC) is the care that involves choice and control as applied in aged care. Consumer-directed care offers a ground to bother caregiver and the client to choose the type of care given and the caregiver at home. Care service provider forms a partnership with the client to ensure that there is a choice of the care required and the client goal. The policies of the government of Australia have put more emphasis on the need to make lives better for aged people living in the country that is on the rise (Stacey, 2011). The government of Australia in 2012 developed a policy dabbed Government’s Living Longer Living Better aged care with the main focus on making the aged care more flexible and the consumer has a choice on the type of care. This created the need for a practice that includes choice and control hence the consumer-directed care. Three area that the consumer-directed care involves include are managing of care service, the cost of the service and the spending of the cost of care between caregiver and the client. In addition, the consumer-directed care enables the client to have greater independence during the care and control of care to the service. This implies that the client together with the caregiver is involved in developing a plan for care and budget for the care service (Moorman & Macdonald, 2013).
Characteristics of consumer-directed care involve various issues that enable the service to reach numerous aged patients throughout Australia. Firstly, the client has said in the type of service they receive, the way the service is delivered, and the caregiver that is involved in service provision. Secondly, the client and the care provider are both involved in developing the plan for the care. The plan that is developed can be budgetary plan or the plan of activities that will be undertaken by the client and caregiver. Thirdly, the client determines the much involvement that is needed during the care and the management of the involvement. The involvement can be in terms of the number of the hours that the caregiver and the client are supposed to be together. Fourthly, the consumer-directed care also gives the client opportunity to understand the funding of the care and spending of the care funds. Funding element of the program is also communicated to the client in order to understand the spent and unspent funds available for the program. Lastly, the consumer-directed care enables the client to evaluate the level of which the care is meeting the need of the client (Edward, Louise & Sara, 2015).
There are many stakeholders that form part of the consumer-directed care model and have a high impact on the service delivery of aged care. Firstly, the government is a major stakeholder that offers an important political, legal and funding for the model. Secondly, the people especially the aged people within the home care setting are key stakeholders since they form the main people that the care intends to benefit. Thirdly, the service providers are also part of the system and are involved in planning and delivery of service. The caregivers work in collaboration with clients to ensure that the service delivery is successful. Lastly, there are some other organizations that are also stakeholders for the model and these include COTA, and ACAT/ACAS (Beeuwkes, Haviland, McDevitt & Sood, 2011).
Funding of consumer-directed care (CDC)
There are many different sources of funds that are sued to foster the consumer-directed care. Firstly, at the pilot stage of the Home Care Packages due to the incorporation of the consumer-directed care model and was funded by Commonwealth. The Commonwealth funding lasted during the pilot program that showed success leading to more need for the consumer-directed care (Paraprofessional Healthcare Institute 2015).
The government of Australia provides the send funding solution for the consumer-directed care. All the approved Aged Care Providers (Providers) are funded by the government of Australia in order to provide Home care packages (Myagedcare, 2016). In order for the homecare to receive the funds from the government, the care provider assesses the consumer on their entitlement to service. The provider together with client develops a care plan that is assessed and evaluated regularly. The care plan that is delivered to the consumer is closely monitored and re-assessed periodically to ensure that it complies with the set standards (Kristen, 2015). Funding of the care program is meant to show commitment to offer quality care to people within homes for a better living. In order to recognize this funding, the provider is expected to recognize funds inform of unspent funds or deferred revenue. One of the issues within the care is the fate of the unspent funds especially when the client changes the provider. These funds are recognized based on the evidence that is available and enable the consumer to switch automatically to another provider. The funds can behold by the provider for 28 days awaiting the consumer to return; funds can be transferred to a new service provider or retained within the home care for other consumers. The number of funds received from the government to provide the consumer-directed care normally reach a maximum of $12,000 per year. Some other expenses include the purchase of wheelchair and this requires high commitments to be shown by the provider and client (Jenay, McBride, Tracy & Wendy, 2014).
Positive of consumer-directed care
The overall analysis of the consumer-directed care shows that the model of care is beneficial and these are felt within the community of people living in Australia ranging from towns to remote places within the country. Consumer-directed care has shows some positive impacts or benefits when applied in the provision of care to aged people. Firstly, the consumer-directed care (CDC) gives flexibility care that enables the aged people to receive better care as required by the government of Australia through better living care policies. The flexibility of the care is felt not only among clients but also among care providers (Iecovich, 2011). Secondly, the consumer-directed care enables people under consumer-directed care to have choice and control that make the everyday life better and enjoyable. The power of choice rests on the cognitive capability of the client and enable them to make an informed decision during the service delivery. Thirdly, the consumer-directed care provides clients with service satisfaction and wellbeing that improves the lives of aged people. The characteristics of the care especially the autonomy, choice, and flexibility make the CDC satisfactory and fit the need of consumers. Lastly, the consumer-directed care is cost-effective care that is also coupled with better outcomes. When comparing the cost and the benefit of the consumer-directed care, the whole model has proved to be cost-effective (Ce et al., 2015).
Negative of consumer-directed care
Despite the benefits of the consumer-directed care (CDC), there are some negatives of the model that can reduce its impacts or require improvement. Firstly, the client is always able to control or manages the care given to them and this makes the consumer-directed care model not applicable in some places. For instance, a client with cognitive impairment and frail elderly people have limited ability to manage their care (Ashley, Hester & Leslie, 2017). Secondly, balancing of funds to meet the client’s needs is challenging since there are many different needs that also needs attention and funds. Clients and the service provider are both involved in planning and budgetary planning and this can be tricky for those clients without the capability to do planning. Thirdly, choices of some consumers may be unrealistic due to personal view on care hence proves the negative impact of the consumer-directed care. Consumers within the model have to make their own choice and control of the type of service offered to them (Ahyoung & Yuri, 2017). Some choice may be unrealistic or unattainable care plan and this has a negative impact on the consumer-directed care. Fourthly, the stressful work conditions have been reported as some negatives of the consumer-directed care. More working hours and overtime payment are key working conditions that make the home care working difficult for providers leading to work dissatisfaction among those working within the Home Care Packages. Moreover, some poor living conditions present at the home of some aged clients leading to unpleasant work condition for service providers (Delp, Steven, Jeanne & Muntaner, 2010).
In conclusion, the paper analyses various aspects of the consumer-directed care (CDC) based on the philosophical, legal, ethical and political basis of the care. The paper revealed three main foundations of the CDC and these are choice, flexibility, and independence that are given priority in the provision of care to aged people in the community. In addition, the paper identifies Home Care Package as an important area that has been used to fully implement the consumer-directed care in Australia. The government offers funding solution to those approved Home Care Packages that help in making the lives of many aged populations within the country. This has resulted in the improvement of care within homes leading to better lives of consumers involved in the program. The management of the program is given to both consumer directly or through a representative in collaborative with care service providers. The consumer-directed care has both positive and negative implication within the service delivery of the care
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