In 2009, the concept of Consumer-Directed Care (CDC) was virtually unheard of in aged care. Although the disability sector had done some work in this area and there was literature on the pilots undertaken in the UK, there was very little on which to undertake a pilot of CDC in the Australian aged care environment.
As a member of the steering committee for a Consumer Directed Care project, I had the opportunity to witness the development of a ‘model’ and participate in the subsequent implementation and evaluation. The project is still the only published research pilot of CDC in Australia that I have found.
The design of the service model was informed by the available international literature (which was scarce), consumer focus groups and a working group involving representation of all stakeholders. The implementation of the model was delivered across 3 aged care provider organisations’ packaged care teams. The most significant challenge was changing existing work practices. The research team provided education on ‘what’ CDC is and how it would change the conversations and relationships with consumers. They also engaged international experts to deliver education and workshops on goal-facilitated action planning, capacity building and re-ablement.
The project evaluation demonstrated that the model has numerous positive outcomes (for consumers) and very few negative implications. Where negative outcomes did occur they mainly resulted from unresolved administrative implementation issues. For the vast majority of intervention group participants it generated positive results. For nine participants, predominantly self-directing at a higher level, involvement in the model was what they termed a ‘life-changing event’.
Three years later, the organisations involved are in an enviable position as the new Home Care Package Guidelines reflect the model developed.
Successful organisations in this time of change will be those with a sense the urgency, strong commitment, understanding of the cultural change required, engagement with its consumers and development of processes and systems that will result in sustained change across the entire organisation.
Sandra Bygrave: thenoagroup