Consumer Directed Care in Aged Care – Token Gesture or Embraced Model?

Original published by Sheryl Aldcroft on LinkedIn

What is the best approach to care in aged care facilities?
Consumer Directed Care and Patient Centred Care have become the “buzz-words” when discussing aged & community care right now- but are either of these models really the best way to provide care?

Often the terms seem to be used interchangeably, as if they mean exactly the same thing. And while it’s true that both approaches concentrate on the patient as an individual rather than the conditions they suffer, there is a huge difference between the two. We believe it’s essentially the difference between having the patient as the focus of the care plan and planning a program of care in partnership with the patient.

Many residential facilities are already committed to person centred care, with care plans specifically tailored towards the individual patient’s needs. This approach has been shown to enhance patient experience as well as decrease disruptive behavior in individuals with dementia and improve staff satisfaction levels. But could we go even further and gain even better results?

A consumer directed care (CDC) approach involves a real culture shift, with care providers actively engaging with consumers and their families, focusing on what is important to them and working out together how they can achieve these goals. So, we are assisting them in achieving the outcomes they want, rather than providing the care we think they need from our observations.

A Consumer Directed care (CDC) approach has become the benchmark for homecare services in Australia, providing individuals and their carers the ability to choose the services they require and who provides them. We have found that it can also show real benefits in residential facilities; giving the people cared for more choice and control over their care, with this autonomy resulting in improved function and wellbeing.

It can be a tricky balancing act; recognising the individual’s right to free choice, autonomy and independence and setting that against any potential risks associated with the choices they make and our duty of care.  But as the seniors lobby group COTA Australia says

“CDC is about the fact that most people have managed their lives all their life and want to go on doing so, despite the challenges they face.”

By building up an individual relationship with the people in our care and listening to and understanding their needs, we can provide them with the information and support they need to make choices about their lives.

Because of the home care model, CDC is often seen as being all about money and controlling individual budgets. However choice can be about much more than spending dollars: from personalising the daily routine and choosing specific activities and therapies to allowing individuals to have a say over the staff member who cares for them.

Offering control to individuals who may have decreased abilities to understand and communicate due to dementia or other neurodegenerative diseases, can seem frightening. But research shows real benefits when a CDC approach is used, with decreased numbers of falls and pressure injuries as well as less need for sedation with psychotropic drugs. A government report has backed the rollout of consumer directed care to residential aged care facilities and encouraged further research.

It’s a big change in attitude for professionals, patients and their families but by empowering individuals to make choices and be active participants in their care we can help them maintain their function, independence and dignity.

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