The rhetoric about “choice” in consumer directed care isn’t translating into practice, an ageing conference has heard.
Dr Tammy Aplin, from the school of health and rehabilitation sciences at the University of Queensland, on Thursday presented findings of an exploratory study into the experiences of a sample of the 1 million Australians who are receiving home care services.
Her research, involving 14 participants in 11 Queensland households, is some of the first to emerge on the issue since the implementation of consumer directed care legislation in 2017.
Dr Aplin said surveys of her subjects, who were receiving domestic assistance, social support and shopping via a mixture of commonwealth home support and Home Support Packages, reflected a wide variety of experiences ranging from “very positive” to “very negative”.
However the study, presented at the Cepar International Conference of Long-term Care Directors and Administrators in Sydney, found while people were happy with being able to choose providers, there was a significant level of frustration about the lack of flexibility once services were delivered.
For example, some clients wanted companionship from people providing domestic services, while others just wanted the job done. Others were unhappy that they had to “fit in” with service providers, or that the services they required weren’t available.
“Choice about who provides a service, or what time of day, or the range of services you might have at your home is limited,” Dr Aplin told Community Care Review outside the conference.
“Providers seem to be offering the same stock standard services but if you want something a bit different, like gardening, or you need some equipment that they don’t provide, then it becomes complex.”
There was also dissatisfaction with lack of information, poor communication, staff inconsistency and the wait for services, as well confusion over the My Aged Care website.
The confusion and lack of information left people who had problems communicating and making informed decisions at risk of receiving poor quality or inappropriate services, she said.
“I think the rhetoric has been that you’ve got choice in not only who your provider is, but how it’s provided,” she said.
“Whereas what seems to be happening on the ground for the people I talk to is that yes you have choice over your provider, but that seems to be where it ends.”
There was also concern over the limited quality assurance and lack quality assurance mechanisms, she said.
Dr Aplin said the challenge for providers is to increase flexibility and become more responsive to individuals so services can be tailored to their needs and preferences.
“Listen to your people, talk to your people about what they want,” she said. “The old structures, which are quite medically based, need to change.”
What clients were unhappy about:
- Lack of information about what’s available
- Confusion navigating My Aged Care
- Inadequate services
- Too long to wait
Recommendations from study participants:
- More flexibility in service provision
- Transparency about costs
- Creation of an advisor role
- Clear information about what is and isn’t provided