Home care redesign must be carer-inclusive

Carer recognition must be embedded into any redesign of the home care system, a researcher says.

Together with Carers NSW and home care provider Bay & Basin Community Resources, University of Wollongong researcher Cathy Duncan has spent the last four years investigating the role of family carers in home care, and how consumer directed care has left them out of the picture.

“In the move to consumer directed care we moved to an individually focused service provision model and that’s fundamentally incongruous with caring,” she told the ACSA conference this month.

“Underpinning all of this is a policy problem where there’s a disconnect between the Commonwealth Carer Recognition act and the home care package program.”

A carer recognition framework

Ms Duncan has used her research to develop a framework for carer recognition in home care packages, based on findings that carers want a voice and shared decision making in home care, as well as access to respite.

She says as well being being embedded in the new home care program arising from the final report of the aged care royal commission, the framework could also act as a compliance monitoring tool for quality standards.

Ms Duncan says any new home care system also needs to recognise the cost of supporting carers, and this must be factored into individual funding.

“Where there is a family carer, there needs to be some acknowledgement of staff time in engaging with the carer,” she said.

“This could include quarantining some of the package funding to support family carers, particularly for higher level carers.”

An individualised respite for carers package could also be considered, she says, which would enable carers to purchase a tailored package of respite.

Excluded and unrecognised

A Carers NSW survey, carried out nationally in 2020, found carers felt excluded, silenced, unrecognised, socially isolated and financially disadvantaged.

“When we asked the question whether aged care services actually asked carers about their needs, the picture that emerges isn’t necessarily positive,” Carers NSW research and development officer Lukas Hofstatter told the conference.

The survey found engagement of aged care services with carers has declined since 2018, with more than 51 per cent disagreeing with the notion that they are asked about their own needs.

“This shows the that recommendations of the royal commission to conceptualise aged care as inclusive of carers has a long way to go.”

There are currently more than 2.6 million carers in Australia. Some 860,000 of those are primary carers and 416,800 are caring for someone over 65.

 More than half of unpaid carers put in more than 20 hours a week.

The lack of a carer is the most common reason for someone going into residential care.

The aged care royal commission’s final report recognised the need for more respite services for carers, finding they often bridge gaps in aged care but were being put under pressure because of unmet need in the home care system.

It also recognised the need for more respite services to support them.

Ms Duncan’s research is being prepared for submission to the International Journal of Care and Caring and Australian Social Work.

Comment on the story below. Follow Community Care Review on Facebook, Twitter and LinkedIn and sign up to our newsletter.