Supporting Aged Care: Consumer Directed Care and Change Theory

This report delves into the critical interface between community services and residential aged care (RAC), highlighting the significance of transitional care for elderly patients. It explores consumer-directed care models, emphasizing patient involvement and individual funding, while also addressing the need for effective discharge planning and medication adherence education. The report examines the challenges in implementing consumer-directed care, such as inadequate healthcare professional training and organizational readiness. Furthermore, it applies Kurt Lewin's change theory model to explain the implementation process, from unfreezing the status quo to refreezing the new practices. It also discusses strategies to reduce hospital readmissions and improve the quality of care, including staff training and the adoption of well-researched procedures. The report concludes by emphasizing the importance of stakeholder feedback and timely identification of potential errors to sustain positive changes in aged care.

Running head: SUPPORTING AGED CARE
SUPPORTING AGED CARE
Name of the Student
Name of the university
Author’s note

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Question 1.
The interface present between a community service and a residential aged care (RAC)
has long been considered as an important issue in the residential aged care services. The
transitional care consists of a broad range of services and environment for the promotion of safe
and the timely passage of the elderly patient. The transitional care includes adoption of the
consumer directed care models, where the consumers are involved actively in the support, the
consumers are provided with individual funding allocation (Naylor et al., 2013). An effective
transition of care should include effective discharge planning, patient’s education about
medication adherence with recommendations for a future follow up, which is mainly done by an
aged care assessment team. McCabe et al., (2018) have suggested that there are many benefits
for the consumers and the carers such as improved health and wellbeing outcomes. Studies have
proved that the health care professionals are often not trained properly to provide a consumer
directed care. An organisation fails to provide a consumer directed care at the time of transition
due the absence of proper leadership strategies, inefficient funding, organisational climate and
the readiness of the organisation for a change.
In order to enter a transition care program, it is necessary that the patients has to be
assessed by the aged care assessment teams. The aged care assessment team might make
mistakes in catching clinical cues, or might not provide proper patient advocacy. Presence of
incompetent health care professionals can lead to clinical errors and might miss to provide proper
patients education.
Question 2

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The concept of the consumer directed model can be explained by the application of Kurt Lewin
change theory model, which is based on a three steps model (Unfreeze- change-freeze) providing
a high approach to change (Lewis, 2019).
The initial stage of implementing any change is to prepare the organisation for the
implementation of the change that involves the dissolving of the status quo, before building up a
new way of operating (Lewis, 2019). Hence, in order to establish a consumer directed care in
transitional care is to identify the mistakes and the loop holes of the type of care. Evaluation of
the care model will help in identifying the near misses and will number hospital readmissions
after a discharge. In order to start at its core, it is necessary to change the attitudes and the beliefs
of the health care workers (Grol et al., 2014). This is only possible by providing education to the
patients. This is the state where goals should be set and planning will be made accordingly. This
should be followed by circulation of the changes that needs to be implemented.
The next stage is stage of change, is the implementation stage. Planning should be made
such that consumer directed care is integrated in to the existing programs and operated within the
constraints of the legislative arrangement (Lewis, 2019). CDC would need in to account the
requirement of the care recipients and their carer and their contribution of the social inclusion.
Appropriate measures should be taken to reduce hospital readmissions. Possible reasons of
avoidable readmissions includes hospital acquired infections, premature discharge, poor
handoffs, medical reconciliation errors and improper transition (Hewner, 2014). The members
of the elderly care assessment team should be provided with appropriate training to reduce the
rate of the adverse outcomes. The cost for a consumer directed care should be curtailed, so that
common people might get access to it. The aged care assessment team should adopt a well-
researched and tested procedures for use in practice, adoption of the care protocols, integrated

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programs of care for use in practice , developed centrally, prevention of the harmful routines and
the procedures (Grol et al., 2014).
The final stage of Lewin change theory model is the refreeze theory (Lewis, 2019). This
should be done when the changes are taking shape and people are embracing the new changes of
working and the health care organisation is ready to refreeze. This should be followed by the
evaluation of the change that has been implemented. Feedback needs to be collected from all the
stakeholders to include it within the protocols.
Moreover timely identification of the triggers of the mistake, training to the nurses,
caregivers, the social workers and proper feedback can make this effective changes to sustain.

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References
Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the
implementation of change in health care. John Wiley & Sons.
Hewner, S. (2014). A Population-Based Care Transition Model For Chronically III Elders.
Nursing Economics, 32(3), 109.
Lewis, L. (2019). Organizational change: Creating change through strategic communication.
John Wiley & Sons.
McCabe, M. P., Beattie, E., Karantzas, G., Mellor, D., Sanders, K., Busija, L., ... & Byers, J.
(2018). A randomized controlled trial to evaluate the effectiveness of a staff training
program to implement consumer directed care on resident quality of life in residential
aged care. BMC geriatrics, 18(1), 287.
Naylor, M. D., Bowles, K. H., McCauley, K. M., Maccoy, M. C., Maislin, G., Pauly, M. V., &
Krakauer, R. (2013). High‐value transitional care: translation of research into practice.
Journal of evaluation in clinical practice, 19(5), 727-733.