Consumer Directed Care: Home Care Packages in Australia - UWS

This essay provides an overview of aged care services in Australia, focusing on the transition to Consumer Directed Care (CDC) within the Home Care Packages Program. It discusses the rationale behind CDC, its underlying principles, and its historical development following the Aged Care Act 1997. The essay highlights the benefits of CDC, such as greater control for the elderly and potential cost savings, while also addressing disadvantages like lower levels of assistance and limited provider choices. Furthermore, it touches upon the ethical considerations associated with consumer-directed care and its political foundations. The analysis provides a comprehensive understanding of CDC's role in reshaping aged care in Australia, with emphasis on the importance of transparency, consumer choice, and re-ablement frameworks.

Running Head: AGED CARE SERVICES IN AUSTRALIA1
AGED CARE SERVICES IN AUSTRALIA
Student’s Name
Institutional Affiliation

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Aged Care Services in Australia
Aged care refers to the living as well as nursing care amenities for older Australians who
can no longer live self-sufficiently or those who need help to sojourn in their homes. These
services include both residential aged care in nursing home and home care services. The
Commonwealth Government under the Health Department is responsible for the Australian Aged
Care System. It provides the funds needed for the sustenance of aged care services while
regulating expenses and overseeing legislation for aged care. Home care services aim to maintain
an aged individual’s quality of life while still in their homes by assisting them with their physical
requirements and day-to-day activities (Day et al, 2017). Home care embraces two forms of
government-funded services for home-based persons. These are the Home Care Packages
Program, which can deliver a greater array of services as compared to the Commonwealth Home
Support Program that offers certain help with daily tasks.
Residential aged care also simply known as residential care, on the other hand, entails the
kind of care and clinical services provided to aged people living in nursing homes. It can be
offered as letup care that is for short periods of time or on a long-lasting basis. The Federal
Government of Australia, under the Aged Care Act 1997, is accountable for residential aged care

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comprising of the control of the standards and principles of care as well as its funding (Fay &
Owen 2012). This essay dwells on the Home Care Packages Program in Australia, bringing to
light its reorganization to Consumer Directed Care (Ottmann et al, 2013). It clearly discusses the
rationale, the future of CDC as well as pros and cons of this model. Moreover, it explains the
ethical issues that are associated with the consumer-directed care system and mentions its
foundation which is mostly based on political matters.
Consumer Directed Care
Consumer-directed care is an aged care system designated to give the consumers more
choice, flexibility, and control regarding the services delivered to them(McCaffrey et al, 2015).
This means that the older people can regulate the types of services and care they are provided
with including who delivers these services, their conveyance and the time of delivery
(Wilberforce et al, 2017). Together with their service providers, the aged come up with a care
plan, decide the level of their immersion in the management of the services provided to them.
This consumer model also provides them with their financial statements, that is, their monthly
income and expenses report that enable them to find out how their funding is distributed among
their various needs and that it is not being wasted. Reviews of these statements allow for
adjustments in case the needs of a particular person have changed. The financial reports also
indicate whether a certain individual is eligible for higher levels of services or if they need to use
their own finances to meet their own prerequisites (Boelsma et al, 2014). Additionally, the
system ensures that their caregivers make monitor all the kinds of care needed as they have to
make formal assessments to this effect (Lowthian et al, 2018).

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Brief History of the consumer-directed Care
The Aged Care Act 1997 provides for the funding and regulation of aged care services.
The approved care providers, that is, individuals who are permitted under the Act to give care
services to the aged can be entitled to collect subsidy payments in respect of the devotion they
offer to the ratified care recipients. The aged care providers are obligated to issue the maximum
sum they charge for their accommodation and additional services. The User Rights Principles lay
out the duties of approved providers in giving home or residential care services. The User Rights
Principles were amended in 2015 to accommodate the Consumer Directed Care model. Despite
being piloted in the Commonwealth funded Home Care Packages since the year 2010, CDC has
only been fully effective from 1 July 2015 when it was mandatory for all Home Care Packages to
be supplied on a CDC basis (Laragy & Allen, 2015). This is mainly due to its success as a pilot
program (Low et al, 2012). During this period an improved capping arrangement was also
established to advance the affordability of the aged care. The high and low care distinction,
which was previously used was removed by the government to increase the elasticity of the care
engagements between care providers and the aged.
The Department of Social Services was the section that was mostly responsible for the
amendment. Throughout early 2015, it held briefing conferences with stakeholders in Port
Macquarie, Sydney, Darwin, Shepparton, Hobart, Melbourne, Launceston, Bunbury, Perth,
Adelaide, Brisbane, Port Augusta, Townsville, Canberra and Alice Springs. An Exposure Draft
of the Amending Principles and a Home Care Packages Programme Consultation Paper were
published by the department in April the same year and both the public and the stakeholders
strongly supported the new provisions proposed. Some useful suggestions were also put forward
to enhance the tractability and further reinforce the relationship between the care providers and

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the aged. For this system to become officially operative, it was vital for the Amending Principles
and all the stakeholder comments to be reviewed by the National Aged Care Alliance’s Home
Care Packages Advisory Group. This association comprises peak provider groups, care recipient
representatives, carers’ legislatures as well as allied health professionals (Petriwskyj et al, 2014).
Consumer Directed Care Principles
The Department of Health’s Home Care Packages Program Guidelines, in 2013, gave out
certain policies that were meant to guide the delivery of home packages on a CDC basis. These
principles include:
1. Consumer Choice and Control: this was the utmost aim for the modification of aged
care services to the consumer-directed care. It means that higher quality, more
individualized and compassionate care would be available to the older people. This value
is meant to ensure that the elders are as independent as possible to bring them happiness
and thus keep them home for a longer period of time (Kaambwa et al, 2015).
2. Deferential and balanced partnerships: the consumers have the opportunity to create a
Home Care Agreement that best suits them and their needs. This puts forward the client’s
rights and duties especially in regards to the amount of control they wish to have relating
to their care (Cash et al, 2017).
3. Rights: one of the major rationales for the CDC is to recognize the rights of the clienteles
in relation to their personalized support and assistance. Consumers are thus asked to
come up with their own goals concerning their care, entailing their level of involvement
and management of their packages (Heath et al, 2018).
4. Transparency: The principles also specify that the aged have access to their financial
statements such as budgets as well as expenditure and income reports in order to make

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well-informed decisions about their care. This creates directness between the elder and
the service provider as the latter is able to freely purchase the services they select based
on the money available for them (Cash et al, 2017).
5. Wellness and re-ablement: a re-ablement framework is required for the aged who have
been discharged from the hospital to assist in their daily activities and other useful tasks.
In the CDC system, the re-ablement services ensure the autonomy of the elder thus
enhancing their wellness (Cardona, 2018).
Benefits of Consumer Directed Care
Greater Control for the Elders: earlier on, providers owned the consumers’ packages
whereby the latter were assigned to them by the government via the bidding process. The aged
were individualistically assessed through the Automated Customer Account Transfer Service
(ACATS) and indicated to the level (1 to 4) of the package they qualify for. They then had to
look for a provider who had matching packages (Jowsey et al, 2016). This process was vastly
unorganized as some of the elders ended up in a partnership with care providers they did not
necessarily want to use while sometimes ending up with lower level packages (Gill et al, 2017).
The CDC system, however, gives the elders and their families better control of their lives as they
have an opinion on how their package is spent (Stones & Gullifer, 2016). It allows them not only
to pick the kind of care that preeminently suits them and decide on how it is distributed but also
choose the best care providers for their individual requirements. If the consumers have special
care needs like dementia, for instance, they have a right to choose specialists in this area as their
care providers.

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Saves the Aged Money: The clients can negotiate with a specified caregiver if he or she
charges very high fees leaving more cash for actual care. In addition, they are involved in all the
transactions handled and provided with monthly financial statements indicating their
expenditures and their total monthly income. This facilitates their savings as they have an idea of
how much cash is needed for what and consequently the remainder. Money is also saved by the
purchase of cheaper services. The currency saved can then be used to fund other services
required.
Maximum satisfaction: It is normal for people to feel more contented when they make
their own decisions entailing money issues. The elders, by being involved in the decisions
concerning their assets identify how their cash is being spent and therefore are making better-
informed resolutions concerning it (Bulamu et al, 2017).
Safety of the Package: once a package has been allocated to a specific individual, they
cannot lose it as they are eligible for it. It cannot also be allotted to another person, meaning that
the elder is free to use as he or she wishes.
Changing of providers does not incur any financial penalty: the aged are certified to
take up another service provider and lose the previous one if they are not well serviced. This
does not incur any financial losses to the elder since any amount required by the provider for
exiting can only be deducted from the package if there is a surplus (Cash et al, 2017). All the
older person needs to do is check the statement for their package to find out if there is a surplus
and their Home Care Agreement to ascertain the provision for exit fee. If this is not provided for,
then changing of care providers can be achieved without any financial drawback (Yeandle et al,
2012).

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Disadvantages of Consumer Directed Care
Lower Levels of Assistance: sometimes the prevailing home care packages are simply
not intensive satisfactory in providing support to those who need supplementary hours of help
every week. In order to offer more assistance, the service provider may decide to increase the
number of care workers attending each visit. This would, however, mean reducing the amount of
time they spend with the aged as well as the total visits. This would subsequently lead to these
elders inability to stay at home further due to the poor quality of the services they receive
(Jowsey et al, 2016). These elders need more than level 4 packages which are not available.
Furthermore, there may be a shortage of workers mainly due to the low wages and deficiency of
benefits that are likely to be associated with this field.
A limited number of providers: CDC permits one to choose their own products and
service providers. This means that the consumer should exit and try to find another provider.
This can be, however, difficult or even impossible in many regions in Australia due to a narrow
choice of care providers. This is also a challenge to the state as they may have to use independent
care providers sometimes. This increases the potentiality of fraud and abuse that may exist as a
result of lack of constant monitoring by the government.
Inability by some users to manage their own care: this list may include people with
cognitive impairment, who may not realize what they need or deserve. Some frail elders also
may simply not want to be completely accountable for their own care.
CDC and Ethics
The study of ethics is majorly concerned with making decisions that advance autonomy
and fairness. In the case of CDC, the cost of providing services would have to be included in

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order to promote equality and the independence of the aged. For an operational cost control
mechanism, the consumers must clearly comprehend the economic exchanges needed to make
conversant allocation decisions. In this scenario, the concept of unlimited wants to be satisfied
with limited resources is applied. Basing on this concept, rationing of the available assets is
unavoidable. Nevertheless, it can be structured in a manner in which it provides a certain level of
self-sufficiency and equity among the consumers.
The core ethical principles for service providers are non-maleficence and beneficence.
This means that the care providers have an obligation to take care of those in need and not to
abandon the consumer (Prgomet et al, 2017). Moreover, they should honor the client’s requests
and denials but may refuse unreasonable demands that could harm their own values.
CDC in Residential Aged Care
Whilst the federal government is anticipated to introduce consumer-directed residential
aged care in the very near future, this is not available currently. This is due to lack of the
necessary enactment costs, strategies, and approaches (Dybvik et al, 2014). Some residential
facilities have already acquired certain aspects of the consumer-directed care in particular areas
such as food. However, there has not been a full implementation of all elements of lifestyle and
care allied with this model in residential homes.
Future of Aged Care Services
Aged care is in evolution. It is progressing into a structure that better supports the welfare
of older people and the provision of care in means that esteem their dignity and maintain their
independence. As aforementioned, there is an amplified focus on consumer control and choice.
Similarly, the population of Australia is increasing and the proportion of older people will

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10
continue to upsurge in the near-term decades. In fact, studies show that by 2096, about 22
percent of Australia’s populace will be 65 years old and above . This growing population
will demand fundamentally reimagined aged care systems and solutions. Preparation for
this growth is one of the key challenges of the aged care policy.
In order to solve these continually arises problems, both the government and other interested
parties (stakeholders) agree on the need for an additional reform for aged care to become even
more of a consumer-centered system. This necessitates orienting the supply of diverse care types
around the demands of users and giving consumers superior choice and control (Gill &Cameron,
2015). This means establishing a demand-driven system, that is, a system that has little
regulatory control. Nonetheless, for this to become operative, some conditions have to be met.
These include:
 Formation of a robust model to assess the entitlement of government-funded aged care
services
 Consumers would have to make equitable and sufficient contributions to cover the
expenses of their care. Fortunately, these contributions should not be so high that they
hinder access to the elder’s care.
 The government needs an in-depth understanding of all the demands of the aged care
services.
 Additionally, government regulations should ensure there is an unbiased supply of
services across of populace groups and in all regions including remote areas which are
sparsely populated.

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Comprehending the nature of the demand for aged care is crucial so as to determine the best
way to satisfy the consumer. The right amount and mix of services should be provided to each
user justifiably. With the persistently growing population of the aged, better-aged care services
should be are continually sort after to accommodate all the elders (Khaksar et al, 2017).
Technology should, therefore, be employed in this area (Douglas et al, 2017). Also, attempts
should be made to increase the number of workers for the aged care as this is one area that id
faced with a huge shortage of workers.
Conclusion
In conclusion, it is evident that the Consumer Directed Care (CDC) for the aged in
Australia has brought about more good than bad. Ranging from independence and greater
satisfaction for the user to utilize the available resources (funds) in a more cognizant manner and
safety of the consumers’ packages, CDC has led to more organization in aged care. This system
has also improved the lives of the older Australians by giving them more freedom which
enhances happiness. CDC also ensures that the ethical considerations put in place are adhered to
as it offers clear principles to be followed by both the consumer and the aged care provider. With
a continuously growing population of the aged Australians, even better systems for aged care
that are more user-friendly are required in the future.

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