Principles of Consumer Directed Care

Consumer Directed Care (CDC) is a new model of care in which the consumers of care are given more flexibility and choice over the care provided. This gives people receiving home care more control on the care services and care packages they receive including how the care is delivered and who provides the care (Gill et al., 2018; Cornell, 2018). This model ensures that the care providers revews and monitors the care to ensure it meets the requirements and needs of the consumer. In case of a change in the care needs or requirements, this model ensures a reassessment to assess the need for change in the care plan (Cash et al., 2017).

The aim of the report is to analyze how consumer directed care in Aged Care can support older people to have more control on the care they receive, evaluating the consumer directed care in aged care services, and how the model empowers elderly people and the positive and negative impact of this model on their health and wellbeing.

Consumer directed care involves several principles that is aimed to help the consumers. These principles are:

This entitles the consumers to have assistance and access to all the possible services and care packages that can be applicable for them. This helps the consumer to decide on their own care packages that can support the consumers to live their lives according to their own wishes (Prgomet et al., 2017).

Access to all the relevant information is vital to allow informed decision making, which makes it an important principle under CDC. Providing all the information to the consumers can help them to better understand the situation, which can support an informed decision that addresses their care needs and based upon their health assessments (Gill et al., 2017).

This helps in the development of a balanced and respectful partnership between the consumers and service providers that is underlined by the rights and responsibilities of both the parties. This is important to ensure the empowerment of the consumer and to exercise their authorities to control and manage their own care. The consumer gets to choose the level of control they can exercise in their care and can differ between different consumers (Laver et al., 2018; Thomas & Allen, 2016).

The framework of restorative and re-enablement strategies of CDC can support the independence of the consumers and reduces the requirements of continuous and increased levels of delivery of service. This is a vital strategy for consumers who enter the care system in a crisis situation requiring the quick provision of services to address the crisis situation (Cochrane et al., 2016).

Empowerment of Elderly People

The CDC system provides rights to the consumers to chose how their budget for the services of their choosing. This helps to make informed decisions about their care. This also implies that all the information regarding budget, cost of service, and the individual budget for the care as well as how their funding is used helps to develop transparency and foster trust in the system (Laragy & Allen, 2015).

CDC can help to empower the elderly because of the key aspects of the system that increases the involvement of the consumers in the decision making process related to their care (Ranson et al., 2016). Such aspects can be supported through:

Self assessment and self identification with the support of an assessor can help to identify the support needs of the consumer through conversations and storytelling and professional assessment of specific conditions as agreed upon by the consumer or their representative and ensuring their involvement in care planning (Mueller et al., 2016).

Orienting the service to the needs of the consumer is based on the strengths of the consumer and addresses any barriers to achieve their care goals. The care starts with assessment of consumer needs, where the assessor listens to the consumer and provides advices and facilitates to achieve those needs (Thi Xuan Mai & Ottar Olsen, 2016).

A positive relation between provider and consumer is supported through an improvement in consumer satisfaction, increase comprehension of the consumer on the care provided and an active participation or involvement of the consumer in his or her care. Studies show that a committed, collaborative and engaging care along with patient satisfaction and active participation being vital for patient empowerment (Van Der Wouden et al., 2016).

Supporting the knowledge of the patient also helps to empower patients. It is pointed out that more knowledge and information helps the patient to understand their conditions in a better way, and identify how their care plan can achieve better health outcomes thereby allowing them to make informed decisions regarding their care (Kaambwa et al., 2015).

A sense of personal control is vital for the patients, since it gives them a sense of having a control over how they would like to be cared and how their funding is utilized to ensure their well being. Studies show that a sense of control over the provision and delivery of care by the patient increases their satisfaction towards the service and helps in their empowerment through the consumer centricity of the services (Ranson et al., 2016).

Benefits of CDC on Health and Wellbeing

CDC ensures that the consumer define the goals of care and deciede what is important for them, planning care for themselves with support as required or requested, as well as decieding upon the services that will be given, how they will be delivered and who will be delivering the services (Walsh et al., 2016; Cash et al., 2017).

Ensuring the safety of the care prevents any adverse effects of the care on the consumer, thereby supporting their overall wellbeing and also preventing unwanted health outcomes. Studies show that care plans that ensures maximum safety for the patients actually helps to ensure their wellbeing and thus supports their empowerment (Friedman et al., 2015).

Consumer centered care can have several advantages and disadvantages for the consumers as well as the providers which have been discussed next:

1. Increases the satisfaction of the consumers and their families towards the care given
2. Improves the reputation of the providers for the consumers of healthcare services

• Increases the productivity and morale of the providers

1. Improves the allocation of resources and funds
2. Minumizes the expense of the care through better and clearer budgeting
3. Empowering the consumers through more information and control on their care

• Providing continuous care through collaborative effort
• Supports compliance to the care needs as informed by the consumer

1. Fosters respect for the consumer
2. Supports wellness and re-enablement practices to improve the wellbeing of consumers

(Gill et al., 2018)

1. Training of healthcare workers towards the consumer directed care approach and consumer centricity of care
2. Developing a trusting relation between the provider and consumer can be challenge and can take time to develop and sustain

• This divers the focus of care from a provider centered approach which can complicate the process of monitoring performance and success of the care

1. For the elderly and frail consumers, making informed choices can be a challenging task especially under circumstances of cognitive disabilities, socio-economic conditions, non-availability of a representative or carer or geographic isolation.
2. CDC can also lead to the consumer’s condition being downplayed, by constructing elderly patients as ‘consumers’ and ignores the specific conditions that prevents them to represent their self interest and thus can be at higher risk than an average consumer.
3. Self regularion of care can also limit the comprehensiveness of the care, instead focusing on the positive outcomes only.

(Kaambwa et al., 2015)

Conclusion: 

CDC is a model of healthcare delivery that places the consumer at the center of the decision making process regarding the care. This ensures that the patient or their representatives have control over the service provided to them, increasing their sense of involvement over their care, which they can deciede upon beforehand. This also helps in the modification of the care plan according to the consumer’s wishes and preferences. Such aspects make CDC an important strategy in aged care as it helps in the empowerment of the elderly, and increasing their sense of control over their lives as well as the provision and delivery of care. CDC supports the health and wellbeing of the consumers through the inclusion of choice and flexibility in care, providing the patient all relevant information to facilitate informed consent, incorporate a partnership in healthcare between consumer and provider. CDC also ensures transparency in the system and supports wellness and re-enablement of the consumers which increases their satisfaction and trust. However, CDC can also be challenging since it can complicate the process of measuring the success of care,  increasing dependence on the consumer for taking their care decisions and adversely affecting the providence of continuous care for the consumers.

References:

Cash, T., Moyle, W., & O’dwyer, S. (2017). Relationships in consumer?directed care: An integrative literature review. Australasian journal on ageing, 36(3), 193-204.

Cochrane, A., Furlong, M., McGilloway, S., Molloy, D. W., Stevenson, M., & Donnelly, M. (2016). Time?limited home?care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database of Systematic Reviews, (10).

Advantages of Consumer Directed Care

Cornell, V. (2018). Will housing tenure drive unequal outcomes for Consumer?Directed Care recipients?. Australasian journal on ageing, 37(2), E68-E73.

Friedman, B., Wamsley, B. R., & Conwell, Y. (2015). Do disabled elderly Medicare beneficiaries with major depression make less use of a consumer-directed home care voucher benefit?. Journal of aging & social policy, 27(1), 87-105.

Gill, L., Bradley, S. L., Cameron, I. D., & Ratcliffe, J. (2018). How do clients in Australia experience Consumer Directed Care?. BMC geriatrics, 18(1), 148.

Gill, L., McCaffrey, N., Cameron, I. D., Ratcliffe, J., Kaambwa, B., Corlis, M., … & Gresham, M. (2017). Consumer Directed Care in A ustralia: early perceptions and experiences of staff, clients and carers. Health & social care in the community, 25(2), 478-491.

Kaambwa, B., Lancsar, E., McCaffrey, N., Chen, G., Gill, L., Cameron, I. D., … & Ratcliffe, J. (2015). Investigating consumers’ and informal carers’ views and preferences for consumer directed care: A discrete choice experiment. Social Science & Medicine, 140, 81-94.

Kaambwa, B., Lancsar, E., McCaffrey, N., Chen, G., Gill, L., Cameron, I. D., … & Ratcliffe, J. (2015). Investigating consumers’ and informal carers’ views and preferences for consumer directed care: A discrete choice experiment. Social Science & Medicine, 140, 81-94.

Laragy, C., & Allen, J. (2015). Community aged care case managers transitioning to consumer directed care: More than procedural change required. Australian Social Work, 68(2), 212-227.

Laver, K., Gnanamanickam, E., Whitehead, C., Kurrle, S., Corlis, M., Ratcliffe, J., … & Crotty, M. (2018). Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens’ jury. Journal of health services research & policy, 1355819618764223.

Mueller, C., Misiorski, S., & Ortigara, A. (2016). The Role of the Nurse in Person-Directed Care. Generations, 40(1), 106-114.

Prgomet, M., Douglas, H. E., Tariq, A., Georgiou, A., Armour, P., & Westbrook, J. I. (2017). The work of front line community aged care staff and the impact of a changing policy landscape and consumer-directed care. The British Journal of Social Work, 47(1), 106-124.

Ranson, N. E., Terry, D. R., Glenister, K., Adam, B. R., & Wright, J. (2016). Integrated and consumer-directed care: a necessary paradigm shift for rural chronic ill health. Australian journal of primary health, 22(3), 176-180.

Thi Xuan Mai, H., & Ottar Olsen, S. (2016). Consumer participation in self-production: The role of control mechanisms, convenience orientation, and moral obligation. Journal of Marketing Theory and Practice, 24(2), 209-223.

Thomas, K. S., & Allen, S. M. (2016). Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers. Journal of Rehabilitation Research & Development, 53(5).

Van Der Wouden, C. H., Carere, D. A., Maitland-Van Der Zee, A. H., Ruffin, M. T., Roberts, J. S., & Green, R. C. (2016). Consumer perceptions of interactions with primary care providers after direct-to-consumer personal genomic testing. Annals of internal medicine, 164(8), 513-522.

Walsh, L., Hill, S., Wluka, A. E., Brooks, P., Buchbinder, R., Cahill, A., … & Tugwell, P. (2016). Harnessing and supporting consumer involvement in the development and implementation of Models of Care for musculoskeletal health. Best Practice & Research Clinical Rheumatology, 30(3), 420-444.

Principles of Consumer Directed Care

Consumer Directed Care (CDC) is a new model of care in which the consumers of care are given more flexibility and choice over the care provided. This gives people receiving home care more control on the care services and care packages they receive including how the care is delivered and who provides the care (Gill et al., 2018; Cornell, 2018). This model ensures that the care providers revews and monitors the care to ensure it meets the requirements and needs of the consumer. In case of a change in the care needs or requirements, this model ensures a reassessment to assess the need for change in the care plan (Cash et al., 2017).

The aim of the report is to analyze how consumer directed care in Aged Care can support older people to have more control on the care they receive, evaluating the consumer directed care in aged care services, and how the model empowers elderly people and the positive and negative impact of this model on their health and wellbeing.

Consumer directed care involves several principles that is aimed to help the consumers. These principles are:

This entitles the consumers to have assistance and access to all the possible services and care packages that can be applicable for them. This helps the consumer to decide on their own care packages that can support the consumers to live their lives according to their own wishes (Prgomet et al., 2017).

Access to all the relevant information is vital to allow informed decision making, which makes it an important principle under CDC. Providing all the information to the consumers can help them to better understand the situation, which can support an informed decision that addresses their care needs and based upon their health assessments (Gill et al., 2017).

This helps in the development of a balanced and respectful partnership between the consumers and service providers that is underlined by the rights and responsibilities of both the parties. This is important to ensure the empowerment of the consumer and to exercise their authorities to control and manage their own care. The consumer gets to choose the level of control they can exercise in their care and can differ between different consumers (Laver et al., 2018; Thomas & Allen, 2016).

The framework of restorative and re-enablement strategies of CDC can support the independence of the consumers and reduces the requirements of continuous and increased levels of delivery of service. This is a vital strategy for consumers who enter the care system in a crisis situation requiring the quick provision of services to address the crisis situation (Cochrane et al., 2016).

Empowerment of Elderly People

The CDC system provides rights to the consumers to chose how their budget for the services of their choosing. This helps to make informed decisions about their care. This also implies that all the information regarding budget, cost of service, and the individual budget for the care as well as how their funding is used helps to develop transparency and foster trust in the system (Laragy & Allen, 2015).

CDC can help to empower the elderly because of the key aspects of the system that increases the involvement of the consumers in the decision making process related to their care (Ranson et al., 2016). Such aspects can be supported through:

Self assessment and self identification with the support of an assessor can help to identify the support needs of the consumer through conversations and storytelling and professional assessment of specific conditions as agreed upon by the consumer or their representative and ensuring their involvement in care planning (Mueller et al., 2016).

Orienting the service to the needs of the consumer is based on the strengths of the consumer and addresses any barriers to achieve their care goals. The care starts with assessment of consumer needs, where the assessor listens to the consumer and provides advices and facilitates to achieve those needs (Thi Xuan Mai & Ottar Olsen, 2016).

A positive relation between provider and consumer is supported through an improvement in consumer satisfaction, increase comprehension of the consumer on the care provided and an active participation or involvement of the consumer in his or her care. Studies show that a committed, collaborative and engaging care along with patient satisfaction and active participation being vital for patient empowerment (Van Der Wouden et al., 2016).

Supporting the knowledge of the patient also helps to empower patients. It is pointed out that more knowledge and information helps the patient to understand their conditions in a better way, and identify how their care plan can achieve better health outcomes thereby allowing them to make informed decisions regarding their care (Kaambwa et al., 2015).

A sense of personal control is vital for the patients, since it gives them a sense of having a control over how they would like to be cared and how their funding is utilized to ensure their well being. Studies show that a sense of control over the provision and delivery of care by the patient increases their satisfaction towards the service and helps in their empowerment through the consumer centricity of the services (Ranson et al., 2016).

Benefits of CDC on Health and Wellbeing

CDC ensures that the consumer define the goals of care and deciede what is important for them, planning care for themselves with support as required or requested, as well as decieding upon the services that will be given, how they will be delivered and who will be delivering the services (Walsh et al., 2016; Cash et al., 2017).

Ensuring the safety of the care prevents any adverse effects of the care on the consumer, thereby supporting their overall wellbeing and also preventing unwanted health outcomes. Studies show that care plans that ensures maximum safety for the patients actually helps to ensure their wellbeing and thus supports their empowerment (Friedman et al., 2015).

Consumer centered care can have several advantages and disadvantages for the consumers as well as the providers which have been discussed next:

1. Increases the satisfaction of the consumers and their families towards the care given
2. Improves the reputation of the providers for the consumers of healthcare services

• Increases the productivity and morale of the providers

1. Improves the allocation of resources and funds
2. Minumizes the expense of the care through better and clearer budgeting
3. Empowering the consumers through more information and control on their care

• Providing continuous care through collaborative effort
• Supports compliance to the care needs as informed by the consumer

1. Fosters respect for the consumer
2. Supports wellness and re-enablement practices to improve the wellbeing of consumers

(Gill et al., 2018)

1. Training of healthcare workers towards the consumer directed care approach and consumer centricity of care
2. Developing a trusting relation between the provider and consumer can be challenge and can take time to develop and sustain

• This divers the focus of care from a provider centered approach which can complicate the process of monitoring performance and success of the care

1. For the elderly and frail consumers, making informed choices can be a challenging task especially under circumstances of cognitive disabilities, socio-economic conditions, non-availability of a representative or carer or geographic isolation.
2. CDC can also lead to the consumer’s condition being downplayed, by constructing elderly patients as ‘consumers’ and ignores the specific conditions that prevents them to represent their self interest and thus can be at higher risk than an average consumer.
3. Self regularion of care can also limit the comprehensiveness of the care, instead focusing on the positive outcomes only.

(Kaambwa et al., 2015)

Conclusion: 

CDC is a model of healthcare delivery that places the consumer at the center of the decision making process regarding the care. This ensures that the patient or their representatives have control over the service provided to them, increasing their sense of involvement over their care, which they can deciede upon beforehand. This also helps in the modification of the care plan according to the consumer’s wishes and preferences. Such aspects make CDC an important strategy in aged care as it helps in the empowerment of the elderly, and increasing their sense of control over their lives as well as the provision and delivery of care. CDC supports the health and wellbeing of the consumers through the inclusion of choice and flexibility in care, providing the patient all relevant information to facilitate informed consent, incorporate a partnership in healthcare between consumer and provider. CDC also ensures transparency in the system and supports wellness and re-enablement of the consumers which increases their satisfaction and trust. However, CDC can also be challenging since it can complicate the process of measuring the success of care,  increasing dependence on the consumer for taking their care decisions and adversely affecting the providence of continuous care for the consumers.

References:

Cash, T., Moyle, W., & O’dwyer, S. (2017). Relationships in consumer?directed care: An integrative literature review. Australasian journal on ageing, 36(3), 193-204.

Cochrane, A., Furlong, M., McGilloway, S., Molloy, D. W., Stevenson, M., & Donnelly, M. (2016). Time?limited home?care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database of Systematic Reviews, (10).

Advantages of Consumer Directed Care

Cornell, V. (2018). Will housing tenure drive unequal outcomes for Consumer?Directed Care recipients?. Australasian journal on ageing, 37(2), E68-E73.

Friedman, B., Wamsley, B. R., & Conwell, Y. (2015). Do disabled elderly Medicare beneficiaries with major depression make less use of a consumer-directed home care voucher benefit?. Journal of aging & social policy, 27(1), 87-105.

Gill, L., Bradley, S. L., Cameron, I. D., & Ratcliffe, J. (2018). How do clients in Australia experience Consumer Directed Care?. BMC geriatrics, 18(1), 148.

Gill, L., McCaffrey, N., Cameron, I. D., Ratcliffe, J., Kaambwa, B., Corlis, M., … & Gresham, M. (2017). Consumer Directed Care in A ustralia: early perceptions and experiences of staff, clients and carers. Health & social care in the community, 25(2), 478-491.

Kaambwa, B., Lancsar, E., McCaffrey, N., Chen, G., Gill, L., Cameron, I. D., … & Ratcliffe, J. (2015). Investigating consumers’ and informal carers’ views and preferences for consumer directed care: A discrete choice experiment. Social Science & Medicine, 140, 81-94.

Kaambwa, B., Lancsar, E., McCaffrey, N., Chen, G., Gill, L., Cameron, I. D., … & Ratcliffe, J. (2015). Investigating consumers’ and informal carers’ views and preferences for consumer directed care: A discrete choice experiment. Social Science & Medicine, 140, 81-94.

Laragy, C., & Allen, J. (2015). Community aged care case managers transitioning to consumer directed care: More than procedural change required. Australian Social Work, 68(2), 212-227.

Laver, K., Gnanamanickam, E., Whitehead, C., Kurrle, S., Corlis, M., Ratcliffe, J., … & Crotty, M. (2018). Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens’ jury. Journal of health services research & policy, 1355819618764223.

Mueller, C., Misiorski, S., & Ortigara, A. (2016). The Role of the Nurse in Person-Directed Care. Generations, 40(1), 106-114.

Prgomet, M., Douglas, H. E., Tariq, A., Georgiou, A., Armour, P., & Westbrook, J. I. (2017). The work of front line community aged care staff and the impact of a changing policy landscape and consumer-directed care. The British Journal of Social Work, 47(1), 106-124.

Ranson, N. E., Terry, D. R., Glenister, K., Adam, B. R., & Wright, J. (2016). Integrated and consumer-directed care: a necessary paradigm shift for rural chronic ill health. Australian journal of primary health, 22(3), 176-180.

Thi Xuan Mai, H., & Ottar Olsen, S. (2016). Consumer participation in self-production: The role of control mechanisms, convenience orientation, and moral obligation. Journal of Marketing Theory and Practice, 24(2), 209-223.

Thomas, K. S., & Allen, S. M. (2016). Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers. Journal of Rehabilitation Research & Development, 53(5).

Van Der Wouden, C. H., Carere, D. A., Maitland-Van Der Zee, A. H., Ruffin, M. T., Roberts, J. S., & Green, R. C. (2016). Consumer perceptions of interactions with primary care providers after direct-to-consumer personal genomic testing. Annals of internal medicine, 164(8), 513-522.

Walsh, L., Hill, S., Wluka, A. E., Brooks, P., Buchbinder, R., Cahill, A., … & Tugwell, P. (2016). Harnessing and supporting consumer involvement in the development and implementation of Models of Care for musculoskeletal health. Best Practice & Research Clinical Rheumatology, 30(3), 420-444.