This project examined the needs, preferences and interests of older consumers needing care and opportunities for the aged care service system to better respond to these consumers.
National aged care reforms and NDIS are changing the way home and community care services are funded, regulated and delivered. Consumers need to be supported in the transition period so that they can exercise choice and control and they have a voice in the reformed service system.
What were the project objectives?
The project sought to:
- examine the impacts of aged care reform on the design and delivery of aged care services
- examine the interests, needs and preferences of older Victorians needing care, with a particular focus on those who identify as Aboriginal and/or Torres Strait Islander, LGBTIQ, culturally and linguistically diverse and those living in regional and rural areas (defined as those from ‘thin markets’)
- identify options to strengthen the ability of the service system to respond to the interests, needs and preferences of older consumers, particularly those from thin markets.
What did the project involve?
Council on the Ageing Vic (COTA) led the project. Municipal Association of Victoria contributed to its development. The project commenced in 2016 and concluded in 2019.
The first stage of the project involved consultations with service providers, federal and state government and peak bodies to understand perceived impacts of the aged care reforms on service design and delivery, including for the Home and Community Care program in Victoria.
The second stage of the project commenced with a literature review on market-driven systems. The project then engaged numerous stakeholders – older community members needing care, family and friends of older people needing care and people with experience working in the aged care system – to discuss consumer needs, interests and preferences and identify options to promote consumer choice and control and to support consumers to navigate the service system. There was a focus on those groups from thin markets. Three ideas intended to better support older consumers to navigate the service system and/or promote their choice and control were tested and honed with consumers and a service provider.
What did we learn?
The first stage of the project identified the need to strengthen consumer voices so that the aged care service system is better informed by consumer needs and preferences. It identified that many older consumers struggle to access the aged care service system – on entry and in navigating the system and utilising services. The reforms may result in service gaps for consumers in ‘thin’ or ‘niche’ markets, such as those living in rural and regional areas, people who identify as Aboriginal and/or Torres Strait Islander, culturally and linguistically diverse consumers and other consumers with particular support needs.
Several opportunities were identified, including improving public health awareness and supporting prevention and early intervention services and better supporting consumers to access and navigate the service system, with a particular focus on those from thin markets. Other opportunities included appropriate market monitoring and stewardship, improving providers’ financial sustainability and leveraging technology to support service delivery and promote consumer choice and control.
The second stage of the project found that older consumers need greater support from the outset to identify their needs, service options and appropriate providers so that they can make informed decisions and exercise choice and control. Information and support must be comprehensible, impartial and advisory and it should be delivered by not for profit or advocacy organisations, preferable those outside of the aged care service system.
Older consumers from thin markets want to engage service providers that communicate effectively, offer flexibility and build and maintain trust through interpersonal contact. Consumers want to have a genuine voice in service delivery and have opportunities to provide feedback on service provision and to change providers if required. Service providers should undergo cultural training in working with consumers from thin markets and this training should be co-designed with consumers.
Stakeholders involved in the project’s second stage supported two ideas for further development: an app to help consumers identify appropriate providers and assist them to navigate the service system and/or a local cooperative run by consumers and service providers staff to promote consumer choice and control.
Stakeholders reported that any solution should promote interaction, provide support before people are in crisis and be clear, easy to navigate and accessible from consumers’ homes. It should also be based on an understanding of consumer backgrounds and preferences and facilitate interpersonal contact.
This project was funded by State Trustees Australia Foundation
The Panel would like to acknowledge the consultant, Katelijne Lenaerts from Synergy Insights Consulting, for leading the co-design process.
For further information about the co-design process used in this project you can contact COTA Victoria on 03 9655 2100 or email email@example.com.