October 20, 2015

Caring for dementia under reforms

Researcher receives $570K to investigate the impact of new reforms on people with dementia.

The impact of reforms to home care arrangements for people with dementia will be the focus of new research by UOW’s Dr Lyn Phillipson, who has been awarded $571,648 as part of a 2015 NHMRC-ARC Dementia Fellowship.

Under changes introduced on 1 July, Home Care Packages (HCP) – which allow people aged 65 and over to receive care in their own home – are now required to be delivered under a Consumer Directed Care (CDC) model.

How people with dementia who receive a HCP respond to the reforms, in which consumers are given greater freedom to advocate for, and engage with, services for their care, will be investigated by Dr Phillipson, from the UOW’s School of Health and Society.

“These are some of the biggest reforms Australia has seen in aged care” Dr Phillipson said. “We want to understand the impact of these changes, in particular on those who may be less able to clearly articulate their needs because of dementia-related cognitive impairment.”

The change to a CDC approach aims to promote greater flexibility for people who receive a HCP, however studies have tended to show that the outcomes of consumer driven care models are better for younger people, Dr Phillipson said.

“Both the international literature and the pilot evaluation of packages in Australia suggest there may be significant challenges with CDC for providers of care, and for older consumers, especially those living with dementia.”

Her project, titled Consumer Directed Care: Understanding and promoting participation and care outcomes for people living with dementia in receipt of a Home Care Package will examine questions including:

·  How engaged are people with dementia in the process of establishing a HCP under the new arrangements?

·  How do we know that their needs have been identified and are being met?

·  To what degree does their ability to participate contribute to the care outcomes of people with dementia?

·  What strategies are useful to promote greater participation and control in care for people with living with dementia?

Although the research will also examine the experience and impact of reforms on family carers and the HCP providers of people with dementia, Dr Phillipson said its focus will be on providing strategies for engagement for the individual receiving the care.

“With the trend towards families moving for work and the rise of single-person households, our demographers tell us that many people will be living alone as they age. Therefore, any sustainable model for home care needs to be able to engage older people directly and ensure that even those with cognitive impairment can advocate for and participate in their care arrangements.”

One of a few of health services based research projects being undertaken by the 76 Fellows awarded funding under the scheme, Dr Phillipson said her study, which will be based at the Australian Health Services Research Institute at UOW, will provide much needed information for policy and practice to ensure people with dementia receive the most appropriate care under a HCP.

About the Dementia Research Development Fellowships Scheme

Announced on Monday (19 October), 76 researchers were awarded a total of $43 million as part of the NHMRC-ARC Dementia Research Development Fellowships Scheme, a new initiative to increase research capacity in dementia. It provides opportunities for postdoctoral researchers to undertake advanced training in the health, medical, fundamental sciences, social, economic and cultural fields relevant to dementia.