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Helping clients to make informed choices in a consumer-directed era: provider

Providing clients greater choice under a consumer-directed model means building trust, listening and offering relevant expertise, a leading provider has said.

As the sector looks to expand greater consumer choice more fully across aged care, services face the risk of providing seniors with choices without also ensuring they are adequately informed.

Aged care services should use their expertise and knowledge to effectively broaden the scope of choice for clients, according to Victorian aged care provider Baptcare.

Kathleen Stewart, Baptcare’s quality partner, said that when clients enter a service they can often only be looking for assistance with certain tasks such as showering or cleaning. “If we were just going to be superficial about client choice, it might end there,” Ms Stewart told Australian Ageing Agenda ahead of her presentation at the Quality in Aged Care conference.

But armed with well-trained, knowledgeable staff and evidence-based tools, aged care providers could identify if a client may be at risk of issues such as falls, depression on malnutrition. From there, they could further highlight other services that may be relevant to a client that they might not have previously considered.

Ms Stewart gave an example of a wheelchair-bound client who had accessed Baptcare’s services to receive help with shopping. Through the assessment process, it was identified the man had not had any rehabilitation. He was offered physiotherapy services, which he chose to take up and eventually, he was able to walk up the stairs in his house, something he hadn’t done in two years.

“But that was never going to be his choice at the beginning, because he’d never had the information that there were more gains to be made. By informing him more was possible, he could make a different kind of choice,” she said.

Ms Stewart said most aged care clients were not health professionals or industry experts, and it was up to services to provide clients with suitable information relevant to their goals, needs and interests.

Likewise, if a client chose to decline a service or make a choice a deemed “risky”, it was the provider’s role to be flexible and respect that.

“It’s much more a shared-decision making process, where we bring the information and the expertise of our profession to the table, and the client brings their values and their view of the world,” said Ms Stewart.

“Both things are necessary for that decision to be informed and for it be in the client’s best interest – and it may not be a decision we would make for ourselves.”

Baptcare’s customer experience partner Belinda Wood said providers had to also be aware that client’s needs and wants may change over time, and engagement must be ongoing.

Clients were often in a time of crisis when they entered services, and addressing immediate basic care needs may be most important at that time. But as the crisis abated it may be more appropriate for a provider to start a conversation with the client about functional gains, or social and lifestyle interests, Ms Wood said.

Moreover, in order to provide effective care, providers had to build trust with their clients at both an individual and organisational level, improving the overall customer service experience, said Ms Wood.

Baptcare has moved away from using an annual survey to get feedback from its clients to using electronic hand-held devices to track customer experience in real time, allowing a “constant dialogue.”

The provider was also now involving customers in strategic planning days and was using client input to help shape the organisation. For example, in one residential facility, residents were helping design and renovate a lounge area to their tastes, said Ms Wood.

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5 Responses to Helping clients to make informed choices in a consumer-directed era: provider

  1. margaret January 29, 2016 at 2:52 pm #

    One of the other key areas in implementing CDC in this age group is educating risk adverse family members, GP’s and even carers who may initially oppose choices and pathways their family member may wish to take. Often the person will defer to the family in order to not “upset”or make a fuss. It takes a level of skill to negotiate around that and empower the person to persevere.

  2. mazza January 29, 2016 at 5:54 pm #

    I fully agree Margaret. Another aspect to the idea of CDC is that to take a ‘strengths based approach” in a residential care setting will reduce the level of funding on the initial ACFI (Funding Instrument report to the funding body). Residential facilities are well versed in making residents appear to require more, not less care.
    My experience has been that facility owners require management to make each new resident appear to be more in need of staff support that they may actually be, in an effort to increase the funding for each resident.
    I am really happy to be challenged on this point, and I would love to be deemed wrong by evidence.

  3. Maria Berry January 31, 2016 at 9:31 am #

    I have to agree on Margaret’s comment. When building that relationship with the older person who only trusts the family member or immediate carer their choices can be around “pleasing them “or “just making it not so difficult”. We are still dealing with a lot of the “silent generation” who won’t voice up or make a fuss. It will require people with that level of skill and knowledge to gain trust, build a relationship, engage with the person and their family (carer) and provide all the information on all the choices. Sometimes these choices may be out of the “Box”…..we all have to start looking outside the “box” …… There is a big wide world with lots of choices. Knowledge of local community and community engagement could be the key. Every community is individual and have some great stuff happening. We just need to start looking at what else is around, build those partnerships and relationships with all. ” We do it best when we do it all together”.

  4. Anita Frayman February 1, 2016 at 12:21 pm #

    The issue of helping clients make informed choices in regard to their own aged care highlights the pivotal role of facilitated family discussions or some type of elder mediation between the older person, family members and aged care service providers. These discussions provide a forum in which the older person can be empowered to express their preferred choices while family members can express their concerns, and the service providers can explain the practicalities of the different options. It is important that the facilitator is trained in managing power imbalances and is experienced in identifying ageism and other factors which may unreasonably inhibit the older person from exercising their right to choose.

  5. Sanjeeta February 2, 2016 at 10:17 am #

    With all due respect to the objectives of the Government, if the home care packages are to truly operate as a consumer directed care model, would it not make sense to open up consumers choice to choose whoever they feel is most appropriate to meet their needs, and not necessarily have that choice limited by only those providers or services who meet requirements such as National Police Certificates and extensive Insurances?

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