Front line home care workers are concerned about the incoming generation of savvy, self-aware and demanding baby boomer clients and what this will mean for them under consumer directed care, research shows.
A Flinders University research paper, Consumer directed care and the relational triangle: power, subordination and competing demands, published in the current issue of the journal Employee Relations, puts the spotlight on the changing dynamics between home support workers, their clients and their employees under the recent change to consumer directed care.
Four managers, 10 co-ordinators and 17 support workers from three NSW organisations were surveyed for the study. Data was collected between February and April 2016 when consumer directed care was still relatively new.
Most support workers, including those who experienced minimal or no immediate change under consumer-directed care, “spontaneously volunteered perceptions about their anticipation of loss of control and increased subordination when the next generation of clients (or “baby boomers”) enter the home care system”.
Some respondents also said they already felt “subordinated” to the client, or as if they were being treated as an employee of the client.
A sample of what workers said about their experience with CDC:
- Baby boomers “will want more for their money”
- “Baby boomers are a ‘generational thing’ as they will tend to have more knowledge … so it could be quite a large change”
- “What I see will happen with the baby boomers (is that) they are used to a certain standard of living and an expectation of a service”
- “I find the new system for me personally is great because I love the fact that the client has more control and they can pick off a menu. I love the fact that they are happier that they have been empowered”
- “The client can have pretty much what they want whereas before there were limitations … The pendulum has swung too far the other way (and) it’s all about what the client wants and not what the care worker may want to do”
- “I didn’t really have a problem with the old system. I think people were quite happy with what we were offering “
Nationwide organisational change
Researcher Graeme Payne came to the study after a long career in HR and workplace relations and realised CDC in the home care sector offered a promising case study in nationwide organisational change.
“The main finding was, first of all, a lot of them had not experienced a significant change yet,” told Community Care Review.
“But some were saying, ‘I feel like an employee, I feel like a servant, I’ve feel as though I’ve lost control.”
Most respondents accepted the notion of CDC and client empowerment and considered it “a great thing,” he said.
But there was concern about the entry of the baby boomer generation into home care.
“Baby boomers probably will be more aware of their rights … there’ll be greater expectations as the baby boomer group comes through and (workers) were saying that they were concerned about that and their relationships.
“They perceived that the relationship may become difficult.”
According to the Australian Bureau of Statistics Australia has 5.5 million baby boomers, defined as those born between 1946 and 1966. The oldest of them have just entered their seventies.
Unique Australian model
Payne says consumer directed care is a buzzword around the world but the Australian model is fairly unique because while in other parts of the world the client is the employer, here the care worker is employed by an organisation.
The research concludes that consumer directed care has resulted in an ambiguous relationship between carers, their employers and clients and says the increasing ageing population makes it essential that workers’ relationships with clients and with their organisation are unambiguous.
“This research says look the relationship is between the employer and the worker and that’s got to be looked after and be precious,” Payne says.
“If you’re employing someone and you’re letting the client tell the worker what to do all the time, the relationship becomes crowded.”