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Home Care Package Program fostering isolation


A co-housing approach to providing support for older women in the community may be preferable to current home care polices, which risk isolating people in their own homes, a researcher says.

Myfan Jordan

Myfan Jordan, director of innovation at the social justice think tank Per Capita, presented recent research which explores attitudes towards models of co-housing for older women at the AAG conference in Sydney on Wednesday.

Per Capita researchers, who collected over 50 hours of data from in-depth interviews with 23 women, found while attitudes varied towards different models of co-housing, “it was clear that women wanted community options”, Ms Jordan said.

She said the research showed that older women wanted to be part of a network that provided a “relationship of support”.

However this isn’t being provided by the individualised, consumer-focused nature of the existing Home Care Package Program, which “goes against being part of the community”.

“What people want isn’t necessarily tasks and activities, it’s to feel supported and to be able to talk about what you need,” she told Community Care Review after her presentation.

“It’s the way we organise the home care packages – we splitt them into menu items, tasks and activities. It’s care as a commodity rather than care as a relationship.”

Models of co-housing

 Per Capita’s research also shed some new light on concerns and preferences around co-housing options.

Respondents had reservations about the home share model, where an older homeowner takes in a tenant who offers support in lieu of rent, Ms Jordan said.

“First of all they had the concern about privacy and the intimacy of the relationship and what might go wrong,” she said.

“Even though it was explained that there are opt-outs and the relationship was carefully managed, people thought it was great but not for them.”

Timebanking, which is commonly used in Switzerland, is based on a reciprocal volunteer model where time spenf volunteering is “banked” for the volunteer’s future support.

This also drew mixed responses, Ms Jordan said, with some unease about the “transactional nature” of the model.

We split (home care) into menu items, tasks and activities. It’s care as a commodity rather than care as a relationship.”

The Older Women’s Cooperative Housing (OWCH) model was the most popular. This is based on larger scale community co-living, based on self-governance and where up to 15-20 individuals can live in self-contained units with common areas.

Ms Jordan told CCR the main finding was that the women were extremely open to co-housing model, to the extent that even those in secure housing said they would move away to access such a community.

“For me that really challenged that notion of ageing in place,” she said.

Ms Jordan said as well as providing a pool of funds to support co-housing options, government policy needed to shift from on individualised home care towards community solutions.

“It’s the way we organise the care packages,” she said. “we split them into menu items, tasks and activities and there’s often inconsistent ways of delivering those tasks within set time limits so it been commodified, it’s care as a commodity rather than care as a relationship.”

Home care packages may be fostering isolation

 Meanwhile, preliminary research presented by Dr Julie Dare from Edith Cowan University supported previous studies that indicated CDC in the home care packages program may be fostering isolation among older Australians.

Some older people are focusing more on instrumental services rather than social support services and that can increase the risk of them becoming isolated.

The findings so far made by Dr Dare’s team are based on interviews with five HCP recipients at a large Perth based provider.

Dr Dare told the conference there is a potential that individuals purchasing home care services might spend their packages in a way that prioritises services rather than social support, possibly because of confusion or lack of information about how they can use their funds.

“The potential there is that, from the perspective of the agency that we are working with that older people are selecting services that are more instrumental in nature,” she said.

“From the agency’s point of view, some older people are focusing more on instrumental services rather than social support services and that can increase the risk of them becoming isolated.”

Dr Dare said there may also be a tendency for service providers to discourage consumers from forming ongoing relationships with care workers, to minimise the risk of exploitation and elder abuse.

“What we’re hearing from the people that we’re interviewing is that they want that closeness with the people that are coming to support them, they want that level of connection. So there’s really that tension between what the service provider is aiming to achieve and what the older person wants,” Dr Dare said.

“Certainly home care packages are a really important strategy to allow people to remain in the home but we need to be ensuring that older people are able to make choices that enable them to remain socially connected.”

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3 Responses to Home Care Package Program fostering isolation

  1. Anonymous November 7, 2019 at 1:53 pm #

    I so agree with this article having briefly worked in a HCP environment. The move beyond tasks and activities is very much influenced by the quality of the client advisor/manager/whatever to think about social connections and other possibilities of living beyond the instrumental tasks of caring. Unfortunately, thinking beyond instrumental tasks means investing in a relationship with client and their family. Equally, clients and their family need time to shift from instrumental activities to other ways of being that are possible from a HCP. I remember being excited when a client wanted to go swimming but rather than being an organic activity, it got mired in unreliable workers, transport options, and miscommunication. When a client did go swimming, the positive impact was visible. Social connections are important but that choice must lie with an older person and/or their family/carer.

  2. Anton Hutchinson November 7, 2019 at 5:23 pm #

    Isolation, no value for money, hit and miss service, no relationship with carers, loneliness, fear, maintenance, lawns, accounts still to pay, confusing package system, being ripped off, insecurity, and only maybe an hour every couple of days!
    Yeah, Nah. Sounds like something a government would think up to placate a lazy irresponsible generation AND have the tax payer fund instead of families having to lift a finger.
    With all the problems and the cost home care simply will be a flash in the very expensive pan and gone… Like it should be!

  3. Peter Couldrey November 8, 2019 at 3:25 pm #

    I would like to wholeheartedly agree with the points raised in this article, as this has been confirmed through my experience of working within the affordable housing sector, both here and in the UK.

    Residents are generally happy to have been provided with a suitable and secure home but can then become rapidly isolated, often because they have been housed in a new area and have little, to no, family support. It is a question of identifying individual needs, offering targeted support and opportunities to engage with other residents and the local community, without tenants feeling in any way obliged to engage.

    Thankfully Affordable Housing Providers in Victoria are moving away from the Rooming House model, but in my experience the forced sociability of this type of housing has had it’s benefits, and perhaps there are lessons to be learnt from this.

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