CDC in Residential Aged Care: Lessons learnt from the first pilot of choice & control

Sep 16
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With the baby boomers moving into residential aged care facilities (RACFs), there is a demand for a different kind of care to what was previously provided for their parents. While movement into residential care may bring positive outcomes, many will struggle with the loss of independence and control over decision-making. Consumer Directed Care (CDC) is designed to provide residents with a new level of involvement in the management of their care package, have more say in the types of services they access and how those services are delivered. Australia is experiencing major changes as the aged care sector comes to terms with a CDC model of care delivery. How CDC is implemented in the residential aged care setting will be imperative to its success.

Mr. Kevin Mercer, the Chief Executive of one of our industry partners (Mercy Health Aged Care) says:

“CDC in residential care is an emerging field of importance. Training in CDC can help us better understand how to implement a care delivery model that is truly directed by the residents. Fitting in with Mercy Health’s model of care, a CDC approach is at the forefront of providing older people with what they want: a greater control over their lives within their RACF. We believe that one of the barriers to CDC implementation is the limited knowledge about the best methods for training staff in performing CDC practices on the floor. The program being implemented by the institute for Health and Ageing (IHA) at the Australian Catholic University will help to address this gap”.

The “Resident at the Centre of Care” (RCC) program aims to assist RACFs to identify and overcome the challenges to CDC implementation. We have identified three central themes for sustainable evidence-based change in care practices within the aged care sector. The themes are (1) a positive collaborative relationship between care staff and the residents, (2) transformational leadership style and (3) organisational climate.

(1) A positive collaborative relationship between staff and residents in RACFs is crucial in facilitating supportive communication with residents. A strong affective bond and mutual understanding between the care staff and the resident encourages the residents’ CDC engagement and can assist resident quality of life and care satisfaction.

(2) Transformational leadership is essential to the translation of CDC-related knowledge and skills into practice in RACFs. This style involves motivating team members to identify with a common vision, and to generate awareness amongst all staff members regarding missions and purposes.

(3) Building on our previous research, some key organisational factors crucial to facilitating improved changes to routine staff practices include management support, innovation, trust and cohesion within teams. Organisations that recognise staff for their competencies and foster their autonomy have shown higher levels of staff self-efficacy, which in turn, impacts on staff members’ ability to take on and embed new practices.

It is expected that the RCC program will not just lead to improved overall well-being among residents, but that will also enhance staff job satisfaction and a reduction of staff turnover in the long term. Results and feedback from a trial of CDC in six residential aged care facilities in Victoria and Queensland will guide further development of staff training. Lessons learnt will assist in the development of the successful and sustainable CDC for adults with dementia and/or communication impairment that is applicable across the wider ageing sector.

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Aged Care Innovation

Submitted by Professor Marita McCabe

Professor Marita McCabe

Professor Marita McCabe is Director, Institute of Health and Ageing, Australian Catholic University.

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