Community Aged Care Packages, Extended Aged Care at Home Dementia and Extended Aged Care at Home - Case Study Example

TITLE: MANAGEMENT OF AGED CARE PROGRAMS AND ACTIONS NAME INSTITUTION Introduction Older people in the world are placed in diverse groups characterized by different needs for care. Different nations of the world have introduced aged care programs and services packages at varying levels in order to comprehensively assist the individuals to care for their health needs. Australia has introduced three care programs to personalize the aged population in the nation (Australian Bureau of Statistics, 1993). They include Community Aged Care Packages (CACP), Extended Aged Care at Home Dementia (EACHD) and Extended Aged Care at Home (EACH). These programs assess the care services rendered to the aged individuals at different demographical levels. Public and private organizations have come together to collectively bring solutions to health concerns of aged people. According to Yee (2005), aging individuals are associated with high prevalence of complex and chronic health conditions. Apparently, the current health models developed in Australia heavily focus on organization and management of aged care service delivery. Policies as well have been developed to guide the implementation of aged programs and services efficiently and effectively at different health domains. Who are the aged? World Health Organization (WHO) defines aged as the people with the chronological age of 65 years. However, this perhaps may not be the definition in continents like Africa who in most case they receive their pension benefits at the age of 60 years (Gornman, 2000; 15). In this case, the definition of aged varies depending on the level of regional development thus making the utility of the definition to be more limited. Policies and principles that guide the management of aged care programs and services depends entirely on the socio-cultural and demographic elements that includes 1) chronology, 2) social role and 3) changes in the abilities (physical characteristics). Aged and aged care programs and actions Any programs and action that tend to provide appropriate care for the old population represent the holistic ‘social product system’ (Gorman, 2005). Health care in this context is normally complex. Therefore, the management of aged care services is characterized by; Clear definition and production of bundles of programs that meet the needs of the old people, Direct contact between the clients (aged people) and service providers in the population, Existence of different stakeholders that provide funding instrument and governance structure (for example, WHO and the government), The nature of social value that leads to government involvement. Government in this case provides regulations to enhance the right services to the right people, Increase in community expectations particularly on service provision ( for example, flexibility of services rendered, responsiveness as well as term of access to the ‘social product system. According to Challis (1995), as individuals grow beyond the age of 65 years, the need for assistance normally increases. This is a result of increase in incidence of physical and cognitive disability. People above the age of 65 years in Australia are about 2.5 million (Survey Report of Disability, Aging and Carers, 2004). 30% of the aged population needs support with personal undertakings like self and health care, 15% needs support with everyday undertakings (for example housework and meals) and about 53% needs little support with assessment of health packages for old population. Income and wealth in Australia are very vital when it comes to use of care as well as the contribution of users to the ‘social product system.’ Apparently, age pension in Australia is an important source of income significant to address the existing cohort of aged individuals (Survey Report of Disability, Aging and Carers, 2004). In 2007, 66% of individuals with the age of 65 years and above received age pension that was to gather for their care at old age. Public and private structure of aged care delivery in Australia Population statistics in Australia shows that 13 per cent of the total population is aged 65 years and above and it is expected to increase to 28% by 2050. The per capita income of individuals at the moment is about $48,000. Factors affecting collaboration and coordination of aged care programs and services One, most of the aged care programs is not flexible and adaptable to the people above the age of 65 years. How aged care services are delivered takes different dimensions (variation in community and residential care) therefore the initiatives brought about by organizations that constitute collaboration and coordination perhaps may differ. Due to this, management of aged care may be compromised. The institutions responsible for these programs should initiate centralize the delivery of health care knowledge in order to enhance collaboration. Two, legal and ethical issues related to aged care programs may compromise the attainment of aged care goals in different organizations with similar objectives. Ethical issues range from policies that guide handling of funds to medical privacy statutes. Aged care system barriers for example incompatibility of federal and state government initiatives with the umbrella organization (WHO) in offering a universal aged care programs. Age care system As mentioned, Australian government has developed a comprehensive care system that watch over community and residential care of the old people. The system normally incorporates various assessment teams that will determine the level of old age eligibility. This would enhance effective development and implementation of aging programs both in the Australian Government as well as the State Governments. Aged care system also comprise of state owned care services for the old people, private arrangements, setting of right living arrangements and home care (normally informal). In this regard, more of subsidies from government, volunteering groups, local government and residential charges are directed to the programs and actions for the old aged. The coverage would be based on the basic needs of the old aged. According to the Commonwealth Report (2008), the diversity in terms of care needs, preferences and wealth among the old population in Australia is expected to be a challenge to Australian Aged care system. On the other side, the literature shows that there are changes in composition for aged care programs and actions (Challis, 1995). The sustainability of aged care services perhaps has taken a new way with more labour intensive that accounts for high relative cost to the stakeholders. This is a result of diverse bundles of services rendered to divers groups of old people in the population (Commonwealth Report, 2008). Community Care for Aged (Aged Programs) Action programs for old aged individuals in the contemporary world are normally managed by various community action agencies (Yee, 2005). These agencies are created by the federal government under the guidance of Economic Opportunity Act 1964 in Australia. The program meant to assess the susceptibility of the old aged individuals that comes as a result of poverty particularly in the geographically designated regions in Australia. Community Action Program of Hillsborough was created by federal governments through the guidance of Economic Opportunity Act (1964) to oversee the management of available health resources from local, private and federal government. The program ensures that aged individuals (people above 65 years of age) gain access to new economic activities in order to achieve self-sufficiency and manage their health. The program focuses on the following actions; Recognition of eligible identity (aged individuals in the population) and obtain funds from states through the Community Services Grants, Disbursement of aging resources through a governing body consisting of 1/3 demographically appointed representatives, Dissemination of aged care responsibilities to the representatives from labour, commercial entities, social welfare and private institutions within the community, Ensuring that there is a similar national network programs within the agencies endorsed to take care of aged individual needs. This should be recognized by both Australian and State Governments. Residential place for the aged individuals measures the dimension of community care. In Australia, 85% of the people above 65 years of age live in private dwelling while about 5% of the aged live in accommodation for the old (retirement villages). Thus it is important to understand that the stability of occupancy (accommodation villages) affects the scope of community care provision and in that regard government policy wish to retain the old people in the community as long as they live. In Australia, Home and Community Care (HACC) program provides support services to the older people especially those that are wishing to live independently at home. The program provides a range of assistance including personal care, social support allied health as well as nursing services. Description of the effectiveness of self-managed programs in Australia The national study shows that Chronic Disease Self-Management Programs (CDSMP) among old age population provides a positive improvement to meet aged care management initiatives. In terms of better health, the program (CDSMP) has reduced depression by 21%, enhanced improved active lives beyond the age of 65 years by 41%, improved quality of life by 6% and management of five indicators of healthier life (reduce fatigue, pain, stress and sleep problems by 10%, 11%,5% and 16% respectively. In terms of better care, the program has ensured that there is an improved medical compliance by the aged individuals. Effective communication between doctors and aged individuals been improve thus susceptibility to aging diseases has been reduced. The program also has integrated aging needs to the millennium development objectives/goals where it ensures that health literacy is uphold. Medical administrators in most of the health facilities have ensured that everyone whoever comes for medical attention should fill out the medical forms. Impact of Aging on Disease Profiles According to Challis (1995), the level of cognitive functioning in aged individuals (above 65 years of age) has lower subtle sporadic memory that often occur before the emergence of a disease and this directly affect the information needed for clinical diagnosis. Studies show that aged individuals has poor memory performance that leads to low reaction to the emergence of the disease. Deficit in visual effects is apparent in aged individuals (Gorman, 1999: 23). Individuals above the age of 65 years are likely to suffer from slow reaction to peripheral stimuli unlike the young individuals. This perhaps may result to increased incidence of accidents especially those incidences that may need fast reaction. Due to these change in disease profiles in the demography, Australian government has developed a number of initiatives (actions) to reduce such incidences in the population. These programs are administered by DVA (Department of Veteran’s Affairs) and VHC (Veteran’s Home Care) (Commonwealth of Australia, 2008). 1. The program designed to deliver services of high quality on community care (those that entails complex cognitive and behavioural needs), 2. One day package care a week for the individuals in residential care. The program targets old people eligible for self and health care in Australia. 3. 7 hours bundle services to the residential care by Community Aged Care Package (CACPs). Key issues affecting quality and safety of aged care Australia is among the top nations offering high-quality aged care for the population (Australian Institute of Health and Welfare, 1998) and there are more avenues of improvement. However, safety as well as quality of aged care provision to the population is still an important concern to the health system on Australia. The following issues affect the quality of care rendered to the aged population in Australia. Availability of data The decline in mortality and morbidity rates in Australia shows that the country is experiencing high level of health care delivery especially for the aged population. However, it is difficult to attribute the general level of health to the care system since aged income levels, housing standards and employment rates affect their health status. The demographic survey/statistics have not rightly quantify the proportion of aged individuals in order to initiate effective aged care programs and avoid overuse of the services rendered to them. Consumer perspective (acceptability of care programs by the aged) Aged care services focuses more on non-clinical aspects and this provide little ground to judge the quality and safety of care provision. Therefore, clients (aged population) look more on the technical skills of the care providers placing more emphasis on personality traits. Therefore, care providers with low personality aspects perhaps may affect the acceptability of the clients in using of the aged care program. Reference ABS (Australian Bureau of Statistics) (1993).Australian and New Zealand Standard Industrial Classification (ANZSIC), Cat. no. 1292.0, Canberra. Australia Department of Health (2011). Strengthening Assessment and Care Planning; A guide fp HACC assessment services in Victoria. Melbourne: Aged Care Branch. Challis, D. (1995). Care management and health care of older people: the Darlington community care project. Aldershot, Hants, England: PSSRU, University of Kent at Canterbury :. Commonwealth of Australia (2008). Trends in Aged Care Services; some implications. Canberra: Media and publications. ISBN 978-1-74037-264-0. Community aged care packages in Australia 2003-04: a statistical overview. (2005). Canberra: Australian Institute of Health and Welfare. Gorman M. (1999). Development and the rights of older people.The ageing and development report: poverty, independence and the world's older people. London, Earthscan Publications Ltd. 3-21. Yee, D. (2005). ‘Insuring Health and Income Needs of Future Generations.’ Generations, vol. 29, no. 1, pp. 13–19. Read More