Would you know how to describe self-management if someone asked you? The COTA Australia project team leading the Increasing Self-management in Home Care project had similar difficulties at the beginning of 2018. There was no nationally agreed definition of self-management in the context of aged care.
Using a co-design process together with the academic research, we identified key areas which underpin self-management. We consider that without these elements an organisation cannot consider their offering as a ‘self-managed’ home care service.
- Do you offer ‘self-management’ to your clients?
- Are you accessing a ‘self-managed’ package from your provider?
- Are you not quite sure how to describe self-management when speaking to friends, colleagues or clients?
Firstly, it’s critical to understand the relationship between the concepts of self-management, self-direction and consumer-directed-care (CDC). CDC is the foundation on which the Australian home care system is built and is the essence of self-management. Without a CDC based system, self-management could not flourish.
The term ‘self-direction’ is a widely used internationally and describes part of the equation in self-management. In a ‘self-directed’ model, consumers must be able to direct their care and take the lead role in decision making. However, self-management includes this self-direction element as well as undertaking practical tasks in managing the package.
Self-management is not an ‘all or nothing’ definition, more accurately it is a spectrum.
Definition of ‘self-management’ in the context of home care in Australia
This definition was developed by the working parties involved in the ‘Increasing Self-management in Home Care’ project. There were two working parties which included key representatives from home care providers and people receiving home care and their carers.
“At present in Australia ‘self-management of Home Care Packages’ is underpinned by a number of key concepts. Self-management means increasing consumer’s and carer’s control of how their funding is spent including authority to decide and directly pay for services, products and activities relevant to their care plan. Self-management allows direct access to funds and financial information regarding their package. Self-management requires the consumer and/or carer to actively engage in managing and directing their home care, the level of involvement is flexible and may include activities such as scheduling care staff and appointments, paying bills and general administration.”
Additional to the definition, we have dissected and described the model elements below for easy comprehension. You must include these attributes as a minimum in a ‘self-managed’ home care model. This is over and above the usual requirements of the consumer directed care.
These options must be on offer to your self-managing clients, regardless of whether the consumer decides to take those options;
Given these options, your clients may choose not to manage any part of their package. In this case you can classify their involvement as self-directed but not self-managed. It’s up to you how you wish to structure your fees based on this. More details around structure are available as part of our resources. Particularly the Provider Toolkit will be useful for further exploration.