If you’re currently exploring Home Care Packages in the aged care system, for yourself or a loved one, a big upfront consideration is how you want to manage the package. Across this series of articles about navigating aged care support at home, we have touched on the option of ‘self-managing’ the Home Care Package.
Self-management is different to the traditional provider management approach where the package provider negotiates the support services with you and then supplies the support workers, usually according to an available roster, while charging an administration fee.
If you opt to self-manage your package, you play the main role in deciding on the services you want, directly employing the staff you choose, and managing their schedule according to your preferences. For people who prefer to have a more hands-on approach, with greater flexibility and control over individual support and care needs, and greater choice on aspects like the level of involvement of support workers, and how your home care funding is used, self-management can work better.
When you self-manage, you’re putting yourself and your family directly in the driver’s seat with greater autonomy to live life as we choose and maintain wellbeing at home, something most of us desire as we age.
Below is a breakdown of the ins and outs of self-managed Home Care Packages and who might benefit from this approach.
What is self-management all about?
Self-management is based on the fundamental principle that older people have been caring for themselves and others their entire lives, and are best placed, alongside their family members, to understand their own support needs. Older people also bring a lifetime of skills in decision-making situations, which are useful when managing in-home care packages.
Self-managing your home care package means taking an active role in organising the practical tasks associated with receiving in-home care through a service provider. Self-management will be different from person to person, and often depends on the provider chosen. But essentially, as long as the services you want are within the guidelines, you can choose what you believe will best meet your needs then find and hire the support workers you want to provide the services; when they will come to your home; and how much you will pay.
Choosing a package provider that offers genuine self-management will allow you to make the most of your own choices about how your money is used to meet your needs in the best way possible.
It’s important to note that opting for self-management doesn’t mean you’ll be left without necessary support. Your home care service provider manages the payment system and will still be there to offer advice and answer any questions you have throughout the course. It’s also possible to negotiate a combined approach, where you self-manage some aspects of your package, and leave other aspects up to your provider. This can be a good balance for people who are more time-poor.
Who can self-manage?
Under the Aged Care Act, everyone has the right to decide whether to be involved in the management of their package, while providers are obligated to offer consistent information to prepare older people for self-management, have a clear agreement around each party’s responsibilities, as well as provide continued support and involvement, if necessary.
Under the Act, Home Care Package recipients themselves, their carer or designated representative can self-manage the Home Care Package. Some recipients directly manage their own packages very well but in many cases, it’s an older person’s family, or another loved one who will take on the responsibility of day to day management.
It’s important to remember that self-managing does require a degree of technology literacy, as well as organisational skills. Professor Lee-Fay Low, an expert in ageing and health at the University of Sydney, suggests self-management is a good option for those who have the skills and time.
“You need to be English literate, you need access to internet technology, be organised, and have time to be able to do it. You also need some level of ability to be assertive and know what you want and be able to negotiate to get what you want. You have to be prepared to stand up for yourself, and advocate for what you’re after,” she says.
What are the benefits of self-management?
The main benefit of self-managing a home care package is having the freedom and control to make choices and decisions about your own life and care and what you believe is best for you – rather than what others might think is best for you.
Individuals choose what services they need, the specific support workers who come into their home, and at what times that support is delivered. The freedom to make these choices and negotiate the terms directly, means home care is often more consistent than is usually possible with the demands of a rostering system.
Many people talk about the ‘dignity of choice’ that comes with self-management. For example, purchasing and making payments can often be done directly, without having to ask permission every time. The package provider may provide you with a debit card and/or a debited bank account to enable payments. Or you may be provided with a personal card and account so your provider can reimburse you after you’ve made a purchase.
Self-management also usually offers financial benefits compared to traditional management. The Royal Commission into Aged Care Quality and Safety found that some providers can take up to half of a consumer’s funding in admin fees. With self-management, there are usually much lower associated administration fees which means more of the Package funding can be invested in actual support services and time.
“Moving to a self-managed home care package can be life changing for people who’ve only had enough support to be showered a few times a week and can now receive support for a shower every single day as well as get out and about in their community,” says Rachel Debeck, Chief Operating Officer at Mable.
Indeed, she says, self-managing and accessing supports through a platform like Mable could potentially see you receive double the hours of support, compared to a traditionally managed home care package.
If you want to explore self-management further, firstly you need to make sure your Home Care Package provider will allow you to self-manage. While everyone has the right to self-manage their Package, Package providers don’t have to offer self management as an option. It’s important to ask the question when you choose your Package provider and remember there are some Home Care Package providers such as HomeMade that actually specialise in self management and offer lower administration fees, around 15% of the package. Do your research upfront and check out Mable’s excellent resources that breakdown everything else you need to know.
Mable is a website enabling older people, as well as those supporting them, to find and choose their own team of care and support workers. To find out more about Mable, click here.