Nothing about me without me - Implementing Wellness and Consumer Directed Support with Older People

Nothing about me without me - Implementing Wellnessand Consumer Directed

Support with Older People

1 May 2023 1

Developing a Consumer Driven Aged Care Workforce Conference

18 February 2016Sydney

Nothing about me without me www.carriehayter.com

Introduction • Wellness and personalisation of social care

– Reflect on the research • Older people and their allies • Staff

• Opportunities and challenges– Providers– Older people and their Allies

• Eight key steps

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Introduction • PhD research

– Why did the issue of choice emerge as a key policy issue in community aged care in Australia?

• Translation work with actors in the social care system


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About Carrie Hayter Consulting

1 May 2023

Transforming social care to put people at the centre of their supports and funding

– Research & Evaluation – Education & Training – Public Speaking – Writing

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01/05/2023 6

Shifting Policy Landscape –Personalisation

Passive Clients

Active Citizens

Block funding Individualised

funding

Rigid inflexible, bureaucratic

services

Flexible responsive services


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Downloaded from http://www.sims.monash.edu.au/subjects/ims5048/week3.htm


8Nothing about me without me www.carriehayter.com

Personhood ‘Consumer’ as

Purchaser Citizen

Social and political rightsEconomic

purchasing power

Relationship between client and

professional

Client Citizen – Consumer

Agency

Mechanisms for enacting ‘choice’ and ‘voice’

Market mechanisms via competition

(LeGrand, 2007)

Managing self interest

(LeGrand, 2007) and voice

mechanisms

Enable ‘choice’ through ‘voice’ mechanisms

(Simmons et al 2011)

Hybrid Choice and

voice mechanism

s

1 May 2023 Active Ageing Conference © Carrie Hayter Consulting 10

Power to Service Users – Evolutionary or Revolutionary?

Community Care Review, November 2015, http://www.carriehayter.com/blog/article/power-to-service-users-evolutionary-or-revolutionary.

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Technical Problems or an Adaptive Leadership Challenge?

Technical problems are well defined.

Their solutions are known and those with adequate expertise and organisational capacity can solve them.

(Heifetz & Linsky, 2002)

Adaptive leadership challenges are entirely different. The challenge is complex

and not so well defined; and the answers are not known in advance

Problems that require us to learn new ways (Heifetz & Linksy, 2002)


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Distinguishing between technical problems and adaptive challenges

Kind of challenge

Problem Definition

Solution Locus of Work

Technical Clear Clear Authority

Technical and Adaptive

Clear Requires learning

Authority and Stakeholders

Adaptive Requires learning

Requires learning

Stakeholders

Source:Heifetz, R., Grashow, A., & Linksy, L. (2009). The Practice of Adaptive Leadership - Tools and Tactics for Changing your Organisation and the World United States of America Cambridge Leadership Associates, pg 20

Adaptive Leadership Masterclass © Carrie Hayter Consulting www.carriehayter.com

01/05/2023 13

Get on the Balcony

Give the work Back

Think Politically

Orchestrate the conflict

Manage your

hungers

Anchor Yourself

What’s on the line

Hold Steady

Adaptive Leadership Elements

Source: Heifetz & Linsky (2002)

© Carrie Hayter Consulting

Step One – Get on the Balcony - get everyone

on the same page


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Wellness Reablement Restorative Person or Consumer Directed Care

Building on the strengths • Right balance

between ‘doing with’ rather than ‘doing for’

• Builds community connections

• Identifies what a person can do and wants to do in the future

• Time –limited targeted interventions to regain function, confidence or capacity

• Evidence-based interventions led by allied health workers that allow a person to make a functional gain or improvement after a setback, or in order to avoid a preventable injury.

• Giving more power to people to determine the who, what, why and how supports are provided


1 May 2023 Consumer Directed Care 16

Expressing choices

Self Directed and Self Managed

The continuum of person-directed support

Structuring Supports creatively with support facilitator

Managing moneyResourcesStaffOutside of service system

Active Support Facilitation Process

Person Centred

Managing Budgets

Step Two – Engage Older People as Citizens -

Nothing about us without us


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Source: Photo downloaded from Ageing Agendas



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Power and RankRank is the power that we have relative to one another in relations, groups , in the community and in the world

Positional Rank This is rank that comes from positions that we occupy

Social Rank This is the rank we are born with ( eg male, female, white, middle class, heterosexual

Psychological Rank Rank that is acquired through life experience

Spiritual Rank This rank that may come from being connected to something greater than ourselves

Source: Aigner, G, & Skelton, L., (2013) The Australian Leadership Paradox, Allen & Unwin, Chapter 10 – pg 107-123


Empowering Older People • Aboriginal and Torres Strait Islander people

– Closing the Gap Report – Aboriginal services navigating people through My Aged

Care • People living with Dementia

– Assumptions about capacity • People who speak a language other than English

– Access Issues to information – Bilingual workers navigating people through My Aged Care


1 May 2023 22

Coercing

Educating

Informing

Consulting

Engaging

Co-designing

Co-Producing

Co-delivery

Co-Ownership

Ladder of Participation – Participation and Engagement?

Doing for

Doing to

Doing With

Doing for themselves

Adapted form Think Public, 2015

User Rights Strategies for

older people in the mid 1990’s

Consumer Directed Care?

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Watch the video https://www.youtube.com/watch?v=WXELgwHQ34o&feature=youtu.be


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www.wavertonhub.com.au

Co-Ownership and Co-Design in Australia


www.homecaretoday.org.au

1 May 2023 Active Ageing Conference © Carrie Hayter Consulting 25

Empowering people with disability

www.mychoicematters.org.au http://www.cdah.org.au/

Step Three – Critically read research and share

it with your staff


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Wellness and Reablement - Research

• Research - UK, Australia and New Zealand – Improved health and wellbeing for older people (Lewin at al,

2013, Parsons et al, 2013, Parsons et al, 2014)– Reduces people’s dependence on paid supports (King & Parsons,

et al 2012, Lewin & Alfonso 2013, Lewin & De San Miguel, 2013) – Role of assessment is critical (Department of Family and

Community Services, Ageing, Disability and Home Care, 2012)• Further research

– People with dementia (Alzheimer’s Australia NSW, 2014)– Engaging carers and service users in their reablement and

wellness (Wilde & Glendenning, 2012)


01/05/2023 Surviving or Thriving in a Consumer Directed World? © Carrie Hayter Consulting

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Personalisation and Carers • Formal care system would not exist without informal carers• Access to personalised budgets

– Conservatism of carers and the risks of personalisation (Needham, 2011)

– The traditional model gives them security and comfort• Choice and comfort for service users may not necessarily bring

choice and comfort for carers• Voices of carers not being recognised and heard (Carers NSW,

2014) • Mainstreaming of carer support funding

– Access to appropriate support?– Block funded rather than individualised funding

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Personalisation and the Workforce • De-professionalisation and increased casualisation of

the workforce (Cortis, N., Meagher, G., Chan, S., Davidson, B., and Fattore, T., 2013)

• Recruitment and retention of workforce (Baxter, Wilberforce et al, 2010)

• Education and skills of the workforce (Glendinning et al 2008)


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30 Day Challenge

Getting Traction and Translating into

Practice

Your Organisation/

Team

Shared understanding and

conversations

Where are we at?


Step Four – Get behind your front-line staff

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Step Five - Think Politically 1. Find Partners

2. Keep the Opposition Close

3. Accept Responsibility for your piece of the mess

4. Acknowledge their losses and accept casualties

5. How can we get our message out there

Picture downloaded from: www.twitter.com

Adaptive Leadership Masterclass © Carrie Hayter Consulting www.carriehayter.com

Source: Heifetz & Linsky (2002)

Step Six – Connect and include people in their community


Step Seven – Form Partnerships


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Step Eight – Be curious, test ideas and share the

lessons Be Curious

I have no special talents.

I am only PASSIONATELY

CURIOUS

ALBERT EINSTEIN Nothing about me without me www.carriehayter.com

Conclusion 1. Get on the balcony and get everyone on the same page2. Nothing about us without us 3. Read research and discuss what it means for your team4. Empower your front-line – they are your best

advertisement5. Think Politically- How will we market what we do?6. Connect people into the community7. Form Partnerships8. Be curious and test ideas and share the lessons

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More Information

Download the eight key steps for implementing wellness and consumer directed support

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Nothing about me without me - Implementing Wellness and Consumer Directed Support with Older People