11

Flying Solo:Flying Solo:

Living at home alone Living at home alone

with dignitywith dignity

Perth Home Care Services

Wendy Francis

22

ContentsContents

Overview of ProgramOverview of Program

Comparison of OutcomesComparison of Outcomes

Case StudiesCase Studies

Success Factors and ChallengesSuccess Factors and Challenges

FutureFuture

33

HistoryHistory

Dementia specific CACPDementia specific CACP’’s s

People living alone with memory lossPeople living alone with memory loss

No voice and highly vulnerableNo voice and highly vulnerable

Programs operating in NSWPrograms operating in NSW

Application HACC Social Support 2005Application HACC Social Support 2005

Extension to other areas 2006Extension to other areas 2006

44

Client GroupClient Group

Person having difficulty remembering, Person having difficulty remembering,

making decisions, thinking through making decisions, thinking through

complex ideas, carrying out practical tasks, complex ideas, carrying out practical tasks,

retaining information and acquiring new retaining information and acquiring new

skillsskills

Diagnosis of dementia not necessaryDiagnosis of dementia not necessary

Living alone or with person who lacks Living alone or with person who lacks

capacity to care; e.g. also has dementiacapacity to care; e.g. also has dementia

55

Key Aspects of ProgramKey Aspects of Program

1. Relationship and Community1. Relationship and Community

2. Monitoring2. Monitoring

3. Support Workers3. Support Workers

66

Relationship and Relationship and

CommunityCommunity

Person Centred Care, social history, interests, Person Centred Care, social history, interests,

roles, strengths and capacitiesroles, strengths and capacities

Trust and rapport, clientTrust and rapport, client’’s ease determines s ease determines

the progress and direction of the servicethe progress and direction of the service

Link to meaningful activities; e.g. art classes, Link to meaningful activities; e.g. art classes,

library, swimming, previous networkslibrary, swimming, previous networks

Support and educate familiesSupport and educate families

77

MonitoringMonitoring

Nutrition: meal preparation, MOWNutrition: meal preparation, MOW’’ss

Medication: management, Webster packsMedication: management, Webster packs

Personal Care: presentation, hygiene, Personal Care: presentation, hygiene,

continencecontinence

Bill paying, shoppingBill paying, shopping

Appointments: i.e. GP, eyes, hearing, clinicsAppointments: i.e. GP, eyes, hearing, clinics

Household management Household management

OSHOSH

88

Hours of ServiceHours of Service

Range: 10 minutes to 5 hoursRange: 10 minutes to 5 hours

Average 3 hours per weekAverage 3 hours per week

Services coalesce around specific events; i.e. Services coalesce around specific events; i.e.

GP, hospital, dental, appointments, home GP, hospital, dental, appointments, home

maintenance, ill health, transitions to other maintenance, ill health, transitions to other

services, linkage to new activitiesservices, linkage to new activities

99

AssessmentAssessment

Formal assessment with family or referral Formal assessment with family or referral

sourcesource

Informal meeting with client via positive Informal meeting with client via positive

personperson

Coordinator or family introduce support Coordinator or family introduce support

workerworker

1010

ExitExit

When direct sustained assistance required When direct sustained assistance required

for:for:

�� ShoweringShowering

�� Medication promptsMedication prompts

�� Meal preparation Meal preparation

Refer to ACAT for CACPRefer to ACAT for CACP

1111

Support WorkersSupport Workers

CharacteristicsCharacteristics –– empathic, non judgemental, empathic, non judgemental, flexible, problem solversflexible, problem solvers

AutonomyAutonomy -- to determine day, time and duration to determine day, time and duration of visit according to client needs and approx 7 of visit according to client needs and approx 7 clients eachclients each

LiaisonLiaison -- directly with family, role model for directly with family, role model for person enhancing communication, education, person enhancing communication, education, informationinformation

1212

StaffingStaffing

Recruitment ForumRecruitment Forum

Attitudes and values, not qualificationsAttitudes and values, not qualifications

70 Applicants: 3 successful 200570 Applicants: 3 successful 2005

2006 same process: 9 successful2006 same process: 9 successful

Attrition of 5 staff: 3 other opportunities Attrition of 5 staff: 3 other opportunities

and 2 unsuitableand 2 unsuitable

1 replaced now 8 ongoing staff1 replaced now 8 ongoing staff

1313

TrainingTraining

Training Alzheimer's Australia Effective Training Alzheimer's Australia Effective

Dementia CareDementia Care

Ongoing training, support, monthly team Ongoing training, support, monthly team

meetings, educationmeetings, education

Attendance at conferences, seminarsAttendance at conferences, seminars

1414

OutcomesOutcomes

Feb Feb ‘‘05 to Feb 05 to Feb ‘‘0606

North Metro onlyNorth Metro only

Mar Mar ‘‘06 to Mar 06 to Mar ‘‘0707

North MetroNorth Metro

East MetroEast Metro

South East MetroSouth East Metro

South West MetroSouth West Metro

1515

DemographicsDemographicsFeb Feb ‘‘0505-- Mar Mar ’’0606--

Feb Feb ‘‘0606 Mar Mar ‘‘0707

Total Total 3030 6464

YoungestYoungest 5656 6262

OldestOldest 100100 101101

Average Age Average Age 8282 7979

Males Males 55 1212

Females Females 2525 4444

With diagnosis With diagnosis 1010 3737

Without diagnosis Without diagnosis 2020 2727

Living alone Living alone 3030 6060

1616

Referral SourcesReferral SourcesFeb Feb ’’0505-- Mar Mar ’’0606--

Feb Feb ‘‘0606 Mar Mar ‘‘0707

ACATACAT 1919 5151

Psycho Geriatric Unit Psycho Geriatric Unit 33 55

HospitalHospital 22 33

Family Family 22 22

Commonwealth Carelink Commonwealth Carelink 11 00

Alzheimers WAAlzheimers WA 11 00

Other Service ProviderOther Service Provider 11 11

Existing client Existing client 11 22

1717

Time on ProgramTime on Program

2005 to 20062005 to 2006

10 Clients exited; 20 Clients ongoing10 Clients exited; 20 Clients ongoing

2006 to 20072006 to 2007

24 Clients exited; 40 Clients ongoing24 Clients exited; 40 Clients ongoing

1818

Client ExitsClient Exits

20062006 20072007

Safety issues res care Safety issues res care 22 1010

Higher level of community service Higher level of community service 3 3 1313

Falls and admission to Hospital Falls and admission to Hospital 44 00

Psycho Geriatric Unit Psycho Geriatric Unit 11 00

Family support Family support 00 11

Total 10 24

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Case StudyCase Study

2020

Success FactorsSuccess Factors

Client ease determines pace of relationship, Client ease determines pace of relationship,

frequency, duration of servicefrequency, duration of service

Coordinator and Support Workers person centred Coordinator and Support Workers person centred

approach, strengths, capacities, interestsapproach, strengths, capacities, interests

Establishing or improving community supports, Establishing or improving community supports,

links or networkslinks or networks

Collaboration with family, education, information, Collaboration with family, education, information,

feedbackfeedback

Tolerance around OSHTolerance around OSH

Links with referral sourcesLinks with referral sources

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Case StudyCase Study

2222

Challenges Challenges Physical Environment, OSHPhysical Environment, OSH

Absence of family supportAbsence of family support

Timely assessments: memory, competency, driving, ACATTimely assessments: memory, competency, driving, ACAT

Guardianship, AdministrationGuardianship, Administration

Links between GP, ACAT, Hospitals, State Administrative Links between GP, ACAT, Hospitals, State Administrative

Tribunal and Service ProvidersTribunal and Service Providers

Links with referral sourcesLinks with referral sources

CALD ATSI clientsCALD ATSI clients

Extension across agencyExtension across agency

Reaching those people without diagnosis; program application Reaching those people without diagnosis; program application

unsuccessfulunsuccessful

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• CommunityWest Inc overseeing Evaluation

Objectives•Evaluate the effectiveness of the DMP

•Identify key success factors and areas for improvement of the program

•Provide feedback and recommendations to the key funding body

•Identify if the program fits within the HACC framework

•Determine if DMP is a best practise model that can be adapted by other HACC funded service providers

EvaluationEvaluation

2424

Agency direction to improve knowledge and skills in Agency direction to improve knowledge and skills in linkagelinkage

Citizenship and self advocacy; learn from disability Citizenship and self advocacy; learn from disability sectorsector

Ways to reach people in early stages without Ways to reach people in early stages without diagnosisdiagnosis

Future

2525

Contact:Contact:

Wendy FrancisWendy Francis

Perth Home Care ServicesPerth Home Care Services

wendyf@phcs.org.auwendyf@phcs.org.au