Concurrent Sessions – Home Care… Healy, Gallagher, Millicer


Concurrent Sessions – Home Care… Healy, Gallagher, Millicer

SKU: ACSA2019-SESSION03 Category:


Home-based end-of-life care: caring@home resources

Sue Healy (Brisbane South Palliative Care Collaborative, Eight Mile Plains, Australia)


The majority of Australians say they would prefer to be cared for and, if possible, to die at home, however, more than 50% die in hospital. Many people, in the terminal stage, are admitted to in-patient facilities because their symptoms cannot be adequately controlled at home.

caring@home, an Australian Government funded project, represents a person-centred model of care that supports the community-based aged-care population to die at home with optimal symptom control. The project has produced resources for organisations, healthcare professionals and carers to support carers to help manage breakthrough palliative symptoms safely using subcutaneous medicines.

caring@home resources, applicable to all jurisdictions in Australia, include:

Guidelines for the handling of palliative care medicines in community services developed by NPS MedicineWise
A template example policy and procedure for organisations to tailor and guide the operational implementation of the resources
The palliMEDS app for prescribers
Online education modules for nurses concerning training of carers
A comprehensive caring@home package for carers that contains step-by-step guides, a diary, videos, a practice demonstration kit and a colour coded labelling system.
caring@home is evidence-based and facilitates high-value care; it supports person-centred outcomes and improves service performance efficiency and effectiveness. National implementation of the project is proceeding apace. To date, more than 250 community services have ordered the free resources. Preliminary evaluation by the University of Technology indicates the project has significantly improved community nurses’ knowledge, skills and confidence in providing palliative care for community-based patients.


Why do in-home care workers not report hazards and what we can do about it?

Mrs Aideen Gallagher1, Mrs Emma Small (Risk Managed)


In home care providers assist people with the tasks of daily living they are unable to do for themselves. These are usually very private and necessary activities of daily living including getting out bed, having a shower, going to the toilet and getting dressed.

The provision of personal care services is a risky business with high rates of injuries amongst workers. 29% of all injuries in the workplace are a result of musculo-skeletal injuries. These can also affect clients as moving incorrectly can contribute to pressure injuries, pain and discomfort. These injuries not only affect workers and consumers, but damage the financial viability and brand of a business.

A key component in addressing these risks, is knowing what they are. Once the risk is known, it can then be assessed and subsequently controlled. This demands the workers on the ground to report these risks however, there is a significant underreporting of hazards from workers in the home environment. This is despite the known high-risk environment and complexity of the tasks these workers do everyday.

This paper will present the research literature to understand why in-home care workers don’t report hazards. It will explain the social and emotional elements at play within this environment. It will outline what a provide can do to encourage these workers to report. Delegates will leave the workshop with tips on how to enhance their hazard reporting system within their business.


Self-management in home care packages: friend or foe?
Ms Anna Millicer (COTA Australia, MELBOURNE, Australia),
Ms Carmel Laragy (RMIT University – Social & Global Studies Centre, MELBOURNE, Australia)


Many consumers and carers are seeking more autonomy in the day-to-day management of their package, but current models often fall short of meeting consumer expectations.

This complete self-management model delivers the goods, and includes capacity building and upskilling of consumers and carers to prepare them for what’s involved.

For providers, the COTA Australia model offers a guide to implementing high-level self-management which meets consumer needs and aligns with the Aged Care Quality Standards.


COTA Australia has completed the Increasing Self-management in Home Care project trial. The project builds on feedback from older people that most consumer directed care offerings do not go far enough in giving consumers meaningful choice, autonomy or control. The findings offer an evidence-based, objective evaluation of a complete self-management model, customised for home care packages.

Funded under a DACS Innovation Grant, COTA Australia’s self-management model was designed and tested by consumers, carers and providers to reflect the unique context of the Australian home care packages program.

Internationally, self-management and increased consumer control models have revolutionised the delivery of social care programs. Characteristics of the COTA self-management model are:

the use of a debit card to allow consumers more direct control of their funding;
online and mobile phone access to home care budget and spending statements;
option to select, employ, roster and pay their choice of support worker;
transparent access and input into care planning;
increased objectivity in decision-making over approved purchases;
mutual and collaborative partnership between consumers and providers including joint responsibilities and formal self-management agreement;
access to helpful people and resources.
RMIT University evaluated the trial using surveys and telephone interviews. The presentation will deliver research outcomes, participant and provider case studies, and highlight the practical tools and resources developed in trial, all of which will be made freely available to delegates. The project’s risk management approach focusing on compliance and alignment to Aged Care Quality Standards will be explored.


Self-management for consumers of home care is a hot topic in the sector and attracts a great deal of interest and discussion amongst providers and consumers. COTA Australia’s evidence based self-management model explores the challenges, benefits, risks and overall outcomes of seven approved providers and 100 consumers as they test the boundaries of self-managed home care packages. The project outcomes deliver enormous value to the sector by making all the project tools and resources freely available for providers to integrate into their existing home care model. Resources designed and tested by consumers, for consumers, are also available at no cost and assist in defining a consistently applicable model that resonates with providers and consumers alike.

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