OCTY3104 Mid-Semester Exam

A person meets the disability requirements if:

The person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition; and The impairment or impairments are, or are likely to be, permanent; and The impairment or impairments result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities: § communication; § social interaction; § learning; § mobility; § self-care; § self-management; and The impairment or impairments affect the person's capacity for social or economic participation; and The person is likely to require support under the National Disability Insurance Scheme for the person's lifetime.

What can the aged care quality and safety comission not do:

Provide advice on the availability of care or services in your local area Provide advice on who should make financial, legal or health decisions on behalf of a person Comment on industrial matters such as wages or employment conditions Ask service providers to terminate someone's employment Provide legal advice or what to include in your care agreement Provide clinical advice about what treatment a person should be receiving Investigate the cause of death (this is the role of the coroner) Determine whether or not a specific event occurred (especially if we receive conflicting accounts of the event)

Key Components of the NDIS:

Reasonable and necessary supports Help people achieve goals A lifetime approach Information and referrals 500,000 Australians

Aims of the NDIS: To ensure

Certainty Equity Sustainability

NDIS will not fund:

Clinical services and treatment of health conditions, including mental health or all medical services such as GPs, hospital care, surgery, rehabilitation, the cost of specialists, etc.; Medications and pharmaceuticals; Sub-acute services such as palliative, geriatric and psychogeriatric care; Post-acute care services, including nursing care for treating health conditions and wound management; Dental care and all dental treatments; or Medical and clinical services where individuals and families have a role in funding.

What are communities?

Communities are individuals tied together by occupational engagement and a collective sense of meaning Refers to a person's natural environment Communities are complex and dynamic A collective of people identified by common values and mutual concern for the development and wellbeing of their group or geographical area.

NDIS is part of a broader system supporting people with disability:

Community Support: Peer support groups, community organisations and advocacy groups Informal Supports: Families and Carers Other government services: Health, Housing, Transport, Education, and Justice National Disability Strategy: A vision agreed by all governments for an inclusive Australia that enables people with disability to be equal members of society

Enablement skill: Consult

Consult with clients and others, exhange views and confer throughout the practice process Brainstorm other options Listen to different perspectives and encourage individuals to respect differences

Skills required for community practice:

Consultancy Education Autonomy Client-centred practice Clinical reasoning Health promotion/Disease prevention Networking Management skills Program evaluation skills Cultural awareness/responsiveness Team skills Occupation-focused Group processes

What is the CHSP?

The CHSP is an entry-level home support program that helps older people to live independently in their homes and communities. It also provides respite services to give carers a break. Aims: To help people live as independently as possible; to focus on working with them, rather than doing things for them; and to give a small amount of help to a large number of people. Who is it for: The CHSP is for frail older Australians who need support to live independently at home and are either: - aged 65 years or over (50 or over for Aboriginal or Torres Strait Islander peoples) and have functional limitations and need assistance - prematurely aged (50 years or older; 45 years or older for Aboriginal and Torres Strait Islander peoples) and are on a low income, homeless, or at risk of being homeless as a result of housing stress or not having secure accommodation. How does it work: Aims to build on people's individual strengths and abilites to help them remain living independently and safely at home; service providers work with the older person to develop their care plan based on their support needs What does it cost: Clients pay a contribution fee towards the cost of services

What is the department of veterans affairs (DVA)?

The Department of Veterans' Affairs (DVA) provides support to current and former serving members and their families and carers through a range of services and payments (including ongoing or one off payments). These services are designed to assist you to manage your health and lifestyle and support those you care for Services available for: Veteran healthcare cards; Local or overseas medical care; Injury or health treatments; Care at home or aged care; Help to cover healthcare costs; Work and social life programs; Navigating Aged Care Gold card: DVA health card - for all conditions White card: DVA health card - for specific conditions acquired during service Orange card: DVA health card - for pharmaceuticals only

Who can help a participant start their plan:

The ECEI Coordinator, LAC or Support Coordinator will help a participant to start their NDIS plan. They can help participants: § Understand their plan and what supports and services they can pay for with their NDIS funding § Connect with community and other government services § Find providers § Put service agreements and service bookings in place with their providers If they have questions, concerns or something in their life changes

What is not covered by the NDIS?

The NDIS Act and the rules made under the NDIS Act also tell us which supports will not be funded by the NDIS. The NDIS cannot fund a support that is: The responsibility of another government system or community service Not related to a person's disability Relates to day-to-day living costs that are not related to a participant's support needs, or Is likely to cause harm to the participant or pose a risk to others.

What is duty of care?

The legal obligation to safeguard others from harm while they are in your care, using your services, or exposed to your activities

Who can provide evidence:

Treating health professionals can work with participants to provide evidence of disability. Examples of common treating health professionals include: General Practitioner (GP); Paediatrician; Orthopaedic surgeon; Occupational Therapist; Speech Pathologist (Therapist); Neurologist; Psychologist; Psychiatrist; Physiotherapist Treating health professionals providing evidence should: § be the most appropriate person to provide evidence of primary disability; and § have treated the participant for a significant period of time (e.g. at least six months).

Policy to Practice in Aged Care

United Nations (International Level) - Human Rights Conventions: Universal Declaration of Human Rights, IFA Declaration of the Rights and Responsibility of Older Persons, UN principles for older persons, UN convention on the Rights of Persons with Disabilities (CRPD) Government responsibilities to uphold Human Rights (Domestic Level) - National legislation (Acts), National and State Strategies/Policies/Guidelines: Aged Care (Living Longer Living Better) Act, Age Discrimination Act, Aged Care Act, Aged Care Quality Standards, Aged Care Charter of Care Recipients Rights and Responsibilities, Guardianship and Administration Act Funding schemes (linked to policy/strategy/guidelines): CHSP, Home Care Packages, Residential Care, Flexible Care (Transition Care/STRC etc Service context - a network of organisations, service structures: Department of Health, Department of Veteran's Affairs, Residential Aged Care Services, Home and Community Care Services, NGO's, Private Practices, Health Care Services, Health professionals Organisational context - the specific individual service structure/systems: Wesley Mission, Blue Care, Anglicare, Ozcare, Alzheimer's Australia, Mercy Health and Aged Care, Uniting Care, Vision Australia, Co.As.IT, Healthstrong Service delivery - What each OT does (OT practice process): OT - ACAT; Allied Health/Service Engagement Consultant; Dependent on Role/Job Description; Assessment/intervention/Equipment Recommendations/Group Programs/Training Programs e.g. Manual Handling

Evolution of the NDIS:

Welfare model --> Whole of life insurance based model Block funding for service providers --> A diverse and competitive market of providers No choice and control --> Choice and control Inconsistent across Australia 'post-code lottery' --> Nationally consistent The NDIS now providers all Australians under the age of 65 with a significant and permanent disability with the reasonable and necessary supports they need to enjoy an oridinary life and to participate in employment and the community

How is an Access Request decison made:

When the NDIA receives a completed Access Request, it will be reviewed against the NDIS Act (2013). The NDIS Act is the law which guides the NDIS and it states who is eligible to get NDIS support. At this stage, a participant may be asked to provide additional evidence to help complete the decision. If additional evidence is needed it may delay the Access Request decision

Key Factors of the NDIS:

Insurance based for early investment to build individual capacity and enable participants to live their lives as independently as possible in inclusive communities deliberate departure from a wealth fare based approach (where the cost of providing disability support were viewed through a short to medium term lens) Choice and control over their lives and can choose the supports they need Reasonable and necessary supports: support or service must be related to the persons disability; must not include day to day living cost (related to disability supports); value for money; must be likely to be effective to work for the particular participant; take into account support given to the participant by other government services or family/carer network in the community

Community-Built Practice

Open systems in constant interaction with their physical, natural, temporal, social, and political environment Collaboration with the community through a strength-based approach: ends when the client-defined community has effectively built the capacity for empowerment Utilises a collaboration model and focuses on the needs and capacities of the community and its members; OT acts as a facilitator; collaborative planning and implementation, equal partnerships in program implementation, and a sense of community ownership of the program

What is the NDIA's vision?

Optimising social and economic independence and full participation for people with disability

Aims of the NDIS: To provide

People the care and support that is objectively assessed and reasonable over the course of their life time. Early intervention where it will improve a person's functioning or slow progression of their disability. Work with carers to make sure the care they provide is sustainable.

What is the NDIA's goals?

People with disability are in control and have choices, based on the UN convention of the Rights of Persons with Disabilities The NDIS is financially sustainable and its governed using insurance principles The community has ownership, confidence, and pride in the NDIS and the NDIA

If someone make an NDIS Access Request, they must provide evidence to the NDIS which demonstrates:

Permanence: They have a lifelong disability; Functional capacity: They are unable to complete everyday tasks at least one life domain (e.g. communication, mobility, etc.), as a result of their disability, without support from a person or specialised individual equipment; The disability impacts their social and work participation, and You require lifetime disability support which is most appropriately provided by the NDIS

Information about disability:

Permanent disability: the type of disability; o the date your disability was diagnosed (if available); o how long the disability will last; and o available treatments (i.e. medications, therapies or surgeries). Impacts on everyday life: Including a description of how each area is impacted: o mobility/motor skills o communication o social interaction o learning o self-care o self-management.

What is in a participant plan:

Personal information (e.g. name and address) Information about the participant's disability and what support they get from their family and friends The support they currently get from the community and other government services Their goals - Short-term < 12mths & Medium to Long-term > 12mths The support included and what funding is provided

Plan Implementation:

Plans include information about: Information about participant participants family and friends; Services and community groups participants goals; Funded supports Viewing a plan: The participant will receive a hard copy of the plan and it can also be found online on the NDIS myplace portal; Participants do not have to give anyone a copy of their NDIS plan; Sharing their plan is their choice.

Enablement skill: Collaborate

Power sharing: working together with clients on occupational issues, client expertise on par with therapist expertice, to do with rather than to do for in a joint intellectual effort or towards a common end

What can the aged care quality and safety comission do:

Protect and enhance the safety, health, well-being and quality of life of people receiving aged care. Promote high quality care and services to safeguard everyone who is receiving Australian Government funded aged care. Independently accredit, assess and monitor aged care services subsidised by the Australian Government. Resolve complaints about relevant services. Help with concerns and complaints about a service provider's responsibilities under the Aged Care Act 1997 or under their contractual funding agreement with the Commonwealth Health care, for example wound care, medication and care assessment Personal care assistance, for example showering, dispensing medication, feeding and mobility Communication, for example how information is shared with you and how your questions are responded to, including complaints Staff roles, for example how they do their job and provide care Living environment, for example safety, security, and cleaning Some fees and charges in care agreements Choice and preferences, for example showering and meal arrangements and tailored activities. We treat each concern or complaint on its own merits and we will carefully assess the information we receive and obtain.

Local Area Coordinators (LACs)

Provide assistance to connect and build informal and natural supports Work with participants to help access and make the most of the NDIS Work with people not eligible for the NDIS as part of Information, Linkages and Capacity Building (ILC) Support participants to build strong, inclusive relationships in their communities LAC Partners in Brisbane and surrounds are Carers Qld

What is the NDIS?

Provides all Australians under the age of 65 with significant and permanent disability with the reasonable and necessary supports they need to enjoy an ordinary life, and to participate in employment and the community Provides support, therapy, equipment, training, early intervention to support people with disability remaining in the community and reaching their goals

What is power of attorney?

Providing a chosen person/persons the power to make decisions on your behalf. Decision might relate to financial matters, lifestyle or medical/health treatment. Short-period of time where the person starts and ends the process (they have not lost capacity to do something for themselves)

What constitutes 'good evidence' of disability:

Recent Completed by a treating health professional who is relevant to participants primary disability Confirms participants primary disability Confirms the impacts of participants disability on the different areas of life Describes previous treatments and outcomes Describes future treatment options and expected outcomes of those treatments.

What is capacity?

Refers to decision making capacity. A person's capacity for decision making is decided according to the law. Capacity is decision specific - it depends on the particular decision being made.

What is residential care?

Residential aged care is for senior Australians who can no longer live in their own home: it includes accommodation and personal care 24 hours a day as well as access to nursing and general health care services Subsidise residential aged care to make sure everyone can access this type of care when it is no longer possible for them to live at home Goals: Aims to provide accomodation and care to older people so they can maintain health and wellbeing (provides accomodation and help with day-to-day tasks, personal care, access to other health practicioner services, and other services) Cost of living can vary: basic daily fee and additional costs based on a resident's means Residential respite care: short-term care provided in an aged care home (gives a carer or care recipient a break from their usual care arrangements)

What is dignity of risk?

Respecting each individual's autonomy and self-determination (or dignity) in making choices. The concept means that all adults have the right to make their own decisions about their health care (take their own risks

Access Request Forms:

Section 1: The Applicant o Part A: Applicant's information o Part B: Privacy and Consent declaration o Part C: Contact methods o Part D: Parent, legal guardian or representative o Part E: Overview of disability o Part F: Signature and Declaration Section 2 : Treating Professional o Part A: Treating Professional's Information o Part B: Evidence of Disability o Part C: Early Intervention o Part D: Existing Assessments o Part E: Evidence of functional capacity o Part F: Additional Notes o Part G: Treating Professional's signature and Declaration

Ways to manage plan funding:

Self-management: can access any providers (do not need to be NDIS registered): The NDIA provides the participant with funding so that they can access the supports that will best help them achieve their goals. Plan-managed funding: The NDIA will provide funding in the participant's plan to pay for a Plan Manager who pays the participant's providers for them, helps keep track of funds and takes care of financial reporting for the participant. NDIA-managed funding: The NDIA pays the participant's providers on the participant's behalf. Providers must be registered with the NDIA to provide services for these participants.

What is Specialist Disability Accommodation

Specialist Disability Accommodation (SDA) refers to accommodation for people who require specialist housing solutions, including to assist with the delivery of supports that cater for their extreme functional impairment or very high support needs. Funding is only provided to a small proportion of NDIS participants with extreme functional impairment or very high support needs who meet specific eligibility criteria. SDA funding under the NDIS will stimulate investment in the development of new high quality dwellings for use by eligible NDIS participants. SDA funding is not support services, but is instead for the homes in which these services are delivered. Basically,the houses are built by industry first then the SDA as a support is paid to that industry body who built the home. i.e. Developers/Organisations (Summer Foundation, YoungCare) invest money and build accommodation (that meets the brief outlined by the NDIS for SDA) that will accommodate the needs of people with SDA funding (i.e. those severe functional impairment and very high support needs) in the hope that they will then attract a person with SDA funding to live there so that the organisation will be paid (out of the participants SDA funding) for the person to live there.

Main principles of communication for people with dementia:

TALK WITH ME: Please talk with me, not my carer, family member or friend. Don't prejudge my level of understanding. PLEASE SPEAK CLEARLY: Make eye contact and speak clearly. Use short sentences, with one idea at a time. Avoid jargon, as I might misunderstand. PLEASE KEEP QUESTIONS SIMPLE: Make sure I am listening and use simple questions and/or repetition, offered with sensitivity. It's easier for me to answer direct questions, rather than open-ended questions, such as saying 'Wasn't it lovely when we went out to the park yesterday?' not just 'Wasn't it lovely yesterday?'. TREAT ME WITH DIGNITY AND RESPECT: I am still a person, so don't patronise me. Respect and empathy are important to everyone. If I act differently it may be because I am having difficulty communicating or because of my disease. DON'T QUESTION MY DIAGNOSIS: The symptoms of dementia are not always obvious. Listen to me and don't minimise my feelings. DISTRACTIONS CAUSE DISRUPTIONS: Less noise and fewer distractions, such as bright lights, will help me to focus. BE PATIENT AND UNDERSTANDING: Sometimes it takes a little longer for me to process information and find the right answer. Don't rush me. Give me more time to respond and compose my questions. BREAK IT DOWN: Providing information in smaller chunks will really help me. SIGNAGE: Please use clear and simple signage.

Who is directing the Aged Care and associated Reform/s?

The Australian Government (Department of Health) Aged Care Sector Committee - "Provides advice to the Government on aged care policy development and implementation. The Committee also acts as the mechanism for consultation between the Australian Government and the aged care sector. Committee members consult within their own memberships and constituencies to ensure stakeholder views inform the policy development process. Aged Care Financing Authority - "Provides independent advice to the Government on funding and financing issues, informed by consultation with consumers, and the aged care and finance sectors."

What are the enablement foundations

Choice, risk, responsibility Client participation Change Justice Power sharing Visions of possibility

Aged Care System

1. May be eligible if the person is an older person (usually 65+ or 50+ for ABTSI) and is experiencing difficulties 2. Register with My Aged Care - Phone call to My Aged Care (1800 200 422) - Need Medicare card 3. Give consent 4. Create client record including information about needs; details of assessments/referrals; results of assessments; and details of any aged care services received 5. Determining Needs: Can be completed via phone or formal assessment 6. Assessments: Have a referral for assessment; Home support assessment with a Regional Assessment Service (RAS) - Low Level Support to stay independent in own home o The RAS assessor can approve you as eligible for entry level services under the Commonwealth Home Support Programme (CHSP) to help you be independent in your home and actively participate in your community. Comprehensive assessment with an Aged Care Assessment Team (ACAT) - More complex care needs: A home care package; residential care in an aged care home; residential respite care; short-term restorative care; transition care; other services that you need. 7. Find and Set up Services 8. Manage Services

What happens after an access request:

Access decision is made: Notification of access met or otherwise Planning conversation and setting goals § Participants and their families will discuss their goals with an NDIS representative as part of their planning conversation. § Not all supports that assist participants to achieve their goals will require funding. Development of a plan § The participant's plan will include the supports the NDIS will fund as well as the government supports that are the responsibility of other services. § Support coordination is included in the plans for NDIS participants permanently residing in an aged care facility.

What are the ten enablement skills:

Adapt Advocate Coach Collaborate Consult Coordinate Design/Build Educate Engage Specialise

Challenges to Community Practice

A collective definition of community practice for OTs has not been created Funding: programs cannot be funded by third parties because the programs and services provided are not considered reimbursable Program sustainability: Must plan for this from the beginning and explore avenues for garnering financial resources to provide ongoing support for the programming or practice Pressure to succeed in facilitating behavioural change OTs may act in roles outside of their profession and may spend time on what is considered 'non-OT' work Achieving success with a program is complicated: disconnect between program and community Need to plan and think in ways different from practitioners in traditional practice settings

What is an advanced health directive?

A formal way to give instructions about your future health care. It comes into effect only if your cognitive health deteriorates and you become unable to make your own decisions (i.e. lose capacity to make decisions).' Outlines what medical treatment or health care you want if you can no longer make decisions for yourself. It can be general (e.g. that you wish to receive all available treatment) or specific (e.g. that you wish to decline a certain medical treatment) Enables you to appoint an attorney for health and personal matters Includes information that health professionals should know, including health conditions, allergies, and religious, spiritual or cultural beliefs that could affect your care.

Who can help with requesting access:

A legally appointed representative can make an access request on the person's behalf A family member, friend or support worker can assist, however the person needs to provide permission for their support person to make an access request on their behalf A local area coordinator or Early Childhood Early Intervention (ECEI) Partners

Disability Requirements in the NDIS:

A person must have a permanent and significant disability or impairment that affects their ability to take part in everyday activities and be likely to require support under the NDIS for life

What can be considered reasonable and necessary?

A support or service: o Must be related to a participant's disability o Must not include day-to-day living costs not related to your disability support needs, such as groceries o Should represent value for money o Must be likely to be effective and work for the participant, and o Should take into account support given to you by other government services, your family, carers, networks and the community.

Access and Establishing Eligibility

Age (under 65) Residency (Australian resident or special VISA) Disability (complex, permanent or likely to be permanent)

What is short-term restorative care?

Aims to improve well-being and independence in order to help older people to continue living in their own home by preventing or reducing any problems with completing daily tasks, improving health and well-being, and avoiding long-term or higher levels of care. Provides services to older people for up to 8 weeks (56 days), and can be accessed twice in a 12-month period. Is a service available to people in the community who have experienced functional decline. Requires the person to have an assessment with an Aged Care Assessment Team (ACAT). Is available to a person if they; are at risk of losing their independence and are able to improve their independence with intervention. Is overseen by the Australian Government who manages the program, develops policy, provides subsidies, allocates places and approves applications for approved providers. Is not available if the older person is currently receiving permanent residential care, a Home Care Package, or Transition Care. Can be accessed by people who are receiving CHSP service, however services must be different, yet complementary. Can take place in a person's home, an aged care (nursing) home, or a combination of both. Provides services that may include, but are not limited to; occupational therapy, physiotherapy, nursing support, personal care, provision of assistive technologies, and minor home modifications. Is funded by the Australia Government who provides subsidies, allocates places and approves providers. Under certain conditions providers can charge client fees. These fees are calculated on a daily basis for every day of care receives. Care fees to be paid by the recipient may be agreed upon in a flexible care agreement.

What is an attorney?

An Attorney is the person you nominate to manage your affairs. You can have more than one Attorney. Attorneys can be appointed to manage your financial matters and/or your personal and health matters. You can specify when you Attorney's powers begin and you can also specify what powers they will have. This is often referred to as the limits of your Attorney's powers'.

What is the Canadian Model of Client-Centred Enablement (CMCE)

Based on enablement foundations and employs enablement skills in a collaborative relationship with clients, who may be individuals, families, groups, communities, organisations, populations, to advance real life toward a vision of health, well-being, and justice through occupation

OT practice in a community setting

Broad and programs are unique to each community and practitioner working in the community OT interventions move beyond the individual treatment of a client to working with systems that affect the ability of an individual or group to achieve work, leisure, and social goals Explores the role of occupation in the shaping of a society and a daily life

What is the NDIA's mission?

Building and managing a world leading national disability insurance scheme for Australians

Access Request:

Initial Contact: Call 1800 800 110 to make request or ask for a form Participants will be asked: o Confirmation of identify and authority or another to act on participant's behalf. o Questions relating to eligibility o Questions regarding consent to enter NDIS and to seek third party information Information about disability: Participants will also need to provide information about their disability.

Primary Services/Programs in Aged Care

CHSP (entry level care): Community and home support (domestic assitance; personal care; home maintenance; home modification; nursing care; aid and equipment; transport; social support); meal and food service; allied health support services; respite care; help with care and housing Home Care Packages (complex level care): Personal care; nursing; allied health and therapy services; specialised support; meal preperation and diet; domestic assistance; home maintenance; home modifications; goods, equipment and AT; transport; social support; care coordination and care management Residential care: Aged care homes (hotel services; personal care; complex care and services); financial assessment before deciding on an aged-care home; means-tested care fee

How to aid communication with people with dementia:

Caring attitude: flexible, allow plenty of time for response, maintain their dignity and self-esteem Ways of talking: remain calm and talk in a gentle manner, keep sentences short and simple, allow plenty of time for what you have said to be understood Body language: use hand gestures and facial expressions, point or demonstrate Right environment: avoid competing noise, use the same approach, maintain regular routines

Unscheduled Plan Reviews

Change of Circumstances: If a participants personal circumstances change significantly and this affects the supports they need from the NDIS, they can request a plan review at any time by completing the change of circumstances form. Request for a Review of a Plan Decision: If the participant is unhappy with a decision about the support budget(s) in their plan they can request a review of the plan decision

Early Childhood Early Intervention

Children (0-6yrs) must experience significant functional impact in two or more of the following areas: o Language and Communication; verbal and non-verbal. o Social and Emotional; play skills, sensory processing, behaviour. o Physical Development; developmental milestones, gross and fine motor. o Cognitive Development; learning, thinking, problem solving. o Self Care Skills; toileting, dressing, eating, sleeping. You do not need a diagnosis to access ECEI supports

NDIS funded supports:

NDIS is responsible for disability related: - Aids such as wheelchairs, hearing aids and adjustable beds; - Items such as prosthetics and artificial limbs (but not surgery); - Home modifications, personal care and domestic assistance that assists people exiting the health system to live independently; and - Therapies required as a result of the person's impairment, including physiotherapy, speech therapy or occupational therapy (but not treatments)

What does the NDIS mean?

National: The NDIS is being introduced progressively across all states and territories. Disability: The NDIS provides support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability. Early intervention supports can also be provided for eligible people with disability or children with developmental delay. Insurance: The NDIS gives all Australians peace of mind if they, their child or loved one is born with or acquires a permanent and significant disability, they will get the support they need. Scheme: The NDIS is not a welfare system. The NDIS is designed to help people get the support they need so their skills and independence improve over time.

What is the OT role in aged care?

Occupational Therapists in aged care can work for a range of different organisations including Government, Non-Government Organisations, Private Practice, Speciality Condition Services etc. working under government funding schemes. Relatively few positions traditionally existed specifically in Residential Aged Care Services - Usually contracted in from a Community Practice Partner or Private Practice - but these seem to be on the rise. OT Australia has been working towards encouraging government to increase incentives to boost numbers of OT's working in aged care

What to prepare for a planning meeting:

Current supports (community and mainstream) About you (your personal details) Daily Life (how you manage every day activities) Your safety, including equipment, accommodate and assistance Community life Usual week with supports included Consider what works well and what to change Short and medium to long term goals Decide on how plan will be managed The support you need to use your NDIS plan Evidence of disability/assessments/reports etc.

What is covered by the NDIS?

Daily personal activities Transport to enable participation in community, social, economic and daily life activities Workplace help to allow a participant to successfully get or keep employment in the open or supported labour market Therapeutic supports including behaviour support Help with household tasks to allow the participant to maintain their home environment Help to a participant by skilled personnel in aids or equipment assessment, set up and training Home modification design and construction Mobility equipment Vehicle modifications

What is short-term care?

Designed to help an individual reverse or slow the difficulties they are having with everyday tasks Program is delivered by a team of health professionals to help manage or adapt to the clients changing needs (looks different for everyone) Delays the need for long-term care and support services as it helps individuals return to earlier levels of independence Services include: aids and equipment, audiology, continence management, cooking assistance, home maintenance, nursing, personal care and assistance, podiatry, allied health, social work, support services, transport, accomodation in residential care, etc How does it work: Provider will work to identify goals, then put together a team of health professionals to work towards them (including a doctor to treat any medical conditions) Care can be provided in a variety of locations (in home, in community, in an aged care home) Can recieve short-term restorative care for periods up to eight weeks, twice in any 12-month period Cost: If the client can do so, they will be expected to contribute to the cost of care and services Eligibility: older person who wants to stay independent, is out of long-term ongoing care, needs help with everyday tasks, and is slowing down mentally or physically or both Cannot recieve if: live permanently in an aged-care home, recieve a HCP, recieving transition care, have needs that go beyond what can be met by the program Can access the program if you receive support from veterans services and CHSP, however if you access both short-term and CHSP they must provide different and complimentary services

How to maintain partnership in community practice:

Develop relationships based on trust and mutual respect Identify common stakeholders Establish a reciprocal learning style Developing open lines of communication Educate community members Be present in the community Maximise resources Practice collaborative program development Build cultural competence and respect diveristy Share accountability

What not to do when communicating to someone with dementia:

Don't argue. It will only make the situation worse Don't order the person around Don't tell them what they can't do. Instead state what they can do Don't be condescending. A condescending tone of voice can be picked up, even if the words are not understood Don't ask a lot of direct questions that rely on a good memory Don't talk about people in front of them as if they are not there.

ECEI Partners

Early Childhood Early Intervention (ECEI) Partners will assist families to determine the right supports to help meet their individual goals. This may include: § Information and referrals § Emotional/professional support § Early Childhood intervention supports and strategies § Building on the strengths of the family to support their child's development § Planning with families whose children would be best supported through an NDIS plan of supports ECEI Partners in Brisbane are The Benevolent Society

How does the NDIS work?

Flexible, whole-of-life approach, support needs met over lifetime. Works with participants, families and carers - Individualised Plans. Provides choice and control - How, when and where supports are provided. Connects participants with community and mainstream supports Funds additional reasonable and necessary supports for pursuing goals, aspirations, and daily life participation. Works closely with community organisation to identify opportunities for people with disabilities.

How does the NDIS meet its aims?

Funding reasonable and necessary supports based on need. Providing more choice and control in lives of people with disability through self-directed options and individualised funding. Ensuring consistent application of eligibility, timely and efficient delivery of supports and early intervention across Australia.

What is capacity building supports?

Help build independence and skills to help reach long-term goals EG: Support coordination, improved living arrangements, finding and keeping a job, improved health and wellbeing

What are core supports?

Help with everyday activities, current disability-related needs, and to work towards goals EG: Activities of daily living, consumables, transport, assistance with social and community participation

Consumer-Directed Care:

Home care packages are delivered on a Consumer Directed Care (CDC) basis. This means you (and your carer) have more choice and control over what services are delivered and where and when they are delivered

What if an access request is not met:

If someone is not eligible for NDIS funded support, our partners in the community can still help. They can: § Connect them with local supports including community health services, playgroups and other activities available in their local area; and § Connect them with disability and other government supports outside of the NDIS You can request a review of an access not met decision

What is guardianship?

If you have not formally appointed a POA/EPOA and it becomes necessary a guardianship board/tribunal can appoint one (formal process). This person can be friend, family member, adult guardian and is a substitute decision maker (makes lifestyle decisions but not financial decisions)

How is aged care being reformed

Improvements and groundwork (2012-2013): new home care packages and supplements; launch of My Aged care Improved access/choice for consumers and stronger system stability (2014-2016): Implementing national voluntary quality indicators for aged care and introducing a national fee framework for the CHSP Consultation for changes/5 year review: Wants to meet the aims and support people to stay at home and be a part of their communities for as long as possible

What is capital supports?

Include higher-cost pieces of assistive technology, equipment and home or vehicle modifications, and funding for one-off purchases including SDA EG: AT and Home Modifications

What is the NDIA's purpose?

Increase the ability of individuals with a significant and permanent disability (participants) to be more independent, and to engage more socially and economically, at the same time as delivering a financially sustainable NDIS that inspires community and stakeholder confidence

What are some challenges in aged care?

Increasing ageing population - Challenges for services to respond to needs. Consumer directed care - when choice isn't choice Risk to vulnerable older adults in market driven model Waitlist for Home Care Packages - over 100,000 (2018) Wasted resources/lack of continuity - different providers "grabbing" jobs Workforce may not be able to meet demand of service needs.

What is transition care?

Is a service that is offered to people directly after a hospital stay to support recovery Provides short-term care specialised care and support to help an individual regain functional independence and confidence sooner for up to 12 weeks but an extension of up to 42 days can be requested. Is overseen by the Australian Government who develops program policy and allocates places to state and territory governments who are responsible for implementing the program and deciding on the best way to meet local service needs and individual care needs. Aims to help older people to avoid the need for longer-term care and delay moving to an aged care home for as long as possible by helping them get back on their feet after a hospital stay. Requires the older person to have an assessment with an Aged Care Assessment Team (ACAT). Is available to an older person if they; are a patient in a public or private hospital, have been told that they're ready to leave hospital, and would benefit from receiving services for a short period of time. Provides different kinds of care and support, such as; low-intensity therapy including allied health services, nursing support and personal care. Can take place in an aged care (nursing) home, a person's home, the community, or a mix of all of these. Is funded by the Australian Government who provides funding through flexible care subsidies which are paid to state and territory governments as approved providers who must provide a co-contribution. Service providers can also request fees from care recipients, if they can afford to contribute to the cost of their care. Delivered in the most appropriate place to help the individual meet their goals: aged care home, in own home, community, mix of locations as needs change with recovery Cannot access transition care while recieving either respite care or short-term restorative care

What is an enduring power of attorney?

Kicks in when a person no longer has the capacity to make a decision for themselves; can be for all matters (health, financial); stops when capacity is gained back. An enduring power of attorney is a legal document that outlines who you would like to manage your affairs, such as when you no longer have the capacity to do so. People can lose capacity for decision making for reasons such as intellectual or psychiatric disability, acquired brain injury, temporary illness such as delirium.

Enablement skill: Educate

Learning through doing, building upon existing skills and learning To create supportive learning environments and to demonstrate/model reflective practice To prompt the learning of skills and present a 'just-right' challenge

Policy to Practice

Level 1: United Nation (International Level) - Human Rights Convention Level 2: Government responsibilites to uphold Human Rights (Domestic Level) - National legislation ('Acts') and National and State Strategies/Policies/Guidelines Level 3: Funding schemes (linked to policy/strategy/guideline) Level 4: Service Contexts - a network of organisations, service structures Level 5: Organisational context - the specific individual service structures/systems Level 6: Service dlivery - what each OT does (OT practise process)

Community-based practice

Location in which OT services are provided (takes place in the community) Specific locations within the community are identified and the skills of and roles that OTs can play in the setting as described Transfers practice skills from the clinical setting to a population-based program development model Integrating the client at the level of their desired community engagement and facilitating their transaction/interaction within the community which promotes health outcomes

Planning process:

Meeting with NDIA planner Plan is developed Plan is approved by NDIA and sent to participant Plan reviewed after 12 months Plans have two parts: o Goals - What the participant wants to achieve (short-term goals and medium to long-term goals) o Supports - Friends/Family, NDIS, Community and other Government Supports

What does Reasonable and Necessary mean?

The support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations; The support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation; The support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; The support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice; The funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide; The support is most appropriately funded or provided through the National Disability Insurance Scheme, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered: as part of a universal service obligation or in accordance with reasonable adjustments required under a law

What is the Home Care Package Program?

This program supports older people with complex care needs to live independently in their own homes. It uses a consumer-directed care approach to make sure the support suits a person's needs and goals. It has 4 levels of packages - from level 1 for basic care to level 4 for high care needs. It subsidises in-home aged care services and services to help people stay connect with their community so that people can stay at home for as long as possible and provides services that sit between CHSP and residential aged care Eligibility: Supports older people with more complex needs to stay at home (must be registered with My Aged Care and be referred for an assessment) How does it work: assigns home care packages to people (older person is able to choose a provider in their area that best meets their needs) Funding: Government subsidy, basic daily fees, income-tested care fees (payed by people who have an income over a certain amount), and amounts for additional care and services not otherwise covered

Disability-related health supports:

To access these supports: o A person must meet the NDIS eligibility requirements and be a NDIS participant, o The need for these supports must directly relate to an NDIS participant's functional impairment, where the support need is ongoing and is and most appropriately funded or provided by the NDIS. The typical types of support available can be grouped into eight 'support type' categories but this is not an exhaustive list. The NDIS will fund disability-related health supports for participants who need help to manage a range of needs including those associated with: o Continence o Respiratory care o Nutrition o Wound and pressure care o Dysphagia o Diabetes o Podiatry and epilepsy.

Enablement skill: Coordinate

To arrange: keep things organised, allocate resources, link people with resources, navigate, network, supervise, manage teams, integrate and synthesis and document information

Enablement skill: Design/Build

To conceive, construct, and create products such as assistive technology or orthotics Visualise possibilities and create new ways of doing things Formulate a plan for, to devise or form a strategy

Enablement skill: Coach

To encourage accountability, guide, challenge, provide options and choices To be a motivational voice and help people see the big picture To develop and sustain an ongoing partnership designed to help clients produce fulfilling results in their personal and professional lives and to enhance their quality of life Emphasis is to coach people to take responsibility for self-direction in naming priorities and goals which are most meaningful to them

Why is aged care being reformed?

To ensure it: Is sustainable and affordable Offers choice and flexibility for consumers Encourages businesses to invest and grow Provides diverse and rewarding career options

Enablement skill: Engage

To involve the client in doing (doing with or in parallel), in participating, in action beyond talk To engage through mutual interest and spark visions of possibility To optimise and tap into potential

Enablement skill: Adapt

To modify or change something to enable performance and engagement To break the occupation into components and re-configure for a specific use or situation To respond to client's occupational challenges based on occupational analysis of the physical, mental, cognitivem social, economic, and other environmental demands and requirements

Enablement skill: Advocate

To raise critical issues and perspectives, raise awareness of issues and to challenge others to think differently, and make new options known to key decision makers OTs advocate for policy changes to enable individuals to engage in occupations

Enablement skill: Specialise

To use specialised techniques in particular situations (hand therapy, therapeutic touch and positioning, psychosocial rehabilitation techniques etc) To ensure that the client understands, agrees with, and participates as they are able and wish to in specialised approaches

What is an ACAT Assessment?

When the assessor arrives at your home, they will ask if you agree to have the assessment. The assessor will have a copy of your client record. This includes the information you gave to the My Aged Care contact centre. They may also ask for your permission to talk to people who support you, such as a family member or carer. For assessment for some services such as residential care, home care and flexible care the assessor will ask you to complete an Application for Care form. The assessor will ask questions about: what support you already have and if that will continue; your health and lifestyle and any health concerns; how you are going with completing daily tasks and activities around the home; if you have problems with your memory; any issues relating to home and personal safety; family and community engagement; speaking to your GP or other health professionals. The assessor can also: consider you for other types of services that meet your needs; give you information about service providers that may offer the care you need in your area; discuss if you might need more support so you can live in your own home, or other options such as an aged care home. The assessor may also talk to you about the possible costs of your services and where you can find further information about this.

What does CDC mean:

You get more say in the care and services you access, how they are delivered and who delivers them to you You have conversations about your needs and goals You work with your service provider to develop your individual care plan You agree how much involvement you have in managing your care package You know how your package is funded and how your individual budget is spent through monthly income and expense statements Your service provider will ensure that your package continues to meet your needs with ongoing monitoring and formal reviews. If your circumstances change you and your home care provider can change your care plan to suit your needs.