Aims of the session
• To learn about DisabilityCare Australia, the National
Disability Insurance Scheme
• To explore how to prepare for DisabilityCare Australia
• To reflect on how families can support practical goal
setting and choosing the supports and services that will
best help people achieve their life plans
• To identify any supports and resources families might
need
What is DisabilityCare Australia?
Group Exercise
• Universal health care scheme
• Comparing Medicare with DisabilityCare
Australia
• Exercise – list features of Medicare
What is DisabilityCare Australia,
the National Disability Insurance Scheme?
• Universal health care scheme
• Has been implemented in other countries in the world
(eg Scotland) successfully and will be implemented here
in Australia over the next few years
• There are many details of the NDIS still to be worked out
• Focuses on those who are most in need who have a
permanent disability
• Focuses on intensive early intervention
• The NDIS will be launched at 4 trial sites from mid 2013
Current model of PDRSS
service
Psychiatric Disability
Rehabilitation Support Services &
Carer Respite Services
•
•
•
•
•
•
•
•
•
•
•
Supported accommodation
Community activities
Learning activities
Socialising activities
Sporting activities
Employment support
Housing support
Group learning
Family education
Personal development/recovery group learning
Breaks away from caring roles
Features of current model
• People are only entitled to services within the region that
they live
• Services are funded to provide a certain number of hours
of service
• The types of services don’t necessarily suit everyone
• Not many services have catered to the needs of people
from diverse cultures
The DisabilityCare Australia
model of service
1. Referral to DisabilityCare Australia
2. Assessment by DisabilityCare Australia
• Assessment of eligibility
3.
•
•
•
•
Planning and choosing services and support
Form a plan of what the person wants and needs to achieve independence
Must be ‘reasonable and necessary’
Establish an individual budget based on the plan
Identify and access services and supports with Local Area Coordinator
4. Review process
• Review outcomes of support
• Changes made as needed
Features of the DisabilityCare
Australia model
• Individuals can decide what types of services they need
• Individuals can choose services that are not necessarily in
their local area
• Individuals can choose services from mainstream
providers
• Individuals can choose culturally appropriate, religiously
appropriate services
Principles that inform
DisabilityCare Australia
Principles that inform DisabilityCare Australia
• Individualism
• Choice for the individual
• Control for the individual
Current vs. DisabilityCare Australia
Service Delivery
Current System
DisabilityCare Australia System
Individuals can choose from the services
that are offered within the local PDRSS
services and Commonwealth Respite
Services for families
Individuals can decide what types of
services they need and from a broader
range of services
Catchment area bound
Individuals are not confined to services
provided within a given area
Services are funded to provide a certain
number of hours of service
Length and intensity of service is provided
according to need
The types of services that are available
don’t necessarily suit everyone
Individuals have the option of seeking
services from mainstream providers
Not many services have catered to the
needs of people from diverse cultures,
religious groups, varying sexuality
Individuals will be able to choose to
purchase what they need from ethnospecific services and those who cater to
the needs of different religions and
sexualities
What does ‘reasonable’
& ‘necessary’ mean?
Supports and services;
• Should support the individual to achieve their goals and maximize
their independence
• Should support the individual’s capacity to undertake activities of
daily living to enable them to participate in the community and/or
employment
• Are effective, and evidence informed
• Offer value for money
• Should reflect community expectations, including what is realistic to
expect from the individual, families and carers
• Are best provided through an NDIS rather than through other
systems of service delivery and support
Carer support
Families can help the person take control by:
• Knowing what helps them manage their illness
• Knowing what they want from life and what they need so
they can reach their goals
• Helping to find information about different options
• Assisting the person to clearly communicate their choices
• Knowing who else can support or advocate for the
person as they choose the support / services they need
to help them reach their goals
Assessment & planning
• What support would be helpful for a family to provide in
the assessment and planning process?
• What things would the family offer?
• How could the family try and ensure that the person was
as involved as possible in making choices?
• What would the family need to ensure they also feel
supported in this process?
Assessment & planning
during acute illness
• Listen to what the person is communicating, both verbally and
non-verbally – carers and families will often be able to
“translate” some of the concerns and fears a person may have
about the assessment and planning process
• Whenever possible, attend to the person’s preferences about
how meetings or conversations are conducted: e.g., the
person may only be able to tolerate short conversations, or
may wish to sit outside rather than inside
• Draw on plans that were discussed or in place while the
person was less unwell – that way their needs and choices can
still be heard
• Carers and family may need to take a more active and
assertive role if the person’s insight and judgement is affected
Assessment & planning
during early recovery
• Ask the person how they would like you to support them in
the process
• Assist the person to access information about their rights and
the options that are available to them
• Encourage the person to access advice or support from peers
• Resist the urge to expect too much or too little: give the
person space to set their own goals and articulate their own
needs
• Offer messages of hope and encouragement
• Notice small achievements
Assessment & planning
in established recovery
• Encourage the person to take the lead in the process: ask if
they would like your support
• Respect the person’s autonomy
• Offer positive feedback
• Notice small and large achievements
What makes a good life?
•
•
•
•
•
•
•
•
•
Feeling well
Having good nutritious food that you enjoy
Having regular exercise that is enjoyable
Having something to do each day that is meaningful to you
Adequate, secure, affordable accommodation
Strong family support
Good friendships and relationships
A positive vision of the future life
Financial support to sustain a good lifestyle
Recovery factors
•
•
•
•
•
•
•
•
•
Acceptance of illness
Hope and courage
Managing symptoms
Education
Reconstructing identity and purpose
Supporting others
Choice, responsibility, control and empowerment
Meaningful activity
Advocacy
(Pat Deegan)
Reflective exercise
Take a moment to reflect on what you know about the person
you care for. Discuss with the other person:
• What areas do you think they have made small progress in
already?
• What areas have they made large progress in?
• What types of questions could you imagine using in a
conversation with your family member to prompt
conversation about issues?
• Which areas that we have identified do you think will be a
priority for them?
• Do you have ideas about what you think would be the most
helpful types of support and services that might be able to be
purchased through DisabilityCare Australia?
Change
• ‘You can’t change other people – you can only
change yourself’
• Changes to our own communication and
actions may result in more effective support
for the person with the mental illness and
more effective care for ourselves as carers
New Strategy for Carers
• Change in Thinking
•
•
•
•
Learning current information about mental illness
Learning new communication skills
De-stigmatising mental illness
Learning about the biological/psychological/social
model of mental illness
• Change in Behaviour
•
•
•
•
•
•
•
•
Using new communication skills
Using new assertiveness skills
Considering own limits
Seeking biological support if necessary
Seeking psychological support
Seeking social support
Implementing a Wellness Recovery Action Plan
Managing change and helpful interventions
• Change in Results
•
•
•
•
•
•
Recovery & hope
Improved relationships
Increased independence
Less family stress
Increased Wellness
Better chance of sustained recovery
Examples of life domains
• Family – How do you want your family to feature in your life?
• Physical and mental – What fitness or health goals do you want to
achieve?
• Social - How do you want to enjoy yourself and with whom?
• Creativity - Do you want to achieve any artistic or creative goals?
• Work - What do you want to achieve?
• Financial - How much do you want to earn, by when? How is this
related to your career goals?
• Education - Is there any knowledge you want to acquire in particular?
What information and skills will you need to have in order to achieve
other goals?
• Advocacy/volunteering - Do you want to make the world a better
place? Do you want to be involved in a social cause? If so, how?
Being an effective advocate
1. Know what the person needs to achieve their life goals; and
know what you (as a carer/family member) need to support
their goals. Be ready to talk about this
2. Know about the most effective service providers and be ready
to offer advice or information when required
3. Know about the rights of the person with mental illness and
your rights as a carer