NDIS and the Aged Care System: Assessing the Capability of
the Aged Care Sector to Support People with Life-long Disabilit...
THE	
  PROJECT	
  TEAM	
  
Patricia O’Brien
U.Syd
Building	
  Bridges	
  Between	
  the	
  
Disability	
  &	
  Aged	
  Car...
From Work
9
And A
Home of
His Own
8
TO AGEING
5
INTRODUCTION	
  
!  Dramatic improvements in life expectancy have led to a large
cohort of people with disability who are ...
THE	
  AUSTRALIAN	
  CONTEXT	
  
Two significant national reports on Ageing &
Disability:
! National reforms to Aged Care,...
DIVISION BETWEEN AGED CARE AND DISABILITY
SUPPORT SYSTEMS
!  Two distinct populations
!  In the general population people ...
AGEING VERSUS DISABILITY SUPPORT
SERVICES
Ageing
!  Medical model
!  Concept of care
!  Later age of onset
!  Maintain exi...
THEORIES OF AGEING
(a) Successful Ageing
! Avoiding disease
! Maintaining high cognitive & physical function
! Engagement ...
THEORIES OF AGEING
(b) Positive Ageing
!  Tornstam (2005) suggested a developmental theory of positive ageing
termed “gero...
THE	
  CURRENT	
  RESEARCH	
  PROJECT	
  
Aims:	
  
! Explore	
  key	
  dimensions	
  that	
  enable	
  or	
  impede	
  co...
THE NDIS
WHAT ARE ITS ESSENTIAL
UNDERPINNINGS?
!  It differs in philosophy from earlier disability support systems
!  It is based o...
ELIGIBILITY FOR INDIVIDUAL SUPPORT
PACKAGES AND FINANCIAL SUPPORT 
!  age – you have to be aged between 0 and 65 years old...
LIVING LONGER, LIVING BETTER
The Federal Government is responsible for Aged Care services in
Australia. From 1 July 2012, ...
COMMON ASPECTS OF NDIS & AGED
CARE INITIATIVES
Both systems aim to support people:
!  to feel physically and emotionally s...
ISSUES TO BE CONSIDERED
!  Are aged care support staff trained to assist people with life-long
disabilities?
!  Are disabi...
PRELIMINARY	
  FINDINGS	
  OF	
  THE	
  CURRENT	
  
RESEARCH	
  
	
  While	
  data	
  are	
  sPll	
  being	
  collected,	
...
CHALLENGES FOR PEOPLE WITH
DISABILITIES AND THEIR FAMILIES
! Problem of growing older in a system not previously
accommoda...
THE WAY FORWARD: KEY GOALS AND
STRATEGIES
!  Knowledge, a responsive workforce
!  Individualised, person-centred planning,...
22
!  Mechanisms to support for older parents and their adult sons or
daughters to prepare and plan for the future eg. “Ne...
THANK YOU
Comments
&
Questions
trevor.parmenter@sydney.edu.au
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Trevor Parmenter - Sydney Medical School, University of Sydney - NDIS and the Aged Care System: Assessing the Capability of the Aged Care Sector to Support People with Life-long Disability

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Trevor Parmenter, Emeritus Professor in the School of Medicine at the University of Sydney delivered this paper at the 5th Annual National Disability Summit 2014. Examining the theme of “Ensuring Sustainable & Successful Disability Reform through the NDIS”, I am proud to present a diverse program showcasing insights and case studies from individuals across the entire Disability Sector to give a realistic and insightful overview of the NDIS rollout to date, and recommendations for moving forward successfully

For more information, please visit https://www.communitycareconferences.com.au/nationaldisabilitysummit14

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Trevor Parmenter - Sydney Medical School, University of Sydney - NDIS and the Aged Care System: Assessing the Capability of the Aged Care Sector to Support People with Life-long Disability

  1. 1. NDIS and the Aged Care System: Assessing the Capability of the Aged Care Sector to Support People with Life-long Disability   Trevor  R  Parmenter₁,₂,  Rafat  Hussain  ₂,Ma6hew  Janicki  ₂,   Marie  Knox  ₁,  Patricia  O’Brien  ₁,     Chez  Legga6-­‐Cook  ₃,  Stuart  Wark  ₂,   Miranda  Cannon  ₂,  Meaghan  Edwards  ₁,  Marie  Parmenter  ₁   ₁  University  of  Sydney,  ₂  University  of  New  England,  ₃  Endeavour  FoundaPon   trevor.parmenter@sydney.edu.au     1
  2. 2. THE  PROJECT  TEAM   Patricia O’Brien U.Syd Building  Bridges  Between  the   Disability  &  Aged  Care   Sectors   Trevor Parmenter U.Syd /UNE Marie Knox U.Syd Matthew Janicki UNE Miranda Cannon UNE Meaghan Edwards U.Syd Rafat Hussain UNEStuart Wark UNE Chez Leggatt-Cook Endeavour Foundation Marie Parmenter U.Syd
  3. 3. From Work 9
  4. 4. And A Home of His Own 8
  5. 5. TO AGEING 5
  6. 6. INTRODUCTION   !  Dramatic improvements in life expectancy have led to a large cohort of people with disability who are ageing. !  There is a significant social welfare challenge emerging for ageing of people with disability who face a double jeopardy of getting older and facing further discrimination. 6
  7. 7. THE  AUSTRALIAN  CONTEXT   Two significant national reports on Ageing & Disability: ! National reforms to Aged Care, Disability Services, and the advent of National Disability Insurance Scheme (NDIS), have changed the policy and funding landscape from a service-centric to an individualized funding focus. 7 Nonetheless, there are substantial gaps in policy & practices between the philosophies embraced by the proposed national reforms and their articulation into practical, achievable outcomes.
  8. 8. DIVISION BETWEEN AGED CARE AND DISABILITY SUPPORT SYSTEMS !  Two distinct populations !  In the general population people who are ageing acquire disabilities later in life !  People with congenital disabilities may age earlier and have earlier onset of complex health needs !  High level of care aged care facilities generally cater for people at end of life stage !  People with life long disabilities may require aged care support for longer periods !  Dementia support is common to both populations !  Retirement may come earlier for people with life long disabilities !  People with life long disabilities seldom acquire assets 8
  9. 9. AGEING VERSUS DISABILITY SUPPORT SERVICES Ageing !  Medical model !  Concept of care !  Later age of onset !  Maintain existing skills !  Develop new interests !  Later development of more complex health problems !  Greater respect from community Disability !  Social model !  Concept of support !  Earlier age of onset !  Maintain existing skills !  Develop new interests !  Life long complex health problems !  Negative community attitudes 9
  10. 10. THEORIES OF AGEING (a) Successful Ageing ! Avoiding disease ! Maintaining high cognitive & physical function ! Engagement with life Rowe & Kahn (1998) suggested that when all three components overlap, successful ageing is represented. But, can all people who are ageing maintain high levels of functioning? This approach lacks subjective elements. Is it a tangible or an elusive concept? 10
  11. 11. THEORIES OF AGEING (b) Positive Ageing !  Tornstam (2005) suggested a developmental theory of positive ageing termed “gerotranscendence.” !  Theory allows old age to possess its own meaning and character. !  Has subjective and objective elements. !  Includes older people’s perceptions of ageing. !  Incorporates bio-psychosocial aspects. !  Has parallels with quality of life concepts in the intellectual disability literature. 11
  12. 12. THE  CURRENT  RESEARCH  PROJECT   Aims:   ! Explore  key  dimensions  that  enable  or  impede  community-­‐ based  ageing-­‐in-­‐place  opPons   ! To  develop  a  be6er  understanding  of  the  complex  range  of   issues  in  posiPve  ageing  and  interplay  of  health,  social  and   support  factors  from  onset  of  ageing  through  to  end-­‐of-­‐life   care.     12
  13. 13. THE NDIS
  14. 14. WHAT ARE ITS ESSENTIAL UNDERPINNINGS? !  It differs in philosophy from earlier disability support systems !  It is based on insurance principles !  It is influenced by a rehabilitation model !  It is underpinned by a neo-liberal market economy approach, incorporating individualism and choice !  It does not embrace the concept of community capacity building !  It does not appreciate the concept of inter-dependence and relationship-building !  It may disadvantage people with intellectual/developmental/ cognitive impairments.
  15. 15. ELIGIBILITY FOR INDIVIDUAL SUPPORT PACKAGES AND FINANCIAL SUPPORT  !  age – you have to be aged between 0 and 65 years old !  disability requirement – you will be assessed based on the impact of your disability on functional capacity to communicate, interact socially, learn, move safely around your home and the built environment, manage your personal care and affairs (banking, bill paying etc) !  People aged over 65 years at the time they request National Disability Insurance Scheme  support will not be eligible. However, future participants can choose to continue with the NDIS once they turn 65.
  16. 16. LIVING LONGER, LIVING BETTER The Federal Government is responsible for Aged Care services in Australia. From 1 July 2012, the new ‘Living Longer, Living Better’ program came into effect with measures such as: !  additional support and care to help older people remain living at home; !  additional help for carers to access respite and other support; !  establishing a gateway to services to assist older Australians in finding information and to better navigate the aged care system; !  Self directed funding. !  Through “Living Longer Living Better”, Extra Home Care Packages have already been made available by the Government.
  17. 17. COMMON ASPECTS OF NDIS & AGED CARE INITIATIVES Both systems aim to support people: !  to feel physically and emotionally safe; !  to remain connected to and engaged with their local communities, families, and friends; !  and remain living in their own homes for as long as possible, doing their own everyday tasks.
  18. 18. ISSUES TO BE CONSIDERED !  Are aged care support staff trained to assist people with life-long disabilities? !  Are disability support staff equipped to support people who age prematurely? !  Do we need a common pool of support staff trained in both disability and aged care? !  Will aged care support packages be sufficient to maintain the life quality of people formerly supported by NDIS? !  What residential options will be available for people with disabilities who wish to leave the parental home?
  19. 19. PRELIMINARY  FINDINGS  OF  THE  CURRENT   RESEARCH    While  data  are  sPll  being  collected,  some  preliminary  findings   include  themes  of:   ! Ageing  in  place   !  The  value  of  social  roles  and  social  networks   !  Concept  of  ageing   ! Social  diversity  and  exclusion  (lack  of  choice  and   compaPbility  in  living  arrangements)   !  Health  issues   19
  20. 20. CHALLENGES FOR PEOPLE WITH DISABILITIES AND THEIR FAMILIES ! Problem of growing older in a system not previously accommodating people with life long disabilities ! New demands upon health & planning services ! Need for life-span approach- the Third and Fourth Age ! Helping to maintain autonomy ! Inclusion in wider community and eliminating isolation ! Promoting informal supports ! Ageism and handicapism ! “Who will be there to care when I am gone?” Janicki (1998) 20
  21. 21. THE WAY FORWARD: KEY GOALS AND STRATEGIES !  Knowledge, a responsive workforce !  Individualised, person-centred planning, monitoring and review !  Active and healthy approach to ageing !  Knowledge of ageing for people with developmental disabilities and preservation of their life history !  Ageing in place (Bigby, 2004) 21
  22. 22. 22 !  Mechanisms to support for older parents and their adult sons or daughters to prepare and plan for the future eg. “Networks of Support” !  Support for adults to remain in their local area, within the family home, or alternative housing and support options when they lose support of parents KEY GOALS AND STRATEGIES (CONT.)
  23. 23. THANK YOU Comments & Questions trevor.parmenter@sydney.edu.au

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