Simon Duffy ran this workshop for COTA Australia and Home Care Today to explore how best to build on the opportunities created by Consumer Directed Care as it is implemented in Aged Care.

1. Realising the
Potential of CDC
in Australia
Citizenship
Community
Creativity
Dr Simon Duffy of the
Centre for Welfare Reform
17th May for COTA
Australia, Melbourne

2. 9.00 - Introductions - Who’s here and why
9.10 - Introductory talk - Citizenship, real wealth and the creativity
9.30 - Discussion - Observation and insights from the Citizen Panel plus time for questions
10.00 - Exercise 1 - Thinking about yourself
10.30 - Morning tea
11.00 - Exercise 2 - Thinking about a good life for you
11.45 - Exercise 3 - Thinking about what good help looks like
12.30 - Lunch
1.15 - Exercise 4 - Thinking about what a good organisation is like
2.30 - Afternoon tea
3.00 - Exercise 5 - Thinking about society and government policy
3.30 - Concluding talk - Acting like a citizen at home and at work
3.45 - Plenary - Final observation and insights from the Citizen Panel plus time for further questions
4.30 - Finish

3. Introductions

4. Everybody - Say hello to everybody at your table -
where you are from and why you are here
Citizen panel - Introduce themselves - Annette, Kate
& Ron
Simon - explains the purpose of the day - the
importance of why

5. Introduction

6. Key questions
• Are we consumers or are we citizens?
• What helps us stay strong as citizens?
• How do we create better support solutions?

10. 1. Purpose - a life of meaning and value
2. Freedom - the ability to control my life
3. Money - enough to ensure independence
4. Home - a safe and secure place of my own
5. Help - support that connects me to others
6. Life - joining in and contributing
7. Love - a life with friends and family
Citizenship means respect

14. Panel response

15. Exercise 1

16. What is your real wealth?
This exercise will allow people to think about the
different resources we have available to us.
Individualised funding can help, but it works best
when it is combined with our real wealth, our gifts,
relationships and communities.
Our real wealth is made up of all the things we can
control, develop or connect to and which can help us
achieve our goals.

17. Work in pairs. Split the time
between you and interview
your partner and make a map:
1. What are your interests,
needs and gifts?
2. Who are the important
people in your life?
3. What communities are you
connected to?
4. What resources do you
control?

19. Thinking in
pictures
Wife and son Church
4 bedroom house
in Sheffield

20. Did anything particular
surprise you?

22. • The human spirit is the most important element of
real wealth and it links and combines the others.
You might also call it hopefulness or resilience.
• People who have lost hope struggle to make use of
their real wealth. They will see no point.
• This is why we must always seeks to uncover and
sustain the spark of life within each person.
• Uncovering what is a good life for someone is
identical to helping people be an active citizen.

23. Exercise 2

24. What is a good life?
Citizenship is not just a philosophical idea, it’s a very
practical way of thinking about the elements that
make up a good life.
This exercise will help people think about their life,
and how this wish to live in order to live well.
Citizenship is a description of the disciplines we need
in order to help us see each other with respect - as
an equal.

26. Continue to work in same pairs and split the time
between you to discuss the questions:
• The table will be assigned a CDC disability level [For this
exercise we don’t care if you are younger or older than 65.]
1. Basic Care Needs
2. Low-Level Care Needs
3. Intermediate Care Needs
4. High Level Care Needs
• Think about the life you will now lead and consider some of
the following questions…

27. 1. Purpose - what gives your life meaning?
2. Freedom - what must you control?
3. Money - how important?
4. Home - means to you?
5. Help - who would you trust?
6. Life - what do you need to be part of?
7. Love - which friends and family?

28. Now - for yourself - with your disability - answer these
questions:
1. Who would you want to represent you if you needed
help with decisions?
2. What kind of activities would you be doing?
3. Who would you look to for assistance?
4. Where would you want to live?
5. How do you see your relationships changing?
6. Can you imagine yourself happy?

29. 0
75
150
225
300
Network Professional
Who will represent you?

30. 0
35
70
105
140
FT Work PT Work Vol. Work Education Love
What will you do with your life?

31. 0
75
150
225
300
Natural PA Service Voluntary
Who will help you?

32. 0
75
150
225
300
Family Friends Alone Service
Where will you live?

33. 0
50
100
150
200
More Less Unsure Same
How important will the people in your be life now?

34. 0
22.5
45
67.5
90
Yes No Not Sure
Will you be happy?

35. • Typically there is a significant disparity between our
aspirations for ourselves and the reality of the
service system.
• We are seeking citizenship - but living in a society
with an institutional past and an institutional
present.
• We will need humility and creativity in order to
bring about change.

37. Exercise 3

38. What does good help mean?
Care services offer only a fraction of the help we
need and too often these services can be inflexible or
can even get in the way of a good life.
This exercise will encourage people to explore the
practical support people need when they experience
illness, impairment or frailty in old age.

39. This is not just about using budgets
differently - it’s about a new kind of
creative partnership between the
person, their family and professionals.

40. • Good support is about working with someone as
their partner in order help people achieve
citizenship.
• Everyone has some real wealth, individualised
funding and professional support should build on
that - not replace or undermine it.
• When we don’t know all the answers in advance
(and when it comes to other human beings we
shouldn’t know all the answers in advance) we
need to solve problems with creativity.

42. Creativity is a natural human
capacity:
• Optimism is essential
• Seeking inspiration and
adapting other ideas helps
• It’s okay to just try stuff out to
see if it works
• Attention to the detail helps

45. Continuing to work in your pairs. Split the time
between you and work out how best to spend your
budget to enhance your new life.
• You will be assigned 3 months worth of funding (for
average use of CDC is 94 weeks and many only use
CDC for much short periods.)
1. $2,000
2. $3,500
3. $7,900
4. $12,000

46. • After you’ve identified at least one idea each of how
to spend your budget discuss your ideas at the
whole table.
• Pick the most creative idea at your table to
feedback to the whole group.
• Each person will write their favourite idea on
piece of paper and hand to Simon at the end of the
exercise.

47. Exercise 4

48. How to organise support?
Professional organisations that provide support to
people in communities can be great allies of older
people, sharing skills, building capacity and
connecting people.
This exercise will enable service providers and older
people to reflect on the ways in which different kinds
of organisation can enhance or obstruct citizenship
for older people.

49. • Home care - agency employs staff, develop a rota and try
to balance people’s preferences as best as possible.
• DIY (partial) - person picks an agency that works best for
them
• DIY (full) - person recruits and employs their own support
• Shared management - person and organisation share
responsibilities
• Shared living - shares life with one or more people that
they pay
• Personalised support - person’s budget (ISF) is
protected by agency and use agreed with person…

53. This also means
being set up
with the right
systems to
make flexibility,
creativity and
personalisation
actually
possible.

57. Older, more
traditional
organisations
can also
transform
themselves to
start providing
personalised
support.

64. Peer power

65. • Pooling budgets - e.g. Get a life
• Combining talents - e.g. WomenCentre
• Rethinking advocacy - e.g. Help & Connect
• Self help - e.g. Pass it on Parents
• Peer support - e.g. PFG Doncaster

73. • As a table discuss the
following:
• If everybody here lived
in your community and
you were going to try
and help people get the
best possible assistance
then how would you
organise support.
• NB people have already
shared some of their
own support solutions
LEVEL No Budget
Level 1 7 AU$80,892
Level 2 10 AU$143,780
Level 3 12 AU$379,308
Level 4 8 AU$384,416
TOTAL 37 AU$988,396

74. Share thoughts &
observations

76. Exercise 5

77. What is a decent society?
This final session will allow participants to explore
policy opportunities and threats to the citizenship of
older people.

79. Don’t panic…
we’re just getting older

80. Why so serious?
• We are frightened of illness,
disability and death
• We have turned care from a
relationship into a business
• Despite our wealth we still feel
insecure about our rights
• We’ve lost sight of the
contribution made by citizens,
family & community
• Markets and service dominate
our thinking

81. Even early
efforts to shift
power and
control back to
citizens become
interpreted as
attempts
introduce
consumerism
into care.

83. Working at your table discuss two questions:
• How would we like to see CDC develop to improve
the citizenship of older Australians?
• What other social and policy changes would
advance the citizenship of older Australians?

84. Concluding Talk

85. How to act like a citizen?
Simon will finish the day with a short talk suggesting
some of the challenges ahead and how people and
professionals can work together to make practical
progress.

86. 1. Citizenship is not different to love, it is love in the
form of discipline.
2. Citizens care about the rights of others, but
welcome responsibilities, and not as burdens.
3. Citizens share what they’ve learned, because
knowledge isn’t private property.
4. Citizens compete when they have to, but
collaborate when they can.
5. Citizens don’t exclude, they welcome in others as
equals.

87. Plenary

88. • Observation and insights from the Citizen Panel
• Questions and discussion