Aging & Social Change: Ninth Interdisciplinary Conference

Abstract

Residential aged care in Australia is shifting from the traditional provider-driven, medical model to one directed by the resident. This change recognizes the link between autonomy and the well-being of older adults, which is reinforced by Australia’s new aged care quality framework emphasizing “consumer dignity and choice”. Many providers are unprepared for this change; they are unsure what residents will request and fear being unable to meet resident needs. This study describes choice as expressed by residents to prepare providers for consumer-directed care (CDC). Interviews were conducted with ninety-six residents in six Australian Aged Care Homes. Interviews addressed sixteen activities of daily living (ADLs), with residents describing preferences for each ADL. Results: Resident preferences covered four themes. i) Non-response: this captured vague, positive evaluations of care, related to fear of being “difficult” and a desire to maintain good staff relationships; ii) Care approach: residents felt rushed during ADLs, preferring staff to be gentle; iii) Care involvement: residents want to contribute to care decisions but feel unable to because they are ill-informed or not consulted; iv) Connectedness: residents requested more opportunities for meaningful conversations, activities and relationships. This study highlights resident desire for greater choice and control and the simplicity of resident preferences. To deliver CDC, providers will need to update processes to promote collection of, and response to resident preferences, and revise staff routines and approaches to care to foster CDC. Most importantly, staff need to become skilled communicators to empower residents to share their true preferences.