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Daughterly Care Blog

The Department of Health Incorrectly Withdrawing Home Care Packages

If you have a Government Funded Home Care Package please read this update.

Since the Department of Health upgraded their software a couple of months ago we have had 6 clients incorrectly notified by My Aged Care that their Home Care Packages has been withdrawn because they had NOT accepted their Home Care Package in time (within the 56 day limit). This made no sense to us as they HAD accepted the Home Care Package within the time limit and more importantly the Department of Health had been paying their Home Care Package Government Funding through Daughterly Care Community Services which was evidence that the client had accepted the Home Care Package within the time frame.

The email sent last Friday from the Department of Health acknowledges this is an industry wide problem.

department health incorrectly withdraws home care packages

Please know that we audit the Home Care Package payments received from the Department of Health each month to identify mistakes

Issues we identify are:

  • incorrect withdrawal of Home Care Packages;
  • underpayments of Home Care Package Government Funding; and
  • adjustments to Income Tested Care Fees (increases or decreases).

Where we identify that an error has been made by My Aged Care we proactively inform My Aged Care to get those issues resolved for you.

The fix (adjustment) will be in the NEXT monthly payment by the Government, or in the following month, if My Aged Care didn’t have time to fix it for the next monthly payment i.e.it can take a couple of months to get My Aged Care errors. By the way, when we complained to My Aged Care about this extra work for us and explained how upsetting it was for Elderly people to be told that their Home Care Package had been withdrawn, My Aged Care staff told us we were fortunate as other Approved Providers have had 60 clients’ Home Care Packages withdrawn incorrectly.

So if you receive any letters from My Aged Care stating your Home Care Package has been withdrawn – don’t ignore it – contact Nicole Hickey straight away or email services@dccommunityservices.com.au

If you receive a letter offering you a HIGHER Home Care Package than you are already on…accept the offer immediately 

You do NOT pay any extra Basic Daily Care Fee nor any extra Income Tested Care Fee to receive a higher Home Care Package – so you will receive more hours of care and support for the same cost therefore accept the higher package immediately.  Every day you delay in accepting is a day’s higher funding forfeited by you.   Sometimes we can tell on the portal that you have been offered a higher Home Care Package – other times, there is no notification to us – so it is safer to assume we have not been advised by My Aged Care and tell us as soon as the letter arrives by emailing services@dccommunityservices.com.au.

Our advice will always be to accept the higher package.

We are enjoying this rain as it has been such a dry winter.

Kate Lambert CEO and Co-founder Daughterly Care

Kate Lambert
B.Ec F.Fin

Daughterly Care CEO & Co-Founder

Categories: Dementia|2 Comments

Dementia Awareness Month 2017 – Art Improves Speech

Today with the arrival of Spring we celebrate new life. The arrival of Spring each year is also an opportunity for all Australians to grow in our personal understanding of the chronic illness dementia – the second leading cause of death amongst Australians. (1)

If every Australian improved their understanding of how to respect, connect with and enjoy life with people who have dementia – the quality of life would improve immensely for the 413,000 Australians living with dementia and their family carers.

“You are Not Alone”

For the second year in a row the theme is “You are Not Alone” precisely because people diagnosed with dementia and their carers (family members) do feel socially isolated. Fair-weather friends drop them. Even some family members see them less. It’s so very sad for both the person with a dementia and equally their carer because they really need the friendship, love and companionship of family and friends more than they ever have.

This month Daughterly Care is working harder than ever to “spring forth” a better understanding of dementia to reduce the stigma.

Daughterly Care is providing more and more opportunities for our clients with dementia to enjoy outings and social connection with their peers, whilst supporting them to remain living in their familiar, loved and comfortable homes. One example of this is our Club Connect Lunches overlooking Narrabeen Lake we hold every 2 weeks.

dementia elders club connect daughterly care

Daughterly Care’s Club Connect at Narrabeen Lake

The Archibald Art Exhibition dramatically improved the speech of a client with dementia

Last Friday we took 3 clients to the Archibald Art Exhibition. One lady is 55 years young with Younger Onset Dementia, and an artist, along with two older ladies in their 80s with different forms of dementia. One of the older ladies has aphasia. This means the part of her brain that allows her to choose and speak her words – is damaged, so she often cannot say what she knows she wants to say. People with aphasia are often treated as stupid or described as “gone” and excluded. We’ll call her Rose, not her real name, but this experience I describe is 100% real.

I know from the Club Connect Lunches I have had with Rose that she understands the conversations being spoken to her and in her company. Rose understands what is being said but mostly can’t find her words so has limited verbal participation in a social setting.

The effect the Archibald Art Exhibition had on Rose was mind blowing!

When Rose returned from the Archibald she couldn’t stop talking!

Rose’s High Care Case Manager Suzie, Live in Carer and I were overjoyed to witness Rose talk for over 30 minutes non-stop.

Rose:

✓ initiated conversation with us;

✓ spoke in whole sentences;

✓ expressed herself perfectly;

✓ answered questions perfectly;

✓ was joyful; and

✓ appeared to have improved self esteem.

Rose told us this was her favourite art piece from the Archibald.

dementia art archibald 2017 daughterly care

Interestingly of the 3 clients we took – Rose was the only one who intensely listened and enjoyed the 60 minute Art Lecture. The other 2 clients felt overwhelmed by all the words – so our Caregivers walked them around the Archibald Exhibition and they enjoyed the art, one on one. Whereas Rose enjoyed the intellectual stimulation of the lecture. Whilst the lecture was especially for people living with dementia – the lecture was not simplified and in fact other people in the Art Gallery stopped to listen too.

anh do art archibald dementia

Winner of the ANZ People’s Choice Award, Anh Do for his portrait of Indigenous actor Jack Charles, 2017 Archibald Prize.  ‘Jack’s face is full of character,’ says Do. ‘I wanted the painting to capture his gravitas but also the loneliness that has been his constant companion. I mixed wet and semi-dried paint to create a texture that would evoke mountains and waterfalls, tree bark, fallen leaves, clouds and rain to encapsulate the beauty of the Australian landscape inside this beautiful man’s face.’

What was even more pleasing was that Rose continued to talk really well the following day to her daughter!

Look at this email Rose’s daughter sent us:

Hi Suzy,

Thank you so much for organising the tickets, and transport, for Mum to attend the Archibald last Friday.

By all accounts it was a wonderful experience and Victoria reported just how stimulated Mum was both during the excursion and afterwards. I noticed the same on Saturday morning, she was not only excitedly talking to me about the exhibition but also generally more cognisant.

I really appreciate this opportunity given to Mum by Daughterly Care, please pass my thanks to Kate as well.

In our experience, people with a form of dementia are never “demented” as I heard a member of the public describe someone last week. Words like “demented” have to be banned – they show the ignorance of the person who use them and they are so very demeaning.

People are never “gone”. Their essential spirit remains. They retain their human dignity and it is we, the people without dementia, who must use our intelligence and abilities to try harder to understand and connect with and assist them to live joyfully, despite the challenges of their dementia diagnosis.

Please post this link on social media or send a link to this blog to a family member or friend who would benefit from a better understanding that dementia is complex and often unique to each person. The best support you can provide is to continue to be there for the person with a dementia and their care partner.

Kylie Kate Lambert Daughterly Care co-founder and Home Care Package expert

Kate Lambert
B.Ec F.Fin

Daughterly Care CEO & Co-Founder

Sources:

https://nsw.fightdementia.org.au/nsw/about-us/media/key-facts-and-statistics

Categories: Dementia|10 Comments

In Home Care Approved Provider breaks Elder’s trust by lying

Last week a Old-School-Approved-Provider who I will call XYZ called their client and said “Daughterly Care has cancelled their services going forward with immediate effect”. The Approved Provider said they would be providing their own care staff from now on.

That was an outright lie to the client’s husband …

aged care home package respite live-in

Photo by Alexandre Debieve on unsplash.com

Let’s call him Ernst. His wife, has Alzheimer’s, let’s call her Edith.

The truth is Daughterly Care had not cancelled Edith’s services.

On the contrary, that same day XYZ Approved Provider had emailed us “cancel all ongoing services effective immediately”.  No explanation given.  Our Case Manager was really concerned that Edith had been hospitalised and for “closure” reasons we asked XYZ Approved Provider what had happened to Edith. No reply. Stony silence.

Ernst was really disappointed in Daughterly Care cancelling their services…

…because our Caregiver, Jenny, is a wonderful companion for his wife and therefore the service works really well.

Edith really enjoys Jenny’s companionship and their time out of the house together gives Ernst precious time to work from his home office, uninterrupted – time that he finds enjoyable, productive and a priceless break away from his caring role.

Ernst, in his 80s, is fortunate to still enjoy his part-time academic career.

When Ernst realised that his faith-based Approved Provider had potentially lied to him he called his Approved Provider Case Manager and asked “why did you tell me Daughterly Care had cancelled us?”

The Case Manager confirmed she lied by answering “it’s bureaucratic”.

Trust is a gift that Elders give Approved Providers and Care Providers ONCE

elders aged care approved providers home

By lying, XYZ Approved Provider had lost Ernst’s trust and confidence.

Ernst was disappointed that XYZ Approved Provider was prepared to put their business wants above his wife’s care needs.

XYZ Approved Provider forgot one very important legal fact that you need to know

From the 27th February 2017, Edith’s Home Care Package, is not the Approved Provider’s Home Care Package to direct.

On the 27th February 2017 the Government fully introduced Consumer Directed Care Reforms and in doing so they gave Edith, and Ernst, as her Enduring Power of Attorney, 9 powerful new rights.

elder rights consumer directed care

Of the 9 new rights, Approved Provider XYZ breached 3 by lying to Ernst:

1. Elders have the right to choose their Approved Provider.… 

Ernst decided not to be a victim, instead he used his personal power and new rights and exercised his right to move Edith’s Home Care Package from XYZ Approved Provider to Daughterly Care Community Services.  He also requested that for the next two weeks that XYZ Approved Provider continue to contract his same Daughterly Care Caregiver, Jenny, so that there was no change to Edith’s routine.

2. Elders have the right to choose who supplies their care… 

Approved Provider XYZ should never have cancelled Daughterly Care Community Services so they could use their own staff. They had no legal right to do that without asking the client. They should have been honest with their client.  They could have said, “we would like to stop using Daughterly Care because we have employed our own staff, is that okay with you?”

(In reality, XYZ is worried that their clients will transfer their Home Care Package to us. But their fear is unfounded – it’s late August 2017 and we have not approached “their clients” and we did not approach this client. We could have transferred this client to us in March 2017 but we didn’t. I personally reassured the XYZ Case Manager, face to face, in our office that we would not approach “their clients” and we have not done so.)

Edith would still have her in Home Care Package with Approved Provider XYZ if they had been less fearful and more client focused.  Secondly, had they been honest with their client – the client might have given their staff a go.

3. Elders have the right to be treated as an equal partner with no retribution.

Lying to Ernst was not treating him and Edith as an equal partner.

Edith and Ernst had absolutely no say in the decision to cancel Daughterly Care – this is not the way Consumer Directed Care works. It’s not the Approved Provider’s money – it’s Edith’s Government Funding.

[As an aside, this is why I call some Approved Providers “Old-School-Approved-Providers” because they supply “Provider-Directed-Care” which is the way the Government funded in home aged care industry has operated for the past 20 years. However “Provider-Directed-Care” is now extinct for Consumers who know and exercise their rights.]

Provider-directed care now extinct

Photo by Andrew Yardley on unsplash.com

The Approved Provider Case Manager’s answer shows the Old-School Approved Provider was prepared to breach the Home Care Package Guidelines issued by the Government and more importantly, disregard the preference of their client and breach their own vision statement.

So after Ernst spoke to his Case Manager, he and Edith got in their car and drove to our Narrabeen office

Ernst wanted to “eye ball us”. Face to face he quizzed us.

“Did Daughterly Care cancel my wife’s services?”

No, we had not.  We had been cancelled by the Old-School-Approved-Provider via email, no explanation given.

“They forget we are human beings, not pieces of meat”

Ernst’s exact words to us were “I’m really pissed off with XYZ, they forget we are human beings not pieces of meat”.

Ernst asked “what could Daughterly Care do if I transferred my wife’s Home Care Package to you?” 

home care package government funded elder aged

Edith is approved for a Level 4 in Home Care Package but has only been assigned a Level 2 Home Care Package (a very common scenario for Elders because the Government doesn’t have enough Level 3 and 4 Home Care Packages to meet the demand). A Team Leader of an Aged Care Assessment Team recently told our Registered Nurse that Elders are likely to have to wait one to two years to receive their Level 4 Home Care Package.  [You can see the Government funding levels for packages on this page].

Edith was receiving 4 hours a week of care paid for by her Government Funded Home Care Package through XYZ Approved Provider.

We explained that Daughterly Care Community Services is also an Approved Provider and we could:

✓ provide 20% more care each week of care;

✓ we would reduce their weekly contribution to the cost of care by 26% pa and they can keep the Caregiver who provides wonderful companionship to Edith, giving Ernst a precious break to work; and

✓ we reduced their administration cost from 35% to 10% pa.

Ernst and Edith considered their options over the weekend and decided to transfer their Home Care Package over to Daughterly Care Community Services.

This lying to Elders is not a once off and it has to stop

Elders have been lied to on many occasions.

One of the worst cases was a lady only in her 60s who was in the palliative care stage from a neurological condition. She had been a Case Manager of community in home aged care and that’s why she chose Daughterly Care to provide her care. She knew from her years of first-hand-experience we were the best in home care provider, she had used for her clients’ care.

Our Caregivers had been looking after her for a number of years until her Approved Provider, let’s call them CDE-Old-School-Approved-Provider, cancelled us with no discussion with the client in order to put their own staff in.

The client was devastated, she was in the final weeks of her life and she wanted to retain the Daughterly Care Caregivers who she knew and trusted so well

elder palliative death dying end life live-in home care

We knew her home, her illness and most importantly, we knew her and how she liked to be supported and cared for.  It was devastating for the client and heart breaking for our Caregivers to see her powerlessness and her sense of hopelessness,  knowing how close she was to the end of her life.

She felt terribly sad and ‘let down’ to be in her final journey of life without her known and trusted Caregivers.

She died two weeks later.

Change at that late stage was cruel and completely unnecessary

No thought for the needs of the client – just what suited their business best.

CDE Old-School-Approved-Provider had decided that strategically they couldn’t keep contracting care work to Daughterly Care – we were too good and when their clients had “consumer choice”, in time to come…well, there was a high risk they would move to Daughterly Care.  So they cancelled our clients across the board – without even making an exception for this palliative client.

Today, if the Elder knows their rights, changing the care provider cannot happen without the client’s permission.

Another cruel example with CDE Old-School-Approved-Provider was that for 6 years we had provided the same mature lady every week to visit a client in her 90s. She was very happy with our Caregiver who she trusted and who knew her, her care routine and her home.  CDE Old-School-Approved-Provider cancelled Daughterly Care with no notice and installed their own carers.

The elderly lady in her 90s was devastated and tried to argue against this change – but this was pre-Consumer Directed Care Reforms, so she had no rights, no power and her Approved Provider did not care to accommodate her preferences.

elder upset approved provider

Those are 2 examples of pre-Consumer Directed Care when clients had no say, no power and no rights.

Once Consumer Directed Care was introduced clients who had enjoyed Daughterly Care and had persevered with CDE staff requested to have Daughterly Care once again provide their service.  Six times one client made this request, 6 times she was denied her right to choose who provides her care.  Finally her daughter threated to lodge a complaint with the Health Minister. Within minutes of that threat, her RIGHT to choose ‘who provides the care’ i.e. Daughterly Care was granted.

Recently the Case Manager of URS-Old-School-Approved-Provider rang to cancel services for a client.  She said “management said we can no longer use Daughterly Care, so expect a lot more cancellations”

I wonder if they will tell the truth to clients or if they will lie to them and give them no choice?

We have not approached “their clients” to transfer their Home Care Package to us. We have respected that “their clients” are “theirs”. Just because  they “merely contract that care work to us” does not make them our clients.

However there are clients who were “our private clients” before they received a Home Care Package from the Old-School Approved Provider. In reality, they are “our clients” and we have the legal right to speak to those clients and most of those clients have transferred their Home Care Package to us because they like dealing with just one company – us.

The reality is that “the client owns the client”

Old School Approved Providers have to learn that they don’t own clients.

The client owns the client. You own you!

It’s not Approved- Provider-Directed-Care – it is Consumer Directed Care now – this is the power the Government has given older Australians now, so that they can remain in charge of their life and aged care.

The only valid long-term truth is that you attract and retain clients by offering great service at good value.  Everyday you work hard to retain clients and short cuts called “lying” will never work in the long run, they will trick some Elders for a while.

In home care is health care for seniors

When in home care is done well it:

✓ improves Elders’ well-being, their quality of their life and their joy of living;

✓ reduces depression;

✓ increases social connection;

✓ reduces unnecessary hospitalisations; and

✓ extends their years living at home, where Elders prefer to live.

The Government knows this, that’s why they offer the Government Funded in Home Care Package Program including to self-funded Older People. That’s also why they have now given more power to Older Australians to control their aged care support.

There is no value in administration

Actually, I write that administration has no value however one of the most common reasons that Elders have given for transferring their Home Care Packages to Daughterly Care Community Services is because of the:

✓ high fees; (Elder loses 46% of her Government funding)
✓ poor accounting; ($29,888.34 overcharge errors made)
✓ high overcharging rates; ($45,263.67 refunded to 3 clients)
✓ secret undisclosed fees; (Elderly Australians getting ripped off by secret fees)
✓ incorrectly charged GST;
✓ high error rates; and ($29,888.34 overcharge errors made)
✓ poor service from the staff of their prior Approved Provider.

So Old-School Approved Providers DO need to get their administration right. But don’t expect praise or Elders to be willing to pay high rates for something that they consider basic and which doesn’t improve their life.

Many organisations charge for case management but then don’t deliver good quality case management that improves Elders’ lives.

A Doctor whose Home Care Package Monthly Statements I recently audited comes to mind

His Old-School Approved Provider took 35% pa of his Home Care Package for their administration and Case Management. Yet his Case Manager had not even organised his extra 10% Government Funding for his dementia which meant the client had missed out on $3,215.65 each year. The Government pays an extra 10% when an Elder has dementia because they know extra care is needed. My audits have found this to be a common mistake. To add salt to the wound, by transferring to Daughterly Care Community Services the client could save $1,100 each month in Home Care Package fees.

Further the Case Manager had not organised for the client to be uplifted from a Level 3 Home Care Package to a Level 4 Home Care Package which they should have done years ago. Free of charge, I explained to the daughter how to make the uplift case and to highlight the various failures in their duty of care  – they promptly upgraded the client to one of their new Level 4 Home Care Packages. (This was early 2017 prior to Consumers being assigned the package directly from the Government).

The Old School Approved Provider Case Manager had not discussed with the client’s wife how she was coping and had not made suggestions on how she could have a respite break every time a Carer came to the house or how she could have breaks even when she was alone with her husband.  And then to worsen the situation the Case Manager contracted the care to 3 different care companies fracturing the service and communication about the clients’ needs even further.

This was despite the wife’s favourite Caregiver being from Daughterly Care.

So our Managing Director and Expert Dementia Care Nurse, Verlie Hall, visited the client and his wife and suggested solutions which had not been thought of, or suggested, free of charge.

To add salt to the wound the client had $9,957.60 in Unspent Government Funding which the client’s wife was unaware of and which could be spent to give the wife more breaks as she was suffering very intensely from carer-burn-out.

When the wife rang her Old School Approved Provider to ask exactly how much there was in unspent funds they wouldn’t tell her and made her feel like it was not her husband’s money to spend.

Yes it is.

From our 19 years’ experience we know …

  • that the real value of in home care lies in the quality of the care;
  • that the quality of care is dependent on the Caregivers provided and the Case Management that is actually delivered;
  • Daughterly Care’s Caregivers are hand-picked to join our team because of their:
    • experience;
    • maturity;
    • uncommon common-sense;
    • kindness;
    • their ability to communicate and relate well to our clients; and
    • their ability to communicate problems and suggest solutions back to us for us to discuss with families so that we can help negotiate solutions that make life more joyful for the person with a dementia and their care partner / family.

Just look at this Progress Note from our Caregiver Tami, which reflects the high quality of care Daughterly Care Caregivers provide:

05/09/2017

Tami Care Worker for elders private home careArrived and prepared breakfast and fresh juice for Melanie and Bruce [names changed].

Worked on some physio with Melanie. I asked her if it was possible for her to imagine walking before her stroke. I believe that Melanie has the ability to walk with a much better gait and pace but fear is holding her back. She is very strong and does her physio effortlessly.

I asked Melanie if she would just hold my hands as I walked backwards. And during that time to just focus on what her memories of walking were like. She offered to try. She did amazing!

Then I suggested to just lock our index fingers to one another and give that a try. She did amazing again!

I suggested she push herself more regularly at home and see if she can gain back her confidence. She then continued walking on her own,  holding her cane in one hand horizontally. All on her own.

Melanie needs encouragement in a compassionate manner and trust that someone is there to keep her safe. Fingers crossed that can be our new focus.

Afterwards we all drove down to Balmoral and walked around the oval. And went to IGA to pick up a couple items for lunch. I prepared lunch for Melanie and Bruce and our time was done.

Sincerely,

Tami

Doesn’t that Progress Note show great quality care!

You can meet 25 of our exceptional Caregivers here.

Here are 14 reasons to choose Daughterly Care for your in home care.

If you are told you can’t have Daughterly Care anymore…

…make sure you are told the truth. Check with Daughterly Care on what organisations / people say about us and then form your own view and make your own decision.

You may need to assert your 9 New Rights to retain our Caregivers.

Perhaps changes to the policies of Old School Approved Providers  will mean that you can only continue with Daughterly Care by transferring your Home Care Package to Daughterly Care Community Services.  We prefer to work with reputable and fair Approved Providers who follow the Government Guidelines. But transferring to Daughterly Care Community Services maybe the only way to receive your Government-Given-Rights if the Old-School-Approved-Provider is not going to honour your rights, your choice and your life.

The Government gave Elders these 9 New Rights to help Older Australians stay in charge of your life and not be ‘pushed around’ by organisations.  You are more powerful seniors now. Use your power.

Kylie Kate Lambert Daughterly Care co-founder and Home Care Package expert

Kate Lambert
B.Ec F.Fin

Daughterly Care CEO & Co-Founder

Categories: Home Care Package|1 Comment