Disability Aged Care Service Podcast

Aruna Ellis
Disability Aged Care Service Podcast

We make person centered care in a safe and caring environment easily accessible in disability and aged care. We do this trough training and education.

Episodes

  1. Episode 4 - Support coordination with Collin Mullan

    04/11/2023

    Episode 4 - Support coordination with Collin Mullan

    This conversation with Collin has been so informative. It was a long conversation packed with wisdom, so I will sum up the conversation and highlight the important points in the show notes. Support coordination is one of the categories of funding that people will often see in their NDIS plan. It can be broken down into probably four key roles within support coordination. So there's level one, level two and level three support coordination. And there's also psychosocial recovery coaching, which is very similar.   Level 1  It's usually under 24 hours a year. So very minimal work needs to be done. It's just a contact point.  Level 2 The second level is called coordination of support. And that's what I do and what the vast majority of support coordinators do in NDIS. And that's a more detailed approach to helping people implement their plans. And it's got a big focus on capacity building. So allowing some assistance to, for participants to learn how to manage their own plans and engage their services.   Level 3 The third level is called specialist support coordination. That's for more complex needs. A specialist support coordinator is quite often an allied health professional or a social worker. So they've got some extra skills to deal with complex issues that might be people who are involved in the justice system and have drug and alcohol issues on top of their disability or maybe facing homelessness or have a very complex care team that needs to be coordinated. Level 4 And then the fourth one that I mentioned was psychosocial recovery coaching. So that's a distinct focus on mental health. It's a lot more flexible with the support.   Support coordination is really a Monday-to-Friday, nine-to-five job. Psychosocial recovery is a lot more flexible and can be provided outside of those hours, across weekends. It can be used in a crisis management situation.  The vast majority of participants that are going to have support coordination is going to be at that level two coordination of support. And just to put people in the picture, about 40% of participants will have support, coordination, and funding. So it's not open to everybody, but you can ask for it. So if, if a participant feels that they need some help with their plan, particularly if it's their first plan, they can ask for support coordination to be put into that funding. If people are struggling to implement their plan and they're not getting support from the agency or the LAC, they can always go back and ask for support coordination. They can put in a change of circumstances to say, I'm struggling with this, I can't get my services engaged, I need some help. Please give me a support coordinator.    An analogy  Entering NDIS territory is like going on a holiday to a foreign country where you don't understand the language. They have different customs, different laws, and different cultures. It's just new territory. The support coordinator is the tour guide. So they're going to try and get you the best experience possible. They're going to help you navigate unfamiliar territory. They are going to translate for you. They're going to help you avoid the pitfalls. And if you're in a foreign country and you want to go and visit a place, they'll go, no, no, no, let's not go at nine o'clock in the morning because everyone else will be there. Let's go at three o'clock in the afternoon, and you'll get a better view and experience. That's the role of the support coordinator to help guide you to get the best experience. And it's also about minimizing risk as well. So ensuring that you get safe, quality services in place that you're protected from people who might defraud you or not provide the best services possible. So to go back to what you were saying, there are a few things that support coordinators do, and NDIS has a big list of what the role is, a little bit of a list of what the role isn't. So the primary function is to help facilitate the plan implementation. So again, it's that navigating, the advising, it's about unpacking the budget, so understanding what all the categories of funding are and how they can be used appropriately and assisting the participant in making that last for the life of the plant. The other aspects that we look at with support coordination is researching different options, providing a range of solutions and a range of services and providers so that the participant can choose the one that they feel most comfortable with and also, you know, mediating any issues that might crop up as well. What should participants or their loved ones look for when they're choosing a support coordinator?   Summer Foundation has a great booklet on choosing a support coordinator. There are two things to look at in choosing a support coordinator. Number 1 is an essential criterion number 2 is a personal preference.   Essential criteria -  I would say get a local coordinator so someone knows your area and the available services. Remote work might work for some people, but it's going to be very difficult for the operator to understand the local market in another area and know who the good service providers are and the ones to stay away from.   Experience brings knowledge, and you refer to the NDIS is a maze if you don't know your way through the maze, the coordinator's going to get lost with the participant.    Asking questions about a person's work history and background experience will help and bring some comfort to that question.   The other thing is the capacity and the caseload that the coordinator has. So that's going to vary depending on whether that coordinator is part-time or full-time. If they work for themselves or in a bigger organization, that capacity is going to change. But generally, if the support coordinator's got a caseload of 40 to 50 participants that they're assisting, that's really, really busy, and they may be spread too thin, they may not be reachable all the time, they may not be able to attend to the crises if they come up. Whereas someone working full-time, if they only have a caseload of 25 or 30, they're going to have much more flexibility to respond in a better way.  Asking the question about capacity is really important. Harking to whether they're a sole trader or work for a big organisation, what happens when that person goes on leave or they get sick? What's the backup plan?    Personal preference I think it's really important to have that rapport between a participant and any service provider, particularly the support coordinator.  There's one point that probably sits between the essential and the personal preferences. I would call it essential. Other people would say it's a preference. That is how independent is the support coordinator. What potential conflict of interest might they have? So if they work for a big organisation that provides a whole range of NDIS services, what's their conflict of interest policy? Are they going to recommend that the participant use that organization's services? An independent support coordinator, particularly someone not delivering other services, will not have that same conflict of interest. So some people love the one-stop shop.So a participant might find that's the easy way to go, but for others, independence, unbiased, objective advice is really important . Another factor that people will need to consider is whether the provider is registered or unregistered. So depending on how the plan funding works, if the NDIA manages the funding for support coordination, then the provider must be registered. If the funding is self-managed or plan-managed, then the participant has a choice of any provider to deliver that support.  Couple of more things that are really good for personal preferences, your own values and the work style of the provider. So things like communication, are their processes going to work in with the needs of the participant?For example, I have a participant who prefers to get all documents printed, and in the mail and in this day and age where we're all used to email and high technology, some providers may not work with the old print and mail-out and get it returned a week later in the mail.   The other thing is specialisations. A lot of support coordinators may specialize. Now that could be in the type of disability, it might be in the age bracket, it could be in in the specific type of service that they focus on or the area within NDIS. So for me, I really enjoy working with families that are going through a transition. So it might be a teenager that's about to leave school, get into employment, look at a future possibility of having their own independent life in their own home, that kind of transition. So I tend to focus on that. Some other support quotas may focus on specific disabilities or they may focus on, uh, particular age groups. So for me, I really don't work a lot with young children, particularly those in the early childhood situation.  The other question I would ask of a support coordinator is how do they bill. Some support coordinators may bill in increments, for example, 15-minute increments. So if they have a phone call with a participant that lasts five minutes, they may bill 15 minutes because that's the way their systems are set up. Some may bill in smaller increments, five minutes or six minutes. I bill in six minutes because it's very easy. It's one 10th of an hour. Makes accounting really easy. But if a participant has three phone calls, for example, in a day, and each of those five-minute phone calls adds up to 15 minutes, the question would be, is the support coordinator going to build one lot of 15 minutes or three lots of 15 minutes? And that can make a really big difference in someone's funding.  The second part of that is how they bill for travel. So with a lot of support and support coordination, providers can bill for their travel time. So the time that they take to go to

    35 min
  2. Episode 1 - Understanding disability

    03/21/2023

    Episode 1 - Understanding disability

    Do you know the word disability has no set definition? That holds across the board. According to the Australian Institute of Health and Welfare (AIHW) - DIRECT QUOTE - Disability is an umbrella term for impairment of body function or structure, activity limitations, or participation restrictions. According to the Australian Bureau of Statistics - Disability is any limitation, restriction, or impairment which restricts everyday activities and has lasted or is likely to last for at least six months. Do you understand what a disability is? We feel it’s important to begin discussing and understanding disabilities—after all, 1 in 5 people living in Australia have some form of disability! So it made sense to help foster the discussion on understanding disability before we entered the maze that is NDIS. Disabilities come in all shapes and sizes and can present themselves in many ways, meaning they aren’t always immediately visible. They can be physical (i.e. difficulty using limbs), sensory (i.e. hearing or vision impairments), cognitive (i.e. learning difficulties), mental health conditions, or intellectual disabilities. Many people with disability will use mobility aids such as wheelchairs or walking sticks which help them move around independently… however sometimes ‘invisible’ disabilities such as anxiety may mean someone prefers not to leave their home without a care or support dog by their side". Each type of disability is unique and comes with varying levels of impairment. That is how much it affects a person. Some people may have a mild form, some moderate, and others severe form. Whatever the type of disability, though, fundamental human rights should always be respected, such as the right to life, equality, non-discrimination, and, if I may add so, love and friendship. Understanding these principles is pivotal if you want to provide adequate support for those with disabilities, whether you’re a loved one, a stranger supporting someone during an emergency, or part of their day-to-day care team. UNDERSTANDING DISABILITY Numbers As per AIHW, 1 in 6 people, or 4.4 million people, have a disability in Australia. Interestingly other places, you find the number to be 5 million. 1 in 3 people has severe disabilities. 1 in 4 people has a mental and behavioural disability. Remember what we spoke about before? Many times, people's disability is not always obvious. If you like to see the survey report, I will put the link in the show notes for you to check out the survey numbers in Australia. At the same time, every individual with a disability has different needs. A survey reveals 1 in 3 people have profound disabilities. They need carers to meet their every need. It is easy to forget the needs of people with disability when we ourselves are not struggling with them. Most people with disability can lead a healthy, fulfilling life with the right support, where they can execute choice and control just as others who do not have disabilities do. Others who can not look after themselves need us to fight their battles. After all, what do we live for if not to make life less difficult for each other? So, in a nutshell, Disability can be of many kinds and affect different people differently. Disability is not always visible. And if you are still here listening to me, we are in the same camp. Thank you for trying your best to make this world a better place.   References https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html https://humanrights.gov.au/our-work/education/face-facts-disability-rights  https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/people-with-disability/prevalence-of-disability  https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/latest-release file:///C:/Users/Aruna/Downloads/metadata-393867.pdf https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Education_Employment_and_Workplace_Relations/Completed_inquiries/2002-04/ed_students_withdisabilities/report/c02 https://aifs.gov.au/sites/default/files/publication-documents/rr16_0.pdf

    25 min
  3. Episode 2 - NDIS, NDIA, NDIS Quality and Safeguards Commission

    03/21/2023

    Episode 2 - NDIS, NDIA, NDIS Quality and Safeguards Commission

    In this podcast, we will explore What is NDIS, What is NDIA What is NDIS Quality and Safeguards Commission The National Disability Insurance Scheme (NDIS) is a social policy reform initiative that provides support and improved opportunities for individuals with a disability. It is the first of its kind in Australia and has the potential to significantly improve the lives of nearly five million people living with a disability in Australia. The NDIS is now available in all states and territories across Australia. The National Disability Insurance Agency (NDIA) is a government agency responsible for implementing the NDIS in Australia. It works with a network of state and territory governments, service providers, and community organizations to create a nationally consistent approach to providing quality support to people with a disability. The agency works to ensure that the scheme is managed properly and that sufficient assistance is provided for people with a disability. Some of its key responsibilities include assessing individuals' eligibility for the scheme, allocating funding and resources, assessing the effectiveness of services provided under NDIS, and making changes when needed. The NDIS Commission is an independent organization established to monitor and regulate the National Disability Insurance Scheme (NDIS) in Australia. The Commission is vital in ensuring people with disabilities have access to quality, safe, and person-centred support services. The NDIS Commission also monitors complaints and takes action if there is evidence of serious contraventions of the standards outlined by the NDIS. They are responsible for providing independent advice and guidance and supervising providers to ensure they meet the NDIS Quality and Safeguarding Framework. The NDIS Commission also advises the Australian Government and works with other agencies to ensure the effective implementation of the NDIS. The NDIS, NDIA, and the NDIS Commission work together to provide a system that allows individuals to choose how to use available funding for support services. This includes ensuring people with disabilities have access to quality support and services. The NDIS Commission plays a vital role in upholding these standards. Together, these three organizations ensure that all Australians with a disability can access the support and services they need. So, in a nutshell. People with disability and their advocates raised their voices and asked the government to provide care, opportunities, and options. Following that, a review was conducted, and many recommendations were made. Post-review legislation was passed in which the government promised to do better for people with disability by establishing a scheme. The legislation was passed, called the National Disability Insurance Scheme Act 2013, and the scheme was called the National Insurance Disability Scheme. To run this scheme, they needed money, so the government at all levels, commonwealth, state, and territory, contributed. Later they applied a levy on the general population through medicare. All this together funds the NDIS. The funds are managed and distributed by NDIA. An independent commission was then established called NDIS Quality and safeguard commission. The commission's main job is to monitor and ensure, on a national level, there is consistency in support and service being provided to people with disability. And these supports and services promote dignity, choice, and control.   References https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Chronologies/NDIS https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BriefingBook45p/NDIS https://www.ndis.gov.au/about-us/governance https://www.legislation.gov.au/Details/C2022C00206 https://www.ndis.gov.au/news/4889-delivering-ndis-roll-out-complete-across-australia-christmas-and-cocos-islands-join-world-leading-scheme https://www.acoss.org.au/wp-content/uploads/2017/09/ACOSS_medicare-levy-FINAL.pdf https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BriefingBook45p/NDIS#:~:text=In%20addition%2C%20funds%20for%20the,reimbursing%20governments%20for%20NDIS%20expenditure. file:///C:/Users/Aruna/Downloads/IG%20ACT%20Schedule%20E%20Bilateral%20Agreement%20for%20NDIS%20Launch%20Between%20the%20Commonwealth%20and%20ACT%20PDF.pdf

    10 min
  4. Episode 3 - Caring for Carers

    03/21/2023

    Episode 3 - Caring for Carers

    Caring for a loved one can be an incredibly rewarding experience, but it can also be emotionally and physically exhausting. Carers often put the needs of their family members before their own, sacrificing their time and energy to provide the necessary care. This selfless act can come with its own set of struggles as carers face physical fatigue and emotional stress while trying to balance a demanding job with providing care. We must recognize the hard work and dedication of these individuals who dedicate themselves to caring for loved ones in need.  Welcome to DACS, your Disability, and Aged Care Service podcast, brought to you by LevHealth where we make person-centred care in a safe, caring environment easily accessible. So let's talk about carers, but before I go there, I need to tell you why. By now, you know I grew up in a big big big family. Growing up we were taught cousins are just brothers and sisters born to aunts and uncles. We knew everyone in the village, and people were always in and out of each other's houses. I have childhood friends, girlhood friends, school friends, nursing friends, and work friends. Church friends and kids friends, parent friends. In short no shortage of people in my life. When I first left home and went to mainland of India, I was surrounded by a few 100s of people all the time, I did a hospital-based nursing course and lived in a hostel with a few 100 girls. There was no escape. But I was lonely, so very lonely. Strangers surrounded me. They were not my people. Faces were different, voices were different, and culture was different. Life was different. Even my sister being there with me was no consolation for me. 5 yrs on I wept bitterly, leaving this hospital and hostel. Strangers had become friends; some even took us to their homes, and the families welcomed us with warmth, love, and food. I love food. Then I came to Australia, and the whole process started again. But this time, the difference was stark. This time there were not many people. There was no community. People were not in each other’s lives as I knew, and I felt so alone. 19 yrs, now Australia is home, and family and friends surround me. But you see, in hard, trying times, I miss my parents and aunts and uncles. Who have been my caretakers and well-wishers who made personal sacrifices and always said a word of prayer? At any given time, a round table conference is going on in my head. In any given scenario, I know exactly what someone will say and the motivation behind it. But I have learned just because one has families does not mean they have a bond. People can be rich in money and poor in love. Love, a social or moral obligation, is no longer enough for people to stay and care for. Negative as it may sound, I have seen much of it. Why is this important? In a big family, there was always someone at hand to take turns. People help when they are around, now look at me so far away from my parents. Lucky for me, my brother and sister-in-law are amazing and care for my parents. And vice versa, my parents greatly help and support them. My aunts and uncles check-in, share a meal and lend a listening ear. With people having smaller families, families living far from each other, and all adults working, people are away. At the same time, the personal space bubble has grown so big that we have forgotten to ask for help for ourselves or our loved ones. We have asked and were let down. Many have forgotten to ask others, “how can I help” or “what can I do for you”. Many have asked and suffered for their kindness—so many scenarios. A quote from Writer Gary Paulsen’s book comes to mind, “ you can take the man out of the woods, but you can't take the woods out of the man”. It's true for humans too, but instead of woods, we need to care. I have noticed that it does not matter if we live in our bubbles. In 95% ( my assumption course), care is needed. You care. I know that is why you are here listening to this podcast. Village life, living in a herd, is not new to humans. We have done that from the beginning of our existence. And we will continue doing that, what families did, now paid workers to do. In an ideal world, life is about codependency. We physically care more for our young ones and teach them how to care for themselves and others. So one day, they can grow up and step in our shoes. We care for our elderly because they are completing their circle of life. We do this out of love and in looking after our elderly, we prepare our young for their future roles. We care for loved ones when they are sick. These are all basic human instincts though vital. They are not the same as caring for someone who can not care for themselves. In the circle of life, there is a phase in our lives that gives us time and opportunity, frees us from intense responsibility, allows us to go after our dreams, and in many cases, lets us live as we want. My husband and I have worked hard to make our children self-sufficient. So if I have to be at work or do not want to wake up early, kids can make breakfast, make lunch and take themselves off to school. My in-laws are self-caring. My mother-in-law is quite capable of looking after herself and my father-in-law and our great uncle. We offer support when we think we are needed, and she asks for help or accepts our offer when she is ready to do so. Having a loved one with a disability changes things. Having a disability, oneself, changes things. And caring takes over a whole new dimension. Now we are relying on others. We want to care for our loved ones. With that need to care, there are also frustrations due to our own physical limitations. Some question their self-worth others live in guilt. The type of disability and the intensity of the disability means for some carers. There is no breathing space. The role of primary care is exhausting. This is why we need to care not only for our people with disability but their carers because these carers get no break in the circle of life. They can not just up and go on holiday. They can not always be spontaneous. They can't sleep in if they want to. They have no downtime to rest and recuperate. They have no freedom to go after their dreams—the fear of the future crushes some. As per Australian Institute for health and welfare, direct quote “ Informal carers are people who provide care to those who need it within the context of an existing relationship, such as a family member, a friend or a neighbour. The role's demands often go beyond what would normally be expected of these relationships.” As per the Australian Bureau of Statistics (ABS) Survey (2018), 1 in 10 Australians provided informal care. And one-third of these carers were between 35 to 54 yrs old. Primary carers are people who provide the most amount of care. One in 3 of the above statistic is a primary carer; females make up the majority. One day I was praising a young lad to his mum about how good he was at this particular thing. After all my gushing, she dejectedly told me, Aruna, you are right, and we are very proud of him, but you know he will never be able to care for himself as other children will. He will never fit the same, he will never be able able to live that ordinary life that we take for granted. I totally understood her. Being a parent has changed us for the better and made us more vulnerable and fearful. Also, nursing has exposed me to many heartbreaks. I do health assessments and write a care plan. We can see the toll caring has taken on families and relationships and the decline of carers' health, income, and happiness. The worry they carry - of what happens when I am gone. The responsibility and alienation other children in the family feel. It is not all bad; I have heard laughter and happy stories that have moved me to tears too. Of course, you hear horror stories too. This is why it is crucial to understand the vulnerability of people with a disability and advocate for them. Caring for a loved one with a disability is a heroic act of selflessness and courage. Carers are the backbone of support, providing essential physical care as well as emotional guidance to those who need it. Without carers, many would be unable to live their lives in the same way they do now. Being a carer can be an isolating experience, as it can be challenging to find the right balance between caring for a loved one and taking care of yourself. You, the mum, the dad, the sibling, the elderly parents, the children, and young adults who find themselves caring for a loved one - salute. And for the rest of us, The gist of the matter is if you are a professional carer and walk into your work for the sake of working, stop and think again. Your sensitivity and care can make a world of difference to the life of the person you care for and those of their loved ones. If you are a carer, remember to look after yourself. If you are a primary informal carer, let me know in the comments what you do for self-care or if you would like me to talk about self-care. Also, please remember the majority of us care. We need clear communication and space to do so. I will discuss building a more therapeutic relationship with your professional carer and getting the most out of the relationship. We will also explore some of the resources available for carers. Until next time take care.   https://www.aihw.gov.au/reports/australias-welfare/informal-carers https://www.carersnsw.org.au

    21 min

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We make person centered care in a safe and caring environment easily accessible in disability and aged care. We do this trough training and education.

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