Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Breaking Traditions of Practice: Workforce Challenges in Implementing Disability Service Standards within Purpose-Built Accommodation for Younger Adults

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Breaking Traditions of Practice: Workforce Challenges in Implementing Disability Service Standards within Purpose-Built Accommodation for Younger Adults

Article excerpt

Without adequate community-based supports, young adults (aged 18 to 65 years) with complex disabilities can find themselves either at risk of, or having to live in, residential aged care (RAC) facilities or nursing homes (Disability Services Queensland and Queensland Health, n.d.). Nursing homes and RACs are typically congregated settings that are characterised by lack of resident choice and control (Tuckett, 2007). As Eaton (2000) noted, 'Traditional nursing homes are not seen as communities of people who are in various stages of living life or aging in place' (p. 608). Unsurprisingly, nursing home placement has several limitations for younger adults with disabilities including social isolation and limited recreation and community participation (Muenchberger, Sunderland, Kendall & Quinn, 2011; Winkler, Farnworth, & Sloan, 2006). RAC services tend to focus on health and medical outcomes and have a limited focus on broader life outcomes such as social interaction and emotional support for individuals (Ryvicker, 2009). Frequently, the experience in RAC environments is one where individuals are vulnerable in terms of having a voice or power (Eaton, 2000). A traditional RAC response for younger people with a disability can create barriers to resource access such as exclusion of funding for equipment (Queensland Health, 2011). Further, there is often a lack of capacity to focus on rehabilitation and other disability-specific therapies, limited disability expertise within the medical workforce, nonindividualised responses, and difficulties for inclusion of family and friends in care (Eaton, 2000).

The emerging focus on young adults in nursing homes in Australia

A significant milestone for younger adults requiring access to 24-hour, seven-day/weekly support occurred in 2006 with the Coalition of Australian Governments (COAG), a cross government peak body, agreeing to provide $244 million (from state/territory and federal sources) to develop alternative accommodation and support models for this 'at risk' population (Disability Services Queensland and Queensland Health, n.d.). Disability Services Queensland (DSQ) responded positively to the COAG agreement by recommending six principles for developing alternative accommodation and support models, specifically: (1) access to a supportive age-appropriate lifestyle; (2) choice, autonomy, participation, dignity and human rights; (3) person-centred approach; (4) compliance with relevant disability and healthcare standards; (5) service provision in community of choice; and (6) collaborative government and non-government approaches (Disability Services Queensland and Queensland Health, n.d.).

DSQ introduced a raft of funding programmes based on specific service and supported accommodation models to respond to younger people with a disability living in or at risk of living in aged care facilities. One model introduced was the Integrated Living Model (ILM) where funding was provided for organisations to deliver individualised service responses through the modification of existing land to include purpose-built accommodation for 10-20 people. The ILM was able to offer an alternative response to the RAC environment. DSQ defined the ILM as comprising a building that could facilitate mobility and independence, provide privacy, promote interaction with family and the broader community, and was homely in nature. Additionally, DSQ outlined that care within an ILM would encourage and support individuality and choice, and services would collaboratively assess and comprehensively plan for the transition of individuals to a new environment (Disability Services Queensland, 2006). Thus, the ILM aimed to move away from a care model that provided limited options for younger people with a disability who were at risk of premature entry into RAC settings, toward a model that provided opportunities for these individuals to negotiate the complexities associated with their care provision in a new and different way. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.