Dementia Care and Support in Victoria
Objective 3

Improve access to services for people with dementia, their carers and their families.

Page content: Introduction | Increase the availability of counselling support services | Increase the availability and flexibility of short-term overnight respite and extended hours respite

Introduction

Service providers report a continuing growing demand for services, and carers express concern about the amount of assistance available. Earlier discussion reported the increasing prevalence of dementia and the growing extent of the burden of dementia. Thus, it is particularly important that services have the capacity to expand their service delivery.

While demand and access are issues for many services, two particular services are pertinent to people with dementia, their carers and their families.

Actions

3.1 Increase the availability of counselling support services

Counselling support has been consistently identified as an area of unmet need for both people affected by dementia and their carers.

With the increasing trend towards early diagnosis of dementia, individuals with early symptoms of the condition are seeking counselling about their changed circumstances and future. Carers of people with dementia are also increasingly seeking access to counselling to cope with the demands of caring.

Carers have identified the need for emotional support and counselling particularly during transitional periods (such as after the care recipient's placement in residential care, or death).

Additional availability of counselling support would assist people from the early diagnosis of dementia through to the stage at which residential care is required. An appropriate infrastructure needs to be identified so counselling is more available along the whole pathway of dementia, and so any additional services have a beneficial Statewide impact.

3.2 Explore options to increase the availability and flexibility of short-term overnight respite and extended hours respite, and support the provision of respite models that are sensitive to people's needs

Respite care is provided in a number of settings on either a planned or emergency basis. According to the 1999 report Targeting in the Home and Community Care Program, the highest levels of unmet need for carers (based on the Victorian Carers Project) were for home maintenance and respite. Day respite represented the area of least use and greatest unmet need. Inversely, the area of highest use and least need was longer term respite.

While the Victorian Carers Project occurred in 1993, prior to the Commonwealth and State carer respite and support initiatives, carers in 1999 continued to identify respite as an unmet need. Consumer consultation by Carers Association Victoria in 1999 indicates that:

• Carers have identified a lack of longer stay and regular weekend out-of-home respite, particularly in facilities located near to where they live.
• Carers have indicated the need for the provision of additional, more responsive forms of day centre respite.
• Carers have identified in-home respite as an area in which it is difficult to access enough hours from the mainstream respite services.
• Carers have indicated a desire for the increased availability of in-home weekend and overnight respite.

In-home respite for older people with high care needs or cognitive behavioural or complex care needs has also been identified as an area of need.

An increased diversity in respite options and supporting services' efforts to meet people's individual respite needs will provide valuable assistance to carers and families in maintaining their caregiving roles.

Implementing a strategy to increase the availability and flexibility of respite options is particularly challenging. The development and delivery of flexible respite options for families require cooperation among existing services.

The Department of Human Services' (2000) evaluation of the Support for Carers Program provides an opportunity to assess the current service quality and use of respite for that program. Further, the Victorian State office of the Commonwealth Department of Health and Aged Care recently reviewed the use of respite in Commonwealth funded residential facilities in Victoria.

It is now necessary to identify impediments to the delivery of respite that is adaptable to people's needs, and to identify current flexible respite services. In addition, supporting service providers so they can develop and establish local strategies to meet individual needs will facilitate the availability of quality respite.

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