Self-Managing In-Home Care keeps older Australians healthy and happy longer

New research has found that self-management of aged care packages can be a successful option for older Australians.


The research found that older Australians pay lower fees and have more money to spend on services and support. As a result, consumers get more personalised care, have increased autonomy, and are less reliant on service providers.


The research was conducted with 100 senior Australians by Dr Carmel Laragy when COTA Australia (Council on the Ageing) sponsored a self-management trial.


Dr Laragy said the findings show that self-managed home aged care is an efficient option. It maximises self-determination and reduces reliance on service providers.


“Through our research, we consistently heard that retaining autonomy and agency in decisions and choices left older people with an improved perception of their physical health and wellbeing when living at home. Having personalised supports also enable some people to remain living at home longer when the alternative was a nursing home,” Dr Laragy said.


Participants reported that they liked self-management because:

  • They had more money to spend on services and support because service providers charged lower fees than traditional case-managed services.
  • They had more choice, control, and autonomy when spending their package, and
  • They particularly liked being able to select their support workers.


Dr Laragy said self-management is a viable option for older people who want more autonomy and control over their aged care package. However, successful implementation requires easy access to information and support when needed.


“The pre-trial data analysis showed that participants wanted to self-manage because they expected that greater choice and control would overcome many frustrations they experienced under the traditional home care model, and they would achieve better outcomes.


“Participants' high expectations at pre-trial were met through self-management, Dr Laragy said.


In the current system, government-funded home support for older people with complex needs is provided through ‘home care packages’. An approved aged care service provider holds the funds, and the consumer has the right to choose and change their provider, know their budget, and be actively involved in selecting services.


While many service providers discourage self-management, others charge reduced fees and support older people, or their family carer, to self-manage.


“Our research adds clarity to a field where some people doubted that self-management is a viable option in aged care, rather than asking if additional choice and control offered by self-management results in better outcomes, we need to ask what factors contribute to self-management resulting in better outcomes.


“Our findings support the expansion of self-management opportunities and more comprehensive evaluations.


“However, traditional service providers face profound organisational change when transitioning to consumer-controlled self-managed services. They need to learn new roles as facilitators and supporters and develop new financial and data management systems to manage individual accounts. It is hoped that our findings will assist this transition,” Dr Laragy said.


Research: Laragy, C., & Vasiliadis, S. D. (2021). Self-managed aged home care in Australia – Insights from older people, family carers and service providers. Health & Social Care in the Community, 00, 1–12. Funding - The Australian Department of Health funded the project.


22 February 2022.