Home Modifications and Their Impact on Waged Care Substitution

Download Publication (pdf 3.35 MiB)

Authors Bridge, C., Carnemolla, P.
Published 11th July 2014
Audience Government/NGOs/Peaks, Industry, Librarians/Researchers/Students
ISBN 978-0-7334-28

There is a relationship between home modifications and community care provision. This research seeks to better understand the potential of home modification services to substitute for waged community care services. This is an important investigation for the purposes of exploring innovative and cost effective care solutions. The need for such research is high given the demands on care labour markets within the context of the challenges presented by Australia's ageing population, of whom a majority are living in older, inaccessible housing. However the potential for home modification substitution has been under explored.

This paper reviews current literature on home modifications and care substitution and is followed by case study examples which examine the relationship between care requirements and home modifications. Each case study demonstrates cost impacts and illustrates the variables affecting home modification and waged care costs. The case-studies utilise data from publicly available Australian data reported by Ageing, Disability and Home Care, Department of Human Services NSW (ADHC), as well as details obtained from actual case files which were supplied by Home Maintenance and Modification Service providers , a sector of the Australian Home and Community Care Program. Initial values derived from the case studies suggest that Home Modifications have the potential to be a cost effective component of a consumer directed community care approach. The case studies in this report introduce the concept of comparisons horizontally across the care stream networks. They serve to illustrate the potential of substituting waged care with self-care supported by home modifications however definitive values in the case studies were constrained by a lack of available data spanning the care streams.

In conclusion, the research suggests that home modifications are an under explored opportunity for substituting waged care through self care. However more longitudinal data collection between health profiles, care costs and home modification is required for further study in order to paint a more detailed picture of the interaction between home modifications and care provision.

Publication History

1^st edition Home Modifications and their impact on waged care substitution by Phillippa Carnemolla and Catherine Bridge, April 2011.  Reprinted July 2014

Table of Contents

• Publication History
• Glossary
• Executive Summary
  • Introduction
  • Project Aims
  • Overview of results
  • Conclusion
• Introduction
  • Why investigate the substitution of care?
  • Background to the research
  • Scope of work
  • Care Terminology
• Research Methodology
  • Literature Review
  • Case Study Approach
  • Cost Analysis
    • How care costs were calculated
    • How care hours were calculated
    • Home modification cost data
• Literature Review
  • General Structure of the Review
  • Community Care
    • Community Care Models
    • Consumer Directed Care
    • Australian Community Care Services
    • Demand for community care
  • Home Modifications and Maintenance Services (HMMS)
    • Who is currently using Australian home modification services?
    • Demand for home modifications
    • Significance of the home environment
    • Home modifications and accessible environment
    • How home modifications improve accessibility
    • Person Environment Fit
    • Home modifications and safety
    • Are there situations where home modifications do not benefit?
    • Home modifications and their impact on care needs
  • Self-care
    • Self-care: The added value of independence
    • Self-care and Bathing
    • Is self-care always the ultimate goal?
    • Self-care and learned helplessness
    • Drivers for a self-care alternative
  • Care substitution
    • Why substitute care
    • How care models substitute for one another
    • Home modifications and care substitution
• A matter of cost: Waged home care and home modifications
  • Economics of Care
    • Cost effectiveness of waged community care
    • Cost effectiveness of home modifications
  • Cost Analysis: Costing Community Care for the case-studies
    • Hourly Care rates and Indexation
    • Care Hour calculation
  • Costs associated with Home Modifications in NSW
    • Home modification provision in NSW
    • Home Modification quotation process
    • Home modification costs used in this study
• Case-Studies
  • Data used in these case-studies
  • Case study – Analysis of Template Design
    • Case study Section (1) - Personal Profile
    • Case study Section (2) Environmental & Care Cost comparison section
  • Final Case-Studies
  • Results
    • Potential cost savings
• Discussion
• Conclusion
  • Recommendations
  • Policy Implications
• References
• Appendix: Literature Search Strategy