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2. Autonomy

Autonomy is the second Guiding VALUE. It involves the provision of choice and respect for choices made; recognition of when a person requires support in decision-making; and optimising a person’s control through sharing of power, decision making and responsibility.

Autonomy is made up of two ‘Elements’: 

  1. Promoting autonomy and independence
  2. Balancing rights, risks and responsibilities

Each Element is then broken down into a set of ‘Actions’, which provide examples of person-centred approaches in four key areas.

 

 

 

 

 

1. Promoting autonomy and independence

The focus on care and relationships between consumers, the organisation and staff is based on involving people in planning by building on individual strengths, interests and abilities.

Working with the consumer and their carers

  • Negotiate with consumers and their carers to meet their individual and preferred outcomes
  • Engage in strategies, relationships and reflection to identify and define consumer’s strengths, abilities, aspirations and goals
  • Communicate and share timely and accurate information with consumers and their carers
  • Facilitate participation in care and decision-making
  • Support consumers to consider who will make decisions on their behalf in the future if necessary
  • Determine the level of control the consumer wants to exercise

Working with staff

  • Help staff to build on their own strengths, abilities and aspirations
  • Encourage and support staff to work autonomously where appropriate
  • Provide opportunities for staff who work alone to get together and learn from each other

Organisational leadership, systems and culture

  • Ensure care plans identify what people can do as well as identifying their support needs
  • Support consumers to participate in decision-making at the level they choose
  • Use a strengths-based approach for assessment models and care planning
  • Communicate consumer’s preferences to relevant staff
  • Encourage consumers to maintain the skills they have
  • Support consumers to express their aspirations and goals for the future including advanced care planning and end-of-life issues
  • Consider all opportunities where choice and control can be improved
  • Support staff to use flexible work practices that promote choice, control and independence

Education, supervision and support

Ensure staff:

  • Understand the meaning of independence is shaped by people’s beliefs and background
  • Know how to support consumers to make their own decisions
  • Understand that progressive deterioration in cognition results in functional decline
  • Understand the importance of respecting the autonomy of every person

2. Balancing rights, risks and responsibilities

A collaborative approach to managing risk promotes a shared understanding upon which risk management decisions can be reached to maximise a person’s opportunities, choice and control.

Working with the consumer and their carers

  • Involve consumers in risk assessment to ensure support enables them to live independently and exercise maximum control of their lives
  • Identify consumers’ preferred method of communication and make it known to relevant staff
  • Utilise the principle of best interest when others are advocating or making decisions on behalf of consumers
  • Ensure consumers living alone without support have access to services that can monitor their safety and support them to remain in the community
  • Take people’s concerns seriously and respond to them in a timely way
  • Seek to identify causes of changed behaviours

Working with staff

  • Support staff to consider risks within the context of what also protects people (their strengths and their support networks) and their right to make choices about their lives
  • Support staff to explore new ideas and ways of practice
  • Support staff to exercise their own judgment where appropriate

Organisational leadership, systems and culture

  • Establish effective communication systems and practices to ensure the right information is provided to the right people at the right time
  • Make clear to staff their responsibilities in relation to risk
  • Make sure support plans are goal oriented and monitored regularly
  • Develop systems to identify and address hazards
  • Implement systems and practices to maintain the safety of the workforce

Education, supervision and support

Ensure staff:

  • Understand the importance of a partnership approach in assessing and managing risk
  • Understand the progressive nature of dementia and the need for regular reviews in enabling and managing risk
  • Understand that dementia can cause changes in behaviour, that the behaviour is not deliberate and may be a sign of pain or distress

Continue to the next VALUE: 3. Life experience

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