Even if we have the most proactive, well-designed and well-intended processes, procedures and systems, we still have to recognise that understanding the individual is key to offsetting some of the issues we create and inherit. Care is an isolated process. It exists to service people and is supplied by people. That means it is also fallible in the same way humans and the way we do things can fail.
However, by being aware of the shortfalls and actively challenging their impacts, we can do a lot to avoid problems as they arise.
By recognising the limitations of care itself, we can help avoid some of the negative impacts on rights-based care such as:
Healthcare and law are established- and that’s great. But it also means they are old and historically based on precedent and learning from one situation to the next. This helps accumulate knowledge. But it also helps accumulate mistakes, bias and problems as well. We have to be mindful that it’s only through new information that we can ask the system to adapt to new requirements.
It includes discrimination and bias
For a very long time, medicine and law were the fields of older, white, straight, able-bodied and affluent men. From the textbooks that have trained professionals through to the procedures and processes that guide everyday decision-making, we have to understand that the default setting on many of the building blocks of care may not reflect who we are as people through exclusion of race, gender, sexuality, disability, age and privilege. Things are changing, but again, adding the experience of those outside this thin wedge in society helps
It’s inflexible in an age where we’re often in flux
Science is not a static pursuit. We learn all the time through technology, understanding the human body, cognitive function and how we operate generally. With each new piece of information comes the potential to infringe on someone’s rights through simply not understanding the changes these advances bring. And that influences every aspect of care, especially at a time where technological advancement is moving so rapidly.
It’s susceptible to our influence
Humans are wonderfully talented, caring, creative beings. We have the ability to problem-solve and innovate. And we’re fundamentally geared towards connection and creating systems that support each other as a means of survival. But we’re also working with creatures that are inherently competitive, stubborn and prone to stress and negative emotions. We cannot expect people to understand an individual’s needs when we’re often grappling with how to meet our own. Not if those needs aren’t documented.
It’s influenced by economics
It’s very difficult to meet the needs of every single person without a clear blueprint of how to action what that looks like. Especially when you have already got documented sometimes competing interests such as the budget, the resources available and end-goals that satiate fiduciary concerns over that of the person. We need money to be able to provide care – but there is not a never-ending supply. Finding a balance between the needs of financial side of care while also providing that care becomes so much easier when we understand the individuals we’re caring for.
Documenting values creates a roadmap
There’s no denying that all care providers are doing their level best to move forward to a far more person-centred, rights-based care model in Australia. There is plenty of oversight and pressure to shift the disability and aged care sectors to models that promote individual care.
And on a systemic level, the accountability is there.
But what we need to do is promote how empowering values-based care is to all Australians. We have to stop waiting for the system to accept us as people with disabilities or who are ageing into the system to finally talk about care that is centred on the individual.
We have to build processes that promote all kinds of people articulating their care wishes and working through the process of understanding what they want from their care-based experiences. If you think about the application of rights-based care, it can give a pregnant mother looking to give birth for the first time just as much peace of mind and individual say in their situation as an elderly woman with dementia looking to enter aged care for the time.
Values-based care key to reducing misinformation
Part of the reason why we see people turning away from care-based offerings is that desire to be assured that they won’t lose themselves within a system that doesn’t reflect them as an individual. People want their individuality respected. They want to know that they will maintain bodily autonomy and the ability to have a say over treatments. They want to know what kind of care and treatment they will receive. And they want to self-research, understand the lay of the land, and make a decision that feels right for them.
Part of how we encourage people to take care seriously and move away from rejecting healthcare when they don’t understand the process is about demonstrating just how individual the process of care is becoming. It also means transparency that can help a person understand how they fit into the scheme of things.
If we’re going to create a relationship with today’s care recipient, we also have to acknowledge that much of the care people have received in the part was not based on their rights. And that it didn’t reflect autonomy, choice, inclusion and fairness for many people who were recipients.
People with disabilities, Indigenous Australians, people with mental health conditions, women, people of colour and many of Australia’s most vulnerable people have a difficult relationship with care precisely because part or all of the pre-existing care models failed them.
For example, if we recognise that the disability community’s unease with euthanasia and end-of-life discussions is tied to policies prior to the eighties that often saw people with disabilities institutionalised for little to no reason, we gain a lot more ability to reach the disability community of today on their terms.
If we can recognise that mental health treatment, while improving, still leaves many Australians with complex mental health conditions with piecemeal treatment and families without appropriate support, we can begin to understand and accept some of the stigma related to disclosure, access and activating care plans at earlier stages of the mental health journey.
Workable rights documents via care plans
Care plans can do wonders to articulate those fears and give a person the opportunity to define what they don’t want from treatment experiences. Instead of being a voiceless person in a crowd asking for assistance at the worst moment, care plans provide the ability to move away from reactive treatments and into responsive behaviours. And through this responsiveness, provide hope with goal setting, a voice with articulation, and a workable document that avoids some of the fear.
By placing people and their rights at the centre of care, we improve health outcomes. By using individual care plans to do it, we create a workable strategy that a person can own, follow through on, and find the appropriate support and buy-in from the available services. And also answer confusion, questions and issues as they arise with a workable, enforceable, measurable document.
It’s certainty, protection and autonomy all in one.