9. Personal care supports
Personal care supports relate to assistance with daily personal activities including assistance with, or supervision of, personal tasks of daily life. For example:
- personal hygiene, including showering, bathing, oral hygiene, dressing and grooming;
- toileting, bladder and bowel management and menstrual care;
- eating and drinking;
- attending appointments;
- use of aids and appliances, hearing and communication devices;
- mobility and transferring, for example moving in and out of bed and on or off the toilet; or
- application of splints, basic first aid due to injuries sustained as a result of a participant’s disability.
Personal care supports may be required across a variety of settings. For example, a participant living alone in their own home, living with family or other people, when undertaking social, recreational, education or employment activities or during holidays away from home.
When personal care supports are being considered, the NDIA will have regard to the degree to which these supports:
- maximise the independence and functional skills of the participant;
- are appropriate to the participant’s age and circumstances; and
- whether alternative arrangements or supports could meet a participant’s needs in a less intrusive manner. For example, aids and equipment may enable a participant to complete tasks for themselves or the provision of training may increase the participant’s independence in the tasks.
Before including any personal care support in a participant’s plan, the NDIA must,amongst other matters, be satisfied that the support will assist the participant to pursue their goals. objectives and aspirations (section 34(1)(a)).
Personal care supports are likely to be supports which assist a participant to pursue a number of different goals, rather than being related to a specific goal.
Personal care supports for children are not intended to replace the usual care and supervision provided, or paid for, by a parent (see does the funding of the support take into account what is reasonable to expect others to provide?). However, the NDIA may fund personal care supports for children with complex needs where the level of support needed is beyond the level usually required for children of the same age.
A participant’s request that intimate personal care not be provided by family members or friends should always be respected and taken into account when determining the level of assistance that should be funded.
Supports to provide assistance with daily personal activities should generally be limited to a maximum of 6 hours per day. This level of support is based on:
- bathing, dressing, toileting and grooming up to 2 hours per day – including bowel management, skin care, bladder management, menstrual care;
- assistance with eating up to 2 hours per day which may include assistance with medication;
- mobility including exercise, positioning, moving up to 1 hour per day; and
- where toileting assistance alone is required, up to 1 hour a day.
In some circumstances, the NDIA may decide to fund higher levels of personal care support. In considering whether a higher level of support is needed, the NDIA will give consideration to:
- whether the participant has high care needs, for example unstable seizure activity or respiratory support;
- the weight (and other physical aspects) of the participant;
- the medical condition of the participant, including any medication required;
- whether the need for a higher level of support is of a temporary nature. For example, due to waiting for a suitable home modification (for example, a bathroom modification) to be completed;
- whether two people are required for transfers;
- whether there are behavioural concerns which require more intensive assistance with personal care activities and there are no other options, for example behavioural support intervention; and
- whether additional time limited funding is likely to reduce a participant’s longer term support costs by building their capacity to independently perform personal care activities.
The NDIA will also consider whether assistive technology , home modifications or other supports can be used to reduce the level of assistance with daily personal activities.