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Table 2 Essential Components - Overarching Philosophies

From: Development of an optimised key worker framework for people with dementia, their family and caring unit living in the community

Overarching Philosophies Key Components Source Quotes from Australian Evaluation of Dementia Key Worker Models
Relationship-centred Relationship- centred care should be the foundation for the key worker role Systematic Review, EWRG, Australian Evaluation “I think it’s all about relationship-building... that’s how you gain trust, you build that relationship, but if you say you’re going to do something, you need to do it” [Key Worker Seventeen]
“Once you have someone walking alongside you like that asI said it can be the difference between a carer actually crumbling in their health.” [Consumer Seven]
Enablement Retaining a sense of self and identity
Focusing on strengths and building resilience
Planning for the future to provide peace of mind
Supporting the person to continue to live their life as they choose
Protecting the rights of people to full citizenship regardless of their age, gender, cultural background
EWRG, Australian Evaluation “I’m looking at who they are as a person. I’m interested in their history, so that we can actually support that and validating who they’ve been, what their likes are what their dislikes are.” [Key Worker Five]
“I think there’s a degree of give and take in this. While I’m well enough to manage, then I will give and say no, I can manage this... her role is to guide me how to intervene for myself.” [Consumer Twelve]
Holistic Encompassing emotional, social, physical and spiritual dimensions of support
Providing a whole of family/caring unit response to support
Recognising support will need to be more frequent and intense at different times with different people
Recognising the relationship that remains between the person with dementia and their caring unit
Inter-professional and inter-sectoral collaboration
EWRG, Australian Evaluation “We take a pretty holistic approach to the whole situation. The person who is living with dementia, it’s very, very hard to separate that person out and provide them with support and not look at the family system that they live with.” [Key Worker Eighteen]
“I think it’s not just the physical help that you need, it is this emotional and supportive role that is so important. It’s definitely got us to where we are now. I truly believe that without the help from [key worker], I think that the only decision open to us would have been to put my uncle into permanent care.” [Consumer One]
Accessibility Diversity, access and equity awareness (rural, regional areas; diverse groups)
Having access to support where there is diminished decision making capacity
Retaining respect and advocating for the rights of all people
Having access to palliation and end of life care in the setting of advanced or impaired decision making
Working with the person and those who support them regardless of age
EWRG, Australian Evaluation “Adaptable, it’s flexible, it covers everything throughout the continuum of the journey... it’s one place for people to actually be given a clue as to what you might need in the future. Giving people what their options are and what times they should be looking into the next option before they need it. Somewhere they know that they’ll be respected and whoever is in this position will try their best to make their lives a little bit easier. An inclusive, holistic person centred approach.” [Key Worker Four]
“I’m really hopeful that I will be able to keep having [key worker] presence in my life, because I would say to you now, without her presence in my life - even as a case manager whose primary role at the moment is to act as an advocate and as to be a support person to me, to provide that emotional and psychological support that I need - without that...I would be overwhelmingly isolated, as somebody with younger onset dementia, living in the community on my own.” [Consumer Twelve]