Author Identifier

Kathleen McCauley

https://orcid.org/0000-0001-5508-5943

Date of Award

2024

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

First Supervisor

Associate Professor Rosemary Saunders

Second Supervisor

Professor Bev O'Connell

Third Supervisor

Dr Olivia Gallagher

Abstract

Australia’s ageing population, coupled with government policies around ageing and the desire of older people to remain living independently in their homes has resulted in the significant growth of Home Care Package (HCP) services across the aged care sector. Home Care Packages are subsidised by the Australian Government and are designed to support older Australians, enabling them to remain living in their own homes. To date, there has been little comprehensive research concerning the experiences of older people receiving HCP services, and the experiences of their caregivers, indicating a significant gap in information and knowledge on this topic. This study thus aims to explore older people’s and their caregivers’ experiences of receiving HCP services.

Older people and their caregivers were recruited in collaboration with HCP service providers across metropolitan areas in Western Australia. Data generation involved the use of a survey distributed to identified older people and semi-structured interviews with older people, their caregivers and HCP service provider coordinators. Twenty surveys were received, which subsequently lead to semi-structured interviews with seven older people and seven caregivers. Theoretical sampling involved the recruitment of an additional older person, two HCP provider coordinators and four older people from the initial recruitment to participate in semi-structured interviews.

In addition, policy documents and reports were used as part of the study data. Data were analysed using a grounded theory approach involving open coding, focused coding and theoretical coding, and constant comparative analysis. Survey data were analysed using SPSS to obtain a series of descriptive statistics and a broad range of information about the study cohort and their general view of accessing and receiving HCP services.

The study findings identify that participants experience 1) a basic social problem termed ‘journeying through uncharted territory’; and 2) a basic social process termed ‘maintaining independent living against the odds’. The basic social problem involves a series of intertwined categories that describe the issues participants faced including deteriorating health, floundering in a complex aged care system and emotional turmoil. In turn, the basic social process involves how participants dealt with these issues, including making adaptations and finding ways to work within the aged care system in informal ways, to maintain independent living.

Based on these findings several recommendations are made for the HCP system, including enhancing accessibility and user friendliness of information and developing pathways to support people to understand and navigate the HCP system. A new system for home care has been proposed for release in July 2025, therefore, these findings will offer a significant contribution to the development of the related policies, in particular in assisting policymakers and service providers to develop and connect policy and practice, to improve care for people who receive support at home and to maintain the ‘ageing in place’ agenda.

DOI

10.25958/0bg9-1665

Access Note

Access to this thesis is embargoed until 25 September 2025

Available for download on Thursday, September 25, 2025

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