What do clients expect of community care and what are their needs? The Community care for the Elderly: Needs and Service Use Study (CENSUS)

Objective: To investigate the relationship between objectively assessed care needs and expectations for care of older people and their carers, before commencement of community care services. Method: Cross-sectional research on 55 community-dwelling older adults and carers, recruited after receiving approval for government-subsidised community care services. Care needs and expectations of care were assessed at interview. Results: Participants' and carers' expectations for their pending community care package did not correspond with unmet participant needs. Instead, expectations corresponded with met needs, that is those for which they already received help, with the exception of expectations of domestic support and personal care. Participants' unmet needs were predominantly in social and recreational activities, eating, and physical and mental health. Conclusions: As community care in Australia becomes consumer-directed by 2015, care services will need to empower clients and carers through education about their needs and available services, as part of the assessment and service negotiation process.