8.2 What are Attendant Care Services?

Definition of attendant care services

Attendant care services are provided to assist a person to manage their essential and regular personal care needs. Services can include assistance with tasks such as toileting, grooming, bathing/showering, eating/drinking and dressing.

Assessments for attendant care services

Claims for attendant care services are assessed on evidence from the client’s treating doctor and/or suitably qualified health professional or suitably qualified rehabilitation service provider.

Where a delegate is not satisfied they have sufficient information upon which to base a decision that a person reasonably requires attendant care services, an assessment should be arranged by an independent and qualified medical professional or rehabilitation service provider with specialist skills, such as an Occupational Therapist.

As part of the assessment, consideration should always be given to the purchase of aids and appliances that may enable a person to perform normal activities of daily living themselves. This facilitates a greater degree of independence for the client, improves their overall ability to function normally in the community and aligns with DVA’s focus on whole-of-person rehabilitation and promotion of independence and self-management. Further information about aids and appliances through RAP, including the one-off approval process for non-scheduled items, can be found in chapter 10.2 of the Rehabilitation Policy Library.

While the need for attendant care services may be identified through a rehabilitation assessment, the provision of attendant care services is not dependent on participation in a rehabilitation program. It is however, desirable that attendant care services are delivered as part of a "package of support" that may include rehabilitation supports, to facilitate the client’s recovery and independence and ensure that their whole of person needs are met more effectively. This is particularly important where a client has severe impairments due to their service injury or disease.

Approval periods

The provision of attendant care services for a short period of time may be relatively common for persons who are recovering from surgery or similar treatment of an accepted service injury or disease.

However, where a client has significant, complex injuries, including for example, spinal or brain injuries which affect the client’s ability to independently manage their personal care needs, ongoing attendant care services may be required.

Regular reviews are encouraged to ensure that delegates have a good understanding of the client’s current circumstances and needs.

Attendant care services and community nursing

The key differences between attendant care services and nursing care are:

Attendant Care

• meets personal care needs (eg. grooming, bathing, feeding, dressing), and not medical care or treatment needs;
• services are provided by professional carers to ensure that clients receive high quality care which is consistent with industry best practice;
• services can only be provided by a relative where genuine exceptional circumstances exist and there is documented evidence from a suitably qualified medical professional about the client’s particular need for such an arrangement. Evidence is required to support a determination in these cases (see section 8.4.6 in this chapter for further information).

Nursing Care

• is necessary for the treatment or medical care of the compensable condition to address clinical needs (ie. administration of medication, dressing of wounds, bowel care, catheter care etc);
• will require the services of either a registered or enrolled nurse;
• may include support to address personal care needs identified through an assessment by a contracted community nursing care service provider;
• will be provided at the direction or request of a legally qualified medical practitioner;
• services should not be provided by family members – this applies regardless of whether the family members holds the appropriate nursing qualifications (see section 8.4.6 in this chapter for further information).