Alarming new research from the Registry of Senior Australians at the South Australian Health and Medical Research Institute has revealed senior people with home care packages spend more than twice the time in hospital as those living in residential aged care.
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The study, funded by the Medical Research Future Fund, involved Flinders University, the University of South Australia and the Southern Adelaide Local Health Network.
It was led by Dr Stephanie Harrison who examined emergency department presentations, unplanned hospitalisations, potentially preventable hospitalisations and time in hospital.
The national data included people aged 65 years and older from around Australia, with 203,278 people living in residential aged care and 118,999 receiving home care packages in the community.
"We found people receiving home care packages spent 7745 days in hospital per 1000 people, compared to 3049 days for people living in residential aged care," Dr Harrison said.
"These people had more emergency department presentations, and unplanned and potentially preventable hospital visits."
People with home care packages accounted for 43 per cent of emergency department presentations, 40 per cent of unplanned hospitalisations and 12 per cent of preventable hospitalisations.
This was contrasted by 38 per cent , 33 per cent and 8 per cent in the same categories for people living in residential aged care.
A spokesman from the Federal Health and Aged Care Department said there was no easy solution for the problem.
"This is a longstanding and growing challenge for governments at every level who are aiming to improve the quality of life of older people," he said.
"Unplanned hospitalisation and for those in hospital considered medically ready for discharge, remaining in hospital while arrangements for their ongoing care are worked through, is challenging for an individual."
He said the department is working with state and local health departments and aged care providers to broker local solutions that meet the needs of people while working on broader reforms that may assist in the medium to longer term.
When transition from home care to residential aged care is deemed necessary after a hospital admission, a number of complex challenges can impact discharge including:
- Legal issues associated with guardianship, enduring power of attorney, and settlement financial matters;
- The need for families to consider a range of options with the older person before deciding on their future care, noting that in some cases the transition to residential aged care can feel daunting for both the older person and their family;
- Finding a suitable bed in a Residential Aged Care Home can also be an issue, particularly if a patient has dementia, high care needs, or challenging behaviours.
- Issues with a patient's eligibility, with some older people requiring care not covered by either the aged care or disability (NDIA) programs administered by the Commonwealth and/or jurisdictions, making discharge to a suitable care facility more complicated.
"Recently introduced reforms by the Federal Government in response to the Royal Commission into Aged Care Quality and Safety will improve the capacity and capability of the aged care system to meet the care needs of older people, reduce unnecessary hospitalisations, and support timely and coordinated hospital discharge," the spokesman said.
This includes working with aged care providers to ensure prompt access to aged care services, including:
- increased funding and supports to aged care providers;
- improving information for older people, their families and carers to make informed decisions; and
- introducing new innovative care models.
"Individual jurisdictions are also implementing measures designed to reduce the number of long stay older patients, which take into consideration specific local circumstances that may be contributing to the problem."
Therese Murray
Wordsmith. Senior journalist. Editor. I have a proven track record in helping people and communities solve their problems. My career is all about telling stories.
Wordsmith. Senior journalist. Editor. I have a proven track record in helping people and communities solve their problems. My career is all about telling stories.
