Home care seniors stay in hospital longer
We’re encouraged to live in our homes for as long as possible, but a study finds that could quicken transition to residential aged care.
People on home care packages spend more than twice the number of days in hospital compared to those living in residential aged care.
That’s the surprising key finding of a South Australian study that examined emergency department (ED) presentations, unplanned hospitalisations, potentially preventable hospitalisations and time in hospital.
The national data compiled by Flinders University and the University of South Australia researchers included people aged 65 years and older from around Australia, with 203,278 individuals living in residential aged care and 118,999 receiving home care packages in the community.
People on home care packages spent 7,745 days in hospital per 1,000 individuals, compared to 3,049 days for individuals living in residential aged care.
Home care recipients accounted for 43% of ED presentations, 40% of unplanned hospitalisations, and 12% of preventable hospitalisations.
This contrasted with 38%, 33% and 8% in the same categories for aged care home residents.
Unplanned hospitalisations and ED presentations are burdensome both for patients and the health system.
A key reason for home care package recipients staying longer in hospital could be that when, because of the condition that hospitalised them, they needed to move out of their private home and into an aged care home.
That could involve waiting for a suitable place to become available. In the meantime, the patient would continue to be hospitalised.
When transition from home care to residential aged care is deemed necessary after a hospital admission, several 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.
Researchers said the findings highlight the challenges faced in long-term care settings, particularly those receiving home care, and the need for further efforts to address high rates of unplanned hospitalisations and ED presentations experienced by an increasing number of older Australians.
The researchers concluded that with the ageing population, understanding older people’s use of health care was essential for planning and provision of services, already under stress.
They also suggested that hospitalisations were stressful and potentially harmful to the older patient and could lead to those living in the community moving to residential aged care sooner, at an increased, and potentially avoidable, financial burden to the taxpayer.
They said the government should act to minimise the early transition of home care package patients into residential aged care by improving support and enabling them to live independently at home for as long as possible.
