scholarly journals The dynamics of residential aged care in Australia: 8-year trends in admission, separations and dependency

2007 ◽  
Vol 31 (4) ◽  
pp. 611 ◽  
Author(s):  
Sharon Andrews-Hall ◽  
Anna Howe ◽  
Andrew Robinson
Keyword(s):  
Length Of Stay ◽  
Aged Care ◽  
Care Homes ◽  
Residential Aged Care ◽  
Funding System ◽  
Higher Categories ◽  
Future Policy ◽  
Over Time ◽  
Care System

The aims of this paper are to analyse changes in dependency of residents in residential aged care homes consequent upon the passing of the Commonwealth Aged Care Act in late 1997, and to establish the extent of resultant changes in the dynamics of residential aged care. The paper outlines the major changes brought by the Aged Care Act, and evidence for the effects of these changes is examined to test the hypothesis that changes in dependency generated changes in turnover and length of stay. The findings show that the proportion of admissions classified at higher categories of the Resident Classification Scale has increased over time, and that the trend to higher classification is even more pronounced by the time residents separate. As funding of residential aged care is based on resident dependency, change in dependency and in the dynamics of the aged care system have potentially significant consequences for Commonwealth funding of providers to ensure care can be provided commensurate with resident needs. The conclusions take up a number of implications of the findings for future policy in relation to planning and funding of residential aged care as a new resident funding system based on the Aged Care Funding Instrument (ACFI) is phased in from mid 2007.

scholarly journals “A good death but there was all this tension around”- perspectives of residential managers on the experience of delivering end of life care for people living with dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica A. L. Borbasi ◽  
Allison Tong ◽  
Alison Ritchie ◽  
Christopher J. Poulos ◽  
Josephine M. Clayton
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Care Homes ◽  
Residential Aged Care ◽  
Life Care ◽  
Advanced Dementia ◽  
Front Line ◽  
Care Managers

Abstract Background End of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia. Methods Focus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis. Results 20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding. Conclusion Aged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.

Progressing Towards a Freer Market in Australian Residential Aged Care

2021 ◽  
pp. 1-25
Author(s):  
Susan F Cochrane ◽  
Alice L Holmes ◽  
Joseph E Ibrahim
Keyword(s):  
Current System ◽  
Aged Care ◽  
Care Quality ◽  
Cultural Safety ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Care Providers ◽  
Fit For Purpose ◽  
Market Driven ◽  
Care System

The Royal Commission into Aged Care Quality and Safety has again focussed attention on the failings of the Australian aged care system. Residential aged care in Australia has become increasingly market-driven since the major reforms of 1997. The aims of increased marketisation include providing residents with greater choice, higher quality services, and increasing providers’ efficiency and innovation. However, marketisation is not meeting these aims, predominantly due to asymmetries of knowledge and power between residents and aged care providers. These asymmetries arise from inadequate provision of information, geographic disparities, urgency for care as needs arise acutely, and issues surrounding safety, including cultural safety. We propose a human rights framework, supported by responsive regulation, to overcome the failings of the current system and deliver an improved aged care system which is fit for purpose.

A systematic review protocol of educational programs for nursing staff on management of resident-to-resident elder mistreatment in residential aged care homes

2018 ◽  
Vol 74 (8) ◽  
pp. 1975-1983
Author(s):  
Julie M. Ellis ◽  
Beatriz Paulina Ayala Quintanilla ◽  
Louise Ward ◽  
Fergus Campbell ◽  
Stav Hillel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Staff ◽  
Aged Care ◽  
Educational Programs ◽  
Care Homes ◽  
Residential Aged Care ◽  
Systematic Review Protocol ◽  
Elder Mistreatment ◽  
Review Protocol

Changes in housing among older women: Latent class analysis of housing patterns in older Australian women

Urban Studies ◽  
2016 ◽  
Vol 55 (4) ◽  
pp. 917-934 ◽  
Author(s):  
Julie Byles ◽  
Cassie Curryer ◽  
Kha Vo ◽  
Peta Forder ◽  
Deborah Loxton ◽  
...  
Keyword(s):  
Older Women ◽  
Latent Class ◽  
Later Life ◽  
Aged Care ◽  
Residential Aged Care ◽  
Administrative Records ◽  
Stable Pattern ◽  
Retirement Village ◽  
New Evidence ◽  
Over Time

Scant research exists on the patterns of changes in older women’s housing, and whether and when women transition into residential aged care (RAC). This study aimed to identify groups of women with different housing patterns (latent classes) over time, with a secondary aim to describe socio-demographic and health characteristics of women in each class. We analysed linked data for 9575 women born 1921–1926 from the Australian Longitudinal Study of Women’s Health (ALSWH), Australian National Death Index, and Residential Aged Care (RAC) administrative records for the years 1999 through to 2011. Seven distinct housing patterns (classes) were identified over time. Four classes showed a stable pattern: living in a house for most surveys (47.0%), living in a house but with earlier death (13.7%), living in an apartment (12.8%), living in a retirement village (5.8%). One class showed a pattern of downsizing: moving from a house to retirement village (6.6%). Two patterns showed transition: from an apartment or retirement village, to RAC and death (7.8%), and from house to RAC (6.4%). This study provides new evidence about socio-demographic and health influences on housing patterns and entry into residential care in later life. These findings can inform policy and aged care planning for women in later life, by identifying patterns of transition into residential aged care, or alternatively, remaining in the community.

scholarly journals Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

2011 ◽  
Vol 40 (4) ◽  
pp. 487-494 ◽  
Author(s):  
J. B. Broad ◽  
M. Boyd ◽  
N. Kerse ◽  
N. Whitehead ◽  
C. Chelimo ◽  
...  
Keyword(s):  
New Zealand ◽  
Aged Care ◽  
Residential Aged Care ◽  
Trends Over Time ◽  
Over Time

scholarly journals Corrigendum to: Who uses residential aged care now, how has it changed and what does it mean for the future?

2020 ◽  
Vol 44 (6) ◽  
pp. 983
Author(s):  
Diane Gibson
Keyword(s):  
Residential Care ◽  
Average Length ◽  
Age Groups ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing Population ◽  
The Past ◽  
The Future ◽  
Australian Bureau Of Statistics ◽  
Care System

ObjectiveThis paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future.MethodsTime series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers.ResultsAlthough the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising.ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future.What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns.What does this paper add?The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future.What are the implications for practitioners?These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.

scholarly journals People living in residential aged care need to BE outside not just SEE outside: associations between quality of life and outdoor access: a cross-sectional study

2019 ◽  
Author(s):  
Suzanne Marie Dyer ◽  
Enwu Liu ◽  
Emmanuel Gnanamanickam ◽  
Stephanie Louise Harrison ◽  
Rachel Milte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Care Homes ◽  
Residential Aged Care ◽  
Small Scale ◽  
Sectional Study ◽  
Model Of Care ◽  
Cross Sectional

Abstract Background The value of providing access to outdoor areas for people living in residential aged care, including those living with dementia, in terms of mood, behaviour and well-being is increasingly acknowledged. This study examines associations between provision of independent access to outdoor areas and frequency of residents going outdoors with the quality of life (QoL) of nursing home residents and compares use of outdoor areas between alternative models of residential aged care. Methods A cross-sectional study was conducted including 541 participants from 17 residential aged care homes in four states in Australia, mean age 85 years, 84% with cognitive impairment. Associations between having independent access to outdoors and the frequency of going outdoors and QoL (EQ-5D-5L) were examined using multi-level models. The odds of going outdoors in a small-scale home-like model of care compared to standard Australian models of care were examined. Results After adjustment for potential confounders (including comorbidities and facility level variables), living in an aged care home with independent access to the outdoors was not significantly associated with QoL (β=-0.01, 95% Confidence Interval (CI) -0.09 to 0.07, P=0.80). However, going outdoors daily (β=0.13 95%CI 0.06 to 0.21), but not multiple times a week (β=0.03, 95%CI -0.03 to 0.09), was associated with a better QoL. Residents living in a home-like model of care had greater odds of going outdoors daily (odds ratio 15.1, 95%CI 6.3 to 36.2). Conclusions Going outdoors frequently is associated with higher QoL for residents of aged care homes and residents are more likely to get outside daily if they live in a small-scale home-like model of care. However, provision of independent access to outdoor areas alone may be insufficient to achieve these benefits. Increased availability of models of residential aged care with staffing structures, training and design which increases support for residents to venture outdoors frequently is needed to maximise resident quality of life.

scholarly journals Who uses residential aged care now, how has it changed and what does it mean for the future?

2020 ◽  
Vol 44 (6) ◽  
pp. 820
Author(s):  
Diane Gibson
Keyword(s):  
Residential Care ◽  
Average Length ◽  
Age Groups ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing Population ◽  
The Past ◽  
The Future ◽  
Australian Bureau Of Statistics ◽  
Care System

ObjectiveThis paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future. MethodsTime series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers. ResultsAlthough the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising. ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future. What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns. What does this paper add?The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future. What are the implications for practitioners?These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Author(s):  
Hannah Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background: Residential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable. The EDDIE program is a hospital avoidance initiative designed to enable nursing and care staff to detect, refer and quickly respond to early signals of a deteriorating resident. The program was implemented in a 96-bed residential aged care facility in regional Australia. Methods: A prospective pre-post cohort study design was used to collect data on costs of program delivery, hospital admission rates and length of stay for the 12 months prior to, and following, the intervention. A Markov decision model was developed to synthesize study data with published literature in order to estimate the cost-effectiveness of the program. Quality adjusted life years (QALYs) were adopted as the measure of effectiveness. Results: The EDDIE program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. The cost-effectiveness analysis found the program to be both more effective and less costly than usual care, with 0.06 QALYs gained and $249,000 health system costs saved in a modelled cohort of 96 residents. A probabilistic sensitivity analysis estimated that there was an 86% probability that the program was cost-effective after taking the uncertainty of the model inputs into account. Conclusions: This study provides promising evidence for the effectiveness and cost-effectiveness of a nurse led, early intervention program in preventing unnecessary hospital admissions within a residential aged care facility. Further research in multi-site randomised studies is needed to confirm the generalisability of these results.

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