Deaths of young people living in residential aged care: a national population-based descriptive epidemiological analysis of cases notified to Australian coroners

Author(s):  
Kathryn Eastwood ◽  
Lyndal Bugeja ◽  
Joshua Zail ◽  
Anna Cartwright ◽  
Alexandra Hopkins ◽  
...  
2018 ◽  
Vol 20 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Sandra Barry ◽  
Lucy Knox ◽  
Jacinta M. Douglas

Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.


2011 ◽  
Vol 35 (3) ◽  
pp. 320 ◽  
Author(s):  
Dianne F. Winkler ◽  
Louise J. Farnworth ◽  
Sue M. Sloan ◽  
Ted Brown

Objective. The aim of this paper is to examine the progress and effect of the current 5-year $244 million national Young People in Residential Aged Care program on the reduction of young people in aged care. Method. Semi-structured telephone interviews with 20 service providers, 10 advocacy organisations and 6 public servants across Australia actively involved in the implementation of the program. Results. The development of new accommodation options has been slow. The 5-year program aims to move 689 young people out of nursing homes; in the first 4 years of the initiative only 139 people had moved out. The lives of those who have been helped by the program have been enormously improved. Conclusions. This study highlights the challenges of achieving a long-term reduction in the number of young people in residential aged care, including the challenge of achieving systemic change to prevent new admissions. Implications. The accommodation options currently being developed for this target group will soon be at capacity. Without sustained investment in developing alternative accommodation options and resources to implement systemic change ~250 people under 50 are likely to continue to be admitted to aged care each year in Australia. What is known about the topic? Prior to the current 5-year, $244 million, national Young People in Residential Aged Care program there were more than 1000 Australians under 50 years of age who lived in aged care facilities. Aged care is not designed or resourced to facilitate the active involvement of young people with high clinical needs in everyday activities or support their continued participation in the life of their community. What does this paper add? In the first 4 years of the national program only 139 people moved out of aged care. The lives of those who have been helped by the program have been enormously improved. The program is unlikely to result in a long-term reduction in the number of young people in aged care. What are the implications for practitioners? Systemic change and sustained investment in accommodation options is required to resolve the issue of young people in aged care.


2015 ◽  
Vol 16 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Dianne Winkler ◽  
Libby Callaway ◽  
Sue Sloan ◽  
Nadine Holgate

Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.


2007 ◽  
Vol 8 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Michele Foster ◽  
Jennifer Fleming ◽  
Cheryl Tilse

AbstractPeople surviving severe acquired brain injury (ABI) may potentially benefit from the Council of Australian Governments' (COAG) 5-year initiative for young people with disability in residential aged-care facilities. Yet critical examination of this policy initiative for ABI population is warranted for 2 reasons. First, reliance on the disability sector to resolve the complexities of long-term care for people with ABI detracts attention from systemic failures at the health/disability sector interface, and notably, debate concerning the role of, and right to rehabilitation. Second, the COAG initiative is being pursued within an extraordinarily complex and variable contemporary care environment, involving multiple services and sectors, and historically, high unmet need. This raises questions as to the adequacy and sustainability of care provided under the responsibility of state-based disability services. In this article, it is argued that long-term care for young people with severe ABI is better served by incorporating a health and rehabilitation perspective alongside a disability support approach. Although the effectiveness of rehabilitation may be contested in some instances of very severe ABI, nevertheless the role of rehabilitation in seeking to reduce the number of young people at risk of entering residential aged care needs to be addressed in policy solutions. It is also suggested that provision of long time care in the contemporary care environment involves a number of challenges due to the complex and changing patterns of need, diverse funding arrangements and mix of government and nongovernment services, and the increasing demand for care.


2021 ◽  
pp. 089826432110392
Author(s):  
Ladan Yeganeh ◽  
Lyndal Bugeja ◽  
Janneke Berecki ◽  
Adrian Laughlin ◽  
Joseph Ibrahim

Objective This study aimed to quantify and describe the characteristics of emergency department (ED) injury presentations and subsequent hospital admissions among residents of residential aged-care facilities (RACFs) in Victoria, Australia between 2008 and 2018. Methods This study comprised a single jurisdiction population-based study of consecutive injury-related ED presentations of RACFs residents using the Victorian Emergency Minimum Dataset (VEMD). Results The rate of ED injury presentations per 100,000 population decreased by .8% per year over 10 years ( P = .03); however, the rate per 100,000 RACF bed days increased by .6% per year ( P = .05). The proportion of presentations subsequently admitted to hospital increased 4.0% per year ( P<.0001). The majority of presentations were due to falls (82.5%), with fracture(s) being the most common injury type (34.0%). Discussion The increased rate of ED visits and hospital admissions in RACFs residents highlights the need to design specialized emergency care services and/or provide better direct access to hospital care for this vulnerable population.


Author(s):  
Mark Brown ◽  
Amelia Condi ◽  
Elise Davis ◽  
Isabella Goodwin ◽  
Di Winkler ◽  
...  

2020 ◽  
Vol 44 (6) ◽  
pp. 831
Author(s):  
Mark G. Brown ◽  
Glenda M. Bishop ◽  
Di Winkler ◽  
Jacinta M. Douglas

ObjectiveOver the past decade, various programs and reforms have targeted the issue of people aged &lt;65 years living in ‘permanent’ residential aged care (PRAC). As context for ongoing policy discourse, the aim of this study was to evaluate trends in rates of young people entering and leaving PRAC from 2008 to 2018. MethodsCounts of people aged &lt;65 years entering, remaining in and exiting PRAC were obtained from the National Aged Care Data Clearinghouse. Age standardisation was used to control for changes in the age and size of the Australian population. Annual age-standardised rates of admissions (subtracting transfers) and exits to the community were calculated. Linear regression models tested for a sustained increase or decrease in age-standardised rates nationally and within state and age subgroups. ResultsNotwithstanding year-to-year variation, neither admissions (subtracting transfers) nor exits to the community showed statistically significant increasing or decreasing trends in the national age-standardised rates. Admission rates varied by age and state. ConclusionsMany more young people are admitted to PRAC each year than return to community living, with no sustained change between 2008 and 2018 at the national level. Age standardisation is crucial for evaluating systemic population-level change regarding younger people in PRAC. What is known about the topic?As at June 2018, over 6000 people aged &lt;65 years still live in PRAC in Australia. Previous research has demonstrated that this cohort experiences a much poorer quality of life on average than people of similar age and disability who reside in other community settings. Various strategies for improving outcomes have been trialled, many aiming to reduce the number of younger people living in aged care; the National Disability Insurance Scheme (NDIS) also has this among its aims. What does this paper add?This paper reports trends in the number of young people entering and exiting aged care, after statistically controlling for changes due to population growth and aging. The paper highlights that national admission rates did not increase or decrease in a sustained manner, and that most of those admitted never return to community living before turning 65 years of age. What are the implications for practitioners?Programs and policies aimed at reducing the number of young people in aged care must grapple with the scale of the issue and its apparent resistance to amelioration over the past 10 years. The results of this study provide a benchmark against which to judge the future impact of the NDIS.


2020 ◽  
Vol 39 (3) ◽  
Author(s):  
Joshua Zail ◽  
Kathryn Eastwood ◽  
Lyndal Bugeja ◽  
Richard Bassed ◽  
Joseph E. Ibrahim

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