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Thursday, December 7, 2023

Fixing Australia’s home-based aged care system

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By Professor Velandai Srikanth, Director of Peninsula Clinical School, National Centre for Healthy Ageing

We know the system of home-based aged care isn’t working well – it lacks integration, is mostly labour-driven and susceptible to workforce challenges, and uses limited technology that could benefit older people and the staff working to help them.

Currently, there are more than 50,000 Australians on a waiting list for a home-care package. These people are frequently isolated, and are generally frail and grappling with a few health conditions.

They not only require help for personal care and home maintenance, but also a system of wellness checks and monitoring, to avoid premature hospitalisation or a move to residential aged care.

Support is mostly provided by family or close friends, if they’re lucky enough to have them nearby, but many require assistance from local council or government support programs, and those with the greatest need often require the Commonwealth-assisted Home Care Packages program.

Although there’s been an increase in funding for the Home Care Packages since the release of the report by the Royal Commission into Aged Care Quality and Safety, there are waiting times of up to 12 months for people to access them.

That’s a year when there’s a high chance of them ending up in hospital, rapidly moving into aged care, or even dying.

While the provision of sufficient home-care packages is being negotiated and delivered, we need to consider smarter ways of bridging the gap for people who are at risk.

There can be innovation in this area that capitalises on existing health support technology, such as personal alarm monitoring systems, that can help us integrate health and care responses for an older person’s needs, to ensure their safety and independence.

Our research at the National Centre for Healthy Ageing, based in the Frankston-Mornington Peninsula area, looks at these technologies, including the MePACS. The system, housed within Peninsula Health in Victoria, has serviced more than 50,000 clients nationally for more than 30 years.

Two-thirds of people using MePACS are more than 80 years old and live with multiple chronic health conditions.

When the person requires assistance (they may have fallen, or are perhaps feeling unwell, etc), they activate their alarm, triggering immediate call-back via the device to determine what assistance is needed – family or friends, emergency services or ambulance – and provides a daily check to ensure social connection and their wellbeing.

The research showed that this simple service led to a 30 per cent reduction in ambulance callouts, with annual cost savings of $1.5 million to ambulance services alone, as well as benefits in reduced hospitalisation costs, and quality of life for the individual.

Identifying those most at risk

The data from more than a decade of MePACS has allowed us to identify those most at risk of hospitalisation or admission to residential aged care via their patterns of personal alarm use, so we can predict need, and target our support systems to those who need it and when.

Soon, we hope to develop ways to match the caller with other services they may need – a GP, a physio, a nurse, or just even a friendly ear for social connection – and then help them navigate to these services, something many people grapple with.

This could be another cost-effective way to bridge the gap for people waiting for an aged care package, until they actually receive the package.

Of course, this isn’t a panacea for all who want to thrive at home, and some people will still require hospitalisation or a move to a residential aged care facility, but it keeps them safe while they’re on that waiting list.

There are many innovations that can bridge the gap for better support and care for older Australians in their home.

As we well know, the ageing of populations is inevitable – and the innovations are there for the testing. It just takes a forward-thinking government to invest in research and implementation of such new models, not only because they can be cost-effective, but because they have the ageing person’s needs at heart.

  • Professor Velandai Srikanth is director of the National Centre for Healthy Ageing. His program of research spans several aspects of ageing health. His primary interest is in the study of risk factors and mechanisms underlying dementia, particularly with respect to vascular and metabolic health.
  • This article was first published on Monash Lens. Read the original article here.
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