Long and winding road: Aged care use before death

Joenperä, Jenni; Zwan, Felicity Van Der; Karmel, Rose; Cooper-Stanbury, Mark

doi:10.1111/ajag.12317

Cited by 5 publications

(3 citation statements)

References 3 publications

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“…We recognise that the findings of ROSA may have limited generalisability to other ageing cohorts because this cohort is of people accessing aged care services, and at this time there is limited evidence informing us to what degree the ROSA population is different from similar ageing cohorts. While aged care service preferences, laws, and the complexity of the case mix have changed dramatically in the last couple of decades,13–15 as of 2016, 70% of aged care ‘places’ were in residential care facilities, 28% were with home care packages and the remaining in restorative care. With the establishment of ROSA, a better understanding of this cohort and its limitations in regard to evaluating areas of ageing will be identified and will then be used as justification and support for enrolment of other cohorts into ROSA.…”

Section: Methods and Analysismentioning

confidence: 99%

Registry of Older South Australians (ROSA): framework and plan

et al. 2019

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IntroductionAustralia’s ageing population puts significant demands on the aged care and healthcare sectors. To monitor the provision of aged care and healthcare services to older people, each government body has an individual data collection system. Together these systems can be the basis for creating the evidence necessary to support future allocation of resources for our ageing community. The Registry of Older South Australians (ROSA) is a cross-sector multidisciplinary (ie, aged care and healthcare) platform built to address the challenges of monitoring people in aged care settings. This protocol describes the ROSA’s framework and plans.Methods and analysisA registry to capture 16 000 South Australians/year undergoing an aged care eligibility assessment was designed. ROSA will contain information captured by the Commonwealth and South Australian state Health Authority, linked by two data integrating authorities, and housed on a secured data platform. ROSA will contain information on the sociodemographic, health, function, psychological, social, home and safety assessment and concerns characteristics, aged care services, general health services, and mortality of people receiving aged care services. Registered participants will be prospectively monitored until their death and yearly updates of their aged care and healthcare services information will be added to the registry.Ethics and disseminationROSA will longitudinally monitor the services provided to a population that puts costly demands on the state healthcare and aged care systems, identify unwanted variation, and underpin future research. ROSA’s expected outputs include an annual report, a research agenda that focuses on high burden conditions and potentially economically impactful questions, educational materials, and risk profiling tools. ROSA was approved by the South Australian Department for Health and Ageing HREC (HREC/17/SAH/125) and the Australian Institute of Health and Welfare HREC (EO2018/2/429).

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Section: Methods and Analysismentioning

confidence: 99%

Registry of Older South Australians (ROSA): framework and plan

et al. 2019

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“…1 In Australia, about 80% of those who died in 2010-2011 aged 65 years or above had used aged care services in the 8 years prior to their death. 2 In the United Kingdom, nursing homes (known as care homes) are an increasingly common part of clinical practice for end-of-life care. 3 Furthermore in the United States, it is projected that the demand for nursing homes will continue to rise over the next few decades in conjunction with the aging baby boomer generation; by 2050, the number of older people in the United States is expected to reach approximately 84 million, nearly double the 43 million reported in the 2012 census report.…”

Section: Introductionmentioning

confidence: 99%

Palliative care and infection management at end of life in nursing homes: A descriptive survey

et al. 2020

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Background: Infections are common occurrences at end of life that are associated with high rates of morbidity and mortality among frail elderly individuals. The problem of infections in nursing homes has led to a subsequent overuse and misuse of antibiotics in this already-frail population. Improving palliative care in nursing homes has been proposed as a key strategy to reduce the use of antibiotics. Aim: The aim of this study was to describe the current status of how nursing homes integrates palliative care and infection management at end of life across the nation. Design: This is a cross-sectional survey of nationally representative US nursing homes. Setting/participants: Between November 2017 and October 2018, a survey was conducted with a nationally representative random sample of nursing homes and 892 surveys were completed (49% response rate). The weighted study sample represented 15,381 nursing homes across the nation. Results: Most nursing homes engaged in care plan documentation on what is important to residents (90.43%) and discussed spiritual needs of terminally ill residents (89.50%). In the event of aspiration pneumonia in terminally ill residents, 59.43% of nursing homes responded that resident would be transferred to the hospital. In suspected urinary tract infection among terminally ill residents, 66.62% of nursing homes responded that the resident will be treated with antibiotics. Conclusion: The study found wide variations in nursing home palliative care practices, particularly for timing of end-of-life care discussions, and suboptimal care reported for antibiotic usage. Further education for nursing home staff on appropriate antibiotic usage and best practices to integrate infection management in palliative care at the end of life is needed.

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“…Understanding movement through the aged care system is important for Federal and State government planning and financing purposes. Indeed, several key studies have detailed the use of aged care services prior to death and the role of disease in explaining entry to care and use of services [5–6]. Considerable descriptive analysis has also been produced by the Australian Institute of Health and Welfare on pathways between hospitals and residential care, use of aged care service by different demographic groups and general detailed statistical overviews of aged care in Australia [6–10].…”

Section: Introductionmentioning

confidence: 99%

Recommended long term care settings following aged care assessments in Australia

Jukić

Temple

2018

PLoS ONE

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The purpose of this study was to examine the prevalence and correlates of recommended long term care settings following aged care assessments in Australia. Using unique administrative data on 500,000 aged care assessments, we utilized multinomial logistic regression models to estimate the association between characteristics of the individual (their assistance needs, health conditions and demographic characteristics) and the recommended long-term care setting. The vast majority (94%) of recommended long-term care settings were for private residences (54%) or residential care (40%). Persons assessed in a setting other than a private residence were unlikely to have a recommended setting for a private residence. Consistent with the assessors toolkit, assistance needs were strongly associated with long term care recommendations. Results provide strong support for the evidence-based approach of aged care assessments in Australia. Nonetheless, with improvements in administrative data linkages and ongoing policy reforms, further analysis is required to reinforce extant policy guidelines.

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Long and winding road: Aged care use before death

Abstract: The comprehensive PIAC database allows research into patterns of use of aged care services that can inform decision-making by clients, carers, providers and funders of the services.

Cited by 5 publications

References 3 publications

Registry of Older South Australians (ROSA): framework and plan

Registry of Older South Australians (ROSA): framework and plan

Palliative care and infection management at end of life in nursing homes: A descriptive survey

Recommended long term care settings following aged care assessments in Australia

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