Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults

Jamieson, Hamish A.; Abey-Nesbit, Rebecca; Bergler, Ulrich; Keeling, Sally; Schlüter, Philip J.; Scrase, Richard; Lacey, Cameron

doi:10.1016/j.jamda.2019.02.005

Cited by 20 publications

(21 citation statements)

References 30 publications

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“…These identified priorities are also in keeping with others who have reported that successful AIP relies on adequate home safety (e.g., ensuring that people have the appropriate grab rails, nonslip surfaces and ramps in place) [ 66 ], and that people’s decisions to remain in their community are based in part on their ability to effectively adapt their home [ 67 ]. Maintaining strong social networks is thought to be essential for successful AIP [ 68 ], and alternatively loneliness has been identified as an independent predictor of nursing home admission [ 69 , 70 ]. Smaller scale interventions addressing these factors have been implemented, including environmental audits to help to improve home safety [ 71 ], activity and discussion groups to enhance social connection [ 72 ], and navigators to help older adults with chronic conditions transition through the healthcare system [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

et al. 2021

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Background Aging in place (AIP) is a policy strategy designed to help older adults remain in their community. While planners internationally have modified aspects of the older adult care continuum (e.g., home care, assisted living, nursing homes) to facilitate AIP, further improvements to community-based supports and services are also required. This study compared and constrasted the community-based factors (e.g., supports, services and personal strategies or characteristics) that family/friend care partners and healthcare stakeholders (i.e., planners/providers) view as most important to help older adults successfully AIP. Methods An initial list of factors shown to influence AIP was created from the academic literature. These factors were used to develop a Delphi survey implemented separately on care partners and healthcare stakeholders. Respondents rated the importance of each factor using a 10-point Likert Scale (1 = not important; 10 = absolutely critical). Consensus in each group was defined when at least 80% of participants scored a factor ≥8 (“very important”), with an interquartile range ≤2. Respondents suggested additional factors during Delphi round one. Results Care partners (N = 25) and healthcare stakeholders (N = 36) completed two and three Delphi rounds, respectively. These groups independently agreed that the following 3 (out of 27) factors were very important to help older adults age in place: keeping one’s home safe, maintaining strong inter-personal relationships, and coordinating care across formal providers. While healthcare stakeholders did not reach consensus on other factors, care partners agreed that 7 additional factors (e.g., access to affordable housing, having mental health programs) were important for AIP. Conclusions Compared to healthcare stakeholders, care partners felt that more and diverse community-based factors are important to support older adults to successfully AIP. Future research should replicate these findings in other jurisdictions, examine the availability and accessibility of the priority factors, and develop sustainable solutions to enhance their effectiveness.

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Section: Discussionmentioning

confidence: 99%

Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

et al. 2021

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“…28 Children and partners reduce the likelihood of entering residential care. 25,29,30 Disability rates have declined among older Australians, as have rates of severe or profound core activity restriction (Table A2). The substantial reduction in stroke rates 31 can be expected to progressively reduce the number of people in residential care as a result of stroke-related disability.…”

Section: Discussionmentioning

confidence: 99%

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

Gibson¹

2020

Aust. Health Review

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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.

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“…Moreover, the 30-days exclusion criterion applied within this study was designed to identify and remove older adults with acute needs or terminal illnesses, and the interRAI-HC assessment was simply a vehicle to expedite ARC admission. Although employed elsewhere 21,25 , this period remains arbitrary and the potential for misclassification exists.…”

Section: Discussionmentioning

confidence: 99%

“…These equivocal findings are likely due to important study design and analytical differences 19 . Also, the competing risk of death has not been explicitly considered before – a factor which is germane to older populations where the likelihood of death is non-ignorable 20,21 .…”

Section: Introductionmentioning

confidence: 99%

Hearing ability is not a risk factor for admission to aged residential care of older persons in New Zealand

Schluter

McAuliffe

Askew

et al. 2019

Sci Rep

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Aged residential care (ARC) admission needs are increasing beyond the available capacity in many countries, including New Zealand. Therefore, identifying modifiable factors which may prevent or delay ARC admissions is of international importance. Hearing impairment is common among older adults and thought to be an important predictor, although the current evidence-base is equivocal. Using the largest national database to date, competing-risk regression analysis was undertaken on 34,277 older adults having standardised home care assessments between 1 July 2012 and 31 May 2014, aged ≥65 years, and still living in the community 30 days after that assessment. Minimal hearing difficulty was reported by 10,125 (29.5%) participants, moderate difficulty by 5,046 (14.7%), severe difficulty/no hearing by 1,334 (3.9%), while 17,769 (51.8%) participants reported adequate hearing. By 30 June 2014, the study end-point, 6,389 (18.6%) participants had an ARC admission while 6,082 (17.7%) had died. In unadjusted competing-risk regression analyses, treating death as a competing event, hearing ability was significantly associated with ARC admission (p < 0.001). However, in adjusted analyses, this relationship was completely confounded by other variables (p = 0.67). This finding implies that screening for hearing loss among community-living older adults is unlikely to impact on ARC admission rates.

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Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults

Cited by 20 publications

References 30 publications

Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

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

Hearing ability is not a risk factor for admission to aged residential care of older persons in New Zealand

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