Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Rahman, Mijanur; Byles, Julie

doi:10.1016/j.maturitas.2019.10.004

Cited by 14 publications

(9 citation statements)

References 23 publications

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“…For some women, RAC may be the only way to adequately meet their needs. However, our data and data from other studies support that home and community care may have an important role in supporting people to stay at home and to delay or avoid admission to an institution (29,43).…”

Section: Discussionsupporting

confidence: 44%

“…Compared to those who use few basic services, those who used more complex care services had a significantly lower rate of admission to RAC, up to nine years from their first HACC service. After nine years, there was no difference in admission to RAC between the home care groups, indicating that RAC may still be required in later life after a very long period of supported home care (29). Across the cohort, from around age 78, we forecast that, on average, women survive around eight years without using aged care services, five years using home care, and around two and a half years in RAC (28).…”

Section: Summary and Synthesis Of Previous Alswh Research On Housing And Carementioning

confidence: 87%

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Housing and Care for Older Women in Australia

Byles

Princehorn

Forder

et al. 2021

Front. Public Health

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Background: Housing is essential for healthy ageing, being a source of shelter, purpose, and identity. As people age, and with diminishing physical and mental capacity, they become increasingly dependent on external supports from others and from their environment. In this paper we look at changes in housing across later life, with a focus on the relationship between housing and women's care needs.Methods: Data from 12,432 women in the 1921–26 cohort of the Australian Longitudinal Study on Women's Health were used to examine the interaction between housing and aged care service use across later life.Results: We found that there were no differences in access to home and community care according to housing type, but women living in an apartment and those in a retirement village/hostel were more likely to have an aged care assessment and had a faster rate of admission to institutional residential aged care than women living in a house. The odds of having an aged care assessment were also higher if women were older at baseline, required help with daily activities, reported a fall, were admitted to hospital in the last 12 months, had been diagnosed or treated for a stroke in the last 3 years, or had multiple comorbidities. On average, women received few services in the 24 months prior to admission to institutional residential aged care, indicating a potential need to improve the reach of these services.Discussion: We find that coincident with changes in functional capacities and abilities, women make changes to their housing, sometimes moving from a house to an apartment, or to a village. For some, increasing needs in later life are associated with the need to move from the community into institutional residential aged care. However, before moving into care, many women will use community services and these may in turn delay the need to leave their homes and move to an institutional setting. We identify a need to increase the use of community services to delay the admission to institutional residential aged care.

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Section: Discussionsupporting

confidence: 44%

Section: Summary and Synthesis Of Previous Alswh Research On Housing And Carementioning

confidence: 87%

Housing and Care for Older Women in Australia

Byles

Princehorn

Forder

et al. 2021

Front. Public Health

Self Cite

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“…Several studies have shown varying associations between use of home-based care services and eventual take-up of residential care. [15][16][17][18][19] However, only…”

Section: Possible Drivers Of Higher Ratingsmentioning

confidence: 99%

The new dynamics of residential aged care in Australia: continuity and change

Cooper-Stanbury

Howe²

2021

Aust. Health Rev.

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ObjectiveThis paper tests the hypothesis that increases in recorded dependency levels of permanent residential aged care clients are associated with reduced length of stay and higher turnover. A secondary objective is to compare the Aged Care Funding Instrument with its predecessor, the Resident Classification Scale, on a common schema. MethodsAdministrative data for all Commonwealth-subsidised residential aged care services in Australia from 2008–09 to 2018–19 were obtained from the National Aged Care Data Clearinghouse. More than 750 000 episodes of permanent residential aged care were analysed. The categories from the two rating systems were mapped to a six-level schema, primarily based on the dollar value of the categories at the time of transition. ResultsThere was a strong trend towards higher dependency ratings across admissions, residents, and separations. However, contrary to expectation, measures of system activity showed a slowing of the system: length of stay increased and turnover decreased. ConclusionsThe mapping of dependency rating schemes to a common rating enables the analysis of long-term trends in residential care dynamics. There is no evidence that the marked increases in reported dependency ratings led to accelerated system activity, consistent with an earlier study. This analysis forms a solid base for ongoing analysis of care appraisals in the context of a possible new rating scheme. It highlights the interplay between policy changes and provider behaviour, and the need for robust data to monitor care appraisals and system dynamics. What is known about the topic?Residential aged care subsidies are determined by care needs in relation to assessed dependency levels, using the Aged Care Funding Instrument since 2008, and before that, the Resident Classification Scale. Between 2008–09 and 2018–19, there was considerable growth in residents classified at more dependent levels, and this would be expected to result in greater turnover in the system. What does this paper add?This paper maps the rating schemes to a simplified, common rating that enables the analysis of long-term trends in residential care dynamics. It shows that the system is slowing, contrary to the trends expected if residents were more frail as the reported ratings imply. The paper examines possible explanations of these trends, and addresses policy implications. What are the implications for practitioners?In the context of a potential new client-dependency classification, this study shows the importance of robust measures of the dynamics of the system—and the underlying data—vis-à-vis the means by which client dependency is assessed.

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“…In international studies, elderly care facilities are generally classified as home and community care facilities (HACCFs) and residential aged care facilities (RACFs) [9,10]. Community care facilities (CCFs) have been developed in China, especially in many rural areas.…”

Section: Introductionmentioning

confidence: 99%

Spatial Disparities and Correlated Variables of Community Care Facility Accessibility in Rural Areas of China

et al. 2021

Sustainability

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With the increasing aging of the world’s population, research on the equitable allocation of elderly care facilities has received increasing attention, but measuring the accessibility of community care facilities (CCFs) in rural areas has received little attention. In this study, which covered 7985 CCFs in 223,877 villages, we measured the accessibility of CCFs in rural areas of Hubei Province by using the nearest distance method. Based on the accessibility calculation, the spatial disparities and agglomeration characteristics of spatial accessibility were analyzed, and the correlated variables related to the accessibility were analyzed from both natural environment and socioeconomic aspects by employing a geographically weighted regression (GWR) model. Our results show that 87% of villages have a distance cost of less than 7121 m and 81% of townships have a distance cost of less than 5114 m; good spatial accessibility is present in the eastern and central regions, while poor spatial accessibility is shown in a small number of areas in the west. The results from the clustering analysis show that the hot spot areas are mainly clustered in the western mountainous areas and that the cold spot areas are mainly clustered around Wuhan city. We also observed that area, elevation, population aged 65 and above, and number of villages are significantly correlated with accessibility. The results of this study can be used to provide a reference for configuration optimization and layout planning of elderly care facilities in rural areas.

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Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Cited by 14 publications

References 23 publications

Housing and Care for Older Women in Australia

Housing and Care for Older Women in Australia

The new dynamics of residential aged care in Australia: continuity and change

Spatial Disparities and Correlated Variables of Community Care Facility Accessibility in Rural Areas of China

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