What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context

Abstract

Background This study aimed to develop a Community Geriatrics Service (CGS) informed by the healthcare and social requirements of community dwelling older people in an Australian context.Methods Stakeholders (N = 108) took part in a needs assessment involving 30-minute semi-structured interviews with general practitioners (GPs; N = 49), and three 2-hour community engagement meetings (N = 59) with older people, informal caregivers, allied healthcare workers, and nursing home directors. Data were transcribed and thematically coded, mapped to source and weighted to the frequency that the theme was raised across sources. Results Five themes informing CGS development and delivery emerged: active health conditions (management of behavioural and psychological symptoms of dementia, falls, multimorbidity, and other relevant conditions), active social challenges (patient non-compliance, need for aged care social workers, caregiver stress, elder abuse, social isolation, and stigma), referrals (availability of specialists, communication, specialist input, and advance care directives), access (lack of transport options, and inaccessibility of local geriatrics clinics and specialists), and awareness (lack of awareness, knowledge, and resources).Conclusions CGS development will need to address access, referral processes and health system navigation, which were perceived by stakeholders as significant challenges. These findings warrant the development of a CGS with an integrated approach to aged care, pertinent for the health and social needs of the elderly.