scholarly journals Young people in aged care: progress of the current national program

2011 ◽  
Vol 35 (3) ◽  
pp. 320 ◽  
Author(s):  
Dianne F. Winkler ◽  
Louise J. Farnworth ◽  
Sue M. Sloan ◽  
Ted Brown
Keyword(s):  
Young People ◽  
Service Providers ◽  
Systemic Change ◽  
Care Program ◽  
Aged Care ◽  
Residential Aged Care ◽  
National Program ◽  
Public Servants ◽  
Active Involvement

Objective. The aim of this paper is to examine the progress and effect of the current 5-year $244 million national Young People in Residential Aged Care program on the reduction of young people in aged care. Method. Semi-structured telephone interviews with 20 service providers, 10 advocacy organisations and 6 public servants across Australia actively involved in the implementation of the program. Results. The development of new accommodation options has been slow. The 5-year program aims to move 689 young people out of nursing homes; in the first 4 years of the initiative only 139 people had moved out. The lives of those who have been helped by the program have been enormously improved. Conclusions. This study highlights the challenges of achieving a long-term reduction in the number of young people in residential aged care, including the challenge of achieving systemic change to prevent new admissions. Implications. The accommodation options currently being developed for this target group will soon be at capacity. Without sustained investment in developing alternative accommodation options and resources to implement systemic change ~250 people under 50 are likely to continue to be admitted to aged care each year in Australia. What is known about the topic? Prior to the current 5-year, $244 million, national Young People in Residential Aged Care program there were more than 1000 Australians under 50 years of age who lived in aged care facilities. Aged care is not designed or resourced to facilitate the active involvement of young people with high clinical needs in everyday activities or support their continued participation in the life of their community. What does this paper add? In the first 4 years of the national program only 139 people moved out of aged care. The lives of those who have been helped by the program have been enormously improved. The program is unlikely to result in a long-term reduction in the number of young people in aged care. What are the implications for practitioners? Systemic change and sustained investment in accommodation options is required to resolve the issue of young people in aged care.

scholarly journals Cost analysis of an integrated aged care program for residential aged care facilities

2019 ◽  
Vol 43 (3) ◽  
pp. 261 ◽  
Author(s):  
Rod Ling ◽  
Andrew Searles ◽  
Jacqueline Hewitt ◽  
Robyn Considine ◽  
Catherine Turner ◽  
...  
Keyword(s):  
Cost Saving ◽  
New England ◽  
Usual Care ◽  
Service Providers ◽  
Care Program ◽  
Aged Care ◽  
Residential Aged Care ◽  
Local Health ◽  
Care Facilities ◽  
Residential Aged Care Facilities

Objective To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents. Methods This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June–September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided. Results Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE saved an estimated A$921214. Conclusions The ACE service supported a reduction in avoidable ED presentations and ambulance transfers among RACF residents. It generated a cost saving to health service providers, allowing reallocation of healthcare resources. What is known about the topic? Residents from RACFs are at risk of further deterioration when admitted to hospital, with high rates of delirium, falls, and medication errors. For this cohort, some conditions can be managed in the RACF without hospital transfer. By addressing avoidable presentations to EDs there is an opportunity to improve ED efficiency as well as providing care that is consistent with the resident’s goals of care. RACFs generate some avoidable ED presentations for residents who may be more appropriately treated in situ. What does this paper add? Telephone triaging with nursing support and training is a means by which ED presentations from RACFs can be reduced. One of the consequences of this intervention is ‘cost avoided’, largely through savings on ambulance costs. What are the implications for practitioners? Unnecessary transfer from RACFs to ED can be avoided through a multicomponent program that includes telephone support with cost-saving implications for EDs and ambulance services.

Council of Australian Governments' (COAG) Initiative for Young People With Disability in Residential Aged Care: What Are the Issues for Acquired Brain Injury?

2007 ◽  
Vol 8 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Michele Foster ◽  
Jennifer Fleming ◽  
Cheryl Tilse
Keyword(s):  
Brain Injury ◽  
Young People ◽  
Long Term Care ◽  
Acquired Brain Injury ◽  
Aged Care ◽  
Residential Aged Care ◽  
Term Care ◽  
Care Environment

AbstractPeople surviving severe acquired brain injury (ABI) may potentially benefit from the Council of Australian Governments' (COAG) 5-year initiative for young people with disability in residential aged-care facilities. Yet critical examination of this policy initiative for ABI population is warranted for 2 reasons. First, reliance on the disability sector to resolve the complexities of long-term care for people with ABI detracts attention from systemic failures at the health/disability sector interface, and notably, debate concerning the role of, and right to rehabilitation. Second, the COAG initiative is being pursued within an extraordinarily complex and variable contemporary care environment, involving multiple services and sectors, and historically, high unmet need. This raises questions as to the adequacy and sustainability of care provided under the responsibility of state-based disability services. In this article, it is argued that long-term care for young people with severe ABI is better served by incorporating a health and rehabilitation perspective alongside a disability support approach. Although the effectiveness of rehabilitation may be contested in some instances of very severe ABI, nevertheless the role of rehabilitation in seeking to reduce the number of young people at risk of entering residential aged care needs to be addressed in policy solutions. It is also suggested that provision of long time care in the contemporary care environment involves a number of challenges due to the complex and changing patterns of need, diverse funding arrangements and mix of government and nongovernment services, and the increasing demand for care.

Young People-Sensitive and Participatory Governance Approaches

2019 ◽  
pp. 80-99
Author(s):  
Jeffrey Kurebwa
Keyword(s):  
Decision Making ◽  
Young People ◽  
Good Governance ◽  
Participatory Governance ◽  
Active Involvement ◽  
Core Set ◽  
Public Resources ◽  
Governance Practices ◽  
Local Levels

This study seeks to make a strong case for young people's visibility in the governance framework, not only in the sectors that are traditionally linked to their wellbeing and development. Young people should be visible with respect to their role in governance and accountability. This will help ensure that commitments made across all these areas are translated into relevant actions on the ground; it will support young people's ability to hold national and local authorities accountable, and strengthen young people's active involvement in promoting good governance practices at the global, national and local levels, laying the foundations for their long-term engagement as active citizens. The state has the responsibility to perform a core set of duties that allow society to function and exist. In doing so, it forges a relationship with its citizens. Participatory governance is one of many strategies of governance, and refers to the processes and deliberations that citizens are engaged in when discussing the distribution of public resources and broader decision making.

“Time's Up”: The Experience of Entering Residential Aged Care for Young People with Acquired Neurological Disorders and Their Families

2018 ◽  
Vol 20 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Sandra Barry ◽  
Lucy Knox ◽  
Jacinta M. Douglas
Keyword(s):  
Young People ◽  
Lived Experience ◽  
Neurological Disorders ◽  
Healthcare Setting ◽  
Aged Care ◽  
Residential Aged Care ◽  
Health Crisis ◽  
Complex Process ◽  
The Individual ◽  
Key Events

Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.

scholarly journals Acute Transition Allliance: rehabilitation at the acute/aged care interface

2004 ◽  
Vol 28 (3) ◽  
pp. 266 ◽  
Author(s):  
Dawn J Kroemer ◽  
Geoffrey Bloor ◽  
Jeff Fiebig
Keyword(s):  
Residential Care ◽  
Public Hospital ◽  
Community Care ◽  
South Australia ◽  
Integrated Approach ◽  
Aged Care ◽  
Residential Aged Care ◽  
Acute Admissions ◽  
Made In

The acute/aged care interface has presented many challenges to funders, providers and planners in the health and aged care sectors. Concerns have long been expressed in the aged care sector about the changing needs of clients admitted permanently into residential aged care from hospitals where the decision for placement would often have been made in a crisis situation, without the opportunity to explore appropriate options. This article describes the process and outcomes to date of a collaborative effort between the acute care and aged care sectors in South Australia to develop a more integrated approach to discharge opportunities for older people. The program involves both residential and community care elements and seeks to provide rehabilitation, to restore function and to avoid inappropriate permanent residential care for older Australians following acute admissions to a public hospital. Interim outcomes are promising and show only 17% of those admitted to the program are discharged to long-term residential care.

Everyday Choice Making: Outcomes of Young People with Acquired Brain Injury After Moving from Residential Aged Care to Community-Based Supported Accommodation

2015 ◽  
Vol 16 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Dianne Winkler ◽  
Libby Callaway ◽  
Sue Sloan ◽  
Nadine Holgate
Keyword(s):  
Brain Injury ◽  
Young People ◽  
Acquired Brain Injury ◽  
Aged Care ◽  
Residential Aged Care ◽  
Small Scale ◽  
Structured Interviews ◽  
Community Based ◽  
Choice Making ◽  
Supported Accommodation

Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.

High-Risk Medication Use in Older Residents of Long-Term Care Facilities: Prevalence, Harms, and Strategies to Mitigate Risks and Enhance Use

2020 ◽  
Vol 35 (10) ◽  
pp. 419-433 ◽  
Author(s):  
Janet K. Sluggett ◽  
Stephanie L. Harrison ◽  
Leona A. Ritchie ◽  
Alexander J. Clough ◽  
Debbie Rigby ◽  
...  
Keyword(s):  
High Risk ◽  
Long Term Care ◽  
Medication Use ◽  
Aged Care ◽  
Residential Aged Care ◽  
Term Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.

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