Benefits of home-like aged care

The INSPIRED project team

The INSPIRED research team: Julie Ratcliffe, Maria Crotty, Stephanie Harrison, Emmanuel Gnanamanickam, Suzanne Dyer, Rachel Milte. Not in picture but authors on the MJA paper): Enwu Liu, Tiffany Easton, Clare Bradley.

An Australian first study examining different models of residential aged care has found that people living in smaller home-like facilities have better quality of life and fewer hospital admissions.

The CDPC funded project found residents in these facilities had a 68% lower rate of being admitted to hospital and 73% lower chance of presenting to the emergency department, after adjustments.

Additionally, benefits in quality of life for the residents were achieved without an increase in the running costs of these facilities.

Data published in the Medical Journal of Australia and presented by Dr Suzanne Dyer at the International Dementia Conference in Sydney, involved 541 permanent residents in 17 aged care facilities across four states of Australia. The study included a high proportion of people with dementia.

In 2016 there were approximately 180,000 people living in permanent residential aged care in Australia, an increase of over 10% in the last five years. The average age of a person living in residential aged care is 84 with 52% of these living with a diagnosis of dementia.

In Australia’s major cities the standard model of residential aged care have more than 60 beds and this size is increasing. There is growing evidence from around the world that more home-like models provide better quality of life for aged care residents.

Dr Dyer, first author on the study and Senior Research Fellow at Flinders University, says these models of care provide benefits for residents.

“Our research shows that residents of these home-like clustered facilities had fewer hospitalisations and also a lower chance of receiving potentially inappropriate mediations, including psychotropics.

“These benefits translated into a better quality of life of the residents and this was achieved without an increase in the running costs of the facilities.

“There is a clear need for further research to explore these potential benefits, including a more comprehensive method of measuring facility running costs such as a ‘bottom up’ analysis,” Dr Dyer said.

The results of this study are part of the larger, the Investigating Services Provided in the Residential care Environment for Dementia in Australia (INSPIRED) study, funded through the NHMRC Cognitive Decline Partnership Centre.

“The INSPIRED study finally provides some evidence on the effect of smaller residential care models similar to the US Green House model and it looks promising, explains project Lead Investigator Professor Maria Crotty.

“A key was to include resident and family input in the study. Residential aged care is being used for multiple purposes so one size doesn’t fit all. A facility model for palliative care won’t work the same for people with dementia,” she said.

Links
Medical Journal of Australia article, “Cluster models of residential aged care are associated with fewer hospitalisations and better quality of life: an Australian cross-sectional study” mja17.00861.R2

BMC Geriatrics article, “Costs of potentially inappropriate medication use in residential aged care facilities”

The Conservation article, Caring for elderly Australians in a home-like setting can reduce hospital visits

example of home-like care

Home-like aged care facility