Academic journal article Australian Health Review

Changes in the Profile of Australians in 77 Residential Aged Care Facilities across New South Wales and the Australian Capital Territory

Academic journal article Australian Health Review

Changes in the Profile of Australians in 77 Residential Aged Care Facilities across New South Wales and the Australian Capital Territory

Article excerpt

Introduction

The proportion of Australia's aged population is growing.1 This demographic shift is consistent with international trends, which indicate that the world' s population aged > 60 years is growing faster than any other age group.2 This population aging can be viewed as a public health success. Australians are living longer, but decreases in infectious disease and improved life expectancy have resulted in an increase in people living with chronic diseases. In fact, Australians are often living with multiple chronic diseases.2,3 Many chronic diseases impair activities of daily living and functional status. Residential aged care facilities, also known as nursing homes or care homes, provide services for Australians requiring ongoing assistance with activities of daily living.4

The proportion of the Australian population requiring residential aged care services is increasing with the aging of Australia's largest demographic cohort, the baby boomers.5,6 The baby boomers are people who were born between 1946 and 1965. Further, Australia is experiencing decreases in birth rates and migration from overseas.7 The 2015 population growth rate was 1.4%, with a 2014 net reproduction rate of 0.869.8 The proportion of the Australian population aged >65 years comprises almost 15% of the total population.9 Combined, these issues are putting increased pressures on aged care services. The Australian Government subsidises aged care, and government expenditure for aged care is increasing.10 For example, the crude cost for residential aged care increased from A$8.9 billion in the 2013 fiscal year to A$10 billion in the 2015 fiscal year.9,11 The number of aged care facilities has increased consistently since 1995.12

In an attempt to address these trends, the Australian Government has introduced a series of policy reforms. Major initiatives started in 2012 and are progressively being implemented.13 To date, bureaucracies and funding schemes have been reconfigured, including the establishment of the Australian Aged Care Quality Agency and the Aged Care Pricing Commission. A new means testing scheme was introduced for payment in 2014. The federal government also abandoned the 'high' and 'low' care designations. Historically, residents were classified as requiring high or low care. Residents requiring high care are those who require regular support from a full-time healthcare professional, whereas residents requiring low care are those who require assistance with activities of daily living.14 Residents are now classified by the government only as being eligible for residential aged care services. Although permanent residents are still classified as requiring either high or low care by these facilities for internal purposes, these classifications are no longer used by aged care assessment teams (ACATs). ACATs are teams of healthcare professionals that review the residential aged care needs of an individual if these needs are to be paid for by the Australian Government. After review and consultation, ACATs report the services that are approved to be received. This means that residents are now more likely to be able to age in place. For example, if a resident's care needs increase, that individual is not required to change facilities unless the circumstances are extraordinary.

Aged care services that occur outside of residential aged care facilities, but could alter residential care provision, have also been reconfigured. A cross-section of the aged population receives home care services, which are referred to as home care packages (HCPs). From July 2013, HCP program services were redesigned to encourage aging at home and empower individuals to choose the services they need.15 The HCP program provides support for services ranging from basic activities of daily living to nursing care, care coordination and case management.

Data on residential aged care demographics and utilisation are important to allow assessment of the effects of new and emerging aged care policies on residential aged care services. …

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