The art of independence

A new study will examine the long term benefits of restorative  home care programs. Megan Stoyles reports.

The Centre for Research on Ageing (CRA) at Curtin University has been given a $96,000 grant to establish the long-term outcomes of restorative home care services provided by Silver Chain, one of Western Australia’s largest home care providers.

The study by Professor Gill Lewin, Professor of Ageing at CRA, will determine whether older people who have regained their independence by participating in one of the Silver Chain programs over a period of five years have a reduced need for aged care services.

Lewin said the aim of such programs was to help older people to regain or retain their independence.

“There is now strong evidence from two controlled trials of the Home Independence Program (HIP) here in Australia, plus UK and US evaluations, that these programs work in the short-term,” she said.

“There is a gap in evidence to show if they work in the longer term, and whether older people return later to need ongoing aged care services, which is what we are examining,” she said.
Victoria and Western Australia have promoted the adoption of restorative home care models for aged care services. Victoria has adopted the Active Service Model for HACC services, while in WA all HACC providers are being assisted to implement the Wellness Approach.

NSW is currently funding four pilot programs promoting an enabling approach to home care in the Clarence Valley in Northern NSW, Singleton in the Hunter Region, and in Northern Sydney and the Eastern Suburbs.

However, the Commonwealth is still waiting for definitive evidence of their long-term effectiveness. It’s expected this study will provide that evidence.

”We are still constructing the data sets as it was a time consuming process taking the project through three ethics committees – Silver Chain, Curtin and the Department of Health” Lewin said.
“Data currently being extracted from Silver Chain’s client database will then be linked by the Department of Health to HACC and ACAP data.”

Lewin said they hoped to be in a position to start analysis in March and the study would take 12 months to complete.

Outcomes are being measured in terms of use of home care and other aged care services where fewer services equate to increased independence.

Silver Chain has been running restorative home care programs in metropolitan Perth since 2001, with more than 12,000 older people having used one of its services.

Some of the data describing the clients of the independence programs and their service outcomes were analysed and presented by Lewin at the Australian Association of Gerontology national conference in November 2009.

This data for 2002 to 2008 showed that 12,334 individuals had completed either HIP or PEP (the Personal Enablement Program, Silver Chain’s other restorative home care program), during that period. The average age of HIP clients was 78 and of PEP clients 75. The areas that they most needed assistance with were housekeeping, shopping, travel, food preparation, laundry, showering and dressing.

More than 80 per cent of the 10,600 clients who were new to home care did not require any ongoing home care services after completing HIP or PEP. This was the case for only 55 per cent of those who were already receiving some home care services and were referred to an independence program because of an increased need. Analysis to determine which client characteristics best predicted program success found that not receiving home care at referral, living with others and not having a carer were all independently associated with an increased likelihood of regaining independence.

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