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Home is where the health is

Research will look into how to give seniors the best chance at staying out of hospital when they need medical treatment. 

Keeping our ageing population from having to leave their homes or residential aged-care facilities for medical treatment will be the priority for a new research project in Western Australia.

Edith Cowan University researchers will investigate ways to reduce hospitalisation rates for people in aged care after being awarded a $303,000 Targeted Research Fund (TRF) grant.

Professor Moira Sim, ECU’s head of medical sciences, will lead the project – Better Access to Home Hospital for Residents in Aged Care Facilities.

“The reality is that we have an ageing population that our health system can’t cope with,” Sim says. “We need to find ways to care for the elderly outside of hospital and home hospital offers a great opportunity to allow people to be treated in a more comfortable environment.”

The project will help set up care plans for residents, which will include options for receiving treatment for acute conditions in aged-care facilities instead of in hospital. This will involve collaboration between two GPs, four Perth aged-care facilities, Silver Chain and St John Ambulance WA.

The model will include education for health professionals, residents and their families about alternatives to hospitalisation, as well as the development of a process to document residents’ treatment preferences.

“When [older people] are admitted to hospital they face increased risk of new infections, falls and bad reactions to medications, coupled with an unfamiliar environment that can cause more stress,” Sim says. “There is no doubt that if they can be treated either in their homes or in a residential aged-care facility where they have been residing it will lead to greater peace of mind. This is important in terms of treating people, as it immediately helps them focus on what needs to be done without getting stressed about their new environment.”

Research shows that residents from residential aged care who are admitted to hospital are more likely to suffer complications such as delirium and feel stress and discomfort from the change in environment. They are also more likely to deteriorate following admission.

“Part of the research will be investigating [how families have] that conversation with their mum, dad, grandparents and other relatives about what kind of medical treatment they need and where they want to have it,” Sim says. “It is important that decisions are made – for non-urgent medical treatment – well in advance so all parties are clear about what will happen when the situation arises.

“We will also be canvassing nursing homes to work with them in their medical treatment of the elderly to see what support that they can offer and how we can incorporate advanced care planning.”

Sim expects many questions to be asked when the study is taking place. She says it is important that the Western Australian government explores all options when treating older people for non-urgent medical care.

“If we work with people ahead of time to address where they want their medical treatment, will it reduce hospital visits?” Sim asks. “And if they do eventually have to go to hospital, will it reduce the amount of time they spend there due to the fact that they have already been treated in their home or aged-care residence?  Will it improve health outcomes overall? Will it enable the hospital system to cope better with emergencies?

“There are a lot of questions to be answered and we are hopeful that this study will result in positive outcomes, not just for the elderly but for everyone involved in the system.”

TRF was established by the Western Australian Department of Health to provide funding for research projects that focus on the capacity of the department to address issues that affect the population of WA.

The research outcomes must clearly link to the capacity of WA Health to address the identified issues, through policy, operational or other transformational changes that are implementable and sustainable.

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