Clustered, home-like models of residential aged care lead to better quality of life for residents at a comparable cost.
That’s one of the key findings of a Flinders University study that compared the approach with standard Australian care models.
Its authors said in 2010-11, most residential aged care facilities in major Australian cities had more than 60 residential places, and added that the average facility size is growing.
While these larger facilities are still typical in Australia, there have been moves here and internationally towards smaller living units designed to resemble homes, with staff focused on providing flexible and adaptable care.
Published today in the Medical Journal of Australia, the research, which forms part of the INvestigating Services Provided in the Residential care Environment for Dementia (INSPIRED) study, compared patient-reported outcomes and resource use for over 500 residents of 17 facilities across four states.
Overall, it found that home-like models, which allowed for smaller groups of up to 15 people, are delivering better outcomes for a comparable cost.
Residents of these models were less likely to be admitted to hospital, and present to an emergency department. They were also 52 per cent less likely to be prescribed a potentially inappropriate medication.
The research team pointed to the US Green House approach, in which residents live in small-scale units that are designed to look and feel more like a home, as an example of such a model that delivers better outcomes for a comparable cost.
Study lead Professor Maria Crotty said other overseas studies have demonstrated that these models of care also perform better in areas like re-hospitalisations, catheter use and pressure ulcers.
“The issue of quality in aged care is always close to the community’s heart and this study suggests there should be increased access to alternative models of residential aged care, particularly those that have evidence of better outcomes for the residents,” Crotty said.
Dr Stephen Judd, chief executive of HammondCare, said it’s important to note that the success of home-like models does not simply come down to the physical environment, but also the social model of care and approach to staffing. To be included in the study, clustered domestic models needed to not only involve small living units of 15 or fewer residents and independently accessible outdoor areas, but also had to show that there were care staff allocated to specific living units, that meals were cooked in the units, and that they supported self-service of meals by residents and their participation in meal preparation.
Judd said: “This research … supports the type of care that HammondCare has been delivering for many years – small, home-like environments, with domestic kitchens and meals being prepared and cooked in the home, where there is easy access to the outdoors.
“It shows that these sort of environments for older people deliver a better quality of life as well as less time spent in hospital – something we all want for our loved ones.”
He said the findings surrounding both quality of life and cost should make it a “no brainer” for governments, philanthropists and other aged care investors to back those models that reflect the evidence.
Dr Suzanne Dyer, lead author on the study, said there is a need for further research to explore the potential benefits of home-like models. “Future research should be directed toward longitudinal projects, applying a more comprehensive method of measuring facility running costs such as a ‘bottom up’ analysis.”
The study was conducted in partnership with the NHMRC Cognitive Decline Partnership Centre (CDPC). This partnership includes the University of Sydney, HammondCare, Brightwater Care Group, Helping Hand Aged Care and Dementia Australia.Do you have an idea for a story?
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