Appropriate care levels at 50%, new study finds

Aged care residents in Australia are receiving on average only half of the appropriate care and even less for other common conditions like depression, a new study has found.

In world-first research, Macquarie University's Australian Institute of Health Innovation evaluated adherence to evidence-based care and clinical practice guidelines for people in long-term residential aged care across multiple common conditions.

The research analysed the care received by 294 residents across 27,585 care encounters in 25 residential aged-care facilities.

Aged care nurses conducted the specialised reviews and found – on average – that indicators for adherence to evidence based care was at an average of only 53.2 per cent.

Common conditions such as skin integrity, end-of-life care, infection, sleep, medication, and depression had less than 50 per cent adherence to indicators for best care, whereas bladder and bowel was at 81.3% per cent.

Lead author Professor Peter Hibbert said the results showed the continued difficulties faced by the aged care sector, including workforce shortages.

"Being treated according to evidence-based care is a fundamental human right and essential for ensuring people in aged care are safe and experience the best possible quality of life," Professor Hibbert said.

"Caring for older people in aged care is likely to become more and more challenging as demand increases and resources become more stretched.

"Understanding where and how evidence-based care is being delivered, or not, is very important to keeping people safe and allocating limited resources."

Management for depression was the lowest at only 12 per cent of appropriate care, despite more than half of the residents experiencing depression symptoms.

Depression is common among older Australians, with 49 per cent of people living in permanent residential aged care having a depression diagnosis.

The research found that only one per cent of residents who have been receiving antidepressants were monitored monthly for side effects, as recommended by the guidelines.

Data for the research was collected from March 1 2021 to 31 May 2021 – around the time the Royal Commission reported its findings.

Professor Hibbert believes the study will provide a benchmark for measuring the impact the policy changes could make.

"We are not judging individual aged care providers with these results," he said.

"This is a commentary on the overall aged care sector, which is struggling to provide residents the right care at the right time.

"The Royal Commission recommended that registered nurses should be onsite 24/7 and that other health care staff would be available, but broader workforce shortages have increased since 2021 – which has put pressure on the system."

The authors said a significant reason for the low adherence rate was the shortage of healthcare workers in aged care and the lack of proper health workforce planning.

They advocated for innovative approaches such as multidisciplinary teams, structured communication and handover, and establishing evidence-based local clinical pathways.

Last year, the Intergenerational Report stated than an ageing population coupled with slowing population growth would strain Australia's economy into the future, and associated workforce shortages would mean the sector would continue to struggle.

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