Aged Care Insite Issue 109 | Oct-Nov 2018 | Page 8

news There’s no place like home Flexibility and access to the outdoors in home-like care rate highly in new research. A ged care residents with dementia feel some elements of care quality are greater in home-like, clustered accommodation models. That’s according to recently released research from the INSPIRED study. Researchers asked Australian residents in different models of long-term aged care – the majority of whom were living with dementia – to rate the quality of the care they receive. While the amount of the care time provided was rated as similar between the models of care, study lead Dr Suzanne Dyer from Flinders University said the residents and family members who responded rated the flexibility of care routines and being able to access the outdoors whenever they wanted as better in a clustered, domestic model of care. “Changes to the way aged care is provided to better align with a home-like model of care has the potential to better meet consumer preferences,” the article’s authors wrote. Chief executive of HammondCare Dr Stephen Judd said the home-like model of care, which the provider delivers, is straightforward. “Let people make themselves at home. “In your own home you have your own space, live by your own schedule, are engaged in meal preparation and cooking, and can go outside when you feel like it,” Judd explained. “With some creative thinking from aged care providers, people living with dementia can still enjoy these freedoms.” Judd said the study is further proof that the clustered, domestic model is the one consumers want. Previous research in the INSPIRED study revealed that the model also delivers better outcomes for a comparable cost. It found 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. 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. By comparison, the home-like model allows for smaller groups of up to 15 people. Following its release, Judd 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.  ■ Reaching out gets results Outreach trial avoids unecessary hospital admissions. Resident Alexina Clarke, who was cared for by the GOAS team. Photo: Multimedia Sauce N ursing homes in Brisbane North have opened their doors to a medical outreach service to reduce unnecessary hospital admissions – and the numbers are in. The Geriatric Outreach Assessment Service (GOAS) was trialled over 12 months in 24 residential aged care facilities across The Prince Charles Hospital catchment. An internal evaluation of the service showed the team delivered 960 episodes of care (an average of four per day), of 6 agedcareinsite.com.au which two-thirds were considered to have potentially prevented ED presentations. Michele Smith, executive manager for aged and community care at Brisbane North PHN, said the hospital treatment averted by GOAS would have cost the Queensland Government anywhere from $3.5 to $4.3m. “By comparison, our pilot project cost $746,000, inclusive of set-up expenses, and we expect GOAS will cost just $464,000 per year to run on an ongoing basis,” Smith said. Surveys with consumers showed that almost all (98 per cent) would be likely to recommend the service to others, while all providers who responded and 87 per cent of GPs said the same thing. The GOAS team also provided over 400 training sessions to upskill the more than 3,000 aged care staff at the participating facilities. Dr Elizabeth Whiting, Metro North HHS executive director of clinical services, said surveys showed most aged care workers felt more confident in managing an acutely unwell resident. Smith said: “Our evaluation confirms GOAS provides responsive, high quality and person-centred medical care at the right time and in the right place.” The team recommended the service be expanded across all hospitals in Brisbane North. Australian Government funding from the PHN covered approximately two- thirds of project costs, with the Metro North HHS providing the balance. While Whiting said more time is needed to assess the long-term effects of GOAS on acute care, she added Metro North HHS will continue to offer it as part of its Residential Aged Care Assessment and Referral (RADAR) Service.  ■