December 3, 2011

AUSTRALIA: These days elderly are more likely to arrive at nursing home in a wheel chair

SYDNEY, NSW / The Sydney Morning Herald / National / Health / December 3, 2011

Elderly more frail before moving to aged care

By Mark Metherell

NOT so long ago elderly people would often drive themselves to a nursing home to check in, according to the aged care executive Robyn Batten.

These days they are more likely to arrive in wheelchairs. Nursing home care has become more intensive and patients are more likely to be frailer and destined for a shorter stay before they die, said Ms Batten, the executive director of the aged care organisation Blue Care.

The changing tempo of nursing home care has been highlighted by a forecast of a sharp rise in nursing home subsidies revealed in the federal government's midyear economic forecast released this week.

The bill for these costs over the next four years is expected to rise by $1.9 billion above the original forecast in the budget in May. The official explanation is that people are ''entering residential aged care facilities with greater care needs than previously anticipated''.

Ms Batten, whose non-profit organisation operates 4500 nursing home beds in Queensland and NSW, said there had been a marked change in the ratio of high-care to low-care patients, whose care status determines what level of subsidy the government pays the nursing home.

The proportion of low-care patients in Blue Cross homes had fallen in the past three years from 40 per cent to 13 per cent.

The trend reflected a ''fantastic'' development in that it showed more people were able to remain in their own homes for longer before entering nursing homes because of the increasing availability of supportive home and community care.

But by the time they arrived at nursing homes, they were likely to have multiple conditions needing more care. About 60 per cent of nursing home patients also have some level of dementia.

Ms Batten said the trend had led to changes to the atmosphere of nursing homes, affecting the staff's social interaction with residents and their more demanding care needs. More frequent bereavements and grieving relatives added to demands on staff.

The median stay for women in nursing homes is about two years and for men about one year.

Rod Young, the chief executive of Aged Care Association Australia, said the increasing funding for aged care at a time when the government was trying to rein in costs was welcome, but also underlined the need for funding reforms recommended by the Productivity Commission.

He said the increasing number of residents with dementia in nursing homes also raised the question of whether Australia should consider moves taken in Britain and New Zealand to separate those with dementia from frail aged residents.

''My belief is that it is unfair to have shared facilities for the frail aged and people who have cognitive impairment. It is a contentious issue,'' he said.

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