Use it or lose it: Community support crucial for older Australians maintaining independence

• Support services such as domestic assistance, social support and personal care vital in preventing early entry to residential care
• Each additional hour of community service received per week was associated with a six per cent lower risk of entry into permanent residential care
• The more hours of home care services that people accessed, the lower their risk of entry into residential care.

A new study assessing the effectiveness of community care services for older Australians has found each additional hour of service received per week was associated with a six per cent lower risk of entry into permanent residential care.

The research, published in journal JAMDA, found the more hours of home care services that people accessed, the lower their risk of entry into residential care.

The community-based services primarily used included domestic assistance (light housework), personal care (showering, dressing), social support (one-on-one companionship visits at home, assistance to attend community-based social activities), transport, and nursing services.

The research found that people who were predominant users of social support services stayed in their own homes for longer, compared to those predominately receiving domestic assistance, personal care, or in-home respite.

“Nearly one million older Australians access home and community aged care services each year, at a cost to the government of over $4 billion. Yet, this study is the first in Australia, and one of very few internationally, to connect service use and meaningful outcomes in home and community care,” said Dr Mikaela Jorgensen from the Australian Institute of Health Innovation at Macquarie University.

The study suggests that improving outcomes for older adults may require a shift in focus from exclusively meeting physical needs to ensuring each person has access to social engagement opportunities.

“The results show that having greater access to community care services may be an effective way of supporting older Australians to remain in their own homes for longer, which the majority wish to do,” said Dr Jorgensen.

While the researchers didn’t undertake a cost-benefit analysis in this study, the government subsidy rate for a person with the highest level of care needs on a home care package is less than $50,000 per year, compared with up to $100,000 for a person with the same level of needs in residential aged care.

Residential aged care is largely government-funded in Australia and is the main driver of projected increases in aged care costs. While delaying entry into residential care does not always reduce care costs, the vast majority of people express a desire to remain in their own homes as they age.

“This study shows that home care services do help to keep older people in their own home for longer. This is what home care is designed to do, but until now there was no-one measuring the outcomes of home care, and what types of services help the most,” concluded Dr Jorgensen.

The research is timely within the current context of Commonwealth Government policy directions in providing older Australians with greater choice in the community care services they receive, and also in terms of showing that this approach is likely to have economic benefits in keeping people engaged in the community.

Jorgensen M., Siette J., Georgiou A., Warland A. and Westbrook J. Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data. JAMDA. October 2017. doi.org/10.1016/j.jamda.2017.08.004

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