Home might be where the heart is, but when it comes to looking after people with dementia, residential aged care might have the edge.
New Australian research shows that people with dementia who move into an aged care facility after a hospital stay are less likely to be readmitted to hospital within one year than those who go back to living in their own homes.
The Australian Institute of Health and Welfare report found that in people living in an aged care facility, 38% of people with dementia were readmitted to hospital over a period of a year, compared to 62% people who were still living in the community.
Transitions to residential aged care after hospital for people living with dementia looks at how people living with dementia move between hospitals and residential aged care and their subsequent use of health services following their hospital stay.
If found that about one in four people with dementia who entered residential aged care after being hospitalised were readmitted to hospital within 12 months, a substantially lower rate than those who continued living in the community.
They were also less likely to have an emergency department presentation, at 50% compared with 63%.
“Dementia is a significant and growing health and aged care issue in Australia that has a substantial impact on the health and quality of life of people with the condition, as well as their family and friends,” AIHW spokesperson Louise Gates said.
“The care needs of people living with dementia increase as their dementia progresses, which often results in people living with dementia moving into residential aged care to receive ongoing care, or changing facilities as care needs change.
“Having a better understanding of how people with dementia access health services and move between hospitals and residential aged care can contribute to improvements in the health and aged care systems and policies to better meet the needs of Australians living with dementia.”
Each year, 79,000 people aged 65 or older living with dementia are hospitalised for a range of reasons, including dementia. Of these people, 62% were living in the community before their hospitalisation while the remainder lived in residential aged care.
“One in four of those people who lived in the community prior to their hospitalisation moved to residential aged care within one week of leaving hospital. This increased to one in three at 3-months and to 37% at 12-months after leaving hospital,” Ms Gates said.
The 2021 Royal Commission into Aged Care Quality and Safety recommended better integration between health and aged care systems to improve outcomes for older Australians and structural changes in data capture to allow the interaction between health and aged care systems to be monitored.
This report used data from the National Integrated Health Services Information, a linked data asset which brings together deidentified information on hospital care, deaths, residential aged care services, prescription medication and services under the Medical Benefits Schedule. Analysing linked data provides new insights into how people with dementia access health services and move between hospitals and residential aged care.
The study focused on people’s first hospitalisation in 2017 and compares transitions to residential aged care or mortality in the 7-days, 3-months, and 12-months after discharge for people with dementia and those without it.
Due to data availability at the time of the study, changes in health and care aged care services following recent aged care reforms and the COVID pandemic were not examined.