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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH FRONT (Open Access)

Who uses residential aged care now, how has it changed and what does it mean for the future?

Diane Gibson https://orcid.org/0000-0001-7235-3719
+ Author Affiliations
- Author Affiliations

Health Research Institute, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2617, Australia. Email: diane.gibson@canberra.edu.au

Australian Health Review 44(6) 820-828 https://doi.org/10.1071/AH20040
Submitted: 2 March 2020  Accepted: 17 April 2020   Published: 21 August 2020

Journal Compilation © AHHA 2020 Open Access CC BY-NC-ND

Abstract

Objective This paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future.

Methods Time series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers.

Results Although the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising.

Conclusion Changing trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future.

What is known about the topic? Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns.

What does this paper add? The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future.

What are the implications for practitioners? These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.


References

[1]  House of Representatives Standing Committee on Expenditure. In a home or at home: accommodation and home care for the aged. Canberra: Australian Government Publishing Service; 1982.

[2]  Office of the Royal Commission. A history of aged care reviews. Adelaide: Royal Commission into Aged Care Quality and Safety; 2019.

[3]  Productivity Commission. Report on government services part F (community services). Canberra: Productivity Commission Australia; 2020.

[4]  Australian Institute of Health and Welfare (AIHW). GEN aged care data. Findings based on use of GEN data. Canberra: AIHW; 2020.

[5]  Borotkanics R, Rowe C, Georgiou A, Douglas H, Makeham M, Westbrook J. Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory. Aust Health Rev 2017; 41 613–20.
Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory.Crossref | GoogleScholarGoogle Scholar | 27888837PubMed |

[6]  Khadka J, Lang C, Ratcliffe J, Corlis M, Wesselingh S, Whitehead C, Inacio M. Trends in the utilisation of aged care services in Australia, 2008–2016. BMC Geriatr 2019; 19 213
Trends in the utilisation of aged care services in Australia, 2008–2016.Crossref | GoogleScholarGoogle Scholar | 31387533PubMed |

[7]  Broad JB, Ashton T, Gott M, McLeod H, Davis PB, Connolly MJ. Likelihood of residential aged care use in later life: a simple approach to estimation with international comparison. Aust N Z J Public Health 2015; 39 374–9.
Likelihood of residential aged care use in later life: a simple approach to estimation with international comparison.Crossref | GoogleScholarGoogle Scholar | 26095070PubMed |

[8]  Australian Bureau of Statistics (ABS). Australian demographic statistics, Sep 2019. Catalogue no. 3101.0. Canberra: ABS; 2019. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/7d12b0f6763c78caca257061001cc588/5815ff86422ef241ca25858a00260a37!OpenDocument [verified 30 June 2020].

[9]  Australian Bureau of Statistics (ABS). Disability, ageing and carers, Australia: summary of findings, 2018. Canberra: ABS; 2019. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/mf/4430.0 [verified 30 June 2020].

[10]  Productivity Commission. Report on government services, part F (community services). Canberra: Productivity Commission Australia; 2010.

[11]  Australian Institute of Health and Welfare (AIHW). GEN aged care data: admissions into aged care. Canberra: AIHW; 2019. Available at: https://www.aihw.gov.au/reports/aged-care/gen-aged-care-data-admissions-into-aged-care/contents/summary [verified 30 June 2020].

[12]  Australian Institute of Health and Welfare (AIHW). Movement between hospital and residential aged care 2008–09. Canberra: AIHW; 2013. Available at: https://www.aihw.gov.au/reports/aged-care/movement-between-hospital-and-residential-aged-car/contents/table-of-contents [verified 30 June 2020].

[13]  Australian Institute of Health and Welfare (AIHW). GEN aged care data: people leaving aged care. Canberra: AIHW; 2019. Available at: https://www.aihw.gov.au/reports/aged-care/gen-aged-care-data-people-leaving-aged-care/contents/summary [verified 30 June 2020].

[14]  Australian Institute of Health and Welfare (AIHW). Residential aged care in Australia 2007–08: a statistical overview. Canberra: AIHW; 2009. Available at: https://www.aihw.gov.au/reports/aged-care/residential-aged-care-in-australia-2007-08/contents/table-of-contents [verified 30 June 2020].

[15]  Australian Institute of Health and Welfare (AIHW). Residential aged care in Australia 2008–09: a statistical overview. Canberra: AIHW; 2010. Available at: https://www.aihw.gov.au/reports/aged-care/residential-aged-care-in-australia-2008-09-a-stat/contents/table-of-contents [verified 30 June 2020].

[16]  Australian Institute of Health and Welfare (AIHW). Residential aged care in Australia 2009–10: a statistical overview. Canberra: AIHW; 2011. Available at: https://www.aihw.gov.au/getmedia/4bb86c5e-ec2e-49e8-a3be-daa934606192/12669.pdf.aspx?inline=true [verified 30 June 2020].

[17]  Australian Institute of Health and Welfare (AIHW). Residential aged care in Australia 2010–11: a statistical overview. Canberra: AIHW; 2012. Available at: https://www.aihw.gov.au/reports/aged-care/residential-aged-care-in-australia-2010-11/data [verified 30 June 2020].

[18]  Australian Institute of Health and Welfare (AIHW). GEN fact sheet 2015–16: People leaving aged care. Canberra: AIHW; 2017. Available at: https://www.gen-agedcaredata.gov.au/Resources/Factsheets-and-infographics/Exits_factsheet.pdf?ext= [verified 7 July 2020].

[19]  Cullen D. Medium- and long-term pressures on the system: the changing demographics and dynamics of aged care. Adelaide: Royal Commission on Aged Care Quality and Safety; 2019.

[20]  Australian Institute of Health and Welfare (AIHW). GEN: Explore people’s care needs in aged care. Canberra: AIHW; 2019. Available at: https://www.gen-agedcaredata.gov.au/Topics/Care-needs-in-aged-care/Explore-care-needs-in-aged-care [verified 30 June 2020].

[21]  Australian Bureau of Statistics (ABS). Survey of disability, ageing and carers. Findings based on use of ABS TableBuilder data. Canberra: ABS; 2018.

[22]  Gibson D, Braun P, Benham C, Mason F. Projections of older immigrants: people from culturally and linguistically diverse backgrounds, 1996–2026, Australia. Canberra: Australian Institute of Health and Welfare; 2001. Available at: https://www.aihw.gov.au/reports/aged-care/projections-of-older-immigrants-people-from-cultu/contents/table-of-contents [verified 30 June 2020].

[23]  Australian Bureau of Statistics (ABS). Housing occupancy and costs, 2015–16. Catalogue no. 4130.0. Canberra: ABS; 2017. Available at: https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4130.02015-16?OpenDocument [verified 30 June 2020].

[24]  Australian Housing and Urban Research Institute. How has homelessness changed between 2011–2016? Melbourne: Australian Housing and Urban Research Institute; 2018. Available at: https://www.ahuri.edu.au/policy/ahuri-briefs/how-homelessness-changed-between-2011-2016 [verified 22 February 2020].

[25]  Kendig H, Gong CH, Cannon L, Browning C. Preferences and predictors of aging in place: longitudinal evidence from Melbourne, Australia. J Hous Elder 2017; 31 259–71.
Preferences and predictors of aging in place: longitudinal evidence from Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar |

[26]  Rowland DT. The prevalence of childlessness in cohorts of older women. Australas J Ageing 1998; 17 18–23.
The prevalence of childlessness in cohorts of older women.Crossref | GoogleScholarGoogle Scholar |

[27]  Evans A, Gray E. Census 2016: location and education affects how many children you have. Canberra: Australian National University; 2017. Available at: https://www.anu.edu.au/news/all-news/census-2016-location-and-education-affects-how-many-children-you-have [verified 25 June 2020].

[28]  Gibson D, Goss J. Ninety and not out – understanding our oldest old. Australas J Ageing 2020; 39 e62–9.
Ninety and not out – understanding our oldest old.Crossref | GoogleScholarGoogle Scholar | 31321847PubMed |

[29]  Rowland DT. Consequences of childlessness in later life. Australas J Ageing 1998; 17 24–8.
Consequences of childlessness in later life.Crossref | GoogleScholarGoogle Scholar | 12321793PubMed |

[30]  Jamieson H, Abey-Nesbit R, Bergler U, Keeling S, Schluter PJ, Scrase R, Lacey C. Evaluating the influence of social factors on aged residential care admission in a national home care assessment database of older adults. J Am Med Dir Assoc 2019; 20 1419–24.
Evaluating the influence of social factors on aged residential care admission in a national home care assessment database of older adults.Crossref | GoogleScholarGoogle Scholar | 30926408PubMed |

[31]  Australian Institute of Health and Welfare (AIHW). Cardiovascular disease. Canberra: AIHW; 2019. Available at: https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/cardiovascular-health-compendium/data [verified 24 February 2020].

[32]  Australian Institute of Health and Welfare (AIHW). Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Catalogue no. BOD 22. Canberra: AIHW; 2019. Available at: https://www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015/contents/table-of-contents [verified 25 June 2020].

[33]  Farrer O, Yaxley A, Walton K, Miller M. Characteristics of older adults with diabetes: what does the current aged care resident look like? Nutr Diet 2018; 75 494–9.
Characteristics of older adults with diabetes: what does the current aged care resident look like?Crossref | GoogleScholarGoogle Scholar | 29542215PubMed |

[34]  Haines HM, Bannon-Murphy H, Amos T, Krones R. Prevalence and management of diabetes in residential aged care facilities in north-east Victoria, Australia. Aust Fam Physician 2016; 45 908–11.
| 27903042PubMed |

[35]  Schoeni RF, Freedman VA, Langa KM. Introduction to a supplement on population level trends in dementia: causes, disparities, and projections. J Gerontol B Psychol Sci Soc Sci 2018; 73 S1–S9.
Introduction to a supplement on population level trends in dementia: causes, disparities, and projections.Crossref | GoogleScholarGoogle Scholar | 29669106PubMed |

[36]  Australian Institute of Health and Welfare (AIHW). Hospital care for people with dementia 2016–17. Canberra: AIHW; 2019. Available at: https://www.aihw.gov.au/getmedia/34d3dd23-56be-4809-b61f-62b7697b9dc4/aihw-age-94.pdf.aspx?inline=true [verified 30 June 2020].