Ageing Well and Aged Care – Putting Consumers First
What is known about the topic? The new Aged Care Act that will commence on 1 November 2025 will significantly reform/disrupt the provision of aged care services in Australia. What does this paper add and What are the implications for practitioners? This paper suggests that the new Act will not achieve the outcomes desired by the Royal Commission into Aged Care Quality and Safety as it does not establish the two key building blocks to aged care reform that were identified by the Commission: independence from Government and a secure source of funding. It argues that a philosophical shift is required that places the people receiving care at the centre of quality and safety regulation through the establishment of an independent Aged Care Commission with guaranteed funding though a hypothecated Aged Care Levy.
What is known about the topic? Why is there so much attention paid to persons receiving aged and home care at the expense of those in the unpaid economy? Why do some calls for a new initiative for older Australians fall on deaf ears. What does this paper add? This paper gives an insight into why the emphasis is on older persons receiving care funded by the Commonwealth and not on initiatives that could improve the lives of older persons in general. What are the implications for practitioners? Practitioners’ can be aware of the difference between preventive social initiatives and those firmly rooted in the medical model of health care.
What is known about the topic? This article explores the integration of artificial intelligence (AI) in aged care, emphasising that technology cannot substitute for systemic reform. While AI is already deployed to detect pain, predict falls, and reduce administrative burdens, its risks include bias, depersonalisation, and inequity when adopted without ethical guardrails. What does this paper add? The article proposes three guiding questions: who designs the AI and who is missing, what outcomes it optimises for, and whether it reduces or reinforces inequities. What are the implications for practitioners? The article concludes that AI should augment—not replace—care, ensuring dignity, equity, and human rights remain at the centre of aged care systems.
What is known about the topic? There is a need to advance quality measurement efforts within Australia’s aged care sector, particularly in the midst of current national aged care and healthcare reforms. What does this paper add? This paper discusses why a national cross-setting evidence-based framework to monitor and evaluate quality and safety of care for older people is critical and proposes a strategy for framework development. What are the implications for practitioners? A national framework will produce the evidence required to inform cross-setting quality monitoring efforts and create the infrastructure required to examine quality and safety outcomes longitudinally.
What is known about the topic? Acute care of the elderly (ACE) wards have been shown to improve outcomes for hospitalised older people through early rehabilitation and early discharge planning. What does this paper add? At least twice daily therapy on an ACE ward was feasible, facilitated discharge home and both staff and patients reported positive perceptions of the intervention. What are the implications for practitioners? Measurement of the scalability and sustainability of this model of care and further economic analysis are needed to determine whether the staffing required negates the cost of avoided subacute admission or bed days saved.
What is known about the topic? High levels of activation measured using the Patient Activation Measure (PAM®) have been associated with improved health behaviours, reduced emergency department (ED) representations and lower healthcare costs. What does this paper add? The PAM® did not predict short-term healthcare use in older adults with mild frailty. However, low levels of activation were significantly associated with ED use in the previous 6 months, indicating older adults may require greater discharge supports. What are the implications for practitioners? Over 50% of patients were at low levels of activation, highlighting the importance of post-discharge care.
What is known about the topic? Frailty is associated with significant mortality and morbidity in hospitalised patients. The roles of the physiotherapist and occupational therapist need further study. What does this paper add? This study provides evidence that early intervention by physiotherapists and occupational therapists in frail patients is associated with better outcomes, specifically reduced pressure injury and reduced hospital length of stay. What are the implications for practitioners? Early intervention by physiotherapists and occupational therapists can be beneficial in the management of frailty. More research is required to further define the specific interventions that are effective.
What is known about the topic? Evidence pertaining to the value of online palliative care information is limited and metrics such as usage data may not be sufficient to determine efficacy. What does this paper add? This paper assesses the value of online palliative care information and provides an innovative description of the cultural, demographic, institutional, and technological eco-system within which online palliative care knowledge is being translated. What are the implications for practitioners? Maximising the impact of online palliative care information requires improvements in access to evidence, visibility, usability, and the development of resources tailored to diverse users.
What is known about the topic? Geriatric Evaluation and Management, Rehabilitation Hospital in the Home (GEMRHITH) is a poorly studied area of sub-acute healthcare practice. What does this paper add? The multidisciplinary GEMRHITH service supported a broader cohort of patients than traditional HITH models across medical and surgical conditions. What are the implications for practitioners? The GEMRHITH service was safe with low re-admission rates and improvements in patient functional outcome scores.
What is known about the topic? The impact and sustainability of integrated palliative care models for people with advanced dementia depends on how well these models can respond and adapt to the context in which they are implemented. What does this paper add? Applying KA McKercher’s (2020) principles of co-design, this case study presents a model of care developed by a diverse group of dementia and palliative care stakeholders. What are the implications for practitioners? Co-design principles can bring together a diverse range of stakeholders to develop new models of care that benefit people with dementia and their carers.
What is known about the topic? The needs of Australians requiring home-based aged care have been examined from various perspectives. However, more information is required about their comprehensive day-to-day needs at the population level. What does this paper add? Only two relevant studies were located, indicating a gap in Australian research on this topic. What are the implications for practitioners? This knowledge gap could impact effective and efficient home-based aged care service-delivery design and workforce planning, since without direct measurement of the day-to-day care and support needs of individuals requiring home-based aged care, the requirements for optimally addressing these needs are not overtly apparent.
What is known about the topic? While some transfers from nursing homes to EDs are necessary, many are avoidable and place older people at an undue risk of harm, burden healthcare services, and incur significant costs. What does this paper add? A multifaceted approach is required to reduce advisable ED transfers, including improved staffing, consumer engagement, interfaces with clinical expertise, and technology integration. What are the implications for practitioners? Practitioners should advocate for better staffing levels, conduct advance care planning in collaboration with residents’ families, and utilise technologies such as telehealth to enhance in-reach expertise and reduce unnecessary transfers.
What is known about the topic? Osteoporosis is a common yet undermanaged problem. What does this paper add? This paper describes a successful approach to finding cases of osteoporosis and shows that flagging this to GPs does not lead to increased rates of management. What are the implications for practitioners? It is unclear how to engage GPs in a manner which will lead them to address population health risks.
What is known about the topic? The ageing population and increasing incidence of chronic illness pose significant end-of-life healthcare challenges. advance care planning (ACP) completion rates are low across Australia, varying by location and healthcare setting. What does the paper add? This study identifies predictors for ACP and advance care directive completion, including having a will, advancing age, being female, having private health insurance, not working, and having one or more medical conditions. What are the implications for practitioners? These findings could inform interventions to improve ACP uptake, guide healthcare professionals to identify groups that engage less in ACP and inform future research.
What is known about the topic? Consumer involvement is crucial for ensuring quality and relevance in research. However, limited research exists on consumer–researcher collaborations in Australian health services. What does this paper add? This study explores staff experiences and perceptions of consumer involvement in research at an Australian health service. It offers insights into barriers and solutions to consumer–researcher collaborations, enhancing understanding in this area. What are the implications for practitioners? Practitioners gain insights into enhancing consumer involvement in research, understanding barriers like resource constraints, and advocating for designated roles. This fosters more meaningful collaborations and improves research impact.
What is known about the topic? Appropriate patient selection is critical for safe and effective Hospital in the Home (HITH) services that deliver positive patient experiences. HITH research predominantly reports on hospital-specific outreach services. What does this paper add? A HITH program spanning metropolitan and adjacent regions was safe for patients but confounding likely impacts estimates of effectiveness. Patients accepted and preferred HITH and understood its impact on the health system. Perceived gaps in service quality were tolerated because of benefits of being at home including enhanced self efficacy. What are the implications for practitioners? Patients, referrers and funders can be reassured that HITH is safe, which will further enhance the program’s acceptability.
What is known? Advance care directives are important so that individuals can plan for the medical treatment they want to receive when they are unable to medically or cognitively make those decisions. Unfortunately for many reasons uptake is low. What does this paper add? Increase in uptake can occur if a health professional individualises support at the right time in the right place and targets the right people. What are the implications for practitioners? Dedicated staff are required to provide time, education and empathy to support people to empower themselves to make decisions about their future medical care.
