3rd Annual Transition Care Conference

ENHANCING  THE  PROFILE  OF  TRANSITION  CARE  

Barbara  Anderson  Principal  Policy  Adviser  –  Ageing  &  Disability  Aged  Care  Unit  Integrated  Care  Branch  NSW  Ministry  of  Health  

30  May  2014  

Transition Care in this time of reform

• Bridging the gap between acute care and community services

BUT….

• Is it as well utilised as it might be?

• Should more be done to promote this valuable service and, if so, what?

My Aged Care website

“ When you have been in hospital, often the most desirable place to go when you leave is to your own home … but sometimes you might need extra help to recover. This is where the Transition Care Program may be able to help.”

• Even in discussions of a more streamlined national aged care system, the role of Transition Care seems overlooked.

• Do hospital clinicians and discharge planners know when to give an older inpatient the option of being discharged to Transition Care?

•  Including time to make a decision about their long term accommodation arrangements?

National Health & Hospital Reform

Older people tend to be seen as ‘bed blockers’

Noeline Brown, Ambassador for Ageing

• Transition care gives older people that rare commodity, namely time.

• Time to reflect, to think through decisions, to consider options.

Transition Care is not care awaiting placement

We need greater promotion of its benefits and its eligibility criteria so that Commonwealth Guidelines governing its operation are more widely understood.

• Currently  a  dearth  of  published  arOcles  providing  evidence  of  the  benefits  of  TransiOon  Care.  

• Anecdotal  evidence  that  some  older  inpaOents  with  potenOal  to  benefit  are  not  being  recognised.  

• Also  easier  to  refer  to  short-­‐term  State-­‐funded  support  services  post  hospitalisaOon  meaning  they  miss  out  on  the  benefits  of  goal-­‐oriented,  restoraOve  therapy  focused  on  re-­‐ablement  and  improved  capacity  to  remain  living  independently  in  the  community.  

More research and evaluative studied needed

Acute to Age-Related Care Services (AARCS) • Specialist aged health staff employed in NSW public

hospitals to facilitate access to community and residential aged care

• Help identify the older inpatient potentially likely to benefit from Transition Care and to facilitate timely referral to ACAT when medically stable.

• Good working relationships between Transition Care services and hospital specialist staff important.

Addressing the needs of Aboriginal and CALD patients

• Avoid  residenOal  TransiOon  Care  units  being  viewed  as  ‘insOtuOons’  and  address  the  fear  of  isolaOon  from  family  and  community.  

• Reassure  older  people  that  they  will  be  returning  home  aXer  their  short  stay  in  TransiOon  Care.  

• Promote  a  culturally-­‐appropriate  environment.  • By  2026,  one  in  every  four  people  over  age  of  80  will  be  from  a  non-­‐English  speaking  background.  

• Ensure  home-­‐based  services  not  seen  as  intrusive  and  respect  the  client  who  may  not  want  ‘an  outsider’  telling  them  what  to  do  and  how  to  live.  

Picture (photo or graphic) of an Aboriginal person over background Aboriginal Artwork

EXAMPLE. LOCAL INDIGENOUS

ARTWORK MAY BE USED HERE AND THROUGHOUT DOCUMENT→

TEMPLATE [NAME] Local Health District

Promoting Transition Care services in rural and remote locations

• Address  discrete  access  barriers  include  non-­‐availability  of  experOse  locally,  distances  involved,  and  lack  of  available  transport.    

• Discuss  issues  up  front  with  prospecOve  client  and  their  family.  

• Tailor  services  to  local  circumstances  and  avoid  unrealisOc  expectaOons.  

Where have we come from? Where are we at? • Since  2002,  4,000  TransiOon  Care  places  now  operaOng  naOonally  

• Reduced  numbers  of  paOents  experiencing  extended  length  of  stay  in  hospital  –  only  1,197  in  2012-­‐13  

BUT  

• NaOonal  occupancy  rates  have  only  improved  from  82%  in  2009-­‐2010  to  85%  in  2012-­‐13  

• And  variaOons  in  rates  across  jurisdicOons  and  locaOons  range  from  55%  to  91%  

Why a 2nd national evaluation needed

• To  assess  the  factors  affecOng  current  occupancy  rates  • To  gain  a  more  accurate  picture  of  whether  the  TransiOon  Care  program  is  meeOng  demand  and  being  accessed  appropriately  by  all  older  people  potenOally  able  to  benefit  following  a  period  of  hospitalisaOon  

• To  idenOfy  what  acOon  can  be  taken  to  improve  access  and  equity,  including  whether  and  where  more  places  are  needed  

Transition Care Program Guidelines State  and  Territory  governments  required  to  collaborate  with  the  Australian  Government  in  the  na4onal  evalua4on  of  the  Transi4on  Care  Programme  (draX  Guidelines  2014).    

….  to  ensure  the  Program  remains  current  and  consistent  with  new  developments  in  health  and  aged  care  and  to  facilitate  changes  iden4fied  through  growing  experience  with  the  Program  (Guidelines  2011).