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Link between home care hours, social support and entry to residential care

Greater volume of home care services and social support are associated with significantly delayed entry into permanent residential aged care, according to new research.

Researchers from the Australian Institute of Health Innovation at Macquarie University looked at the service use and outcomes of 1,116 older adults who began accessing a Home Care Package between July 2015 and June 2016 via the electronic care management data of a large aged care provider operating in NSW and the ACT.

The study aimed to see whether there was an association between the volume and type of services that people received and how quickly they were admitted into permanent residential aged care.

The researchers found that each additional hour of service received per week was associated with a 6 per cent lower risk of entry into permanent care, said lead investigator Dr Mikaela Jorgensen, a research fellow at AIHI’s Centre for Health Systems and Safety Research.

Dr Mikaela Jorgensen

“The more hours of home care services that people accessed, the lower their risk of entry into residential care,” Dr Jorgensen told Australian Ageing Agenda.

“We also found that people who were predominant users of social support services stayed in their own homes for longer,” she said.

The study identified groups of clients based on similar patterns of types of services.

People in the social support cluster used social support services for two hours per week on average alongside other home care services for two hours per week, Dr Jorgensen said.

“People in the social support cluster had delayed entry into residential care compared to those predominately receiving domestic assistance, personal care, or in-home respite,” she said.

Dr Jorgensen will share the findings of her research at the Australian Association of Gerontology national conference, which takes place in Perth on 8 – 10 November.

Implications for all stakeholders

People who access a home care package are required to have greater control over the types of care and services they access under consumer-directed care but there is little published information connecting service use and meaningful outcomes, Dr Jorgensen said.

“This research provides evidence for consumers, care providers and policy makers about how home care services may be utilised to optimise outcomes.”

The study also demonstrates the possibilities of using electronic data collected by aged care providers to monitor care over time, she said.

Dr Jorgensen said further work was needed to investigate how community care services impacted other key outcomes, such as quality of life and social participation.

The research has recently been accepted for publication in the Journal of the American Medical Directors Association.

Dr Mikaela Jorgensen is presenting at the AAG conference on 10 November.

Australian Ageing Agenda is the media partner of the Australian Association of Gerontology.

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8 Responses to Link between home care hours, social support and entry to residential care

  1. Therese Adami September 27, 2017 at 12:52 pm #

    Congratulations, great to have the data and evidence to support this for older Australians and the benefit of HomeCare. Social Support done well can make a great difference to all of us! Thanks for sharing

  2. Anonymous September 27, 2017 at 2:03 pm #

    I look forward to hearing more at the conference. While I am not dismissing the work and the findings, I am wondering if there is a correlation between social and community engagement and delayed entry to residential care rather than social support hours per se. So it is the hours or the support to access meaningful connections that makes the difference?

  3. Sandra Matrai September 27, 2017 at 2:14 pm #

    You are preaching to the choir.
    I work for an organisation whose social support program runs 6 days weekly, and we have been running large group and small group social support for over 30 years. In that time we have helped hundreds of seniors stay in their own homes into their 90’s and 100’s through a varied program of conversation, games, live music and dancing, and a whole range of small group activities.
    After years of observation we can confirm that social support and connection contributes meaningfully to ones well being, and may be the most important component in happy, healthy ageing in place.

  4. Densie Doree September 28, 2017 at 1:03 pm #

    I am a trained Art Therapist, with twenty years’ experience in age care / disability services.
    In the past I have experienced people who live in residential homes or within their own homes declining to participate in any activities. They just want to retreat to their rooms or stay at home. They say ” I am too old, they have no meaning or purpose in life”. However, when people are encouraged to participate in age appropriate, meaningful person centred approach programs that meet the individuals needs, then that person’s quality of life starts to improve. Their self esteem grows and the person now has a meaning in life.
    I work for a community service provider not- for-profit organisation. They support and run social inclusion programs tailored around the person individual needs. “Person centred approach”. Each week we run social connections program, social luncheons, cinema outing, gardening groups day trips to Botanical gardens, Homestead, Phillip island and much more…..And a volunteer home visit scheme. These outing and 1:1 visits enhance each person’s social skills, assist people to reconnect with others in their community, build friendships and to maintain a sense of belonging.
    Our team of professionals work closely with people who are living with dementia in their own homes.
    The social inclusion programs and support from the organisation has supported people in their 80,90+ to stay in their homes longer, and most of all, to continue to live a full and meaningful life.

  5. Joan McEwan September 29, 2017 at 10:14 am #

    I have been a fully qualified health professional for over 30 years and have seen many evidence based programs in that time. As a holistic practitioner addressing body, mind and soul I believe we all need to work together to maximise our health and life opportunities.

    Reiki healing has been around for thousands of years and has been used widely globally with amazing results . I would love to see Reiki healing being offered to all health care practitioners working in the aged care sector to become qualified in this modality to support the aged to bring a more holistic approach to their lives and support a more dignified and balanced approach to ageing. Offering this service could potentially relieve the burden of social support and address some issues within the “ageing in care” model.

    Would love to hear your thoughts on this concept….

  6. Lissa October 1, 2017 at 7:25 am #

    What’s this “RISK of entry to residential”? Why is it a risk to go into a well run aged care facility and get quality 24hr care if you need it? What a silly statement….making it seem risky to go into aged care.

    Staying home is the preference for most people and it’s certainly the preference for the Govt who have been planning for this for the last decade+ as the baby boomers aged. Of course their research shows what they want it to show. Feels like propaganda.

    Put more funding into the wonderful at-home services like community care and day respite services and things would run much more smoothly without the need for the propaganda.

    All aged care feels stretched to the limit at the moment.

  7. Peter Corser October 9, 2017 at 5:31 pm #

    As the carer of my wife of 63 years I have to say that no matter how well run residential care centres are , they are still not home. There is a difference also in people, some of whom may enjoy the social life of a care facility but certainly in our case where my wife has Alzheimers, the familiarity and comfort of home is important. I can well understand the results showing the more support in the home or socialy that the carer has, the less likely for their partner to go into care. Far to often the carer reaches a crisis point and has no option but to put their partner into residential care. With support that crisis can be avoided, or at least put off for a time. From my own experience I cant say it too strongly, how much that support means to me.

  8. Marion Byrne October 18, 2017 at 4:03 pm #

    Yes it’s better to be in your own home. The government provide financial assistance to agencies, who many claim they are ‘not for profit’, but take up to 70% from the allocation, so the client is left with a small amount to cover home cleaning, home maintenance, respite etc. The client usually pays a weekly fee also. Time to check up on the agencies & see what they are charging per hour. The worker averages $20 per hour, work cover, super & looking don’t make it $50 per hour.
    Agencies skim 15 to 30% off before it’s allocated, then another 30 to 40% once it’s allocated. Be fair & most people will be able to stay at home. CDC’s – what happens to money in the pot if the client dies, bet it doesn’t go back to the government!

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