Funding is not the issue

A Monash University study has been widely quoted as finding that government subsidised exercise participation could be the solution to getting and keeping more older adults active.

If you follow me on LinkedIn, have read any of my contribution to the Australian Ageing Agenda or heard me talk at a conference, you will be aware I am a passionate believer in exercise and can think of nothing better than seeing more older Australians engaged in meaningful physical activity.

But I am also passionate about calling out bad behaviour, or in this case academic misdirection. The government already does subsidise exercise for older adults but I couldn’t find any reference to this in the Monash study.

The Commonwealth Home Support Program has the allied health and therapy service type that allows older adults to get involved and stay involved in exercise. Home Care Package dollars can be spent on exercise participation. There is also the Medicare supported Chronic Disease Management Plan and Type II Diabetes Program where older adults can get bulk billed or subsidised participation with an exercise physiologist.

The Short-Term Restorative Care Program is another subsidised government initiative that allows eight weeks of intensive allied health participation including exercise. DVA, NDIS, and the local government subsidies for transition care can all be used to support exercise participation. And then, while not government subsidies, there is also private health insurance. 

“Why aren’t these better used” is the question I think the study of over 7,000 older Australians should have been asking. But the point I am trying to make is there is already a lot of unused funded entry and participation pathways to get older adults involved in exercise.

The study’s lead researcher is also quoted as saying this study will help cement the effectiveness and cost benefit of participation. But we already have plenty of evidence. If you go to PubMed, the National Library of Medicines article search engine, and type in the “benefits of exercise for older adults” you will get over 18,500 results. If you then add “cost” to the beginning of your search title you get over 1,500 articles. Do we need more evidence? We know we can save money and so does the government.

A recent Flinders University study revealed the economic burden of frailty being three times greater than among non-frail individuals with the majority difference in spending being due to hospital admission. They concluded that we need to get people involved in countermeasures – such as needs targeted physical activity and exercise – earlier. But again did not tell us how.

Education needed

A starting point would be consumer and care staff health literacy. I think it is fair to conclude most people know that being involved in exercise is good for you. But how many understand the support that is out there? If we educate clients and their families, and the aged care staff who support them about the health value and avenues of participation, and on the subsidies available, we will be taking steps in the right direction.

Next, we need more aged care provider buy-in and a stronger government message. And with community reform on the table the government has a unique opportunity to strengthen the quality standards language. Language that directs providers to incorporate evidence-based consumer focused reablement and exercise with meaningful outcomes into every individual care plan is the second step in the right direction. If the quality standards mandate reablement, just like they do better food, nursing and care then the aged care sector will need to respond with creating access and opportunity.

Importantly, providers don’t need to wait. They can embrace this evidence now and establish or enhance their own programs or work with external agencies to ensure better health for their clients. They can also educate their staff and encourage them to help clients make the link between dignity, independence and exercise. With more clients destined to age in the community, reablement is the best solution we have to reduce complex care needs and the associated burdens that will come with it.  

Dr Tim Henwood is principal consultant at AgeFIT solutions and an exercise physiologist whose PhD research focused on resistance training for older adults

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