In an era where the silver tsunami is making waves in healthcare systems worldwide, Australia is no exception.
The ageing population is growing, and with it, the demand for medical services tailored to the unique needs of older adults.
It’s a challenge that has long been on the radar of healthcare professionals and policymakers alike. However, amidst the concerns, a beacon of innovation has emerged from St Vincent’s Hospital in Melbourne, where a pilot program has achieved remarkable success in addressing this pressing issue.
The program, which embedded a geriatrician within the emergency department (ED), has not only halved the number of older patients admitted to hospital beds but paved the way for a more compassionate and efficient approach to elder care.
This initiative has diverted nearly 150 elderly patients from unnecessary hospital stays, saving a staggering 900 acute bed days over a year.
The Australian Medical Association (AMA) has been vocal about the need for long-term funding agreements to better support older Australians.
The number of older Australians presenting to emergency departments is on the rise, so the AMA’s call to action is timely.
Data from the Australian Institute of Health and Welfare underscores the urgency, revealing that older adults account for almost half of all public hospital bed days nationally.
St Vincent’s Hospital’s Geriatrician in the Emergency Department (GED) service is a testament to the possibilities of innovative thinking.
By providing specialised care and considering the broader context of an elderly person’s life, including their illnesses, medications, and support systems, the GED service has enabled patients like 85-year-old Beverley Minogue to receive the care they need without the stress of a prolonged hospital stay.
‘I’ve got osteoarthritis. It’s just all worn out. It’s bone on bone,’ she said. ’I slept downstairs for four nights.’
Beverley’s story is a heartening example of the program’s success. After her knee gave out, she was expecting a lengthy hospitalisation.
Instead, thanks to the GED service, she was sent home the next day with a comprehensive support plan, ‘It’s wonderful because you can stay home. You don’t have to be stuck in the hospital and not be able to sleep,’ Ms Minogue said.
The program’s benefits extend beyond the patients themselves. By freeing up hospital beds, the GED service allows other patients to receive the care they need more promptly.
Moreover, the program has not led to an increase in re-admissions, indicating that patients are receiving effective care in the comfort of their own homes.
Dr. Richard Kane, the clinical director of geriatric medicine at St Vincent’s, has been instrumental in establishing the program.
He emphasises the advantages of recovering at home, where patients are in a familiar environment. This can lead to quicker recovery times and reduced risks associated with hospital stays, such as falls and delirium.
‘It’s something to do with the familiarity of your own environment. Because of the foreign environment that we operate in, people tend to get less sleep. They tend to be less active.’
The GED service operates by sending hospital staff to visit the patient at home the day after discharge, followed by daily visits from a multidisciplinary team tailored to the patient’s needs.
Patients also have access to a 24-hour hotline for immediate medical assistance if their condition deteriorates.
‘If we’re able to put the right support in place for them, their family, and our services, they can recover in their own homes.’
The program, funded by the Victorian government, the hospital, and philanthropic contributions, is now ongoing and seeking specific funding from the federal government’s Strengthening Medicare initiative.
Similar schemes are being trialled across the country, reflecting a nationwide effort to meet the healthcare needs of an ageing population.
The AMA advocates for increased hospital funding to support programs like the GED and more flexibility in hospital funding to include community healthcare links for at-home programs.
With the proportion of public hospital beds for Australians over 65 more than halving since 1991-1992, the need for action is clear.
As Australia awaits the following National Health Reform Agreement, which proposes to adjust the share of Commonwealth funding for state-run hospitals, the healthcare community hopes the incoming government will recognise the importance of such initiatives.
The success of St Vincent’s Hospital’s GED service is a promising development in elder care, offering a model that could be replicated nationwide.
It’s a step towards a future where the healthcare system is not only prepared for the challenges of an ageing population but also where older Australians can receive the dignified and effective care they deserve.
We are excited to see such innovative approaches taken to improving the lives of older Australians. Have you or a loved one experienced a similar program? What are your thoughts on the potential for at-home care to revolutionise elder healthcare?
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