Population ageing is a global phenomenon. Over 15% of Australians are over 65 years old and this number is expected to rise to 22% by 2056. Older Australians carry a disproportionate burden of chronic illness and overall disability, thereby requiring ongoing assistance and support services. The impact of an ageing population in the aged care sector is evident by the consistent increase in resident numbers across Australian Residential Aged Care Facilities (RACF), and almost doubling of Home Care package program places over the last decade. Over 97% of RACF residents, and 81% of Australian government Home and Community Care program recipients are older adults.
As the aged care sector strives to provide the best care to our ageing population, new and innovative approaches facilitating the care provision process are warranted. One approach could be the adoption and integration of Digital Health Technologies (DHT). The World Health Organisation defines DHTs as secure and cost-effective use of computer and mobile devices to process, transmit and store data and information for health-related matters. DHTs have the potential to fundamentally change the ways in which care is planned and provided across the aged care sector.
Computer and web-based platforms have been widely used in RACF settings to effectively manage documentation, administration, and care. More recently, technology has been integrated in carrying out a more diverse range of activities: from receiving prospective client applications, completing funding applications, to facial recognition apps for pain assessment, and companion robots. The last decade has also seen growth around electronic and web-based information platforms designed to assist aged care clinicians in care-planning and decision-making processes. While technology has the potential to promote and improve care, there also remains the risk of information overload, lack of appropriate engagement, and/or over reliance on technology. Therefore, while researchers, policymakers, and the tech-industry continue to collaborate and innovate, their endeavours should be underpinned by the value statements of the ‘Technology Roadmap for Aged Care 2017’ which highlights the need to involve end-users in the technology development process and to have technologies integrated into aged care policies and processes, rather than placed separately as an add-on.
In the community setting, DHTs can play a role in assisting and empowering community dwelling older adults who require some level of assistance in their daily lives. As almost 90% of older Australians report of having one or more chronic health conditions, technology mediated self-management approaches have potential to help these individuals better manage their chronic conditions. This approach could be further strengthened by integrating tele-monitoring systems to monitor and support the older person’s self-management plans. Furthermore, technology could be used as a tool to help older people carry out online grocery shopping, engage in web-based social and support groups, and to source health information; all of which could contribute towards healthy aging-in-place. However, as many older adults may have low digital health literacy, it is essential that support systems are available to encourage and support their use of such technology. Further, providing skills and education to home care service providers and primary care health professionals on how to best utilise the power and versatility of DHTs to improve care and promote independence of community dwelling older adults will be crucial.
The ELDAC project is using DHTs in making evidence and resources for aged care to support end of life through a comprehensive, free website and a helpline/email advisory service and these provide access to a range useful resources and ‘toolkits’. The information and resources curated in the ELDAC website are reviewed for their credibility and relevance and are presented in a way which is easy to access and use in everyday care situations. The toolkits are designed to guide healthcare providers from aged, home or primary care setting through various steps involved in provisioning quality care to older adults. We have also started work on an experimental digital dashboard to help care providers in their everyday decision-making. To access the full range of evidence-based resources at ELDAC, visit: www.eldac.com.au
Priyanka Bhattarai, Research Associate, ELDAC (End-of-Life Directions for Aged Care)
palliAGED is an example of a free website that makes it easy to find and use palliative care evidence and practice resources in aged care.