Access to primary healthcare by older Australians either living in residential aged care facilities or unable to leave their homes can be very challenging.
General practitioners are increasingly choosing not to provide visiting services to people living in the community. Many people upon entering residential aged care are surprised—and shocked—to find that their GP is no longer able to continue providing them with the healthcare they have been used to.
Older people have higher healthcare needs than the general population. Lack of access to primary care can lead to higher use of emergency healthcare. And there is strong evidence that this is indeed the case, with older people’s use of emergency care rising at a faster rate than can be accounted for by population ageing alone. This trend is expected to continue.
Further compounding the problem is the fact that due to fragmentation of services across the health and social care sectors, alternatives to hospital admission are often not readily available or are difficult to arrange.
It is well-recognised that many older people present to hospital with a range of complex care issues, in addition to the acute illness that brought them there. They are likely to be frail and consequently at risk of functional decline, adverse events and decreased morbidity.
It is clear to me that what is needed is a comprehensive and holistic approach to meeting the healthcare needs of older people within primary care, acknowledging that most consumers of aged care services require health services, with many also requiring disability, palliative care and community services.
Primary care can be delivered by a range of professionals, including general practitioners, community-based nurses, allied health workers, aged care and rehabilitation providers, interdisciplinary and in-hospital clinicians, and pharmacists, as well as family and other informal caregivers.
As part of the End of Life Directions for Aged Care (ELDAC) consortium AHHA has created the ELDAC Primary Care toolkit to support these groups in providing high-quality care to older Australians.
The Primary Care Toolkit sets out the various steps involved, including catering for people of diverse religious and cultural backgrounds. There are links to fact sheets, guides, discussion starters, patient resources and podcasts, as well as resources supporting quality improvement in the primary care setting.
HealthPathways teams developing and updating their palliative care and advance care planning pathways will also find useful information and resources in the toolkit.
Access to clinically appropriate, high-quality and safe primary care must be available to people receiving aged care services. ELDAC, and AHHA as an ELDAC partner, support this goal.
We believe that the resulting benefits to older Australians will include better health, fewer hospital admissions, shorter hospital stays when admitted, and improved quality of care overall.
Find out more about ELDAC on the website www.eldac.com.au.
Alison Verhoeven, Chief Executive for Australian Healthcare and Hospitals Association (AHHA) the national peak body for public hospitals and publicly funded healthcare providers.