Care model achieves better resident outcomes at no extra cost

By Sandy Cheu on June 6, 2018  in IndustryResearch & Clinical

Aged care residents living in smaller home-like clusters have a better quality of life and experience fewer hospital admissions, according to new research.

The Flinders University study involving 541 permanent residents in 17 aged care facilities investigated the consequences and costs of living long term in clustered home-like aged care between January 2015 and February 2016.

The 17 facilities across New South Wales, Queensland, South Australia and Western Australia providing standard care (13) and clustered household models with 15 residents or fewer (4) were compared based on location, facility size, staff training costs and direct care hours.

The research found that residents living long-term in clustered home-like aged care had a significantly higher quality of life compared to those in standard care as reported by study participants.

Residents in the home-like aged care environments also had a 68 per cent lower rate of being admitted to hospital and 73 per cent lower chance of admission to the emergency department, the study published in the Medical Journal of Australia on Monday found.

The study found raw facility running costs were similar between models, but significantly lower residential care costs in the clustered household approach after adjusting for differences in participant and facility characteristics.

The researchers estimate the clustered model saved governments approximately $14,000 per resident per year in health and residential care costs.

Aged care providers should consider offering cluster home-like models of care to better meet consumer preferences, said Dr Suzanne Dyer, a Flinders University senior research fellow and lead author on the paper.

“More aged care facilities should adopt this model of care to improve the quality of life and outcomes of people living in aged care,” Dr Dyer told Australian Ageing Agenda. 

The criteria for clustered home-like facilities in this study included having an independent accessible outdoor area, allocation of care staff to specific living units, meals cooked within the units, self-service of meals by residents and residents’ participation in meal preparation.

Facilities that did not meet these requirements were identified as providing a standard model of care.

The residents living in the clustered home-like facilities were more likely to receive more than two-and-a-half direct care hours per day (77 per cent) than those in standard facilities (45 per cent), according to the study.

Dr Dyer said clustered models of care provided better outcomes for residents without a regulatory approach.

“The government should look at ways of incentivising alternative models of care and rewarding models that provide better outcomes for residents, maximise their independence and promote individual choices and social connectedness,” Dr Dyer said.

The findings of the research have been welcomed by dementia specialists HammondCare, which has been using clustered home-like models of care for many years.

“Not only are home-like residences providing better health outcomes, they are also cost effective,” CEO of HammondCare, Dr Stephen Judd said.

He said the combination of the smaller home-like environment, social model of care and staffing approach is key to the success of this model.

“It should be a no brainer for governments, philanthropists and other aged care investors to back those models that reflect the evidence, because at the end of the day, that’s what will produce better outcomes for older Australians,” Dr Judd said.

The study is part of the Investigating Services Provided in the Residential care Environment for Dementia in Australia (INSPIRED) study funded through the NHMRC Cognitive Decline Partnership Centre.

INSPIRED has also developed an evidence-based tool that allows aged care providers to gain insights into their residents’ experiences of aged care using a short survey (read our report here).

Access the study here.