As many people are aware, Australia is grappling with an ageing population, a pressing issue that has profound implications for the health system. The country is currently witnessing a surge in hospital presentations of older adults, a situation that is expected to only get worse.
Between 2015 and 2020, the rate of older Australians admitted to hospital increased by 3 percent annually. This was the highest increase of any age group. Older Australians are more likely to stay in hospital longer than younger patients.
This has placed significant pressure on our hospitals, leading to increased emergency department waiting times and ambulance ramping, a situation where ambulances are unable to unload patients at hospitals, leading to delays in patient care.
Some experts, such as Dr David Green, Director Of Emergency Medicine at the Gold Coast University Hospital, have proposed geriatric hospitals, designed specifically to cater to those over the age of 65, as a potential solution.
So, is this the solution, or are there other ways to address this issue?
Experts argue that geriatric hospitals could be tailored to the needs of older patients. For example, signage could be clear and in large print, and spaces may be designed to be quiet.
Specialised hospitals could play a crucial role in providing more targeted care for conditions such as dementia. Currently, there are many people with dementia stuck in public hospitals for an average of 50 to 60 days, while they wait for a place in aged care. Many of these people have no medical reason to be in hospital. Often, public hospitals do not have the expertise to provide specialised care for dementia patients.
However, geriatric hospitals would also need specialist staff, or the quality of care would be compromised. According to Bond University Academic Kieran Le Plastrier, older Australians with complex health needs may not have access to all the different kinds of specialists that they need in a geriatric hospital. He used the example of previously operating psychiatric hospitals. At these hospitals, it was found that people received excellent mental health care, but they did not always receive the physical health care they needed.
There are also questions about whether a geriatric hospital would have enough patients to run an efficient emergency department. Without an emergency department, it would rely on already stretched ambulance resources to transfer patients to it from other hospitals.
Experts argue that a better solution could be to increase access to Home Care Packages. Home Care Packages can provide elderly Australians with access to various services, including housework, meals, allied health support and transport. Access to services like this can reduce the need for hospital stays and help keep people living at home independently for longer. Without appropriate care at home, people often end up in hospital where they may wait weeks or months for a transfer to aged care.
In addition, we need to examine the transfer process from hospital to aged care. Currently, in Queensland, people without a next of kin or power of attorney have to wait while they are assigned a guardian by the Queensland Civil And Administrative Tribunal, a process which can take up to six months.
Greater capacity in Australia’s aged care system could also help to address this issue. In some cases, people wait in hospital beds, beyond the time when they are ready to be discharged, due to a lack of aged care beds.
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References
Alexander, H (20 November 2023) ‘On any given day, 550 people are in our hospital beds with no clinical reason to be there’, Sydney Morning Herald, accessed 18 September 2024
2Mahe, D (2 September 2024) ‘Geriatric hospitals could ease bed shortages, ambulance ramping, doctor says’, ABC News, accessed 18 September 2024
Partington, A, Whitehead, C & Karnon, J (18 September 2024) ‘Could geriatric hospitals reduce pressure on the health system? Maybe – but improving aged care is paramount’, The Conversation, accessed 18 September 2024