Illawarra's aged care outreach program │ Illawarra Mercury │ December 11, 2023

Illawarra Mercury

Watch Illawarra's aged care outreach program │ Illawarra Mercury │ December 11, 2023 - Illawarra Mercury on Dailymotion

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00:00 Hey Janelle, how are you going?

00:03 It's early morning and the aged care outreach service has received its first call out of

00:08 the day. Medical supplies are being restocked and the team is off to a local aged care facility

00:14 to assess a resident who is unwell, one of many to be seen today.

00:18 The main things we're seeing is for sepsis, infections, whether it be chest infection

00:24 or urinary infection, cellulitis, acute pain, confusion, behaviour disorders, fall management.

00:34 But this hasn't always been an option for residential aged care facilities.

00:39 In the past when there's been no real alternative, because we're not an acute clinical setting

00:43 here, we do have nurses but we're not a hospital, so often the nurse would have to make a decision

00:49 for the person to go to hospital just because we couldn't provide that level of care or

00:53 that level of expertise even to assess them in the first place.

00:57 Peter Whittle from Illawarra Diggers says the impact on residents of unnecessary trips

01:02 to emergency or a prolonged hospital stay cannot be underestimated.

01:08 It can be quite disorientating and quite stressful for them as well because they often come back

01:12 on slightly different medication to what they were on when they went away. They've been

01:17 away from their home environment, what's their home now. It can take quite a long time to

01:23 reorientate and get back to normal baseline for them, so sometimes weeks.

01:28 In its first phase of operation, the outreach service has seen extraordinary results. In

01:34 the first month alone, 117 residents living in aged care facilities were assessed by the

01:40 team, with 93% safely treated in the home without the need to go to hospital. By November,

01:48 the number of referrals had jumped to almost 600, with 86% of residents able to receive

01:55 in-home care. The program delivering benefits all round.

02:00 Just last week we had a resident who we kept on the books for a week giving IV antibiotics

02:04 to and you think that, that was potentially a two to three week stay they would have had

02:08 in hospital. They're really complex acute patients that we're managing to treat and

02:13 definitely the family are just so happy. Their mental health is in check, which is really

02:17 important. They have familiar faces every day, they stay within their routine, which

02:22 is going to make them not be so deconditioned. We're avoiding ED altogether, so we're caring

02:27 for them in the home, but we can also directly admit them. So they're avoiding ED even when

02:31 they do need an admission and when they do come in then they're very organised. They've

02:36 already seen a geriatrician, they've already seen a nurse practitioner, they've got a plan

02:40 in place, so when they hit the ward the staff actually know what to expect.

02:44 So having real emergencies able to access the emergency ward is what it's all about

02:49 and our residents often it's not an emergency. When it is, absolutely that's where they should

02:53 be, but when it's not an emergency, it's just needing a higher level of clinical care, then

02:59 it's great that they can have it here and not take up room in the hospital.

03:02 It's made people realise that you can treat people in the home. Not everyone needs to

03:07 come to ED, that a lot of this work can be done somewhere else.

03:11 Part of our funding is to increase capacity and capability within the nursing home for

03:15 their staff members, upskilling them, completing some competencies that they wouldn't have

03:20 already had available to them. Having an outreach service where there's

03:23 a lot of skill set, there's a lot of other expertise, gives them support in their learnings

03:30 as well and helping them diagnose and make the right decisions.

03:35 Whilst the outreach service was being established, work was also underway on expansion of the

03:40 Transitional Aged Care Program, which has included the development of a residential

03:45 style ward at Fig Tree. This is now providing an alternative for patients who are waiting

03:51 in hospital to transition to a residential facility. It's delivering better outcomes

03:57 for both patients and the community. It is about having people in the right spot

04:02 at the right time and that's why we need these beds, because they're supported with the right

04:06 staff, with the right level of staffing, a little bit more allied health support, a little

04:12 bit more diversional therapy and the aim is to make their life as close to home as possible.

04:20 So it's a totally different focus to what we see in hospitals.

04:22 This program is a vital initiative to meet the current challenge of residential aged

04:27 care bed access, while also easing pressure on our very, very busy hospitals.

04:33 So as these initiatives continue to grow in 2024, it's about delivering the right care

04:39 in the right place with teamwork and collaboration. Really at the end of the day, it is lovely

04:45 to sit back and just say, we have had an impact. Like it's been a hard year. There's been a

04:49 lot of work involved in getting us to this point, but we're seeing things change slowly

04:54 but surely.

04:55 [Music]

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