Many elderly people live in rural and remote communities. Some of these people will require residential aged care.
Participants valued staff who were honest and trustworthiness, and continued in their roles for long periods (to increase familiarity with their needs, aid communication, and promote stability of care). They also appreciated that a central contact was regularly communicated with to relay any changes.
The ageing process is complex and the challenges for families caring from a distance are multiple. Long-distance carers are highly reliant on aged care services to provide them with regular, timely communication about the quality of their elders’ wellbeing and health status. They also want their service providers to take the initiative and inform them of any problems that arise. Having trusted, honest staff is critical.
Participants also highlighted the need for aged care services to be flexible in their approach, particularly in the provision of psychosocial care. This involves attending to the needs of the elderly person beyond their material well-being, including promoting social connectedness and enabling people to be their own selves. It can be delivered in residential aged care and community-based aged care, such as in home support or community centre services.
In remote places, the social resilience of older people is often linked to their deep connection with place and their collective ability to support one another through mutual aid. However, this can become fragile as the number of older people increases and they require more formalised care services to assist them with daily living activities.
A range of services can be provided in rural and remote areas, from the Country Referral Unit to GP Plus Health Care Centres in Ceduna and Port Pirie that offer integrated doctor, allied health and community care services. The Royal Flying Doctor Service provides medical and emergency services to remote communities.
Various government agencies are seeking to reduce hospital admissions through telehealth, such as the SA Virtual Care Service, which was rolled out this year and provides patients at the scene of an incident with a personalised assessment via video link. It is expected to reduce ED admissions, emergency calls and ambulance responses by up to six hours per episode.
While a number of new technologies have been introduced to support the aged care sector, this study found that many are not being well utilised by rural and remote carers. The reason is that packaged care packages are designed and funded on a metropolitan model and do not always work in small rural and remote communities.
Mental health issues can impact on the quality of life of older people. This is particularly the case if these issues are not identified and addressed early on. Various factors can contribute to mental health problems in older adults, including life stressors (e.g. financial worries, relationship issues) and a general decline in social support as ageing occurs. However, the risk of developing mental health problems may be increased for some older adults, as a result of specific events such as dementia and/or a significant ongoing loss in functional capacity.
While a range of factors can impact on mental wellbeing, some of these are more significant than others. For example, a person’s self-perceived health and their ability to participate in social activities are key factors that influence mental well-being. A lack of social participation or a sense of isolation can also lead to feelings of depression, which in turn can have negative effects on a person’s physical health.
For these reasons, it is important for aged care providers to consider how they can improve the mental health of their residents. This is important not only for the sake of the resident, but also for the staff who care for them and the wider community.
A recent qualitative study found that long distance carers value regular, proactive communication from aged care services regarding their elders’ wellbeing and the range of services available to them. In addition, they would like to see aged care services provide better access to information and guidance on how to navigate the system.
In September, the South Australian Government launched a remote health service to help reduce pressure on emergency departments. The 24/7 virtual care service allows patients to be consulted by doctors and nurses via phone or video link, rather than requiring them to travel to hospital. The service is expected to reduce the number of unnecessary hospital admissions and alleviate the burden on emergency departments, which have already been under significant pressure during the COVID-19 pandemic.
Country SA PHN offers a range of rural and remote health services, including GP Plus health care centres in Ceduna and Port Pirie and the Royal Flying Doctor Service operates doctor and nurse clinics in rural and remote locations. To find out what’s available in your area, call the Country Referral Unit on 1800 003 307.
As Australia’s oldest population grows, there is an increasing need for aged care services. However, a lack of resources can make accessing these services difficult. In rural and remote communities, older people can often feel isolated from the rest of society, resulting in a lower quality of life. This can also affect their health and wellbeing, making it important to connect with others in their community.
Having home care services available could be one way of addressing this. But in order to get the most out of these services, it is essential that they are easily accessible and promoted. This will require more than just providing a service – it will also be necessary to have skilled workers with the right expertise to deliver the service.
It is important to note that home care services are a vital component of the aged care system, and a high level of utilisation can help prevent avoidable hospital admissions and increase life expectancy. Despite this, there are challenges in delivering these services in rural and remote areas.
The Country SA Primary Health Network has launched a new service that is helping to address this issue. The 24/7 remote health monitoring service is available to country South Australians who have a GP referral. The service uses a tablet to allow patients to monitor their own health, including blood pressure and oxygen levels. The results are then uploaded to a secure website and reviewed by a nurse. If there are any concerns, the nurse can liaise with an after-hours GP to discuss what action might be needed.
Another way of ensuring that elderly care is available in rural and remote communities is through boosting community capacity. This can be achieved by developing a network of services that provide access to health professionals and specialists. It can also include developing support groups that help to share information and experiences. This will also allow seniors to connect with each other and support each other.
Ms Gail Fraser, Acting Chief for Ageing at the Council for the Aged, says that more aged care facilities are needed in regional and rural South Australia. However, this can be challenging in the current climate of declining funding for aged care. For example, the electorate of Grey which covers 92 per cent of South Australia’s geographical area did not receive a single new aged care place in the latest round of funding.
The availability of aged care services in remote SA is a significant issue for many people. While the number of subsidised aged care places has increased, it is not enough to accommodate the demand. There is also a lack of home care service programs in regional and country SA. Providing community care in rural and remote Australia could be a way to alleviate this problem. Community care involves having a worker come into your house to clean, do the shopping and take you to appointments. This can be a big help for people who have mobility issues or have chronic health conditions.
Despite the growth in aged care places, older Australians from rural and remote areas have less access to them than other age groups. This can be due to the geographical size of some regions and the cost of transport. It can also be a result of policy changes that have reduced the amount of residential aged care available.
However, the overall incidence of admission into services remained similar, and utilisation varied between the different types of aged care services. There were fewer admissions into PRAC, but more into HCP. In some cases, this was due to an increase in the use of telehealth technology that enables patients to be assessed by doctors via video link from their homes, rather than attending an emergency department in person.
Another factor that has affected utilisation of aged care services is the shortage of workers in rural and remote areas. This has been exacerbated by the emergence of the gig economy, which sees people working independently and offering their services on a contract basis. The reliance on independent contractors can have an impact on the quality of services and the amount of supervision required by staff.
The lack of access to aged care services can also be caused by cultural and language barriers. Although a small percentage of the overall population is from non-English speaking backgrounds, they are under-represented in ATSI and CALD aged care service utilisation. This is a concern for policymakers, who should consider how to improve the uptake of services amongst this group.