People caring for those with dementia have identified respite care as one of their critical care needs. Their low use of respite care, however, appears to belie this stated need.
Evidence about respite use patterns for people with dementia and their carers has to date largely been based on small-scale studies and qualitative research. A recent systematic review of the literature on transitions in care of people with dementia found little that described common pathways and transitions between care types, including the use of respite care (Runge et al. 2009).
This study aims to fill part of this evidence gap using nationally linked administrative data to quantify the extent to which residential respite care is taken up by those with and without dementia. The study is based on 32,000 members of the Pathways in Aged Care (PIAC) cohort who had an approval for residential respite care use from an Aged Care Assessment Team (ACAT) in 2003-04.
The nature and the size of the data set lets us draw robust conclusions on factors that affect the take-up of residential respite care among those with an approval. In particular, this bulletin reports findings about the influence of dementia status, carer status and English proficiency on the take-up of respite care. The main findings are summarised below.
Take-up of residential respite care
- Only about a quarter (27%) of people approved for residential respite care (RRC) actually used it within 12 months of their approval.
- A somewhat greater proportion of people with dementia (32%) took up RRC than those without dementia (25%). The difference was statistically significant.
- Having a carer increased the likelihood of a client taking up RRC. Among those recommended to live in the community, a person with a co-resident carer was more likely to take up respite than those with a non-resident carer (31% and 25%,respectively).
- Dementia status and carer status acted independently on the probability of taking up respite care; that is, there was no interaction between dementia status and carer status.
- For people recommended to live in the community, those born in non-English speaking countries had a lower take-up rate (24%) than those born in Australia or other English speaking countries (28%). This difference was statistically significant.
- Dementia status and English proficiency acted independently on the probability of taking up respite care; that is, there was no interaction between dementia status and English proficiency.
Movement into permanent residential care after using respite care
Current literature shows that dementia is a key predictor of institutionalisation. Statistical modelling confirmed that if a person had dementia or no carer, there was an increased likelihood of admission into permanent residential care within 12 weeks of take-up of RRC.