Transitions to residential aged care after hospital for people living with dementia

Dementia is a collection of symptoms caused by a range of disorders affecting the brain (WHO 2019). It is usually a progressive condition and usually irreversible. People living with dementia will have increasing health and personal care needs over time. Consequently, people living with dementia are high users of health and aged care services and often move between these two systems.

The Royal Commission into Aged Care Quality and Safety (Royal commission 2021) highlighted the need for Australia’s health and aged care systems to be better integrated to improve outcomes for older Australians:

• Recommendation 66 calls for improvements in the quality of transfers between residential aged care facilities and hospitals to ensure resident's health status, medications and advanced care directives are communicated when residents enter and exit hospital.
• Recommendation 67 calls for structural changes in the way health and aged care data are collected and reported in Australia to allow the interaction between health and aged care systems to be monitored.

Currently, it is not possible to examine the quality of communication between hospitals and residential aged care facilities in existing national data. However, we can examine movements between residential aged care and hospital settings and outcomes for this group using linked data.

A recent report using linked Queensland and Victorian hospital and aged care data showed that on discharge from hospital, 1 in 10 people aged 65 or over required an aged care program with a higher level of support (AIHW 2020). Other studies have shown that Australians living with dementia were more likely to move to residential aged care compared with Australians without dementia (Welberry 2021).

Using linked data to examine transitions from hospital into residential aged care for people living with dementia

With Australia’s growing and ageing population, the number of people living with dementia is expected to rise to just under 850,00 people by 2058 (AIHW 2023). Understanding how people living with dementia access and transition between the health and aged care systems, particularly hospitals and residential aged care, is needed to inform planning for current and future care needs and assess coordination of care. It is also essential to identify points along the care continuum that need improving. This study aimed to use linked data to examine transitions of care for people living with dementia following hospitalisation.  

Specifically, the study aimed to:

• Examine transitions to residential aged care or mortality among people with dementia within 7 days, 3-months and within 12-months after hospitalisation, and how this compares to people without dementia.
• Explore the reasons that people living with dementia are hospitalised, the factors that may influence their length of stay in hospital and whether they transition to residential aged care.
• Summarise key healthcare services used by people living with dementia in the 12-months following their hospitalisation, and whether this varies by use of residential aged care.