The Case For Early Intervention Allied Health For Aged Care Residents: Insights From Australia’s Leading Allied Health Provider
As Australia’s leading provider of allied health services to ageing Australians, Plena Healthcare is passionate about the benefits of evidence-based allied health services and creating a positive impact on aged care residents’ wellbeing and quality of life.
We understand the balancing act required by aged care providers in meeting the varied needs of residents, while also meeting their regulatory obligations. We pride ourselves on partnering with aged care providers to develop allied healthcare solutions that equip them to be future–ready as the industry evolves.
Insight: The Impact of the Strengthened Aged Care Standards
A new Aged Care Act has been drafted by the Australian Government to strengthen Australia’s aged care system. The new Act is centered around the rights of older people when accessing aged care, to ensure those who access aged care services funded by the Australian Government are treated with respect and have the quality of life they deserve.
The Act will include new oversight and accountability arrangements which will be informed by the strengthened standards, benchmarks and insight data. With the standards focused on wellbeing, re-enablement and quality of life. Allied healthcare will be an important component of delivering on these areas.
Insight: Unforeseen Impacts of AN-ACC
As part of AN-ACC, the Department of Health endorsed providers to design their own allied health framework, but recommended providers spend a minimum of 4% of their funding on allied health. The Aged Care Royal Commission (2021) further called for an increase in allied health and a greater focus on restorative and preventative care.
Despite this, the current volume of allied health services delivered is now significantly lower than in 2021, resulting in a higher incidence of clinical risk and events.
With cost pressures across the sector, many providers have seen allied health as a solution to control costs, however, given the expectation regarding allied health funding, many of our provider partners are now looking to get ahead of the game to meet future benchmarking requirements.
We have strongly advocated for the inclusion of allied health minutes in the mandatory care minutes to recognise a multidisciplinary aged care workforce and approach. Read more about our case for adding allied health care to the mandatory care minutes, here.
It the meantime, it is evident, that the aged care sector requires explicit guidelines from the Department to promote sustainable best-practice allied health solutions.
Insight: Data and Benchmarks Are Being Complied That Will Guide the Direction of Allied Health Services in Aged Care
The Department is actively reviewing the volume and type of allied health services being provided in aged care and is seeking to develop a new allied health staffing quality indicator as part of the National Quality Indicator Program (NQIP)
As part of the review, a pilot will run through March and April 2024 that aims to gather data and insights on the volume of allied health care minutes delivered, per resident, per day, as well as the percentage of residents who receive allied health services.
The Department is also actively reviewing various benchmarking studies and is in consultation with Allied Health Professionals Australia (AHPA), a national voice for allied health professions, which recommends 15 mins of Allied Health per resident, per day.
Meeting these benchmarks will be paramount for all residential aged care providers.
Insight: Early Intervention Matters
As a provider of allied healthcare services to over 100,000 Australians, we see day–in and day–out the benefits of allied health preventative practices and we also see the consequences of not incorporating early intervention.
Early intervention approaches result in the reduction of chronic conditions, falls and complications associated with ageing. This ultimately reduces long-term healthcare costs and enhances residents’ quality of life.
When an early intervention approach is not chosen in the short term, this may seem favourable to an aged care facility by reducing their allied health spend. However, long term we know their costs will increase when attempting to address the deterioration of conditions and circumstances that could have been mitigated or prevented.
Economic Costs of Inadequate Allied Healthcare
Evidence shows significant impact on the economy from treatable conditions.
For example, with podiatry care, chronic health wounds are an economic burden in Australia costing the health system around $3 billion per year. Recent research suggests investing in evidence-based care for Australians with diabetic foot ulcers could save around $2.7 billion over five years. That is around $9,000 per person aged under 75 and $12,000 per person aged over 75. Around 85% of diabetes-related amputations are preventable if wounds are detected early and managed appropriately and that is why podiatric care is vital in preventing ulcer reoccurrence.
Falls and injurious falls cost the Australian healthcare sector over $2.3 billion (2020), and the flow–on effects into care requirements within residential aged care are significant. A 2019 randomised control trial demonstrated a physiotherapy-led falls prevention program reduces the cost of falls in residential aged care in Australia.
Read how the insights from this study informed the development of our award-winning Plena Care Pathway, here.
Falls are the number one cause of preventable death in residential aged care, and physiotherapy-led programs are known to reduce falls by up to 55% in this setting. Our highly skilled mobility experts at Plena are trained to save and improve lives by collaborating with residents to stay active and ultimately confident in their movement.
In residential care, Australian studies have identified a prevalence of malnutrition from 22% up to 50%. Poor nutrition amongst older adults within long-term care settings is unfortunately common. A study of twenty-one Victorian aged care services concluded that the provision of meat and dairy foods (both important sources of protein) did not meet the recommended guidelines. Furthermore, the study concluded that 68% of people in the study were malnourished or at risk of malnutrition. (Iuliano, S., et al., Dairy food supplementation may reduce malnutrition risk in institutionalised elderly. The British journal of nutrition, 2017. 117(1): p. 142-147.)
Malnutrition increases the risk of falls, osteoporosis and fractures, slows wound healing, morbidity and mortality and contributes to poor quality of life. Plena dietitians are experienced in supporting residents who are at risk of malnutrition or are malnourished through person–centred dietary intervention (a food first approach). Our dietitians also support food service teams within residential aged care to provide flavoursome meals suitable for the specific nutritional needs of older people and a dining environment that supports social engagement and a sense of belonging.
Swallowing difficulties (also known as dysphagia) are prevalent in more than 60% of people living in aged care*. (Steele, C., Greenwood, C., Ens, I., Robertson, C., & Seidman-Carlson, R. (1997). Mealtime difficulties in a home for the aged: Not just dysphagia. Dysphagia, 12(1), 43–50. )
That’s more than 6 in 10 people who have difficulty safely swallowing food and/or drinks. These high rates of dysphagia in aged care mean it is vitally important care staff know how to identify a person with dysphagia and how they can support them. Plena speech pathologists work with residential aged care residents, their families and staff (including nursing and kitchen staff) to identify, assess and treat swallowing difficulties. We provide education on how to correctly prepare food and drink textures that are appropriate for various resident needs, using the IDDSI Framework.
The Industry Will Continue To Evolve
While the evidence shows that allied health is a crucial service in the aged care industry, without clear guidelines from the departments, many providers are unsure regarding the adequate provision of allied health services.
This is why minimum standards and benchmarks will soon be introduced that many aged care providers will not be prepared for.
We believe all Australians living in residential aged care should have the right to access allied health services to improve and maintain the quality of life that they deserve. We will continue to partner with leading aged care providers to facilitate access. Our agile service model balances commercial goals with clinical benefits, not only delivering outcomes to meet business objectives now, but enabling providers to be future ready.
If you’d like to speak to us about how we can partner with you and future-ready your facility, get in touch today.
