An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit
Abstract Background Older people subject to homelessness face many challenges including poor health status, geriatric syndromes, and depression, coupled with barriers in accessing health and aged care services. Many are in need of formal aged care at a younger age than the general population, yet, i...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-03920-3 |
| _version_ | 1797836308150747136 |
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| author | Claire M. C. O’Connor Roslyn G. Poulos Anurag Sharma Costanza Preti Najwa L. Reynolds Allison C. Rowlands Kyall Flakelar Angela Raguz Peter Valpiani Steven G. Faux Michael Boyer Jacqueline C. T. Close Leena Gupta Christopher J. Poulos |
| author_facet | Claire M. C. O’Connor Roslyn G. Poulos Anurag Sharma Costanza Preti Najwa L. Reynolds Allison C. Rowlands Kyall Flakelar Angela Raguz Peter Valpiani Steven G. Faux Michael Boyer Jacqueline C. T. Close Leena Gupta Christopher J. Poulos |
| author_sort | Claire M. C. O’Connor |
| collection | DOAJ |
| description | Abstract Background Older people subject to homelessness face many challenges including poor health status, geriatric syndromes, and depression, coupled with barriers in accessing health and aged care services. Many are in need of formal aged care at a younger age than the general population, yet, in Australia, specialised aged-care services to support this vulnerable cohort are limited. Methods This study was an evaluation of a new purpose-built aged care home for people with high care needs and who are homeless or at risk of homelessness. Over the first 12 months post-admission, the study examined: (1) changes in residents’ physical, mental, psychological and social health, and (2) the costs incurred by the study cohort, including any cost benefit derived. Results Thirty-five residents enrolled in the study between March 2020 – April 2021. At admission, almost half of residents were within the range for dementia, the majority were frail, at high risk for falls, and had scores indicative of depression. Over time, linear mixed-effect models showed significant improvement in personal wellbeing scores, with clinically significant improvements in overall health related quality of life. Levels of physical functional independence, frailty, and global cognition were stable, but cognitive functional ability declined over time. Comparison of 12 month pre- and post- admission cost utility data for a smaller cohort (n = 13) for whom complete data were available, suggested an average per resident saving of approximately AU$32,000, while the QALY indicators remained stable post-admission. Conclusion While this was a small study with no control group, these preliminary positive outcomes add to the growing body of evidence that supports the need for dedicated services to support older people subject to homelessness. |
| first_indexed | 2024-04-09T15:06:46Z |
| format | Article |
| id | doaj.art-c62d22cea1b342539537c71b809c207c |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-09T15:06:46Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-c62d22cea1b342539537c71b809c207c2023-04-30T11:27:25ZengBMCBMC Geriatrics1471-23182023-04-0123111810.1186/s12877-023-03920-3An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefitClaire M. C. O’Connor0Roslyn G. Poulos1Anurag Sharma2Costanza Preti3Najwa L. Reynolds4Allison C. Rowlands5Kyall Flakelar6Angela Raguz7Peter Valpiani8Steven G. Faux9Michael Boyer10Jacqueline C. T. Close11Leena Gupta12Christopher J. Poulos13Centre for Positive Ageing, HammondCareSchool of Population Health, University of New South WalesSchool of Population Health, University of New South WalesCentre for Positive Ageing, HammondCareCentre for Positive Ageing, HammondCareCentre for Positive Ageing, HammondCareSchool of Population Health, University of New South WalesCentre for Positive Ageing, HammondCareHaymarket FoundationDepartments of Rehabilitation Medicine and Pain Medicine, St Vincent’s HospitalChris O’Brien LifehouseNeuroscience Research AustraliaSydney Local Health DistrictCentre for Positive Ageing, HammondCareAbstract Background Older people subject to homelessness face many challenges including poor health status, geriatric syndromes, and depression, coupled with barriers in accessing health and aged care services. Many are in need of formal aged care at a younger age than the general population, yet, in Australia, specialised aged-care services to support this vulnerable cohort are limited. Methods This study was an evaluation of a new purpose-built aged care home for people with high care needs and who are homeless or at risk of homelessness. Over the first 12 months post-admission, the study examined: (1) changes in residents’ physical, mental, psychological and social health, and (2) the costs incurred by the study cohort, including any cost benefit derived. Results Thirty-five residents enrolled in the study between March 2020 – April 2021. At admission, almost half of residents were within the range for dementia, the majority were frail, at high risk for falls, and had scores indicative of depression. Over time, linear mixed-effect models showed significant improvement in personal wellbeing scores, with clinically significant improvements in overall health related quality of life. Levels of physical functional independence, frailty, and global cognition were stable, but cognitive functional ability declined over time. Comparison of 12 month pre- and post- admission cost utility data for a smaller cohort (n = 13) for whom complete data were available, suggested an average per resident saving of approximately AU$32,000, while the QALY indicators remained stable post-admission. Conclusion While this was a small study with no control group, these preliminary positive outcomes add to the growing body of evidence that supports the need for dedicated services to support older people subject to homelessness.https://doi.org/10.1186/s12877-023-03920-3HomelessnessAged careTrauma informed careWellbeingHealthService evaluation |
| spellingShingle | Claire M. C. O’Connor Roslyn G. Poulos Anurag Sharma Costanza Preti Najwa L. Reynolds Allison C. Rowlands Kyall Flakelar Angela Raguz Peter Valpiani Steven G. Faux Michael Boyer Jacqueline C. T. Close Leena Gupta Christopher J. Poulos An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit BMC Geriatrics Homelessness Aged care Trauma informed care Wellbeing Health Service evaluation |
| title | An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit |
| title_full | An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit |
| title_fullStr | An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit |
| title_full_unstemmed | An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit |
| title_short | An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit |
| title_sort | australian aged care home for people subject to homelessness health wellbeing and cost benefit |
| topic | Homelessness Aged care Trauma informed care Wellbeing Health Service evaluation |
| url | https://doi.org/10.1186/s12877-023-03920-3 |
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