Community Aged Care Use, Health and Sociodemographic Factors Associated With Unplanned Transitions to Permanent Residential Aged Care Among Australian Women With Dementia
Mariko Carey, Dominic Cavenagh, Michelle Kelly, Kristy Fakes, John Attia, Julie BylesBackground
Unplanned transitions to permanent residential aged care (PRAC), often precipitated by a crisis, can be stressful for people living with dementia and their families. Limited research has examined the role of community aged care in unplanned transitions to PRAC. This study aimed to (1) examine the proportion of Australian women with dementia who have an unplanned versus planned admission to residential aged care and (2) identify the sociodemographic, health and aged care service characteristics associated with unplanned versus planned admissions to residential aged care.
Methods
Secondary analysis of survey and linked administrative data from the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health. Participants were included in the analysis if they had been admitted to PRAC between October 2009 and June 2020 and had dementia at admission. The pattern of home services use prior to PRAC entry was analysed using a latent class analysis approach.
Results
The cohort included 1564 eligible women with mean age 89.95 years. Just over half (56.5%) had an emergency hospital admission in the three months before PRAC admission. Using lower levels of home support or home care services and being partnered were associated with lower odds of unplanned transition to residential aged care. Conversely, using high levels of home care or using minimal services, having a greater number of chronic conditions and poorer functioning with activities of daily living were associated with higher odds of an unplanned versus planned transition.
Conclusion
These findings highlight that for women with dementia with low to moderate support needs, it may be particularly important to reduce barriers to accessing community aged care services. Receipt of such services may help in monitoring dementia progression and facilitating a planned transition to residential aged care.