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Better access to doctors vital for the nation’s elderly

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Aged care providers need to work more closely with doctors to better integrate medical care into the services they offer and improve the treatment of the elderly, according to AMA President Dr Steve Hambleton.

With the number of people requiring aged care set to soar, Dr Hambleton said it was vital that action be taken now to improve the provision of medical services in residential aged care facilities.

In an opinion piece in the Australian Financial Review, the AMA President said that last year one in 10 aged care residents – 93,400 people – were transferred to hospital for treatment, causing disruption and distress for them and their families and adding to the burden on already busy hospitals, often unnecessarily.

Instead, he said, many of these people could be cared for where they live, as long as there were the necessary facilities and support.

“The aged care sector is a component of the health system,” Dr Hambleton said. “It needs to be supported by Government to better integrate medical care into the sector so older Australians can get the care they need in aged care settings.”

One of the considerations is appropriate support for doctors who visit aged care homes.

Only around 21 per cent of GPs regularly visit nursing homes, and they often have to deal with significant inconveniences in trying to see their patients, including basic practicalities like finding a car park and getting security access (a particular problem for after hours visits).

Often, they also encounter problems locating their patient, obtaining their file and finding a staff member who can describe their patient’s symptoms.

When they do get around to treating their patient, it is often in a shared room, compromising privacy, and often without the basic facilities and equipment needed by the doctor.

Dr Hambleton said a dedicated core of generally older GPs tolerated these conditions because of their long-standing commitment to the care of their patients but, as they aged, younger practitioners were not coming through to take their place.

“As the current group of doctors retire, there is a risk we will face a dramatic drop in the medical workforce available to aged care residents,” the AMA President said.

To help address the problem, aged care services needed to provide dedicated, adequately equipped clinical treatment areas, and to ensure there were sufficient registered nurses on site to manage patient care between doctor visits – an improvement that would also reduce the number of times residents were transferred to hospital.

This, Dr Hambleton said, would require greater Government support for aged care providers.

The cost could be ameliorated to some extent by improving the services provided to elderly to help them live at home for longer, particularly by giving GPs direct input into the assessment of what services and support an elderly person needs to continue to live at home.

“It is important that aged care assessments that trigger access to Government-funded services seek the input of the person’s treating medical practitioner, so that funding is directed to the most critical needs,” Dr Hambleton said.

The AMA President said support for carers was an important part of this equation, and called for doctors to be given authority to arrange urgent respite care.

“Almost half of all primary carers have a disability themselves, and their health can rapidly deteriorate, he said. “In these situations, the doctor needs to quickly arrange residential respite care for the older person being cared for. When this is not possible, the only alternative is admission to hospital, and that can make the situation much worse.”

Dr Hambleton said “the time has come” for careful planning to make the aged care sector ready for the challenge of a rapidly ageing population, and said it would need “more support and resources to make [the necessary] changes”.

Adrian Rollins