Jan 25, 2024

Aussie researchers focused on improving the transition into residential aged care

25_1_24_HC_on-trac
Members of the research group from L-R: Dr Shanna Fealy, Professor Suzanne McLaren, Associate Professor Melissa Nott and Associate Professor Belinda Cash. [Source: CSU]

Transitioning into residential aged care can be a challenging and highly emotional experience for many older people, but Charles Sturt University hopes a new project will reduce the mental health toll by unearthing new tools to help improve the journey.

Key points

  • Research shows that depression rates are alarmingly high in residential aged care, with approximately half of residents experiencing mental health concerns, compared to 10-15% of older people living at home
  • Charles Sturt’s Ageing Well in Rural and Regional Australia Research Group has received $600,000 from The Ian Potter Foundation to fund their Improving the Mental Health of Older Australians Navigating the Transition to Residential Aged Care (ON-TRAC) Project
  • ON-TRAC will be co-designed, co-produced and trialled with aged care providers Uniting AgeWell (Victoria and Tasmania) and St Agnes Care and Lifestyle (New South Wales), plus aged care consumers and informal carers

The ON-TRAC Project was inspired by several conversations involving St Agnes Care regarding the support on offer to incoming residents, Post-Doctoral Research Fellow Dr Shanna Fealy told HelloCare. 

“One of the issues from their discussions was they believed there was a missed opportunity to do something more to help future residents as they transitioned into aged care. We found that the transition before going into a residential aged care facility was undervalued,” she explained.

“It comes back to that time frame being a profound life transition for many and unfortunately, this transition is characterised by distress. There were examples of a good transition to residential aged care linked to being informed and involved in the decision-making process.”

Dr Fealy added that many older people feel as though their independence is lost when their entry to aged care results from a decline in cognitive or physical health, leading to increased rates of depression.

Research suggests depression rates in aged care settings are alarmingly high with roughly 50% of residents experiencing symptoms of depression. This is disproportionate to the general population and is not a normal part of ageing with the rate of depression in the community around 10-15%.

Dr Fealy said the critical health changes that lead to residential care admission can often be the spark for ongoing mental health challenges, such as depression, anxiety or stress.

“Those early factors leading into the transition do have a short-term impact for the first three months of relocation but then the combination of factors around the transition and life in a new facility has a profound impact. They compound each other and lead to these increased incidents of depression,” she said.

With the $600,000 grant from the Ian Potter Institute to be spread out across five years, the team at Charles Sturt University will focus on research in 2024 to better understand the transition process.

This will include partnering with the National Ageing Research Institute (NARI) to interview older people and their carers with lived experience plus managers and staff from aged care organisations Uniting AgeWell and St Agnes Care. 

“We have two good industry partners for this part of the project and we’ll get their experience and perspective of people transitioning so we have that holistic understanding of what’s happening and the areas we can improve on,” Dr Fealy explained. 

“The first phase will inform the second phase, our co-design workshop. This means bringing everyone to the table, including the people transitioning into aged care, their carers and managerial staff.”

“From there we will have an evidence-informed psychological intervention but we don’t know yet what it will look like. And that’s the lovely mystery about it all. We know what the evidence says at the moment, what might work and what might not work but we want to hear from everyone involved so they can help co-design this intervention,” she added.

With a clear focus on preventing depression or anxiety, Charles Sturt University’s research will provide an important solution to a pressing issue in the aged care journey. 

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  1. My name is Jamie Fehon and I appeared on 4 corners in relation to the abuse of my mother.
    I am so happy with you working on the tra sition into aged care as I have seen this needs a lot of attention.
    The care staff don’t have time for these difficulties and is so traumatic on the new residents.
    Keep up the good work .

  2. I am not a resident of an aged care nursing home and I would suicide before I ever entered one as my belief is that they are death camps. I would need to speak one on one with any surviver of an aged care home for a few weeks and be mentored. i would need help to grieve my freedom loss and I would need to get out of the palce on aregular basis and walk in agreen place or be by the ocean on a regular basis.

  3. thank you, i have worked in nursing homes all my life, and watched elderly people come in and get so depressed as they are now stuck , then overloaded with medication which creates another problem , such as anger ,addiction, regular and prn meds overload their system, which keeps them asleep or dozy, day and night—–(forced sleep).it was not until i saw my own husbands neglect chemical restraint that i now understand the ( cruelty) of age care. we need to firstly ( ween) them into care, not just taken and left. i am more interested in dementia care. lots more to say if i get the opportunity.

  4. I am a retired Old Age Mental Health Psychiatrist. I was also able to approve ACAT assessments when needed using our own team of health professionals. In my view the transition from home to aged care is often too sudden and driven by pressures to move patients out of acute hospitals, often places they should not have been sent to in the first place. Bridging with domiciliary assessments, home support and Day Hospital can permit a graduated change if managed carefully and with respect for the rights of the patient. Sadly now the focus seems to be on getting an ACAT “ticket” to an Aged Care facility in a crisis due to lack of graduated resources and hospital bed shortages.
    Efficiency in health delivery requires time to help patients get fully well and recover after illness, or adapt progressively to changing circumstances. Concentrating on only short stay hospital care is inefficient in the long term if the results are worse mental and physical health.

    1. I wholeheartedly agree with this view as an aged care navigator that supports people with transition to aged care. This is a huge transition in life made much worse due to the sudden move without time and space for the individual and family to adjust to their new reality. Seeing social workers in hospitals pressured to clear beds and finding any free room without time to assess the suitability, the individuals wishes and a vision for how life can be going forward would make anyone depressed. We need an overhaul of how this transition is executed and experienced and why we educate clients to plan ahead before a health event so that this new life stage does not come in crisis without any preparation emotionally and practically. We also circumvent the pathway to aged care where possible to help people return home from hospital with bolstered support where there is capacity. Unfortunately people are put on this pathway before exploring and exhausting all options due to resourcing and pressure on the health system. Dignified ageing is lost in current systems and I applaud this research initiative.

  5. Just wondered if anyone has thought to look at the impact on the carer, many are left to cope with feelings of guilt which of course compound if their loved one is unhappy.

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