SEARCHCOHORTgeriatrics, public health

cohort·geriatrics, public health, family medicine, internal medicine, observational study·PMC10139912

An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit

BMC Geriatrics · 14 authors, 9 centres

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TL;DR

This study evaluated a new Australian aged care home for older people experiencing homelessness or at risk of it over the first 12 months after admission. It found significant improvements in residents' subjective wellbeing and health-related quality of life, while healthcare costs to the government decreased.

Full summary

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Thirty-five residents (median age 75.6 years, 65.7% male) were followed over 12 months post-admission using standardized health and wellbeing instruments. The study found statistically significant improvements in personal wellbeing scores and clinically significant improvements in health-related quality of life (EQ5D-VAS), with PTSD symptoms decreasing to below typical cutoffs for homeless populations. Levels of physical functional independence, frailty, and global cognition remained stable, but cognitive functional ability declined. The findings provide preliminary evidence supporting dedicated aged care services for this vulnerable population.

STUDY TYPE

cohort

SPECIALTY

geriatrics

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10139912

An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit

BMC Geriatrics

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ABSTRACT

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. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-023-03920-3. Keywords: Homelessness, Aged care, Trauma informed care, Wellbeing, Health, Service evaluation, Cost–benefit

CITATION EXPORT

Claire M C O’Connor, Roslyn G Poulos, Anurag Sharma et al.. An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit. BMC Geriatrics. (2023). https://doi.org/10.1186/s12877-023-03920-3

AUTHORS

14 · 9 CENTRES

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

1Centre for Positive Ageing, HammondCare, Sydney, Australia
2School of Population Health, University of New South Wales, Sydney, Australia
3School of Psychology, University of New South Wales, Sydney, Australia
4Neuroscience Research Australia, Sydney, Australia
5Haymarket Foundation, Sydney, Australia
6Departments of Rehabilitation Medicine and Pain Medicine, St Vincent’s Hospital, Sydney, Australia
7Chris O’Brien Lifehouse, Sydney, Australia
8Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
9Sydney Local Health District, Sydney, Australia