Kathleen Ison - Lower Hunter NSW Health - The Use of Flexible Packages to Increase Occupancy

Stepping Up or Down Flexible Transition Options

Presenter Kathy Ison CNC Lower Hunter TACP

Hunter Valley TACP

• Three LGAs – Maitland, Cessnock & Singleton • 7250 km2 “Mines and Vines” • Population over 65yrs 2009 - 18815 • Expected growth rate of 54% 2029 - 41580 • 43 TACP Packages

• 6 Flexible packages Residential or Community

Residential Unit TACP

•  Located within Cessnock Hospital • Commenced Feb 2010 • Home like accommodation

TACP Unit

Unit Staffing

• Nursing – RN and EN every shift – AIN three days per week for activities

•  Allied Health, low intensity therapy – Physiotherapist – Occupational Therapist – Dietitan – Social Worker – Speech pathologist

Activities

•  Exercise Group •  Falls day •  Cooking activities •  Meal Preparation •  Talking group •  Word Games •  Board Games •  Melbourne Cup •  Football Grand Finals

Admissions March 2014

•  There have been 169 admissions to the unit •  LOS has varied from 1 day – 84 days • Main Reasons for Unit admission

– Mobility progression – Awaiting Home Modifications – Carer education – Medication education compliance – Lone rural livers

Stepping Down

• No time frame at start of unit transfer but goals are set that client should achieve before going home.

•  Average LOS 28 days • Home access visits can be done • Community access can be done • Client encourage to recommence social

activities

Outcomes

Stepping Up

•  There have been 31 clients that have used the unit as a step up.

•  This is where the client has been at home and then comes to the unit.

•  First Client Oct 2010, Clients carer was taken to ED in Ambulance

•  Average LOS 19 days • Outcomes Home, ACF or Hospital.

Reasons for Step Up

Outcomes from Step Up

Feedback

•  Survey for unit clients – Why has the unit helped

Gave me time to get more confident Allowed time for rails/ramp to go in My daughter got to go away I wasn’t lonely over Christmas

Feedback

•  Survey of Carers – How has the unit helped

Saw Dad benefit from care setting Was allowed to take her out anytime Great knowing their safe Got mum use to being in care – and she liked it They just had more time to get better

Feecback

•  Survey of staff Option to continue care if carer unwell support/supervision short term ie trial of void, medication monitoring learning Blister pack Support for those who have no support at home on initial

discharge from hospital Increase confidence post fall, closer supportive

environment Ability to go from TACP Community back to unit for closer

supervision, without another hospital admission.

Lower Hunter TACP

• Clients benefit from the flexibility

•  Staff benefit from the options of care

•  Families benefit from access to TIME for decision making

Thank You