Demand for health care services to meet the needs of older Australians is growing rapidly. Between 2010 and 2050, the number of older people (65-84 years) will more than double, from 2.6 million to 6.3 million, and the number of very old (85 and over) will more than quadruple, from 0.4 million to 1.8 million.
Future generations of older people are likely to have more complex health needs and expect a higher quality and level of service. There will be an increasing preference by older Australians to live and be cared for in the community wherever possible and for as long as possible. The demand for quality dementia and palliative care in all settings will increase.
Many older Australians are transferred into residential aged care facilities from hospital after a long and complex hospital admission, and have multiple and complex health care needs that require ongoing medical care and management. This trend will continue.
The residential aged care sector must be able to provide the level and quality of medical and nursing services to meet the needs of an ageing population.
Further, properly funded medical care provided to residents will help provide older Australians with quality care in appropriate settings as they reach the end of their lives. This will have the added bonus of freeing up acute care beds.
MBS rebates for services provided by medical practitioners and practice nurses must reflect the time and complexity of providing ongoing medical and dementia care to older people living in aged care facilities and in the community. The current Medicare rebate for these services should be at least doubled.
Efficiency gains in providing medical care can be achieved by extending the Medicare items for video consultations to general practitioner consultations to residents of aged care facilities and patients who are immobile.
Palliative care in residential aged care and the community must be improved through the introduction of dedicated Medicare rebates specific to the medical care provided to people at the end of their life.
Additional funding should be provided to encourage arrangements between aged care providers and medical practitioners to ensure ongoing access to medical care in residential aged care.
Aged care must make appropriate facilities available – including adequately equipped clinical treatment areas that afford patient privacy, and information technology to enable access to medical records and improve medication management.
Nursing care in the aged care sector must be adequate to meet the needs of residents and support the ongoing medical care of residents.
Community care, including domiciliary services for older people, is of crucial importance. Services should be matched to the needs of each individual, be comprehensive, be linked to the medical services received by the patient, and be coordinated at the practice level.