Evaluation of domiciliary services and hospital discharge for older people with chronic and complex conditions

Many older people remain in hospital after the acute phase of their illness due to a delay in implementation of community services to respond to their ongoing needs for domiciliary care. The Macarthur Health Service has well-coordinated ambulatory and aged care services, which provide acute and subacute care in the home. The teams consist of medical, nursing, and allied health professionals. In spite of these services, some older people still cannot receive treatment in their own home due to the lack of acutely responsive domiciliary care. This support may only be needed on a short-term basis during the acute phase of their illness or as a bridging service whilst the longer term Home and Community Care (HACC) services are put into place. Carrington Temporary Aged Care Program (CTACP) has provided services that assist clients temporarily with personal care, domestic assistance, shopping, provision of meals, transport and psychosocial support, until the appropriate HACC service is available, for a maximum period of eight weeks. Thirty five patients discharged from Macarthur Health Service have received this service to date in 2002. Patient and carer satisfaction and quality of life measures indicate that this is a valuable and effective service to the client.