What we need as we get older : perceptions of elders, carers and community healthcare providers in the Macarthur region of Sydney

Aims: To gain a triangulated understanding of the healthcare and social requirements of community dwelling over 65-year-olds in the Macarthur region of Southwest Sydney. Methods. Patients, carers, Primary Healthcare Workers (GPs), allied healthcare workers and nursing home directors of nursing were invited to participate as part of a service development programme. Invitations were coordinated through the community geriatrician, the local Primary Healthcare Network, the three local state Councils and contacts through Campbelltown and Camden Hospitals. Thirty-minute semi-structured interviews were conducted with healthcare workers and three two-h community engagements meetings were facilitated by the community geriatrician (experienced in qualitative approaches). Data were transcribed and thematically coded by a single analyst, mapped to source and weighted to frequency that the theme was raised across sources. Results. Data were collected between February and September 2016 from multiple hospital, community and patient/ carer sources. Significant themes emerged which included: Primary Healthcare workers (management of multimorbidity, ease of referring to a specialist and delays to seeing a referral), allied healthcare workers (lack of staff to see referrals, reduced funding to run services or innovate) and patients/ carers (lack of podiatry services, lack of understanding of what geriatricians do/ offer, lack of understanding of what services exist in local area). Multiple suggestions were made for improvements which were triangulated across the diverse groups. Conclusions. Access, referral processes and health system navigation are perceived to be significant issues in our area warranting the development of an integrated care approach to aged care pertinent for the healthcare and social needs of the elderly. This has implications for development of community geriatric and wider services to the elderly. Limitations include the use of a single researcher and lack of data saturation at completion.