AGED CARE LOW VS HIGH

Recently on my gerontology prac, I wondered what determined whether a patient that required aged care went into low care or high care.

There was a patient on my prac who was admitted due to hospital from an aged care facility due to functional decline, staff at the low care facility report this particular patient was to not able to return to the facility because they were unable to cope with their needs, and basically admitted the patient to hospital because they believed they required a high care facility to “cope” with this patient.

This patient’s mobility was limited in terms of distance although they were independent with a WZF up to 30 metres. If they were to return to the low care facility they needed to walk independently to the dinning room, which was 80 metres. My aim of treatment was to build to this level so that the patient could return to the low care facility. The patient’s mobility had a big influence on whether or not they went into low or high care. This reflects in the staffing and funding difference between the low and high care facilities.

From this example we see that mobility has an influence in whether a patient requiring aged care goes into low or high care, but not the whole picture.

Assessment of patients going into residential care is done by someone on the Aged care assessment team (ACAT) they ask a number of questions relating to the patients needs and determine what appropriate placement for each individual is. This essential determines the funding paid to the residential care facility.

Funding is based on three domains
Activities of daily living
Behaviours
Complex Health Care

In reflection, it is not the physiotherapist job to determine whether or not a patient goes into aged care, although in the hospital system we are the experts on patients mobility and are uniquely positioned to rehab patient to a level which achieves there maximal level on functionality. I thorough knowledge of discharge options is required to discharge patients to the most appropriate facility to care for there needs.