Abstract
Objective
Older women are more likely than men to enter residential aged care (RAC) and generally
stay longer. We aimed to identify and examine their trajectories of care needs over
time in RAC across 3 fundamental care needs domains, including activities of daily
living (ADL), behavior, and complex health care.
Design
Population-based longitudinal cohort study.
Setting
RAC facilities in Australia.
Participants
A total of 3519 participants from the 1921-1926 birth cohort of the Australian Longitudinal
Study on Women's Health (ALSWH), who used permanent RAC between 2008 and 2014.
Methods
We used data from the Aged Care Funding Instrument, National Death Index, and linked
ALSWH survey. Participants’ care needs in the 3 domains were followed every 6 months
up to 60 months from the date of admission to RAC. Trajectories of care needs over
time were identified using group-based multitrajectory modeling.
Results
Five distinct trajectory groups were identified, with large variation in the combinations
of levels of care needs over time. Approximately 28% of residents belonged to the
“high dependent–behavioral and complex need” group, which had high care needs in all
3 domains over time, whereas around one-third of residents (31%) were included in
2 trajectory groups (“less dependent–low need” and “less dependent–increasing need”),
which had low or low to medium care needs over time. More than two-fifths of residents
(41%) comprised 2 trajectory groups (“high dependent–complex need” and “high dependent–behavioral
need”), which had medium to high care needs in 2 domains. Higher age at admission
to RAC and multiple morbidities were associated with increased odds of being a member
of the high dependent–complex need group than the less dependent–increasing need group.
Conclusions and Implications
Identification of the differential trajectories of care needs among older women in
RAC will help to better understand the circumstances of their changing care needs
over time. This will facilitate appropriate care planning and service delivery for
RAC residents, who are mostly older women.
Keywords
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Article info
Publication history
Published online: October 24, 2019
Footnotes
The study was supported by the Australian Government Department of Health and ARC Centre of Excellence in Population Ageing Research (CEPAR) (grant no. G1900719).
The authors declare no conflicts of interest.
Identification
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© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
