Ageing Australians make up the largest consumer group of healthcare. The risk of developing hospital acquired iatrogenic complications for older patients led to the development of hospital avoidance programmes, which aim to provide care in the patients’ own environment, such as their home or Nursing Home.
With a team of nurses, general practitioners and aged care facility staff all working together, the Hospital in the Nursing Home (HINH) service can provide education, support and advice so that unnecessary presentations to hospitals are prevented and residents are cared for in the most appropriate environment.
Rhonda Purtill, HINH Manager at the Royal Brisbane and Women’s Hospital joined us recently to discuss the significance of HINH service and how Advance Care Planning can assist in overcoming the challenges when adopting the HINH programme.
1) Hospital in the Nursing Home (HINH) service provides an alternative option for the acute management of residents in aged care facilities. How was the HINH service developed and why?
The Hospital in the Nursing Home Service RBWH Metro North was developed in February 2006 in order to support elderly residents to remain in their aged care facilities.
Evidence suggests that elderly people attending emergency departments and acute care settings are more prone to developing iatrogenic events e.g increase in falls, infection, disorientation, delirium.
Aged care facility residents have a unique set of needs usually complex with associated diminished capacity. It can be a frightening experience because of the change in environment. Acute hospital staff often lack the expertise in caring for these people and they are often time poor, especially in emergency departments. There is a much higher risk of developing a hospital acquired complication. Crilly, Chaboyrer and Wallis 2011 remind us that functional decline occurs by the second day of hospitalisation and rarely returns to baseline.
It is the delivery of the right care at the right time in the right place and for the right resident for all the right reasons.
2) What are some of the benefits with the HINH service?
Providing Residents with appropriate clinical interventions within their own environment and within their home.
3) What are the key challenges when we adopt the HINH service to care for the residents?
Some of the key challenges include:
4) How can Advance Care Planning (ACP) assist in overcoming these hurdles?
Some of the ways include:
5) You will be speaking at the upcoming Hospital in the Home Conference on the 26th and 27th May in Melbourne, on the topic Hospital in the Nursing Home Service- Advance Care Planning – It’s Everybody’s Business! Is there a key message you’d like to share with the conference audience?
How can we as a society openly discuss how we wish to die without it being seen as a taboo subject? Let us break down the barriers and demystify the dying process before we are no longer able to make the appropriate decision and choose, dying is a part of living.
To find out more about the event, please visit the 14th Annual Hospital in the Home Conference website.