Factors influencing care and support for older adults with traumatic injury in Australia: a qualitative study

Abstract

Purpose

To investigate factors influencing provision of care and support to older adults with traumatic injury in Australia, from a health service and policy perspective.

Methods

Semi-structured interviews were undertaken with 16 clinicians, support providers, researchers, policy makers, and representatives from peak bodies in Australia, who had experience across injury, ageing, and disability sectors. A thematic analysis was performed using a framework approach.

Results

Themes identified included prolonged injury recovery in older adults, limited accommodation options, restricted access to preventive care, escalating care needs over time, issues with siloed funding schemes and funding availability, and the need for advocacy to coordinate care across different schemes. Certain themes were specific to people who were older when injured. Others related to people who had acquired an injury at a younger age and were ageing with injury. However, most themes had relevance for both groups.

Conclusions

For older adults, this research has highlighted a range of cross-sector problems which impact upon the potential to recover from injury and to age well with injury. To improve the lives of older adults with injuries, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors, and improved advocacy and case management.

Implications for rehabilitation

• To address the lack of long-term, multi-disciplinary preventive care for age-related conditions and secondary complications in people with injuries, older adults may need more prolonged, or individualised, care following injury, episodic health checks, and a greater focus on long-term health care.

• Accessible and well-coordinated specialist housing and support responses, that offer timely access to health care professionals and carers trained in both ageing and disability, and enable greater support for “ageing in place”, are required to manage changing care needs of people ageing with injury.

• There needs to be greater involvement of geriatricians, nurses, and allied health care professionals within the aged care sector in order to care for people with complex needs, including older adults with injury-related disability.

• To reduce gaps in care and support for injured older adults, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors.

Keywords:

• Older adult
• traumatic injury
• health services
• policy
• ageing
• qualitative

Acknowledgements

The authors acknowledge Jade Hurst and the TAC research team for their assistance and collaboration throughout the development of this research. The authors also wish to thank the larger Monash University project team for the provision of feedback and input into the original research: Professor Keith Hill, Dr Ben Beck, Associate Professor Sharon Newnam, Dr Melita Giummarra, and Dr Natasha Brusco. The authors also thank the participants of their research for their time and for sharing their insights.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This research was funded by a Grant [T034] from the Transport Accident Commission (TAC). BG was supported by an Australian Research Council Future Fellowship.