FOCUS QUESTION 2
WHAT ARE PRIORITY ISSUES FOR IMPROVING
AUSTRALIA’S HEALTH?
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a growing and ageing population
healthy ageing
increased population living with
chronic disease and disability
demand for health services and
workforce shortages
availability of carers and
volunteers.
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assess the impact of a
growing and ageing
population on:
the health system and
services
health service workforce
carers of the elderly
volunteer organisations.
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More older people (aged = 65+) are living longer
@ 30/6/2011 more than 3 million Australians are
65 or over = 14%
By 2031 this will increase to 19% - 21%
In 2009 94% lived at home or in self care
accommodation
In 2011,11% were employed with 53% working part
time
In 2006 27% were volunteers
In 2009, at age 65 females expect to live another
21.8 years and males another18.7
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Females could expect to live a further 16.1 years
without assistance and males 15.2 years
Health ageing is both a state (health status) and a
process (adapting to changing life circumstances
and engaging in healthy behaviours)
The govt. has responded by encouraging people to
plan for their financial security and independence
for their later years. They have also provided
services and support depending on needs. They
also want aged people to contribute for as long as
possible. If people are sick in later years it means
less income for the govt. via tax and this results in
reduction in economic growth.
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The govt. has appointed an ‘Ambassador for Ageing’, who is
responsible for;
Promoting positive and active ageing
Encouraging contributions made by older people
Promoting community govt. programs and initiatives to the
public
Assisting older people to access these programs
National goal – ‘Ageing well, ageing productively’ which focuses
on; disease prevention, reducing illness periods, maintaining
economic and social participation.
These initiatives lead to better health outcomes for older
Australians, therefore reducing the economic burden on the
govt.
HSC online http://hsc.csu.edu.au/pdhpe/core1/focus/focus1_2/4004/1-23/health_pri1_2_3.htm
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Although the picture is quite good, the extent of
disability & disease, often involving multiple conditions
(comorbidity) tends to increase with age.
44% of aged have a disability, 11% of those severe or
profound core activity limitation (i.e. needing assistance
with activities relating to communication, mobility and /
or self care)
81% of those aged 85 or more have disability, of whom
54% have a severe or profound core activity limitation.
(notice the change)
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49% of 65 – 74 year olds have 5 or more long term
health conditions, increasing to 75% of those aged 85 or
more.
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Most common diseases are:
Some degree of vision or hearing loss
Arthritis or other musculoskeletal problems
Elevated blood pressure and cholesterol
Despite this 2/3 rate their own health as good,
very good or excellent. This suggests they view
their own health against their peers and what is
expected for their age.
Between 1988 and 2003 prevalence rates for
disability remained fairly stable and more recent
information suggests the physical health of older
Australians in some age groups may be
improving. (but the jury is still out on that!)
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As a consequence of an increase in the Aust. Pop
living with a disease or disability; the demand for
health care and aged services has risen.
The govt. has proposed a number of initiatives to
meet the needs of older Austs. including;
More nurses to cater for demand in emergency
dept. and other high demand areas.
 expanding the roles of nurses
Increase in community care, such as home-help
services and meals-on-wheels
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In addition the govt have been concerned that many people
suffering poor health are unable to contribute to the workforce,
leading to labour shortages. The govt. has responded to
improving retirement income by;
 means tested age pension to provide income after
retirement
 compulsory superannuation provided by employers. The
minimum level of the superannuation guarantee is 9% of
employees gross salary.
 voluntary, private superannuation contributions and other
forms of private saving are also encouraged. Some through
tax benefits.
 These initiatives encourage planning for financial security
and independence for their later years. This reduces the
economic burden for the govt.
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Those aged 55 or older are the heaviest consumers of
medical services. The rising national health expenditure is
driven by;
 Relative health price increases
 Growing & ageing population
 Non-demographic growth in health care
when older people are discharged from hospital, they are
less likely than younger people to return to their home and
are more likely to enter residential aged care or die. In
particular, a high proportion of injury related hospitalisation
for older people is followed by discharge to residential aged
care or another health facility.
It is anticipated that there will be little growth in the number
of available carers compared to the anticipated rise in
demand for home-based support. This will likely cause
shortages in carers in the future.
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Service providers that offer aged care in the community
and through aged care provide a mix of private and
religious or charitable orgs, as well as state, territory and
local govts.
For older people who can no longer live at home there are
publicly funded places in aged care homes, called
residential aged care. There are 2 types; high–level and
low-level.
High level provides nursing care when required, meals,
laundry, cleaning & personal care.
Low level gives the person assistance with meals, laundry
and personal care.
Other services include; personal care, home helpers, home
maintenance and/or beautification, food delivery,
transport services and community health centres.
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Most older Austs. prefer to stay at home so there are
a number of programs designed to help with daily
activities that have become harder for these people to
manage on their own. This is called community care.
HACC – home and community care program and
CACP – community aged care packages are 2 such
programs for people who would qualify for @ least
low-level care in an aged care home.
HACC services aim to meet basic needs to maintain
a person’s independence at home and in the
community. They include community nursing,
domestic assistance, personal care, Meals on Wheels,
transport and community based respite care.
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Aust’s workforce consists not only of paid
workers but also carers and volunteers, who are
ALSO AGEING with the rest of the pop.
Austs over the age of 55 contribute
$75Bill/annum in unpaid caring and volunteering
activities.
Caring & volunteering are beneficial to the
economy.
There are over ½ mill volunteers over 65 who
volunteer for non-profit org. As such the paid
and unpaid work of older Australians is essential
to a well-functioning and caring society, which
ultimately enhances the quality of life for all
Australians.