Effect of an ageing population on services for the elderly in the Northern Territory.

Abstract

Objective The aim of the present study was to describe the elderly population of the Northern Territory (NT), explore the challenges of delivering aged care services to this population and implications for the acute care sector. Methods Data gathered from a variety of sources were used to describe the demographic and health profile of elderly Territorians, the aged care structure and services in the NT, and admission trends of elderly patients in NT hospitals. Information regarding NT community and residential aged care services was sourced from government reports. NT public hospital admissions from 2001 to 2015 were adjusted by the estimated Aboriginal and non-Aboriginal populations. Results In 2015, elderly people constituted 9.2% of the NT population and this number is predicted to increase. Between 2001 and 2015, the number and rate of elderly admissions to NT public hospitals increased significantly. Compared with other jurisdictions, aged care in the NT is dominated by community services, which are of limited scope. Important geographical and economic factors affect the availability of residential aged care beds. This, in turn, affects the ability of elderly people to transition from hospital settings. Conclusions The NT has a relatively small but growing elderly population with increasing needs. This population is markedly different compared with its counterparts in other Australian states and territories, but receives aged care services based on national policies. Recent changes to community-based services and increases in residential beds should improve services and care, although remaining challenges and gaps need to be addressed. What is known about the topic? Increasing health and care needs of elderly people will place significant stress across the health and aged care system. In Australia, most aged care services are apportioned and funded under a national system. The NT has a markedly different population profile compared with the rest of Australia, which gives rise to unique considerations, but its aged care structure is based on nationally developed policies. What does this paper add? Elderly people in the NT are increasingly using acute care services. Aged care services in the NT have higher ratios of community-based services to residential aged care facilities (RACF) as a consequence of a 'younger' cohort of Aboriginal elderly people who live remotely. In addition, economic factors affect the low number of RACF places. As evidenced in past years, a small pool of beds can adversely affect the numbers and length of stay of elderly people waiting in hospitals. What are the implications for practitioners? The NT has a small but growing population of elderly people, which will place an increasing burden on acute care services that are ill equipped to manage their specific needs. Recent RACF and flexible care bed approvals may alleviate past difficulties to transition hospital patients awaiting RACF placement. Significant changes at the national level to community-based care services that increase flexibility for providers may bring about better outcomes for remote elderly recipients. However, high costs and issues with remote servicing will remain. Psychogeriatrics remains a major underserviced area in the NT with no prospective solution.