Person-centred acute hospital care for older people transitioning to residential aged care- whose needs are being met?

Abstract

ABSTRACTThe acute health care system in Australia, as in the global north, has been increasingly dominated by neoliberal market principles prioritising efficiency and cost reduction. This has occurred in conjunction with a shift towards ‘personalised care’ models in health and social services. Personalised care models are intended to support the provision of holistic health care and consumer choice. Yet, the bureaucratic context of acute health care produces constrained applications of person-centred care that can undermine patient participation. Personalised care models have been criticised for diminishing the choices available to socioeconomically disadvantaged groups. There has been scant attention to these equity issues and ethical implications of the model for older people transferring from acute hospital settings to residential aged care. This is significant, as this major life event is associated with social- and identity-related losses; can produce poor health outcomes; and is affecting an increasing population of older people. The aim of this paper is to address this gap in the debate through a critical literature review applying Tronto’s critical ethics of care. We highlight the current Australian context for this patient group and the transferability of palliative care models as an example for change in practice and resource allocation.