FOCUS QUESTION 2 WHAT ARE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH?

 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.  assess the impact of a growing and ageing population on:  the health system and services  health service workforce  carers of the elderly  volunteer organisations.

 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 % lived at home or in self care accommodation  In 2011,11% were employed with 53% working part time  In % were volunteers  In 2009, at age 65 females expect to live another 21.8 years and males another18.7

 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.

 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 - 3/health_pri1_2_3.htm 3/health_pri1_2_3.htm

 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)  49% of 65 – 74 year olds have 5 or more long term health conditions, increasing to 75% of those aged 85 or more.

 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!)

 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

 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.

 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.

 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.

 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 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.

 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.