Community trial to enhance care of the older person

The Community Transition Care Program will play a major role in the support of elderly patients in the new GEM@Home trial.

A new, innovative trial has begun to safely support the acute and long-term care needs of elderly people in Metro North who have complex and chronic health conditions associated with ageing.

Community and Oral Health Transition Care Team Leader Leanne Carroll said across Metro North we have seen an increased demand on community services to provide healthcare that supports healthy ageing and the multiple care needs of the elderly.

“Currently, we help patients transition back home or into a nursing home, by providing short-term home or community care after a hospital stay,” Ms Carroll said.

“The Metro North Geriatric Evaluation and Management at home (GEM@Home) trial will provide a community-based, geriatrician-led service, which aims to minimise hospital stay and support the ongoing care needs of the older person in their own home.

“The GEM@Home trial will support early transfer of older patients from hospital and build clear pathways for the ongoing management of age-related conditions and reduce hospital readmissions.”

The trial will see five additional Hospital in the Home places dedicated to the older person, where patients will safely receive comprehensive care in their home, following their stay in The Prince Charles Hospital.

“Elderly patients will have access to a multidisciplinary team, including a dedicated geriatrician, nurses, physiotherapists, occupational therapists, dieticians, social workers, pharmacists and speech therapists in the home,” Ms Carroll said.

“As part of planning for sustainable care at home the service will include long-term care planning coordination for patients, and access to medication and equipment as required.”

The trial will run until the end of the financial year with the aim, if successful, to develop a broader service to support elderly people at home across the whole of Metro North.

The pilot is being led by Metro North Health staff from Community and Oral Health’s Community Transition Care Program and Innovation and Research Centre, as well as The Prince Charles Hospital.