Transitions of Care Among Older People Entering Residential Aged Care Homes

Objective: Improving the quality of care transitions among older people living in residential aged care homes (RACHs) is an area of national and international concern and priority. Pathways for entry to RACHs between the community, hospital and RACH services have not been longitudinally examined in Australia. This study aimed to characterise older people's care transitions preceding permanent RACH entry. Methods: A retrospective cohort study using linked, cross-sectoral data from the Registry of Senior Australians National Historical Cohort was conducted. Non-Indigenous individuals aged 65–105 years who entered RACHs in two Australian states during 2015–2019 were included. Transitions between community-based care settings, hospitals, temporary RACH services and permanent RACHs were characterised and summarised with descriptive statistics. Results: In total, 102,821 individuals entered 1058 RACHs. Overall, one in five residents (22%, n = 22,994) directly entered permanent care in a RACH from the community. The most complex entry to care pathway was also the most common pathway, with 27% (n = 28,155) of residents transitioning from hospital to a temporary RACH service before entering a RACH permanently. Conclusions: This study found older people often undergo multiple and frequently complex transitions between care settings before entering a RACH permanently. These findings highlight the need for new policies to prioritise the safety and high quality of care transitions among this population. Timely and complete information handover is important to optimise continuity of care, and healthcare professionals should be cognisant that older people often transition to new care settings that may not be permanent.