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Changing needs mean older women need more complex care at home

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Women using home nursing services are older, less likely to have been born in Australia and have more complex medical needs than 10 years ago, a Melbourne research study has found.

Bolton Clarke Research Institute conducted the retrospective analysis of home nursing clients as part of the two-year Older Women Living Alone project. De-identified data were analysed from women clients aged 55 years and older living in Victoria for each year between 2006 and 2015.

Researchers found that over the study period there was a decrease in nursing service utilisation by older women living alone who were aged under 85. For this group of women, the decline in service usage was most pronounced for those aged 65-74 years.

In contrast to the trend for younger women living alone, women over 85 and living independently showed increased usage of home nursing care over the 10-year period. Women over 85 and living with others also showed increased service usage.

“Women using home nursing services are older than a decade ago and are also more medically complex and more likely to originate from countries other than Australia and speak languages other than English,” lead author Marissa Dickins said.

“This all adds to the complexity and support required to care for these individuals in their own homes.”

The study, published in the Australasian Journal on Ageing, showed that overall, fewer women living alone were using home nursing – a decrease by 13 per cent over the period. However there was a substantial increase of 10-33 per cent in service use for women aged over 85, regardless of living status.

The proportion of older women born in Australia decreased over time, as did their likelihood of speaking English as their preferred language.

“The complexity of health issues of all women accessing the home nursing service also increased over the 10-year period,” Dr Dickins said. “We’re certainly seeing more diagnoses than we used to see previously.

“Women living alone were less likely to be discharged from the home nursing service to home and more likely to be discharged from home nursing care to hospital in 2015, while the opposite was true for women living with others.

“The increased age of women accessing home nursing care and the fact they’re living with more conditions supports previous research indicating that as our medical knowledge grows and care improves, we are getting better at managing diseases.

The research paper is the first to examine women’s use of home nursing services over time.

“As clients age it’s important to understand their changing needs to help service providers understand how best to support them,” Dr Dickins said. “We have to assess whether there are services we may be able to put in place to help them age well at home for as long as possible.”

The full research report can be found at: https://onlinelibrary.wiley.com/doi/full/10.1111/ajag.12735