Creating evidence to better support transitions from residential to community based locations of care
Often entry into a residential care facility is a last resort, when physical and cognitive deterioration results in high level of care needs that exceed the availability of personal and community supports. Residential care facilities are increasingly becoming places where older adults receive care until death. Few transition back to the community. Although it has been suggested that a substantial proportion of individuals residing in residential care in Northern British Columbia do not exhibit the clinical need for this level of care the actual prevalence and clinical profiles of these unique residents is currently unknown. These persons may require an alternative setting of care [ASC] where their care needs may more appropriately be met in non-institutional community based settings. A potential solution to address the increasing numbers of ASC persons in residential care who do not exhibit the clinical need for this intensive level of care may be discharge with support to community settings.
In partnership with Northern Health (NH) this mixed methods study will expand understanding of ASC in three phases. In phase one (secondary data analyses); person-specific health and clinical data will be analyzed for all persons assessed for care in NH to determine the prevalence of ASC residents in residential care. Bivariate, multivariate, and thematic analyses will profile ASC persons in residential care compared and contrasted to all persons assessed for care in NH.
Phase two (qualitative analyses) will examine ASC persons preferences, and the preferences of their family/caregivers, for location of care including perspectives on potential discharge to community based care settings (such as private residences, retirement homes, or assisted living). These findings will identify resources and supports necessary to facilitate this transition in a rural and remote context. Together, findings from phase one and two will inform development of a phase three pilot project to support transition for residents back to the community.
Considering the increases in pressures on limited health care resources, reducing the demand for residential services by supporting the relocation of ASC residents from residential care back to the community has the potential for significant impact. A move to residing in the community not only has potential for positively impacting the health and quality of life of the person but also has potential for financial cost-saving implications for health policy decision makers. Findings may also be applicable to other regional jurisdictions to inform similar challenges with the emerging population of ASC residents in residential care.
