Characteristics, care and support needs of older Victorians requiring a government-funded Home Care Package: An observational study

Objectives: To describe sociodemographic characteristics and comprehensive day-to-day care and support needs of older Victorians requiring government-funded home-based aged-care, and to explore associations between vulnerability factors and complexity indicators in this population.

Methods: A population-based observational study was conducted using de-identified, routinely collected aged-care assessment data for Victorians approved for a Home Care Package (HCP) between January 2019 and June 2022.

Results: The study population (n = 94,975 individuals), approved for one of four HCP levels (Levels 1 (5%), 2 (38%), 3 (34%) or 4 (24%)), was aged 82 years on average (SD 7.6), commonly born outside Australia (48%), with people of higher socio-economic status more likely to be approved for a high-level HCP. Advanced care and support needs such as for showering (53%) and dressing (43%) were common, with higher overall needs when cognitive and behavioural concerns such as short-term memory loss (75%) or agitation (21%) were present. 79% reported at least one vulnerability factor such as being socially isolated, culturally and linguistically diverse, or Aboriginal and Torres Strait Islander peoples, and 49% reported at least one complexity indicator. The three most prevalent complexity indicators were significant cognitive changes (29%), self-neglect (17%) and emotional/mental health issues (11%), which were generally positively associated with vulnerability factors.

Conclusions: This population-based study provides evidence of the diverse sociodemographics, and often advanced day-to-day mobility, functional, physical, cognitive, behavioural, psychological and psychosocial care and support needs of people requiring home-based aged-care. It also highlights the multifaceted complexities within this population. Results could inform home care service-delivery models and workforce skill-mix requirements to efficiently and safely meet these needs.