A new service model has been developed and put into practice for older people living with alcohol-related brain injury (ARBI) and complex behaviours, enabling them to transition into long-term residential aged care.
Wintringham, the Victorian service that developed and trialled the model says it demonstrates that extreme behaviours arising from ARBI can be managed within the aged care system in a cost-effective and humane manner.
The specialist welfare organisation providing housing and care to elderly, frail men and women who are homeless or at risk of homelessness, which received funding from the Wicking Trust for 10 years to develop and test the model, completed its final report on the project last month.
“The behaviours of those with ARBI mean they cannot be accommodated within mainstream aged care,” Wintringham’s founder and CEO Bryan Lipmann told AAA.
“They exist on the fringes of aged care, sapping disproportionate resources from multiple government agencies and portfolios including aged care, mental health, drug and alcohol, justice, hospital and community services, housing and homelessness.”
Wintringham’s Wicking project addressed the issues raised by systemic failures to improve outcomes for this subgroup including humane treatment, cost and effectiveness.
“We believed that with appropriate resourcing we could provide a comprehensive, permanent solution to the otherwise intractable and expensive problems generated by this group,” Mr Lipmann said.
The key components of the two Wicking programs tested as part of the project were intensive case management, neuropsychological assessment and individualised behaviour management planning and monitoring.
Staff working with selected participants received additional training around behaviour management principles and diversional activity support to facilitate their participation in structured recreational activities.
The research estimated the economic savings to government through the Wicking model as opposed to “life on the streets” at approximately $11,000 per participant per year.
“The Wicking projects demonstrated the potential to be packaged as a transitional care model from which participants would emerge with a high likelihood of successfully transitioning into a more traditional Wintringham aged care service,” Mr Lipmann said.
“Another trial in a separate setting is needed to test whether transition results into Wintringham aged care can be replicated. This would yield vital information on the most successful and cost-effective transition model.”
To inform future policy and practice
Mr Lipmann said there were positive indicators of recognition at the national level of the need to address exactly the issues generated by the cohort studied.
“The Wicking project will contribute to a greater understanding of what is achievable when a highly supportive model of residential care is provided to people with ARBI and complex behaviours,” he said.
“For the first time in Australia, this knowledge base is poised to inform government initiatives to provide a supportive, enabling and cost-contained future for such clients.”
The Wicking Trust focuses on funding projects around Ageing and Alzheimer’s disease. Grant Hooper, The Wicking Trust’s senior grants manager said he was excited at the success of Wintringham’s Wicking Projects.
“The significant outcomes achieved for participants and staff, not to mention the cost savings achieved, indicates that Wintringham has identified a highly-effective model of care for this very challenging and often excluded members of our community,” Mr Hooper told AAA.
“We hope that the learnings from the Wicking projects will now inform change in policy and practice across the sector.”
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