Barwon Health steps up to provide specialist dementia care

Regional health service provider Barwon Health has joined an exclusive list of Specialist Dementia Care Program (SDCP) providers, with the experienced Roz Nolan leading their team in Geelong.

Barwon Health is the 17th SDCP site in Australia and the first to be run by a public health organisation in a regional setting. Each SDCP unit is funded by the Federal Government, through the Department of Health and Aged Care.  

Providing appropriate care to aged care residents with very severe behavioural and psychological symptoms of dementia is one of the toughest challenges aged care providers face. 

Many facilities lack the resources and training to support residents with high needs, which often results in those residents being forced out of mainstream residential care. The Department of Health and Aged Care says this cohort accounts for roughly 1% of all people living with dementia. 

While that appears small, hospitalisations due to dementia result in an average 15-day stay; that’s more than five times as long as all hospitalisations at 2.7 days. Avoiding hospitalisation and allowing residents to return to a less intensive care setting is paramount.

Ms Nolan, who previously established an SDCP in metropolitan Melbourne, is the Facility Manager for Barwon Health’s Blakiston Lodge site, based at the McKellar Centre in North Geelong. 

She said their eight-bed unit provides the perfect opportunity to offer person-centred care that’s focused on each resident’s needs. 

“The aim is to bring residents in at their heightened level. Most of the time these residents who cannot be cared for in mainstream aged care are discharged to emergency departments. We want to get in before that happens,” Ms Nolan told hello leaders. 

“But often these residents have been transferred to hospital several times because their behaviours have escalated to the point where they can’t be managed in the aged care facility.”

Ms Nolan explained that many residents at Blakiston Lodge come from emergency departments and hospitals because they can no longer stay in a private mainstream aged care home. 

Regarding the SDCP, eligibility can only be determined by Dementia Support Australia to ensure a nationally consistent referral pathway is in place. However, anyone can make the initial referral to Dementia Support Australia for assessment.

“It’s not a short process. Dementia Support Australia will come out and do a thorough needs-based assessment. If they’re in a nursing home or a hospital they’ll gather the data from the family, they’ll go back through the history, speak to doctors,” Ms Nolan explained.

“It needs to be thorough because when they finally get to our facility we need to know everything from day dot: the story of their lives, how they’ve progressed to where they’re at now. We use that information to transition them to a much more stable status.”

Dementia care has been Barwon Health’s strength for some time. The Blakiston Lodge site has a pre-existing 45-bed dementia unit for residents with severe behaviours – but not necessarily eligible for SDCP – plus 30 beds dedicated to older people with severe behaviours linked to mental health.

SDCP offers transitional care and the goal is to return residents to their previous residential care home, or a new less intensive setting. With a maximum stay of 12 months, Ms Nolan said they talk about discharge planning very early on.

“Getting an aged care bed in a regional area is extremely difficult. We want the resident to go back to a care setting where they’re supported by their loved ones. Nobody wants to stay an hour or two away from where they live or where people who support them are,” she said.

“The goal is we get this message right and have people referred appropriately and early enough to an SDCP so they do not have to go to the emergency department because that is the worst place for dementia. That is how we can help the community.”

With a multidisciplinary team dedicated to the SDCP, residents receive consistent and familiar care throughout their stay. Staff also work closely with residents to encourage the use of dementia-friendly domesticated settings like the homestyle kitchen, a feature that Ms Nolan said is a first for public health providers. 

Importantly, a dedicated team has translated into a successful track record for Ms Nolan. Just like other SDCPs, an extensive handover process supports the facility when a resident returns to them. There is even a four-week safety net period during which a resident can return to the SDCP if their behaviours escalate again, rather than going to the hospital.

But as Ms Nolan told hello leaders, that has never happened during her four years of experience across two facilities. 

Although Blakiston Lodge’s SDCP is in its infancy and the first admissions have just arrived, Ms Nolan expressed her pride over the Barwon Health team, praising their approach to dementia care and the residents. 

“It’s a feel-good moment for the staff [when a resident leaves]. I think the sooner we get one in every public health network around Australia the better it will be for healthcare in general,” Ms Nolan added.

Two SDCPs are expected to open in 2024 with Hall & Prior in Perth and Anglicare Southern Queensland in Brisbane helping the Government edge towards its own goal of 35 SDCP units.