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The evidence that preventative home visits delay admission to nursing homes for community dwelling older adults is inconclusive, but there is some evidence to support the use of preventative home visits to delay nursing home admission for older adults who are already dependant in activities of daily living.

Prepared by:

Charmain Jones and Elizabeth Wyatt


May 2012

Review Date:

May 2014

Clinical Question:

Do preventative home visits to community dwelling elderly adults delay admission to nursing homes when compared to their peers who do not receive preventative home visits? 

Clinical Scenario:

The world’s population is aging. The world-wide proportion of aged people is predicted to increase from 6.9% of population in the year 2000, to 19.3% in 2050 (Low, Yap & Brodaty, 2011). In Australia, the remaining life expectancy for a 65 year old has increased from 15.7 years in 1969, to 21.8 years in 2009 (Australian Bureau of Statistics [ABS], 2011). These statistics put into sharp focus questions about the best ways to manage the increasing aged care need (Low et al.,2011).

There has been some shift in emphasis towards community based care, due to both cost and consumer preference (Low et al.,2011). In 2009, the Australian government spent 0.8% GDP on aged care and this is expected to increase to 1.8 of GDP by 2049 (ABS, 2011). The main contributor to this cost was institutional care (ABS, 2011). In addition to the financial cost of nursing home care, there is a price to be paid in terms of quality of life. Nursing home residents report depression relating to lack of freedom and privacy, a sense of social isolation and discontinuity from their previous life which can contribute to declining physical and functional status (Choi et al., 2008).

Given that home visit programs are commonly undertaken by occupational therapists as well as by other allied health professionals, we sought to evaluate evidence for the effectiveness of preventative home visits in supporting older adults to continue living at home. Improving the ability of older adults to live at home is thought to improve quality of life and reduce the financial burden on the health care system by delaying admission into nursing homes.

Clinical Bottom Line:

There is evidence to support the use of preventative home visits as an effective intervention to delay nursing home admissions for community dwelling older adults who are already dependant on assistance with ADLs.

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