Year

1994

Degree Name

Doctor of Public Health

Department

Department of Public Health and Nutrition

Abstract

This study seeks to evaluate the impact of the ACAT program within the Illawarra Area Health Service. The purpose of the study was to describe outcomes from the ACAT activities in 1992 and first six months of 1993, these include consumer satisfaction, range of services offered to the clients and carers' involvement in the consultation and negotiation process.

The main sources of data were ACAT records, team co-ordinator's information and the study instrument. Of 285 carers selected for the study, 149 (52%) carers responded to the mailed questioimaire. Of questionnaires received, 117 (41%) questioimaires were completed, six questioimaires (2%) were partially completed, and 32 (11%) explained that they did not wish to participate. Due to the age of the chents and their frailty, in this investigation there was a large data loss. One hundred and thirty six (48%) carers of the total sample did not respond to questioimaires. In this study total response rate was 41 per cent. ACATs' clients were the study subjects and their carers responded to the study questionnaires. Criteria for selection of study subjects were that they were 65 years or over, had an identified carer and were deemed to be able to participate in the investigation by the local ACAT co-ordinator.

The range of services offered to the clients, carers' involvement in consultation, negotiation with ACAT concerning the elderly friend/relative and carers service satisfaction were the study variables. Most carers were older than 65 years of age and suffered from a number of chronic illnesses. The fact that 33 per cent of carers suffer from stress was one of the findings. Carers reported caring responsibilities negatively affected their health. Dementia was the illness with the highest incidence among the clients.

A number of institutional and Community Services were offered to ACAT clients. Seventy per cent of clients were referred to Community Services. Community Home Nursing was the most frequently used of the different Commimity Care Services (n=52)(46%).

Most carers (57%) were satisfied with services which their elderly relative/friend received. Despite carers' worry about their elderly friend/relative and the fact that caring responsibility had a negative effect on their own health, a large number of the carers were satisfied with the services and happy to continue caring responsibilities. There was no significant difference between level of satisfaction and the effect of caring responsibility on the carer's health.

Need for services beyond those already utilized was not high, but need for Respite Care was frequently mentioned (34%) (n=38). Forty five per cent (n=50) of carers had one contact with ACAT members. Carers were usually not involved in the process of decision making by ACAT about services required, since twenty one per cent (n=28) were consulted by ACAT staff only twice and only twenty six (n=29) per cent were consulted three times and more. Also, eight per cent (n=9) of the carers reported that they had never been contacted by ACAT staff.

Overall Aged Care Assessment Teams successfully offer a range of Community Services to the aged residents of The Illawarra. Carers were mainly weU satisfied with the services received.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.