Due to a significant increase in access to community-based care, older Australians are unlikely to transition into residential aged care until they begin to experience more complex health issues and higher levels of care requirements.

As a result, residents within these facilities would benefit from regular participation in a range allied health treatments, yet access to such is extremely difficult.

“Allied health professionals are important providers of care for older people, regardless of whether the person is living at home or in a residential aged care facility,” says Allied Health Professionals Australia CEO Claire Hewat.

“However, access to allied health services in residential aged care is typically far more limited than it may be in the community.

“Aged care facilities typically have few or no allied health professionals employed.

“Older people living in the community are able to access Medicare-funded allied health services including both chronic disease and mental health services. However, these are not able to be accessed by residents of aged care facilities.

“Instead funding is based on the Aged Care Funding Instrument which a number of reviews have shown is not providing sufficient access to allied health services or supporting overall wellness and reablement.”

Ms Hewat says allied health interventions share a focus on restorative care and reablement that seeks to keep older people as independent and well as possible.

“By accessing appropriate allied health services, older people are likely to be less prone to falls, have better mental health, be more able to manage day-to-day tasks such as cooking and washing, and be more likely to manage and overcome functional issues that may arise from illness or the ageing process.

“Many older people experience depression, particularly those living in residential aged care who may be there due to increased frailty and need for care, diminished mental capacity due to dementia, may have lost a partner, and whose move to residential care means they are no longer connected to their community.

“The psychological services provided by psychologists, mental health occupational therapists, mental health social workers and music therapists can help people deal with what they are experiencing and improve their mental wellbeing.”

Multidisciplinary teams including physiotherapists, exercise physiologists and occupational therapists can assist with physical functionality, while dietitians and speech pathologists would provide essential support to reduce rates of malnutrition, which is more common in the elderly.

“Older people are very likely to experience foot issues that can significantly impact their mobility and overall health. Podiatrists provide essential foot care and may also be supported by an orthotist where an older person may need specific aids to help them maintain mobility.

“Appropriate allied health interventions can not only provide significant benefits for aged care residents but have been shown to reduce hospitalisations which benefits the older person and the broader health system.”

University of Melbourne Professor and Head of Music Therapy, Felicity Baker says allied health services such as music therapy are especially important to more vulnerable people in residential care, such as those with dementia, because they are often no longer able to actively participate in other activities.

“Hearing is the last sense to go so even when someone’s eyes are closed, they can still hear music and therefore still experience the stimulation of memories. It is also calming for them.

“We would like a music therapist to be available to support all of these vulnerable people living with dementia.

“We are undertaking a large study to demonstrate the effects and cost effectiveness of music therapy with the long term aim of securing ongoing funding for music therapy as part of standard care.

“Music is safe, familiar and can help to restore a sense of familiarity through evoking memories. Also, people tend to be more talkative and socially engaged after sharing music with others.”

Ms Baker says she believes a lack of knowledge and a true understanding of allied health services and their specific benefits is a further barrier to effective access to treatment.

“(For example), music therapy is currently confused with the musical memories program which uses ipods, often unmonitored with people with dementia.

“We believe that this may be okay for some people living with dementia, but for those who are more progressed, they are in need of the human contact and connection that is a key component of music therapy.

“The music is shared between a music therapist, others (if in a group) and the person with dementia.

“This distinction is not yet understood by all aged care home management, except where the management have seen music therapy in action.”

Mr Hewat says while it is likely that many residential aged care services would like to provide greater access to allied health services, the major barrier is the ability to fund those services.

“AHPA strongly believes that any reforms must happen urgently and must specifically focus on the health and wellbeing of the older person with an emphasis on maintaining and improving functionality and independence. “

This cannot be achieved without funding appropriate, high-quality allied health services as well as a well-trained and appropriately resourced aged care workforce that can support that work.”