Population Health and Strategic Direction

Download Health and health care of older people in Western Sydney

Health and health care of older people in Western Sydney:
background and discussion document

Increasing life expectancy and the impact of the so-called ‘baby boomer’ generation is producing an increase in the number of older people in our community, in absolute numbers and as a proportion of the total population.

It is likely that for new cohorts of older people years lived both and without severe disability will increase. and substitute morbidity and mortality will be important issues (characterised by multiple comorbidities as death and onset of chronic disease are prevented or delayed but other diseases/disabilities are substituted). We can expect therefore, that the number of people with various chronic and disabling conditions surviving into old, and very old, age will tend to increase.

The key challenge for service providers will be to develop and maintain models of care that balance the needs of acute medical management with those of subacute care and rehabilitation. There will be an increasing number of very elderly people with acute, or acute on chronic conditions in sub-specialty areas with many of the same needs as those currently in Geriatric units.

The key issues for service planning and provision will therefore have more to do with arrangement of services and programs as with increases in the size of the older population. Importantly secondary/tertiary prevention along with delay of onset and management of existing disability will have to assume greater importance in acute care settings.
Predictions of overwhelming demand for health and disability services may therefore be inaccurate. Although many older people will have some degree of disability (often related to chronic illness) and a proportion will be heavy users of health services, most will be well and functioning in the community. Expectations of health programs and services may shift, in parallel with the expansion in the number of people with some manifestation of chronic disability. It is the pattern and severity of chronic illness and disability, however as much as the absolute burden of all grades of disability that will be central to understanding and managing health and health care need and demand in the older population.