Transitions to residential aged care after hospital for people living with dementia

Effect of conditions reported during hospitalisation and aged care characteristics on average length of stay

This page compares the impact of various factors on the length of hospitalisation for people living with dementia who survived for at least 7-days after their first hospitalisation. Comparisons are made to people without dementia to determine whether these impacts are typical of all adults aged 65 or older or unique among people living with dementia.

Linear regression models were used to determine the adjusted effect of each factor of interest on average length of stay for people living with dementia and people without dementia. An example of what the “adjusted effect” means is provided below and detailed methods are available in Technical notes.

The models were conducted separately for community-dwellers, aged care residents and people who transitioned to aged care. All models included:

• Dementia
• Age
• Sex
• Delirium
• In-hospital falls
• Pressure injuries
• Pneumonia
• Urinary tract infections

For people who transitioned to residential aged care, the model also included:

• Eligible and awaiting entry to residential aged care
• Use of respite residential aged care after discharge

For aged care residents, the model also included:

• Whether the person moved to a different aged care facility after discharge

Impact of living with dementia

The impact of living with dementia on length of stay varied depending on people’s change in usual residence after hospitalisation, age group, and for aged care residents whether they had a potentially preventable condition. 
 Compared with people without dementia, the average length of stay for people living with dementia was:

• 3 to 6-days longer for community-dwellers at different age groups
• 1 to 6-days shorter for people at different age groups who transitioned to residential aged care
• Similar for people who were aged care residents who did not have a potentially preventable condition and 2–6 days shorter for people who did have a potentially preventable condition.

Impact of age and sex

For community-dwellers and aged care residents age and sex had very little impact on length of stay, and average length of stay was similar for men and women and for people aged 65–74, 74–84 and 85 or older.

For people who transitioned to residential aged care, average length of stay was 2-days shorter for women than men and older adults had shorter lengths of stay than younger adults.

Impact of potentially preventable conditions

People living with dementia and people without dementia who experienced a potentially preventable complication during their hospitalisation had longer lengths of stay than people who did not.

For people who transitioned to live in residential aged care, experiencing a potentially preventable complication had a similar impact on length of stay for people living with dementia and people without dementia. The impact on length of stay ranged from:

• 13-days longer in hospital for people who developed delirium to
• 25-days longer in hospital for people who developed a pressure injury.

For community-dwellers the impact of pneumonia on length of stay was different for people living with dementia (26-days longer in hospital) and people without dementia (22-days longer in hospital). All other potentially preventable complications had a similar impact on length of stay for community-dwellers living with dementia and community-dwellers without dementia. The impact on length of stay ranged from:

• 17-days longer in hospital for people who developed delirium, to
• 31-days longer in hospital for people who developed a pressure injury

For aged care residents, the impact of experiencing an in-hospital fall was the same for people living with dementia and people without dementia, who spent 18-days longer in hospital. For all other complications, people living with dementia had smaller increases in length of stay than people without dementia. The impact on length of stay was:

• 6-days longer in hospital for people living with dementia and 8-days longer for people without dementia who developed delirium
• 8-days longer for aged care residents living with dementia and 11-days longer for aged care residents without dementia who contracted pneumonia
• 11-days longer for aged care residents living with dementia and 14-days longer for aged care residents without dementia who developed a urinary tract infection
• 8-days longer for aged care residents living with dementia and 15-days longer for aged care residents without dementia who developed a pressure injury

Impact of being eligible and awaiting entry to residential aged care or using respite residential aged care

For people living with dementia or without dementia who transitioned to living in residential aged care:

• People who were reported to be eligible and awaiting entry to residential aged care spent 13-days on average longer in hospital.
• People who entered a residential aged care facility as a respite user (rather than as a permanent resident) spent 11-days on average shorter in hospital.

Impact of moving to a new residential aged care facility

For people living with dementia or without dementia who were aged care residents:

• People who moved to a new residential aged care facility after discharge from hospital spent 30-days on average longer in hospital compared with people who returned to their original aged care facility.

Aged care residents who moved to a new residential aged care facility had similar lengths of stay as people who transitioned to living in residential aged care. These results indicate that aged care residents who need to or want to move to a new residential aged care facility after a hospitalisation may face similar barriers to entering a new facility as people who are moving to a residential aged care facility from the community after a hospitalisation.