Critical Interim Support: innovative case management for older people experiencing barriers to accessing aged care services

A serious service gap exists in the aged care sector for older people living in vulnerable situations, who experience deep disadvantage. The Critical Interim Support (CIS) program addressed barriers to accessing aged care services faced by people living at home.

At a glance

CIS used case management approaches to connect people to the aged care services system and community-based services. It maintained interim and vital (or critical) support until the person had established connections with sustainable and ongoing supports.

Dive deeper

The Brotherhood of St. Laurence (BSL) ran the CIS pilot for four years from 1 September 2020, with the support of philanthropic funding. Over the course of the pilot, CIS case managers worked with 379 clients, with an average length of engagement of four months, and 97% of these clients were supported to remain living at home.

Key features of the CIS pilot were the provision of intensive case management services alongside navigation, coordination and advocacy support, no time limits on the length of engagement and access to the pilot based on limited social and financial resources.

The aim of the CIS pilot was to provide much-needed support to older people experiencing social isolation and financial impoverishment, who are often ‘hidden’ from sight and unable to access home-based aged care services. The pilot developed from an observation that older people eligible for home care supports may be stuck on long waiting lists and were vulnerable to further deterioration of their situation.

A combination of barriers to accessing aged care services were observed in the pilot, including individual barriers (such as a lack of awareness of available and eligible services, social disconnection, self-neglect behaviours, complex family situations, elder abuse and experiences of trauma) and systemic barriers (such as long waiting lists for assessments and services, difficulties accessing My Aged Care and out-of-pocket expenses).

Key findings:

• Necessity of critical interim support: Some older individuals require assertive outreach and intensive case management to continue living at home. Without such support, they risk worsening circumstances and increased care needs.

• Cost-effectiveness: Supporting older people to remain at home is more cost-effective to governments than residential care and helps to reduce hospital admission costs (by addressing reasons for frequent hospital presentations and reasons for delayed discharge).

• Importance of case management: While overlapping with services like the federal government’s Care Finder program, the pilot provided complementary and essential case management, which Care Finders currently cannot offer. Although Care Finder provides navigation and connection services for older people to aid access to aged care services, it cannot deliver the case management support that the Critical Interim Support pilot provides.

Policy implications:

The evaluation of the CIS pilot suggests that integrating intensive case management into existing programs such as Care Finder could enhance support for vulnerable older people in Australia. Given the cost savings and improved outcomes associated with intensive case management, expanding such services could be beneficial.