Background: While the majority of people living with cancer are aged over 70 this is not reflected in service planning, clinical trials, intervention studies or treatment choices. A recent medical record audit at St Vincent’s showed that there were no specific supportive care assessment and limited referral to sub-acute ambulatory care services (SACS) for older people with cancer (OPWC).
Aims: To improve the care for OPWC through:
• an expanded supportive care screening process
• capacity building of SACS staff to increase referrals to community based rehabilitation
Methods/design: The study involved:
1. Development of a geriatric screening assessment (GSA) for eligibility to SACS
2. Assessing and addressing the learning needs of SACS staff in relation to working with OPWC
3. Documenting cancer service staff views about OPWC
Results: The majority of SACS staff (81%) did not feel confident in their knowledge about OPWC before the training program but most (72%) were more confident afterwards. A third of the 491 OPWC screened did not have clear rehabilitation needs and the rest were not referred due to ongoing medical issues or because they did not live in the SACS catchment area. Less than half of the patients were discussed in an MDM but allied health assessments (AHA’s) and referrals increased with the introduction of the GSA.
Conclusions: While this project did not result in referrals of OPWC to SACS the training program for SACS staff was a success and AHA’s were improved to include GSA factors. The complexity of care for OPWC was further highlighted through interviews with staff.
Relevance to the field: This study begins to meet the gap in focus on the needs of OPWC and adds to our knowledge about improved linkages between acute and community based care.