Elephant In The Room | Wound Awareness Week 2008

The Aged and Health Care sectors are under increasing pressure to provide the highest levels of care for older people. This pressure is the result of rising public awareness and expectation, government funding models, health care initiatives, demand for places within residential care and low numbers of health care personnel. Coupled with rising costs within the health and aged care sectors, Federal and State governments are trying to find new ways of managing the care and fiscal burden; however, wounds do not seem to represent an area of major concern for any level of government.

The predominant wounds amongst older people are skin tears, pressure ulcers and venous ulcers – the healing and treatment of which can last for many years and cost many thousands of dollars. These wounds cause significant suffering, loss of independence and changes in lifestyle for tens of thousands of Australians – older and younger. Wounds and wound management also represent a significant fiscal burden on the individual and families as treatment for long term and chronic wounds is often not funded under existing health care schemes. A lack of funds and resources within the community and aged care sectors therefore leads to increased illness resulting in unnecessary hospitalisation. In turn hospitalisation adds to the growing pressures on an already overburdened health care sector and a vicious cycle develops. And all of this happens if the person is lucky enough to survive – something which many elderly people do not if they cannot afford the right treatment themselves.

…over 60,000 older Australians in RACF’s alone have a wound

One research report (Sussman, 2003) indicated that 25% of people in Residential Aged Care Facilities (RACF’s) have a wound. Based on 2007 estimates this would equate to over 60,000 older Australians in RACF’s alone who have a wound. Using current population predictions this figure could rise to more than 120,000 in 2041. Further evidence of the effect of the changing age demographic is offered by Professor Nick Santamaria et al, (2005). Santamaria’s 2005 literature review suggests that the prevalence rates for pressure ulceration amongst the population of Australian institutionalized elderly ranges from 0% to 43%. In Santamaria et al’s 2005 ‘PRIME’ study of 1,956 institutionalised elderly people, a pressure ulcer prevalence rate of 26% was discovered. Other published reports correlate with this data. Based on the reported PRIME prevalence, about 20,000 people in the high care nursing home population could have a pressure ulcer at any point in time. When added to the number of people with hard to heal ulcers of the leg, pressure ulcers in the hospitals, people suffering burns, cancers and people with ulcerative disease like Epidermolysis Bullosa that affects younger people in the community, wounds really do represent an enormous health issue.