Use of home care services by older Veterans and dependants in Melbourne, Australia, 2007-2016

Military life may have a lasting effect on Veterans and their dependants, resulting in a different aging experience than among the general population. This study investigated the home care utilization of older community-living individuals supported by the Australian Department of Veterans' Affairs (DVA).

This was a retrospective cohort study covering 10 years of data (Jan. 1, 2007-Dec. 31, 2016) on episodes of care provided by a home care organization. Veterans and dependants were compared with age- and gender-matched non-DVA-supported clients. Descriptive statistics and generalized linear mixed-effects modelling were used to characterize home care requirements.

Of 26,093 episodes, 45.3% involved Veterans (91.7% male) and 54.7% involved dependants (99.6% female). The median hours of care per episode for Veterans and dependants were 60% and 62% more, respectively, than for non-DVA-supported individuals. Veterans and dependants were 3.3 and 3.8 times more likely, respectively, to utilize assistance with personal care. After adjusting for confounding, Veterans and dependants were associated with 16% and 14% more hours of home care per episode, respectively. Cognitive dysfunction and complex care requirements increased the hours of care by, on average, 17% and 52%, respectively. Compared with episodes involving non-DVA-supported clients, episodes with Veterans and dependants were 35% more likely to result in a transfer to hospital.

Veterans and dependants used more home care assistance to live in the community than their non-DVA-supported compatriots. Appropriate and adequate health and welfare services need to be developed for this unique group to support well-being into later life.