Last year, the Aged Care Royal Commission revealed many older people were not receiving Comprehensive Geriatric Assessments (CGAs) because the Medical Benefits Schedule (MBS) items for conducting assessments were only directed towards geriatricians, not other specialists – now, evidence to support the item numbers being changed to be ‘fit for purpose’.

A team of Australian researchers has found that the use of CGAs can cut an older person’s risk of death – but often come too late to prevent them moving into residential care.

The study, which looked at 75,000 older Australians on the Registry of Senior Australians (ROSA) being assessed for Home Care Packages (HCPs) between 2011 and 2015, found just a quarter (28.2%) had undergone a CGA.

Another third (36.7%) had a management plan, while one third (33.0%) had received coordination of team care arrangements.

Only 5.4% had received a medication review.

She attributes the 5% drop in mortality to the CGA identifying issues and addressing them, and says anyone at risk of frailty should be having an assessment.

However, the uptake in Australia is low compared to the UK where health assessments are actually recommended for anyone who is deemed frail.

“The first step is to increase awareness that it is beneficial,” she explained. “Then from a health professional and consumer point of view, they are more likely to have it. Sometimes, the assessments are offered to the consumer and they say ‘why do I need it?’”

However, Professor Visvanathan adds that these assessments need to be conducted much earlier in the game, citing the 5% increase in people who underwent CGAs entering residential care.

“Generally, they are being done at a time of crisis rather than being done routinely,” she said.

“The GP is usually trying hard with the family to keep the person at home, but that doesn’t prevent entry into residential care. It does need to be done more proactively.”