More care will be offered to the elderly in the community
under proposed changes to Otago District Health Board
services which will begin in September.
At the end of August, the assessment treatment and
rehabilitation day hospital service at Dunedin Hospital,
known as the Gibson Rehabilitation Centre, will stop in its
present form, although the Gibson Day Unit, which offers a
day programme for elderly mental health patients, will
Those attending the rehabilitation centre had been picked up
and dropped off and given a meal on the day they attended, at
a cost of $4 a patient. (Sometimes patients could be on the
bus for two to four hours, a review of services
stated.)Stopping this is expected to save the board about
$100,000, although mental health and community services group
manager Elaine Chisnall said some of that money would be
redirected into providing care in the community.
Last financial year's figures showed the Gibson Day Unit
hospital expenses were below expenditure by $47,000, but the
assessment and rehabilitation centre was $238,376 in the red.
Mrs Chisnall said the proposed changes were not chosen
because they would save money, but because it was considered
the existing services were not fully meeting the needs of the
elderly and that a more community-oriented approach was
Mrs Chisnall said research indicated people benefited from
receiving rehabilitation services in their own environment
rather than travelling to a hospital.
The current service, which had been running on its present
site for at least 10 years, was out of step with modern
practices which were geared to integrating hospital and
Among the issues with the existing service was a high rate of
people not attending because they did not understand why they
should, the cost of providing the service was costing
significantly more than the revenue received, services were
duplicated for some patients, and some rehabilitation lacked
goals for those attending.
Under the proposed arrangement, an inter-professional clinic
would continue to be based at the hospital, offering limited
places for people requiring comprehensive outpatient
assessment on four afternoons a week.
The existing day hospital caters for 75 appointments a week.
There would also be a community-based rehabilitation service
offering services - physiotherapy, speech language therapy,
occupational therapy, for instance - to rehabilitate people
in their homes.
This will involve the staff who work at the clinic still
being run at the hospital.
In addition there will be an early response team, led by an
experienced aged care registered nurse, who will provide a
same day response to those people who are referred by their
doctors as needing assessment and early intervention.
The aim of this is to prevent hospital admissions and provide
the help required so people could remain in their own homes
or a residential aged care home.
It was hoped that eventually a nurse practitioner with a
specialty in aged care could be appointed to lead this
service. This would complement the work of nurse practitioner
specialising in psychiatric care of the elderly, Liz Langer,
who was appointed in 2007, which has been successful in
reducing hospital admissions.
Mrs Chisnall said the changes would involve increased
collaboration with community health care providers.
The review began in May last year and is expected to be
implemented over the next year.
Staff working in the day hospital will be redeployed to work
under the new arrangements.
One of the concerns raised in feedback on the review was a
proposal to discontinue transport to the mental health
patients using the Gibson Day Unit and it was decided that
transport should continue for those who could not access
Meals will also only be provided for the mental health
patients if they are attending a session which occurs over
the usual midday meal time.
Day hospital services for over 65s
•From August 31, the Gibson Rehabilitation Centre at Dunedin
Hospital will close, replaced by:
•A community-based rehabilitation service offering home
•An inter-professional clinic at the hospital on four
afternoons a week. (Transport and meals will not be provided
•An early response team aimed at preventing acute hospital
•The Gibson Day Unit for mental health patients will
•Transport will continue to be provided to this for patients
who cannot access alternatives.
•Meals will also be provided in the Gibson Day Unit if
session runs over a lunchtime.