More older adults are presenting to Australian hospitals with injury – most commonly from falls – yet our healthcare system has poorly defined, person-centred pathways to support them through the duration of their recovery.
Researchers from Flinders University’s Caring Futures Institute have taken steps to remedy this situation with a set of recommendations, highlighting the preferences of older people.
Jill Williams, a Senior Lecturer in the College of Nursing and Health Sciences and a Flinders PhD candidate (under the supervision of Professor Kate Laver and Professor Gill Harvey), was lead author of research to understand the needs and preferences of older people and their families using health systems after suffering traumatic injuries.
“Older adults make up a large proportion of injury presentations and the consequences of injury are often more significant as we age, with significant impacts on people’s independence, confidence and quality of life,” says Ms Williams.
“We needed to speak with them to help define the key components of a preferred care model offered by health services for older populations.”
The research found that while hospital care is strong, there are gaps in communication, support during transitions (especially when people are discharged from hospital) and access to holistic, geriatric-informed care across the continuation of their recovery process.
“This work is important because recovery doesn’t end at discharge from hospital, and we found that this phase, in particular, isn’t well supported,” says Ms Williams. “People can experience a decline in function, confidence and independence – and much of this is avoidable.”
The emergence of these issues for older people during recovery has flow-on effects for families, who often take on increased support roles. It also places increased pressure on the health system through ongoing demand and potentially, avoidable readmissions.
“Importantly, our research shows that recovery involves much more than physical healing, it includes cognitive recovery and emotional wellbeing, as well as social participation and identity re-establishment. Without understanding people’s lived experiences, we risk designing systems around the existing services rather than around what people actually need and value.
“This research ensures that recovery care is grounded in these people’s real-world experiences and priorities.”
The research has identified gaps in healthcare pathways and systems and makes recommendations to inform improvements. This includes designing clear, coordinated healthcare pathways that flexibly support what care should look like across the entire recovery journey.
It also supports stronger interprofessional care by highlighting how to work collaboratively and focuses on improving transition care from hospital to home, which reduces distress and the experience of fragmented care during early recovery.
To improve the care of injured older adults, participants in the study recommended care coordination from hospital to home, improved access to rehabilitation and support following discharge, investment in staff expertise and training in geriatric care, and a specialised care pathway for injured older adults.
A key component is informing workforce development, particularly by building geriatric capability across all settings, from acute care through to community services.
“Overall, this work is about building both the pathways, or ecosystem, and the workforce needed to deliver high-quality recovery care,” says Ms Williams.
“This research supports my passion as a clinician and educator to support the collaborative care of all people, but particularly older populations, and it grows my expertise in research, implementation and service evaluation.”
This work has immediate relevance within South Australia, particularly within the Southern Adelaide Local Health Network, but Ms Williams also believes it has universal benefits.
“It actually has global relevance, as many health systems are adapting to rising injury presentations in older people, and alongside healthy ageing and preventative measures, there is a need for better recovery care,” she says.
“This study underscores the importance of a comprehensive and person-centered approach to care for older people following injury, offering valuable insights for healthcare providers and policymakers to enhance the quality of care and improve outcomes for this population.”
The research team is also looking at international guidance on the care of injured older adults from across trauma, orthogeriatrics and other clinical services – along with a completed pilot program of a patient navigator service, which further builds knowledge in this area.
The research – “Exploring the needs and preferences of older trauma patients: a qualitative study”, by Jill Williams, Cath Connolly, Madison Chapman, Martie Botha, Javaria Murad, Dieter Linde, Cindy Harrington, Maria Crotty and Kate Laver – has been published in BMC Geriatr. DOI: 10.1186/s12877-025-06801-z.