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Healthy at Home (formerly SAFTE Care) Model of Care

What is Healthy at Home?

The Healthy at Home Model of Care (formerly the SAFTE Care Pilot Program) was developed as a response to the rapid growth in the ageing population.  It aims to provide an effective model of care that provides a better alternative to inpatient care and supports older people in their home environment.  It is an interagency model that provides integrated community care for people aged over 65 years (over 45 years for Aboriginal and Torres Strait Islander people) with emerging acute care needs.

 
Camilla is 82 years old, lives alone and is receiving radiotherapy treatment. She has a history of alcohol and tobacco abuse. Camilla visits her GP daily but forgets what she is there for. She appears agitated, unsteady on her feet and very confused. GP refers Camilla to the Healthy at Home team. Healthy at Home team visit Camilla at home. They confirm dementia and poor health. Camilla's dog, Copper, also appears unwell. Healthy at Home team liaise with GP and cancer clinic. They arrange transport at appointments. They organise RSPCA to assess Copper and provide baths. Camilla and Copper continue to receive support at home.

Healthy at Home offers:

  • a combined assessment by a health clinician and ComPacks Case Manager within 48 hours of referral
  • fast tracking of diagnostics and assessment
  • up to 6 weeks of case management to set up access to long-term, sustainable, patient and carer support.

Entry referral is the key

  • Changes in the older person are often subtle and are often not identified as a sign that the older person is becoming unwell.  Early identification of subtle deterioration allows for early diagnosis and intervention.  A key aspect of Healthy at Home is to intervene prior to the patient being in crisis.

Healthy at Home is designed for people who are:

  • aged 65 years and older (45 years for Aboriginal & Torres Strait Islanders)
  • at significant risk of acute deterioration and likely admission to hospital.

 

Implementing Healthy at Home

Guidelines, Tools and Hints to help implement the Healthy at Home Model.

 

View the Healthy at Home Model of Care PDF PDF File (1.6M)

 

Literature and references that validate Healthy at Home

 

Contact - to find out more about the Healthy at Home Model of Care


Principal Project Officer
Health Services Performance Improvement Branch, NSW Health
Phone: 02 9391 5903

 
 
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