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June 2016
 

 


Outback medical centres facing a challenge

Outback medical centres facing a challenge

Call for more nurse practioners

Sick and ill-prepared grey nomads an outback headache

By Dennis Amor
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ILL-PREPARED grey nomads heading for Australia's remote regions are causing some outback medical centres to buckle under the pressure.

Some have pleaded with the ageing travellers to pre-plan their adventures and make make sure they have provided for their health needs.

A team of researchers put the problem under the microscope and has now published a report on the dilemma.

One of them, Dr Catherine Hungerford from Charles Sturt University in New South Wales, believes more trained nurse practitioners could help remote medical centres cope.

Holders of a masters degree, these nurses are able to refer patients to other health care professionals, prescribe medications and order diagnostic investigations.

"They actually do very similar things to the general practitioner, but the beauty of it for the government is they're not quite as expensive," Dr Hungerford, head of the university's School of Nursing, Midwifery and Indigenous Health, said.

She said some grey nomads heading into the bush had the wrong idea there would be health services everywhere where they could obtain medicines and treatment.

The academics' research report said there was evidence to suggest older people were taking in excess of 200,000 caravanning trips for six weeks or more each year, with about 70,000 to 80,000 caravans or motorhomes touring the country at any one time.

"In addition to the possible advantages achieved from the purchase of a caravan or motorhome and subsequent travel around Australia, benefits for older people include the purpose or meaning in life created from travelling post-retirement," it said.

While many grey nomads fitted the popular or stereotypical image of "cashed-up" retirees who travel around Australia while they are still healthy enough to enjoy the lifestyle, not all of them contributed to the wealth of the communities they visited.

"For example, some commentators argue that the economic benefits reaped from older tourists visiting small towns and communities may not cover the cost of the services they consume."


'High rates of chronic disease and medication use'


The researchers said many grey nomads had an expectation that the services they needed would be available as required, regardless of location or capacity of the local communities to provide health services.

"This generates a number of challenges for health service providers with the brief to meet the health needs and preferences of all consumers who present to them for help," they said.

"Generally speaking, the health profile of grey nomads is similar to that of the wider population of Australians aged 65 years or older.

"This includes high rates of chronic disease and medication use."

A National Health survey had indicated that almost all Australians aged 65 years and over reported at least one long-term health condition.

More than 80 percent of people in this age group reported three or more long-term conditions, including hypertension, diabetes and cardiac problems.

"While such conditions do not necessarily preclude travel, questions about their management and the appropriateness of services delivered by health professionals in remote destinations should be raised by the older person who is travelling for long periods," the researchers said.

The issues had been highlighted by findings of a case study of the Kimberley region.

"Each year, approximately 265,000 tourists visit this region, thereby increasing the population more than sixfold, with those aged 65 years or more representing approximately 13 percent of all visitors.

"Some 260 travellers, aged 50 years or more and staying in motorhomes or tents at Fitzroy Crossing, were surveyed, with 68 percent identified with chronic diseases, hypertension the most prevalent.

"The majority (61.9 percent) were taking regular medications, of which only half were carrying enough to last them the duration of the trip.

"As few as nine percent had a health summary from their usual general practitioner, and 39.2 percent were not adequately vaccinated according to recommendations made by the Australian National Health and Medical Research Council."

The researchers conducted telephone interviews with 40 doctors in the Kimberley region who provided primary health care to residents and travellers, and 24 nurses who delivered services from remote clinics with no resident medical practitioner.

Nine out of ten indicated it would be helpful if grey nomads carried a health summary that included an active problem list and history of health conditions, current medications and allergies.

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