ORCID Profile
0000-0001-7540-4032
Current Organisation
Liverpool Hospital
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Publisher: Hindawi Limited
Date: 06-2017
DOI: 10.1111/HSC.12456
Abstract: The prevalence of dementia will continue to increase with the ageing of the population. Many people living with dementia will reach a stage where surrogate decision-makers-mostly family carers-will need to make a range of decisions on their behalf. The aim of this study was to learn from surrogate decision-makers how they can be most effectively supported in this role. The study employed a qualitative design using semi-structured face-to-face or telephone interviews with a purposive s le of 34 surrogate decision-makers of people living with dementia. Transcripts of participant interviews were reviewed using a thematic approach to analysis. Four main themes were identified from this analysis: needing greater community awareness of dementia and its impact intervening early in cognitive decline relying on health professionals for ongoing support and seeking and using support from wherever is relevant for each person. Based on this analysis and a review of the literature, we propose a wholistic set of recommendations for the support of surrogate decision-makers. Healthcare professionals need to help family carers understand the likely trajectory of dementia, including the significance of surrogate decision-making. They can support the person living with dementia and their surrogates to undertake advance care planning and they can act as empathic guides during this process. Health and community care organisations need to provide a "key worker" model wherever possible so that the person living with dementia and their surrogate decision-maker do not have to seek support from multiple staff members or organisations. Carer support programmes can routinely include information and resources about surrogate decision-making. Community and government organisations can help people prepare for the possibility of becoming surrogate decision-makers by promoting a greater public awareness and understanding of both dementia and advance care planning.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2011
DOI: 10.1007/S10823-011-9155-9
Abstract: Dementia is a chronic illness involving increasing levels of care, often provided by family members, particularly in culturally and linguistically erse (CALD) communities. Multicultural community link workers are often the primary service providers assisting families to access health and welfare services and as such have extensive experience of, and possess in-depth knowledge about, CALD family care-giving for dementia. While research has been undertaken on dementia in CALD communities, this research has not focused on the experiences and perceptions of these multicultural workers with regards to CALD family care-giving. In response to this gap in the research, this paper presents the results of an empirical investigation of multicultural workers' perspectives with regard to the cultural traditions informing CALD family care-giving, CALD families' understandings of the term 'carer' and family arrangements regarding care. Due to their close relationship and knowledge of families, multicultural workers can offer an important perspective that is invaluable in informing the provision of carer education and support within CALD communities.
Publisher: SLACK, Inc.
Date: 08-2000
DOI: 10.3928/0098-9134-20000801-09
Abstract: Nurses need training to recognize early signs of dysphagia so they may manage older adults with difficulty in swallowing before it leads to other health problems.
Publisher: Informa UK Limited
Date: 14-08-2008
DOI: 10.1080/01634370802039460
Abstract: Telephone-mediated group programs are an important but under-utilized medium for reaching frail or disabled older persons' family carers who are in need of support. The primary purpose and style of group programs can range across a broad spectrum&ndash encompassing educational, supportive and therapeutic types. Gerontological social workers are the members of the multidisciplinary care team whose training, experience and supervision makes them most suitable for facilitating this broad range of group types. Drawing on the experience of training a number of group facilitators, this article provides suggestions for social workers contemplating the use of telephone-mediated groups and highlights groupwork skills peculiar to conducting group programs via the telephone.
Publisher: Springer Science and Business Media LLC
Date: 06-1998
DOI: 10.1007/PL00009569
Abstract: Excretory-secretory products (ESP) of T. vaginalis have been shown to inhibit sperm motility, viability, and functional integrity, leading to a decreased fertilization rate in vitro. This study investigated whether T. vaginalis induce apoptosis and ultrastructural changes of sperm using flow cytometry and electron microscopy. Incubation of sperm with T. vaginalis ESP increased phosphatidylserine externalization and DNA fragmentation, and decreased mitochondrial membrane potential. Transmission electron microscopy of sperm incubated with ESP revealed abnormal features such as distorted heads, broken necks, and acrosomes exocytosis. This is the first report that demonstrates a direct impact of T. vaginalis ESP on sperm apoptosis and architecture in vitro.
Publisher: Wiley
Date: 04-05-2011
DOI: 10.1111/J.1365-2702.2010.03635.X
Abstract: Aims and objectives. To explore current practice and opportunities to improve practice in decision‐making about transfer of nursing home residents to hospital. Background. Nursing home staff are often faced with the decision of whether to send a resident to hospital for medical treatment. While many residents will benefit from going to hospital, there are also several risks associated with this. This study sought to add to the existing body of research on this issue by seeking the views of nursing home managers, who are the persons most frequently involved in making these decisions. Design. Qualitative design using purposive, quota s ling. Method. Qualitative interviews with 41 nursing home managers from south‐western Sydney, Australia. Results. Factors affecting the decision to transfer a resident to hospital include acuteness of their condition level and style of medical care available role of family members numbers, qualifications and skills mix of staff and concern about criticism for not transferring to hospital. Two factors that have not featured as strongly in previous research are the roles of advance care planning and support from local hospital and community health services. Conclusion. While transferring a nursing home resident to hospital is often necessary, there are many situations where they could be cared for in the nursing home therefore, avoid complications associated with being in hospital. Apart from a range of factors already identified in the literature, this study has highlighted the important role that advance care planning and support from local health services can play in reducing unnecessary transfers to hospital. Relevance to clinical practice. There are several strategies that nursing homes and local health authorities can adopt to promote advance care planning and build better support systems between the two sectors, thereby reducing the numbers of residents who need to be transferred to hospital for their health care.
Publisher: Elsevier BV
Date: 07-2008
DOI: 10.1016/J.IENJ.2008.05.005
Abstract: The numbers of frail older persons using emergency departments are already considerable and will continue to increase over time. There are a number of issues related to the assessment and care of older patients that are significantly different to other patient groups. The traditional emergency department (ED) model focusing on rapid triage, treatment and throughput does not meet the needs of many older patients, who have complex presentations, and require comprehensive assessment and referral. In response to this, there are already a number of appropriate and innovative approaches to the care of the older patient demonstrated in the literature. Nurses have a crucial role in contributing to these approaches and in raising the profile of quality care of the older person. Some specific areas that ED nurses can focus on include a more comprehensive approach to assessment and discharge planning, improved communication with the patient and their personal carers, attention to basic nursing care, and making the physical environment safer and less stressful for the older patient. While developing collaborations with their aged care nursing colleagues is important, emergency nurses need to view care of the older person as a central part of their own core business.
Publisher: Wiley
Date: 24-11-2009
DOI: 10.1111/J.1741-6612.2009.00383.X
Abstract: To gain an understanding of how advance care planning (ACP) is understood and approached by managers of residential aged care facilities. Qualitative interviews with managers from 41 residential aged care facilities from South Western Sydney, Australia. Content and thematic analysis of interview transcripts. The majority of facilities do not have a systematic approach to ACP, but tend to initiate discussions about end-of-life treatments late in a resident's illness. There are varying degrees to which these discussions are used in ongoing care planning or made explicit if the resident is transferred to hospital. A number of factors are identified that support the implementation of ACP. A continuum model of practice is proposed that describes four broad approaches to practice under the domains of initiation, scope, follow-up and documentation of ACP as well as the organisational leadership adopted around ACP.
Publisher: SAGE Publications
Date: 06-2011
Abstract: Dementia incidence rates are rapidly increasing among culturally and linguistically erse (CALD) Australians, and there is very little local research to inform practice. In response, a qualitative study employing focus group methods was undertaken with carers from 4 CALD communities—Arabic-speaking, Chinese-speaking, Italian-speaking and, Spanish-speaking. The study examined the experiences and perceptions of these family carers with regard to their caregiving for a person living with dementia (PLWD). Analysis revealed that while considerable similarities exist across the experiences and perceptions of carers from all 4 CALD communities, there were nevertheless some important distinctions across the different groups. These study findings have significant implications for those working with CALD communities.
Publisher: SAGE Publications
Date: 19-03-2013
Abstract: Australia, like other ethnically erse societies, needs to provide culturally appropriate health care to all its citizens. One way of facilitating this is to ensure that health services research adequately reflects the circumstances and needs of culturally and linguistically erse (CALD) communities within the population. This article discusses the fieldwork phase of a qualitative research project on dementia caregiving in 4 CALD communities in south west Sydney, Australia. Rather than focusing on the study results—which have been published elsewhere—this article presents and discusses crucial fieldwork issues that arose in the conduct of the project, particularly regarding participant recruitment and facilitation of focus groups. In being transparent about some of the difficulties encountered and how these were managed, we offer suggestions for other researchers wanting to include CALD communities in a meaningful way in their research projects.
Publisher: SAGE Publications
Date: 08-2006
Abstract: A vital aspect of the care of people living with dementia is the provision of respite services, which allow family caregivers a break from the caring role. The flexibility of such services has consistently been identified as a major factor in whether families make use of them. This study of dementia respite services explores the notion of flexibility and then presents a comprehensive checklist that respite service providers can use to assess the flexibility of their service. It then provides brief descriptions of a number of creative respite programs that are ex les of flexible service provision.
Publisher: Springer Science and Business Media LLC
Date: 09-10-2012
Abstract: People with dementia and their family carers need to be able to access formal services in the community to help maintain their wellbeing and independence. While knowing about and navigating one’s way through service systems is difficult for most people, it is particularly difficult for people from culturally and linguistically erse (CALD) communities. This study addresses a lack of literature on the use of formal services for dementia by people from CALD backgrounds by examining the experiences and perceptions of dementia caregiving within four CALD communities – Italian, Chinese, Spanish and Arabic-speaking – in south western Sydney, Australia. The study used a qualitative design and the methods included focus groups with family carers and one-to-one interviews with bilingual/bicultural community workers, bilingual general practitioners and geriatricians. A total of 121 family carers participated in 15 focus groups and interviews were held with 60 health professionals. All fieldwork was audiotaped, transcribed and subjected to thematic analysis. People from CALD communities are often unfamiliar with the concept of formal services and there may be strong cultural norms about maintaining care within the family, rather than relying on external services. CALD communities often have limited knowledge of services. There is a preference for services that will allow families to keep their relative at home, for safety as well as cultural reasons, and they are particularly reluctant to use residential care. While there is a preference for ethno-specific or multicultural services, mainstream services also need to ensure they are more flexible in providing culturally appropriate care. Positive outcomes occur when ethno-specific services work in partnership with mainstream programs. Dementia service providers need to develop a trusting relationship with their local CALD communities and promote their services in a way that is understandable and culturally acceptable to members of these communities. While members of CALD communities may have difficulties accessing formal services, they will use them if they are culturally and linguistically appropriate and can meet their needs. There are a number of ways to improve service provision to CALD communities and the responsibility for this needs to be shared by a range of stakeholders.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2004
DOI: 10.1097/00124645-200403000-00006
Abstract: Nurses in staff development have a strong focus on developing programs that support the needs of in idual learners. They are much less focused on ways that their programs may support ongoing practice change in the workplace. This article outlines a number of characteristics of staff development programs that are trying to incorporate an organizational change perspective. It then illustrates these characteristics with a case study of a specific staff development program.
Publisher: SAGE Publications
Date: 05-2004
DOI: 10.1177/153331750401900312
Abstract: People with dementia living in the community interact with a range of people who provide services to the public. Within these interactions, there may be communication problems associated with symptoms of the person's dementia. Problems include memory loss, difficulty communicating clearly, inability to grasp complex ideas, and problems handling money. This article describes a project that set out to promote training in dementia awareness for public contact staff with the expectation that it would help them better cater to people living with dementia. We worked with a police service, members of a city council, and staff of community pharmacies. This report provides suggestions about appropriate learning outcomes and program content and recommends steps to help others set up similar education programs.
Publisher: Elsevier BV
Date: 03-2009
Publisher: SAGE Publications
Date: 13-09-2013
Abstract: Members of minority populations often have difficulty knowing about and accessing dementia services. One of the strategies used to promote access is the employment of bilingual/bicultural workers (sometimes referred to as multicultural, link or outreach workers). This study involved interviews with 24 bilingual/bicultural workers in south western Sydney, Australia to gain a better understanding of their role within the dementia field. Seven themes emerged: importance of working with family process of building trust when moving between two cultures importance of understanding the culture self-care and culture flexibility of their role linking community members and linking communities to mainstream services. Bilingual/bicultural workers play a significant and complex role in supporting in iduals and families within their community who are affected by dementia. The significance of their role needs to be more clearly acknowledged in the development of policy, further research and service provision within the dementia field.
Publisher: Hindawi Limited
Date: 07-2007
DOI: 10.1111/J.1365-2834.2007.00722.X
Abstract: This paper explores the literature on change management from the discipline of organizational studies to provide insights that nurse managers can use in their professional practice. The paper will benefit nurse managers by extending the nursing discourse on change management to include wider theoretical and academic perspectives. Important aspects of change management explored are the roles of power and political behaviour, how much change can be planned and controlled, how to combine top-down and bottom-up approaches to change, the role of emotions in the change management process, a comparison of prescriptive and analytical approaches to understanding change, and the connection between theory and practice in managing change. While nurses can draw much useful information from within the nursing discipline, they can also benefit by exploring other disciplinary areas. In the case of change management, there are many useful lessons nurses can carry over into their professional practice.
Publisher: SAGE Publications
Date: 10-2013
Abstract: There are limited language- and culture-specific support programs for carers of people with dementia living in Australia. A group intervention for use with Chinese and Spanish speakers in the United States was adapted to the Australian context, and a pilot study was undertaken with these 2 communities. The intervention is based on a cognitive behavioral therapy approach and was delivered by bilingual health professionals. The adapted material comprised 7 sessions, spanning 2 hours in duration. All 22 participants completed the Depression Anxiety and Stress Scale—Short form (DASS-21) pre- and postintervention. A significant decrease in depression, anxiety, and stress was observed among Spanish speakers a significant decrease in depression and anxiety was present among the Chinese speakers. The implications are considered in the context of Australia’s changing aged care service system.
Publisher: SAGE Publications
Date: 19-11-2015
Abstract: Objective: To evaluate the impact of frailty, measured using the Canadian Study of Health and Aging Clinical Frailty Scale, on outcomes of older people hospitalized with acute illness. Method: Consecutive patients were randomly allocated to a model development s le or a model validation s le. Multivariate analyses were used to model in-hospital mortality, new nursing home placement, and length of stay. Variables selected in the development s les were tested in the validation s les. Results: The mean age of all 2,125 patients was 82.9 years. Most (93.6%) were admitted through the emergency department. Frailty predicted in-hospital mortality (odds ratio [OR] = 2.97 [2.11, 4.17]), new nursing home placement (OR = 1.60 [1.14, 2.24]), and length of hospital stay (hazard ratio = 0.87 [0.81, 0.93]). Discussion: Frailty is a strong predictor of adverse outcomes in older people hospitalized with acute illness. An increased awareness of its impact may alert clinicians to screen for frailty.
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/PY11014
Abstract: Providing information about dementia has been shown to produce immense benefits for people living with dementia and their carers. The dementia information needs of culturally and linguistically erse (CALD) families have not been comprehensively investigated. Addressing this research gap, the current study examines the perspectives of a range of stakeholders – CALD family caregivers (Arabic, Chinese, Italian and Spanish speaking), bilingual and bicultural workers, bilingual general practitioners and geriatricians – about dementia-related information. The study focussed on sources of information, issues of access and considerations for improving information provision. The main findings that are relevant for improving policy and practice are: the need for a more strategic and coordinated approach to dissemination structures and processes, a greater emphasis on supporting and enhancing the interpersonal aspects of information provision, the need for a greater range of information for CALD communities and the need to ensure information resources and processes reflect the circumstances and needs of these communities.
Publisher: Informa UK Limited
Date: 11-2018
DOI: 10.2147/CIA.S171508
Publisher: Wiley
Date: 17-04-2008
DOI: 10.1111/J.1741-6612.2008.00282.X
Abstract: To document the views of family caregivers of persons with dementia about quality of life for their relative during the late and terminal stages of the disease, as part of an exploratory study of best quality care and support. Fifteen former caregivers (five wives, five husbands, two sons, three daughters) participated in in-depth semistructured interviews. Participants identified three main sets of indicators of quality of life: the physical body, the physical and social environment and treatment with respect and dignity. The constructs 'quality of life' and 'quality of care' tended to be conflated in the experience of caregivers. An important role for caregivers was to interpret and represent the subjective experience of the person with dementia. Quality of life needs to be understood from multiple perspectives. Caregivers' views are a central part of this understanding and should be used to inform future research and service development.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/486516
Abstract: The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.
Publisher: Informa UK Limited
Date: 08-2003
Abstract: Falls and falls-related injuries are a major problem in residential aged care. While there are many factors contributing to falls in this group, there are also a number of strategies that can help reduce falls and associated injuries. While programs to prevent falls must be multifactorial and multidisciplinary, nurses in residential aged care will play a central role in setting up and coordinating such programs. This paper reviews a broad range of nursing, medical and allied health literature. It then synthesises the research findings to outline a comprehensive series of recommendations that nurses can use to improve clinical practice in this area.
Publisher: Wiley
Date: 03-1996
DOI: 10.1080/09595239600185711
Abstract: This article provides an overview of the literature in the area of research dissemination, and suggests ways of increasing communication between researchers and clinicians. It then describes a dissemination project based at the Centre for Education and Information on Drugs and Alcohol (CEIDA) which was designed to convey the results of a major research project in the alcohol and other drug area to practitioners in New South Wales. The article includes the development, implementation and evaluation of the project. The format employed-an intensive workshop conducted in different locations-was found to be a useful strategy, particularly when used to promote a large research project of clinical significance and when used in conjunction with other dissemination strategies.
No related grants have been discovered for Christopher Shanley.