ORCID Profile
0000-0002-4186-314X
Current Organisations
Lund University
,
National Ageing Research Institute
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Aged Health Care | Virtual Reality and Related Simulation | Information Systems | Sociology not elsewhere classified | Public Health and Health Services not elsewhere classified | Public Health and Health Services | Computer-Human Interaction
Health Related to Ageing | Ageing and Older People | Infectious Diseases | Information and Communication Services not elsewhere classified |
Publisher: Cambridge University Press (CUP)
Date: 07-01-2013
DOI: 10.1017/S104161021200227X
Abstract: Background: Elder abuse in care homes is probably common but inherently difficult to detect. We developed the first questionnaire to ask care home workers to report abuse anonymously. Method: We held qualitative focus groups with 36 care workers from four London care homes, asking about abuse they had witnessed or perpetrated. Results: The participants reported that situations with potentially abusive consequences were a common occurrence, but deliberate abuse was rare. Residents waited too long for personal care, or were denied care they needed to ensure they had enough to eat, were moved safely, or were not emotionally neglected. Some care workers acted in potentially abusive ways because they did not know of a better strategy or understand the resident's illness care workers made threats to coerce residents to accept care, or restrained them a resident at high risk of falls was required to walk as care workers thought otherwise he would forget the skill. Most care workers said that they would be willing to report abuse anonymously. Care workers were sent the newly developed Care Home Conflict Scale to comment on but not to complete and to report whether it was acceptable and relevant to them. Several completed it and reported abusive behavior. Conclusion: Lack of resources, especially care worker time and knowledge about managing challenging behavior and dementia were judged to underlie much of the abuse described. We describe the first instrument designed to measure abuse by care home workers anonymously field-testing is the logical next step.
Publisher: Springer Science and Business Media LLC
Date: 12-05-2021
DOI: 10.1186/S12877-021-02233-7
Abstract: This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health. Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112 , registered 06/05/2019 – retrospectively registered.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2019
Publisher: Wiley
Date: 03-04-2017
DOI: 10.1111/AJAG.12405
Abstract: To examine older Australian's perspectives on how their sexual lives can best be supported and/or improved. Fifty-three, semi-structured interviews were conducted with Australian men (n = 30) and women (n = 23) aged 60 and over. Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including normalising the occurrence of sex and sexual desire in later life increasing and improving on the quality of, cultural representations of older adults introducing policy, educational and practice-based changes in age care facilities to support the consensual sexual expression of residents and ensuring that sexual health c aigns and education are inclusive of older people. Our findings present clear implications for further developing sexuality education and public health c aigns, training and education of health-care professionals, and generating social and cultural change pertaining to the acceptability of the ersity of sexual expression in later life.
Publisher: Wiley
Date: 25-04-2019
DOI: 10.1111/APPY.12355
Abstract: As Australia's aging population increases and ersifies, there will be a growing need to address the burden of dementia among culturally and linguistically erse (CALD) communities. Due to a lack of CALD-appropriate services and bilingual health professionals, older people from CALD backgrounds often receive a delayed diagnosis of dementia. The use of telemedicine (TM) to deliver video-interpreting services may overcome the barriers of interpreter availability when diagnosing and assessing dementia in older people from CALD backgrounds. This paper aims to present a review of the literature on the use of TM to deliver video-interpreting during dementia assessments. Factors affecting the reliability and agreement, feasibility, and satisfaction and acceptability when using TM or video-interpreting have been described. The review found evidence that dementia assessments conducted via TM are as reliable as face-to-face (FTF) assessments and that participants are satisfied and find TM acceptable. There was less evidence about the feasibility of TM from the health care perspective, particularly regarding the acceptability and potential financial cost-savings. Only five studies investigated the use of video-interpreting during clinical assessments with CALD patients. Although video-interpreting was found to be satisfactory among CALD patients and clinicians, a common finding was the preference for FTF interpreting. More research is needed to examine the financial feasibility and the health care perspective on the implementation and adoption of TM for dementia assessments. The use of TM to deliver video-interpreting for dementia assessments has never been investigated and represents a significant gap in the literature.
Publisher: Cambridge University Press (CUP)
Date: 29-04-2013
DOI: 10.1017/S1041610213000471
Abstract: Background: Health services are encouraged to adopt a strong person-centered approach to the provision of care and services for older people. The aim of this project was to establish a user-friendly, psychometrically valid, and reliable measure of healthcare staff's practice, attitudes, and beliefs regarding person-centered healthcare. Methods: Item reduction (factor analysis) of a previously developed “benchmarking person-centred care” survey, followed by psychometric evaluations of the internal consistency reliability and construct validity, was conducted. The initial survey was completed by 1,428 healthcare staff from 17 health services across Victoria, Australia. Results: After removing 17 items from the previously developed “benchmarking person-centred care” survey, the revised 31-item survey (Person-Centred Health Care for Older Adults Survey) attained eight factors that explain 62.7% of the total variance with a Cronbach's α coefficient of 0.91, indicating excellent internal consistency. Expert consultation confirmed that the revised survey had content validity. Conclusions: The results indicated that the Person-Centred Health Care for Older Adults Survey is a user-friendly, psychometrically valid, and reliable measure of staff perceptions of person-centered healthcare for use in hospital settings.
Publisher: Wiley
Date: 22-05-2015
DOI: 10.1111/APPY.12191
Abstract: Depression and anxiety are two common mental health problems among older people. There is evidence that using well-validated screening tools can improve detection of depression and anxiety among this group. The review explored the use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) for screening depression and anxiety among older Chinese immigrants, one of the largest and fastest growing groups of older immigrants in Western society. It focused on the GDS and GAI because both are designed specifically for older people. Online literature searches were conducted in MEDLINE, CINAHL, and PsycINFO. A narrative approach was used to review included papers. A total of 21 articles were included. There were limited data on anxiety among older Chinese immigrants, with only one unpublished report identified. There were 13 studies (20 articles) using the GDS with this group. Results of these studies indicated that the GDS is a reliable tool in this population however, there was limited validity data. Two versions of the GDS-15 have been used with older Chinese immigrants, including the standard GDS-15 and Mui's GDS-15. Prevalence of depression ranged between 20% and 30% in most reviewed studies. Results of this review have practical implications for clinicians in their use of these tools with older Chinese immigrants in Western countries, such as the different GDS versions. It also suggests a number of directions for future research, such as the inclusion of clinical s les and consideration of the ersity within this group.
Publisher: Wiley
Date: 12-2012
DOI: 10.1111/AJAG.12001
Publisher: Wiley
Date: 09-07-2008
DOI: 10.1111/J.1440-1584.2008.00982.X
Abstract: To test the feasibility (for a potential randomised controlled trial) of a computer intervention for improving social interaction and promoting the mental health of rural carers. The study combined pre- and post-intervention measures with interviews to determine the feasibility of the intervention and the acceptability of the study design to participants. The intervention consisted of providing 14 rural carers with computers and a 4-week training program on basic computer skills, using email and the Internet. The study was conducted in a rural community setting. The carers were 12 women and two men, aged from 50 to 81 years, with an average of 65.5 years. Measures of social isolation (UCLA Loneliness Scale), depression (Geriatric Depression Scale), carer burden (Zarit Burden Interview) and computer confidence were taken at baseline and at a 3-month follow-up. Interviews were completed at follow-up to discuss outcomes of the study. A focus group discussion was conducted with 11 participants to discuss the study and resolve computer issues. Most carers reported increased confidence in email and Internet use. There was improvement for most participants in depressive symptoms and social isolation, but little change in carer burden. Participants identified many social benefits associated with the computer intervention, such as intergenerational connection, community building, skills and confidence and preparation for the future. The intervention was found to be practical and acceptable for a group of older carers. It was concluded that it would be feasible to conduct a large randomised controlled trial of the intervention.
Publisher: Elsevier BV
Date: 06-2013
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16142
Abstract: People living with dementia (PLWD) fall more frequently, with more adverse consequences, than general community-dwelling older people however, falls prevention evidence for PLWD is limited. Increased success of falls prevention strategies for PLWD may rely on tailored interventions to address dementia-specific risk factors. The Australian person-centred care environment highlights the need to better understand sharing of falls prevention knowledge between clients, carers and health professionals. This study aims to examine knowledge of falls prevention for PLWD among community care health professionals (CCHPs) and explore effectiveness of an action–research approach to enhance falls prevention practice. Consecutive action–research sessions were conducted with four groups of Australian multidisciplinary CCHPs (n=18), including a knowledge survey of CCHPs, followed by implementation of action plans. Thematic analysis of the transcribed discussion was undertaken. Results showed limited knowledge and understanding of evidence-based falls prevention strategies, but small incremental changes made by CCHPs through action research offered insights into enhancing knowledge and awareness. Appropriate professional development for community care health professionals is needed to support falls prevention for PLWD, along with associated organisational changes, to ensure knowledge is adequate.
Publisher: JMIR Publications Inc.
Date: 04-04-2022
Abstract: ndia is undergoing a demographic transition characterized by population aging and is witnessing a high dementia rate. Although nearly 7 million people live with dementia in India, dementia awareness is poor, and current resources addressing dementia care are basic and often incomplete, duplicated, or conflicting. To address this gap, this study aims to use digital media, which has had a massive technological uptake in India, to improve dementia care in India. he objective of this paper is to describe an intervention study design that examines the feasibility and acceptability of Moving Pictures India, a digital media resource to improve dementia care in India. his study employs a mixed methods design and is ided into 4 phases: (1) video interviews with Indian caregivers and health professionals (2) coproduction of resources (3) pilot randomized controlled trial (RCT) and (4) dissemination and analytics. The pilot RCT will follow an experimental parallel group design with 2 arms aiming to assess the impact, feasibility, and acceptability of the developed resources. The primary outcome measures for the pilot RCT will be feasibility and acceptability, while the secondary outcome measures will be caregiver burden, mood, and quality of life. his study received funding from the Alzheimer’s Association in the United States in July 2021. In 2023, we will enroll 60 dementia caregivers (40 caregivers in the intervention arm and 20 in the control) for the pilot RCT. The study has been approved by the National Institute of Mental Health and Neuro Sciences Ethics Committee (26th IEC (BEH.SC.DIV.)/2020-21 dated November 11, 2020) the Health Ministry's Screening Committee, India (proposal ID 2020-10137) the Curtin University Human Research Ethics Committee (approval number HRE2020-0735) and the NARI Research Governance Office (site-specific approval dated March 17, 2021). his protocol is designed to deliver unique, coproduced, and evidence-based media resources to support caregivers of persons with dementia in India and other countries aiming to utilize digital media for dementia care. If the intervention is found feasible and acceptable, postpiloting analytics and qualitative feedback will be used to develop an implementation trial to evaluate the effectiveness of the potential low-risk high-benefit intervention in practice. linical Trials Registry-India CTRI/2021/01/030403 ctri.nic.in/Clinicaltrials maindet2.php?trialid=50794 ERR1-10.2196/38456
Publisher: Wiley
Date: 04-06-2013
DOI: 10.1111/AJAG.12047
Abstract: Urinary incontinence is associated with increased fall risk, and fall prevention programs include recommendations to manage continence as one component of fall reduction. However, the evidence to support this recommendation is unclear. The aim of this study was to identify continence management interventions that are effective in decreasing falls. A systematic review of the literature was conducted. Studies were included if they evaluated the effect of any type of continence management strategy on falls in older adults. The included studies were assessed for quality, and data relating to participants, interventions and outcomes were extracted by two independent reviewers. Four articles met the inclusion criteria. Two studies were randomised controlled trials, one a retrospective cohort study and one an uncontrolled intervention study. Interventions included pharmacological agents, a toileting regime combined with physical activity and an in idualised continence program. Only the study evaluating the combination of physical activity and prompted voiding found an effect on falls. It is surprising that there has been so little research into continence management interventions that include fall outcomes. A toileting regime combined with physical activity may reduce falls in residential care. There is a need for further studies investigating the impact of continence management on falls.
Publisher: Human Kinetics
Date: 06-2023
Abstract: Background : The Exercise interveNtion outdoor proJect in the cOmmunitY (ENJOY) Seniors Exercise Park program uses specialized outdoor equipment and a physical activity program to engage older people in physical activity, with multiple health benefits. We determined the cost-effectiveness of the ENJOY program. Methods : The economic evaluation compared health care utilization costs 6 months prior to and 6 months post ENJOY program participation. Incremental cost-utility analysis for the primary aim (quality of life) and incremental cost-effectiveness analysis for the secondary aim (falls) were used. Analyses took a societal perspective inclusive of Australian government-funded health care and pharmaceuticals in addition to hospitalizations, community-based nursing and allied health, and community services. Productivity costs were also calculated. Results : Fifty participants (average age 72.8 y [SD 7.4] and 78.0% [n = 39/50] women) were included. Participation in the ENJOY program reduced health care costs in the 6 months following the program: preintervention, $9764.49 (SD $26,033.35) postintervention, $5179.30 (SD $3826.64) observed postintervention reduction −$4.585.20 (95% confidence interval, −$12,113.99 to $2943.59 P = .227) without compromising quality of life (mean difference [MD] 0.011 95% confidence interval, −0.034 to 0.056 P = .631) or increasing the likelihood of a fall (−0.5 95% confidence interval, 0.00 to −0.50 P = .160). The ENJOY intervention is likely cost-effective. Conclusions : Planning for shared community spaces should consider the benefits of a Seniors Exercise Park as part of the built environment.
Publisher: Wiley
Date: 15-05-2013
DOI: 10.1111/AJAG.12040
Abstract: The objective of this study was to report older Australians' views about what they want from aged care reforms expressed in submissions to the Productivity Commission's 'Inquiry into Caring for Older Australians' and the 'Conversations on Ageing' (Conversations). Consumer responses to the 'Inquiry into Caring for Older Australians' (n = 59) and findings from the Conversations (n = 31) conducted by the Honourable MarkButler with the Council on the Ageing were summarised. Older people wanted to be included as full citizens in community life with their contributions acknowledged, including as carers. They wanted high quality, accessible and respectful services that supported their independence and over which they had control. They wanted fair and transparent funding arrangements and care that caters for ersity in Australia's older people. They wanted reform to be soon and to have bipartisan support. This paper provides consumer perspectives to inform aged care policy, practice and research in Australia.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH12168
Abstract: Objective. This study sought to explore the impact of care recipient falls on caregivers. Methods. Ninety-six community-dwelling caregiver−care recipient dyads participated in a 12-month prospective study. Falls and other accidents and service use were recorded. Dyads were assessed at baseline and after each fall. Assessment included the Zarit Burden Interview and a post-accident survey developed for the present study. Focus groups were then conducted to further explore the impact of falls on caregivers. Results. Fifty-four care recipients (56%) experienced falls within the 12 months of the study. There was a significant increase in caregiver burden after the first fall (Zarit Burden Interview score increased from 24.2 ± 14.2 to 27.6 ± 14.5, P 0.01). Twenty-four percent of caregivers reported that they had altered their usual routine after the fall, mainly not wanting to leave the care recipient alone. However, there was no increase in the number of services used. Focus group discussions highlighted the need for constant vigilance of the care recipient, a lack of knowledge about support services and concerns related to utilising respite care. Conclusion. Falls among care recipients have a significant impact on carers, including an increased fear of falling, prompting the need for even closer vigilance. What is known about the topic? Falls are a significant problem for older people as one in three older people fall each year and injurious falls are the leading cause of injury-related hospitalisation in older people. In Australia falls cost the economy over $500 million per year. What does this paper add? This paper adds a unique perspective to the falls literature, that of the older person’s carer. Falls are a significant problem for community-dwelling carers of older people, contributing to carer burden and impeding the carer’s ability to undertake activities of daily living because of the perceived need for constant vigilance to prevent the person they care for from falling. What are the implications for practitioners? Practitioners should ensure that carers are aware of evidence-based falls-prevention practices and services, such as group and in idual exercise programs, home modifications and podiatry, that might assist to prevent falls in the person they care for and therefore reduce the burden of care.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.MATURITAS.2015.06.034
Abstract: The adverse mental health effects of caring have been studied, frequently in carers of people with dementia. Less is known about the mental health of carers of people with other conditions. This study compared depression and burden in older carers looking after people with a variety of conditions. Over 200 older carers interested in participating in the Improving Mood through Physical Activity in Carers and Care-recipient Trial were included in this cross-sectional study, using the Geriatric Depression Scale (GDS) and Zarit Burden Inventory (ZBI). Overall there were 43% of carers who were depressed and a quarter of them reported moderate-to-severe burden. Carers of people with physical conditions had the highest levels of depression and burden. Patient diagnosis, hours spent caring, and burden were associated with depression, while hours spent caring and carer depression were associated with burden. These factors contributed approximately 25-30% of the variance of depression and burden, respectively. The diagnosis of the patient was a factor associated with depression, and older carers of people with physical conditions were at the highest risk. It is important for clinicians to assess the mental health of all carers, regardless of the patient diagnosis.
Publisher: Springer International Publishing
Date: 2019
Publisher: Cambridge University Press (CUP)
Date: 21-02-2013
DOI: 10.1017/S1041610213000070
Abstract: Background: Behavioral and psychological symptoms of dementia (BPSD) have been associated with increased carer burden and early institutionalization. BPSD are more responsive to treatment than are cognitive and functional decline. Little is known about how family carers understand and try to reduce these symptoms. This study aimed to explore the strategies used by carers looking after someone with high levels of BPSD. Methods: Twenty-five carers were interviewed using a semi-structured interview with the Neuropsychiatric Inventory (NPI). They were all caring for someone eligible for an Extended Aged Care at Home Dementia Package, which targets people with BPSD. Results: Participants reported high levels of BPSD with a mean score of 8.2 for symptoms (range 2–12, SD = 2.38) and a mean NPI score of 51.4 (range 14–111, SD = 28.74). Distress scores were also high with a mean of 18.5 (range 2–42, SD = 11.33). Carers described on average, fewer than four strategies for managing BPSD. Encouraging activity, utilizing psychotropic medications, identifying triggers, restraining or treating in a paternalistic manner, and meeting physiological needs were the most commonly used strategies. Conclusion: While family carers are often at the forefront of identifying triggers and addressing unmet needs, findings from this study suggest that some carers have a limited repertoire of strategies despite experiencing a large number of symptoms. There is a clear need for ensuring evidence-based programs to educate and support carers in identifying triggers, understanding symptoms and learning to cope with these symptoms.
Publisher: Cambridge University Press (CUP)
Date: 24-03-2011
DOI: 10.1017/S1041610211000494
Abstract: There is a large body of published research relating to depression in residential homes for older people (also called long-term-care homes, and including both nursing homes and hostels) (Ames 1990 1993 Seitz et al ., 2010 Snowdon and Purandare, 2010 Snowdon, 2010). However, despite increased detection and more frequent treatment in recent years, depression remains a significant problem for many older people living in such settings. This guest editorial summarizes current knowledge about prevalence, etiology, detection and screening, treatment and outcomes of depression in residential homes and concludes with a summary of key issues requiring urgent future action.
Publisher: Wiley
Date: 28-08-2019
DOI: 10.1111/AJAG.12718
Abstract: Australia's aged care workforce is facing pressures due to increased demands from an ageing population. This paper reflects upon whether existing workspace environmental design evaluations are supporting the aged care workforce. This brief report was informed by a 2018 Optimising Aged Care Workspace Environment Symposium with three streams: (a) Developing, (b) Implementing and (c) Evaluating Aged Care Workspace Environments. Symposium key messages included the following: 'evidence (lived experiences and feedback) from both older people and the aged care workforce needs to inform both development and implementation of aged care environment design'. The Evaluating Aged Care Workspace Environments stream key messages included the following: 'evaluation approaches are required that are responsive and appropriate to the complex dynamic aged care workspace contexts'. To better inform the design of future aged care settings and support the aged care workforce, principles-focused evaluations of existing aged care settings with input from the aged care workforce are required.
Publisher: Informa UK Limited
Date: 10-08-2017
DOI: 10.1080/13607863.2017.1364347
Abstract: This article examines relationships between experiences of ageism and four specific mental health outcomes among older Australian adults, including whether these relationships vary depending on age, gender, and sexual orientation. A survey was conducted nationwide involving 2137 participants aged 60 years and older. Mental health variables included depressive symptoms, anxious symptoms, general stress, and positive mental health or flourishing. Recent experiences of ageism were found to be strongly related to poorer mental health on all four mental health variables. However, experiences of ageism appeared to have a greater effect on the mental health of those who were younger in age (specifically depression), of men more so than women (specifically depression), and of those who identified as heterosexual as opposed to other sexual orientations (specifically general stress). These findings suggest that experiences of ageism may be an important factor in the health and well-being of older adults, especially for those who are younger, male, and heterosexual, and may need to be taken into account when devising strategies for supporting healthier and happier ageing.
Publisher: Wiley
Date: 24-01-2013
DOI: 10.1111/J.1741-6612.2012.00643.X
Abstract: This study aimed to compare perceptions about elder abuse among health professionals and students in the same health disciplines. The Caregiving Scenario Questionnaire (CSQ) was disseminated to Australian health professionals from two metropolitan health services and to university health care students. One hundred and twenty health professionals and 127 students returned surveys. Significantly more students than health professionals identified locking someone in the house alone all day and restraining someone in a chair as abusive. There is a need for further definition clarification and education about detection and management of elder abuse for health students and professionals in Australia. Student education should include consideration of the real-life situations likely to be encountered in practice. Education for both students and health professionals should include strategies for carers to manage difficult situations such as the one described in the CSQ.
Publisher: Hindawi Limited
Date: 06-02-2022
DOI: 10.1111/HSC.13737
Publisher: Springer Science and Business Media LLC
Date: 18-07-2019
Publisher: Cambridge University Press (CUP)
Date: 08-11-2017
DOI: 10.1017/S1041610217002332
Abstract: Older Chinese people are one of the largest and fastest growing immigrant groups in Western countries. The Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) are screening tools that have been specifically designed for older people. This study explored their validity, concurrent reliability, and cultural appropriateness for detecting depression and anxiety symptoms among older Chinese immigrants living in Melbourne, Australia. A total of 87 Chinese people were recruited from Chinese senior groups. Five screening tools were used, including the GDS, the GAI, the Hospital Anxiety and Depression Scale (HADS), the Kessler 10 (K10), and the Patient Health Questionnaire (PHQ-9). Data were collected through standardized interviews. The GDS and the GAI were found to be reliable and valid tools for detecting depression and anxiety in this s le. Based on the results of the five screening tools, approximately 20% of participants exhibited clinically significant symptoms of depression and 8% of anxiety. Unexpectedly, there was a higher rate of depression and anxiety symptoms among Mandarin speaking people compared with Cantonese speaking people. This study adds to the evidence that older Chinese immigrants are at greater risk of depression than the general older population. It suggests that primary care and mental health services should be aware of and responsive to the increased risk of depression among this group and that further studies are needed to investigate what is contributing to this increased risk.
Publisher: SAGE Publications
Date: 09-2020
Abstract: Men aged 85 years and over have the highest rate of suicide of any age or gender group in Australia. However, little is known about their trajectory toward suicide. The objective of this study was to understand the role of masculine norms and other life factors in the suicidality of older men. Thirty-three men aged 80 years or more took part in a semistructured focus group or interview, and/or completed a survey. Participants were asked about the issues facing older men, well-being and aging, physical health challenges, social support, mental health and help-seeking, and suicide and suicide prevention. Five themes emerged: “finding out we’re not invincible,” “active and tough,” “strong silent types,” “decision makers,” and “right to die.” Participants spoke about masculine norms that had influenced their lives as providers and decision makers, and now influenced how they coped with aging and their journey toward death. For some participants, suicide was seen to be a rational alternative to dependence in their final years. Suicide prevention should adopt a gendered approach and be cognizant of the influence of gender roles and masculinity in older men’s lives. Further research and prevention efforts should be mindful of the impact of masculine norms of self-reliance and control on an older man’s decision to end his life. Suicide prevention efforts should work to reduce stigma around the challenges of aging, maximize opportunities for control, facilitate social connection, and improve residential aged care.
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/09638280600902760
Abstract: This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH). Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers. The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled in idualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment. Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.
Publisher: Cambridge University Press (CUP)
Date: 30-12-2015
DOI: 10.1017/S1041610214002774
Abstract: One of the most difficult times for family carers is when the person they care for moves into a residential care home. Although they are relieved to some extent of the day-to-day tasks of caring, they lose the company of their loved one, which can be especially difficult for spouse carers. It is not always easy to obtain residential placement near to the carer's home, so carers may have to travel some distance to see the person they care for, which they often do on a daily basis. Furthermore, they lose control of the care provided, including the perceived quality of that care. They may also lose services, such as home care, or benefits, such as carer payments, that they were receiving on behalf of the person they were caring for or due to their caring responsibilities. These issues are often poorly recognized and managed in a service system that focuses more on the instrumental rather than emotional and social aspects of care for older people. It is often thought that residential care placement signifies the end of the caring role. However, qualitative research in this area highlights that family care is not relinquished when the cared for person goes into residential care and this is clearly demonstrated in the review of the qualitative literature by Afram and colleagues in this issue.
Publisher: Cambridge University Press (CUP)
Date: 05-2014
DOI: 10.1017/S1041610214000751
Abstract: The literature available on the format of the feedback session following assessment of memory impairment is minimal. This study explored how this information should be presented from the perspective of patients and their families. Thirty-two semi-structured interviews were conducted with memory clinic patients and their carer at the clinic visit that followed the feedback session, to ask: what they recalled, what they found helpful, and what they thought was the best way to disclose a diagnosis of dementia. A second interview was conducted with 14 patient/carer dyads at their next appointment. Recall of information from the feedback session was variable. Most respondents (76% of patients 66% of carers) thought that a direct approach was best when informing the patient of a dementia diagnosis, and that both written information and compassion demonstrated by the doctor were helpful. Opinions on whether all the information should be given at once or in stages were ided. The current format of the feedback session needs revision to improve recall. Patients and their families want a direct approach to be used by a supportive and professional doctor with an opportunity to ask questions. They want the support of a family member or friend when they are told of their diagnosis and they would like a written summary to refer to afterwards.
Publisher: Duke University Press
Date: 21-04-2021
Abstract: We revisit the discussion on family limitation through stopping and spacing behavior before and during the fertility transition with a s le of 12,800 settler women's birth histories in nineteenth- and twentieth-century South Africa. Using cure models that allow us to separate those who stop childbearing from those who continue, we find no evidence of parity-specific spacing before the transition. We do find evidence of non-parity-based birth postponement before the transition. Increased stopping and parity-independent postponement characterized the beginning of the fertility transition, with increased parity-specific spacing following later in the transition phase.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.ARCHGER.2014.04.001
Abstract: Previous research demonstrates that physical activity has psychological benefits for people of all ages. However, it is unclear whether people caring for a frail or ill relative would derive similar psychological benefits, considering the potentially stressful caregiver role. This article reviews the current literature describing the effect of physical activity interventions on the psychological status of caregivers. A search from January 1975 to December 2012 identified five intervention studies investigating physical activity and psychological status in caregivers. These focused on female Caucasian caregivers who were older than 60 years. The physical activity interventions improved stress, depression and burden in caregivers, but small s le sizes, short-term follow up and varying results limited the generalizability of the findings. There were few trials investigating male caregivers, and most care-recipients were people with dementia. Studies with caregivers of different ages and gender, with a range of physical activity interventions, are needed to clarify whether physical activity has psychological benefits for caregivers.
Publisher: Australian Population Studies
Date: 25-05-2019
DOI: 10.37970/APS.V3I1.44
Abstract: Background Population ageing is projected to reduce labour force growth and aggregate labour force participation, whilst increasing demand for informal carers. Increasing the labour force participation of Australians who face barriers to employment (including carers) is part of the solution to labour market pressures occurring due to demographic change and may improve the financial wellbeing of carers. Aims To examine the availability, usage and barriers to accessing Special Working Arrangements (SWA) to provide care while employed in Australia. Data and methods The 2015 ABS Survey of Disability, Ageing and Carers was used to measure the prevalence of the availability, usage and barriers to SWA to care stratified by carer status and gender. Results About 94% of workers reported access to at least one type of SWA (n=25,094). Of this group, about 22% have used SWA to care in the last 6 months. The proportions using SWA to care were highest among primary carers (64%) followed by other carers (43%) and non-carers (19%). Of those who have used SWA, about 15% wanted to use additional SWA to care in the previous 6 months, but faced barriers in doing so, with higher proportions of primary carers (24.6%) and other carers (21.8%) reporting barriers. The main barriers faced by employed carers included insufficient paid leave and/or work commitments. Conclusions A range of paid and unpaid arrangements are necessary for carers to combine paid work with their caregiving responsibilities. Labour market legislation and workplace policies should be strengthened to reduce barriers to take up of SWA.
Publisher: Cambridge University Press (CUP)
Date: 30-07-2010
DOI: 10.1017/S1041610210001560
Abstract: Background: This paper describes the evaluation of the Memory Lane Café service in Victoria, Australia. The Alzheimer's Australia Vic Memory Lane Café model aims to provide a social and educational service to people living with dementia and their carers, family members or friends. Dementia is a serious health issue in Australia, with prevalence estimated at 6.5% of people over 65 years of age. Living with dementia has significant social and psychological ramifications, often negatively affecting quality of life. Social support groups can improve quality of life for people living with dementia. Methods: The evaluation included focus groups and surveys of people with dementia and their carers, staff consultation, service provider interviews, and researcher observation. The Melbourne Health Mental Health Human Research Ethics Committee approved the project. Participants included people with dementia (aged 60 to 93 years, previously enrolled in the Alzheimer's Australia Vic's six-week Living With Memory Loss Program), their carers, friends and/or family members, staff working in the Cafés, and service providers with links to the Cafés. Results: This evaluation found that Memory Lane Cafés promote social inclusion, prevent isolation, and improve the social and emotional well-being of attendees. However, Cafés did not meet the needs of all potential attendees. Conclusions: The evaluation recommended that existing Café services be continued and possibilities for extending the Cafés be explored. Based on evaluation outcomes, the Department of Health Victoria is funding four additional pilot programs in café style support services.
Publisher: Wiley
Date: 07-2019
Publisher: Cambridge University Press (CUP)
Date: 26-01-2017
DOI: 10.1017/S1041610216002301
Abstract: Older informal caregivers aged 65+ years account for 34% of all carers in the USA (Family Caregivers Alliance, 2016), 22% in England and Wales (Carers UK, 2015), and 24% in Australia (Deloitte Access Economics, 2015). For many older carers, this means looking after their spouse or intimate partner who in many cases has dementia (Donnellan et al ., 2015). As the incidence of dementia increases, the need to understand the impact of caring on these intimate relationships becomes more vital, so the experiences of spousal caregivers can be anticipated, validated, and supported. It is also important to understand the gender differences in these care relationships, so that education and services can be tailored to meet the different needs of men and women caregivers. Sexual activity in later life is associated with both mental and physical health (Ganong and Larson, 2011 Anderson, 2013), and is therefore, important to maintain, perhaps even in the context of caring for someone with dementia.
Publisher: Human Kinetics
Date: 2023
Publisher: Cambridge University Press (CUP)
Date: 16-06-2010
DOI: 10.1017/S1041610210000992
Abstract: In 1945 Vannevar Bush made a report to the President of the U.S.A. in which he argued for the value of basic and public welfare research in the post-war era (Bush, 1945). Since then, the research industry has burgeoned, albeit with constant appeals for greater funding. Alongside this growth in research, the consumer movement has also grown. Since the 1970s, for ex le, the “consumer/survivor” movement in the U.S.A. has been calling for greater roles for people with mental health disorders in the running of their mental health services. This movement was one result of a societal change towards empowerment of people in what some considered to be an authoritarian, hierarchical system of health care provision. In the late twentieth and early twenty-first century, the two movements have started to collide, as consumer groups request more transparency and a bigger role in research funding allocation, and researchers ponder the merits of consumer involvement in their highly technical fields of expertise.
Publisher: Informa UK Limited
Date: 09-2003
Publisher: OMICS Publishing Group
Date: 2014
Publisher: Oxford University Press (OUP)
Date: 11-11-2013
Abstract: Falls prevention evidence is strong, but little is known about uptake of strategies for people living with dementia (PLWD). This mixed-method systematic review aimed to integrate evidence of falls prevention efficacy with views/experiences of PLWD. Eight electronic databases were searched. Inclusion criteria included quantitative or qualitative studies examining knowledge translation of falls prevention strategies in community-dwelling PLWD and/or their caregiver. Study quality was assessed, and findings are narratively described. Six quantitative and five qualitative studies were included. Study quality was mixed. Quantitative studies showed limited evidence of effectiveness on reduction in falls risk, falls and hospitalization rates, nursing home admission, decline in activities of daily living, and adherence to strategies. Qualitative themes showed inclusion of caregiver and health professionals as key to program success, but many factors influence participation. Synthesizing the findings generated a new understanding of falls prevention for this high-risk group. A focus upon health professional and caregiver involvement and accommodation of in idual preferences may result in increased engagement with falls prevention strategies.
Publisher: CSIRO Publishing
Date: 17-05-2021
DOI: 10.1071/PY20161
Abstract: Primary carers play an important role in supporting the Australian Government’s policy of ‘ageing in place’ or encouraging people to receive care in their own homes or communities rather than in institutions. Supporting carers in their role is therefore an important aspect of the policy’s success. Despite numerous programs in place, this study finds that among carers of older Australians, a relatively high proportion (39%) cite unmet needs in their carer role, including a need for financial support, physical assistance, emotional support, improvement in carer health and more respite care. Concerningly, unmet support needs were shown to be strongly associated with markers of poor carer well-being, including an almost 2-fold increase in odds of poor carer satisfaction (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.24–2.51), a 4- to 5-fold increase in the odds of changes to physical and emotional well-being (OR 5.29, 95% CI 3.83–7.31), deterioration in financial situation (OR 4.60, 95% CI 3.26–6.48) and strained carer–recipient relationship (OR 3.79, 95% CI 2.39–6.01).
Publisher: Cambridge University Press (CUP)
Date: 16-01-2017
DOI: 10.1017/S1041610216002386
Abstract: Interventions to support and skill paid home carers and managers could potentially improve health and well-being of older home care clients. This is the first systematic review of interventions to improve how home carers and home care agencies deliver care to older people, with regard to clients’ health and well-being and paid carers’ well-being, job satisfaction, and retention. We reviewed 10/731 papers found in the electronic search (to January 2016) fitting predetermined criteria, assessed quality using a checklist, and synthesized data using quantitative and qualitative techniques. Ten papers described eight interventions. The six quantitative evaluations used erse outcomes that precluded meta-analysis. In the only quantitative study (a cluster Randomized Controlled Trial), rated higher quality, setting meaningful goals, carer training, and supervision improved client health-related quality of life. The interventions that improved client outcomes comprised training with additional implementation, such as regular supervision and promoted care focused around clients’ needs and goals. In our qualitative synthesis of four studies, intervention elements carers valued were greater flexibility to work to a needs-based rather than a task-based model, learning more about clients, and improved communication with management and other workers. There is a dearth of evidence regarding effective strategies to improve how home care is delivered to older clients, particularly those with dementia. More research in this sector including feasibility testing of the first home care intervention trials to include health and life quality outcomes for clients with more severe dementia is now needed.
Publisher: Cambridge University Press (CUP)
Date: 08-07-2016
DOI: 10.1017/S1041610216001010
Abstract: Few current studies explore psychological well-being among older Chinese immigrants in Australia. The study addressed this gap and provided preliminary data on psychological well-being among this group. Four indicators, namely depression, anxiety, loneliness, and quality of life, were used to present a comprehensive picture of psychological well-being. Participants were two groups of community-dwelling older people, specifically 59 Chinese immigrants and 60 Australian-born people (median age=77 and 73, respectively). Data were collected through standardized interviews. The Geriatric Depression Scale, the Hospital Anxiety and Depression Scale, the de Jong Gierveld Loneliness Scale and the WHO Quality of Life questionnaire were used to measure depression, anxiety, loneliness, and quality of life, respectively. Chinese participants’ median quality of life score was higher than the scale mid-point, indicating relatively high levels of quality of life. However, 10% exhibited symptoms of depression, 6% had symptoms of anxiety, and 49% felt lonely. Compared to Australian participants, Chinese participants reported poorer quality of life and higher levels of loneliness. Importantly, the difference in quality of life remained when the impact of socio-demographic factors was controlled for. This study was the first to use multiple indicators to explore psychological well-being among older Chinese immigrants in Australia. Its results suggest that their psychological well-being might be worse than that of Australian-born people when using loneliness and quality of life as indicators. In particular, loneliness is a common psychological problem among this group, and there is a need for public awareness of this problem.
Publisher: Cambridge University Press (CUP)
Date: 27-11-2017
DOI: 10.1017/S0144686X17001222
Abstract: Experiences of ageism are associated with poorer health outcomes. Sexual activity and interest are areas in life where the impact of ageism may also be evident as popular culture often depicts the older body as asexual, undesirable or sexually impotent. We explore the possible links between experiences of ageism and sexual activity/interest in later life using data from a study of Australians aged 60+. We explored characteristics of those who were more likely to have experienced ageism (measured using the Ageism Survey) and the relationships between experiences of ageism and measures of sexual interest/activity in later life (N = 1,817). Experiences of ageism were greater among those without a partner, unemployed participants, those with lower incomes and poorer self-rated health. Adjusting for these differences, experiences of ageism were more likely to be reported by those who had not had sex in the past two years and were not sure about their hopes lans for sex in the future. Those who reported their sexual interest had increased or decreased since 60 also reported greater levels of ageism experience, as did those who wanted to have sex more frequently in the future. Ageism appears to impact sexual activity and interest in different ways. It is critical that social policy aims to reverse attitudes that reinforce the view of the ageist asexual and unattractive older body or person.
Publisher: Wiley
Date: 10-12-2010
DOI: 10.1111/J.1741-6612.2010.00484.X
Abstract: Older people receiving informal care at home appear at high falls risk. This study investigates frequency, circumstances and factors associated with falls risk for older care recipients, and their informal caregivers. Ninety-six dyads, recruited from caregiver agencies, underwent a home assessment, including falls risk, function, depression, quality of life, self-rated health and carer burden. Care recipients were at high falls risk. In the past 12 months, 58% had fallen and 26% twice or more. Common falls risk factors were polypharmacy, multiple medical conditions and requiring functional assistance. Caregivers exhibited multiple health problems, moderate burden and reduced quality of life. Where care recipients had high falls risk, caregivers had significantly higher carer burden and depression. Low functional level and high care recipient health problems were independently associated with risk of falling (P < 0.05). Strategies to reduce falls risk in this cohort are necessary, together with supporting the needs of the caregiver.
Publisher: Informa UK Limited
Date: 02-02-2018
Publisher: Wiley
Date: 11-03-2016
DOI: 10.1111/AJAG.12306
Abstract: The aim of this study was to improve our understanding of depression and anxiety among older immigrant Chinese Australians. The study was based on the National Ageing Research Institute's Cultural Exchange Model, an iterative process of exchange between researchers and stakeholders. The project involved a range of components including consultations with health professionals and community workers about perceptions of depression and anxiety within the Chinese community. This paper reports on these consultation findings. Thematic analysis generated five main categories to explain participants' perceptions of depression and anxiety within the Chinese community. Themes included: lack of knowledge personal weakness rather than illness stigma somatisation and experience of migration in later life. Responses to questions about education and information dissemination were collated separately and reported. Views of depression and anxiety among older Chinese people suggest that educating the community may be an important way to improve mental health literacy and help-seeking behaviour.
Publisher: Frontiers Media SA
Date: 02-11-2016
Publisher: Springer Science and Business Media LLC
Date: 21-09-2016
Publisher: Oxford University Press (OUP)
Date: 17-02-2015
Abstract: Older Chinese immigrants are one of the largest and fastest growing groups in Western societies. This article used the solidarity-conflict model to synthesize current research examining parent-child relationships in this group. A comprehensive literature search was conducted in the CINAHL, Medline, and PubMed databases to identify relevant articles. A narrative approach was used to review the literature. Thirty-six articles were identified. Compared with Caucasians, older Chinese immigrants are more likely to live with children and have higher filial expectations. However, considerable numbers live independently. Of these, most live in public housing and rely on the community rather than their children for instrumental help. Many older Chinese immigrants have adjusted their filial expectations and valued being independent. They also provide extensive household help to their children. There are indications of intergenerational conflict, probably due to generational differences in attitudes toward life and limited intergenerational contact. This review suggests that although filial piety continues to influence older parent-child relationship in Chinese immigrant families, many changes have occurred. These findings have important implications for service planning and delivery for this cultural group. This review also provides evidence for the utility of the solidarity-conflict model.
Publisher: Oxford University Press (OUP)
Date: 20-12-2020
Abstract: Without an effective screening tool, accompanied by clear guidelines of what to do when elder abuse is suspected, health workers may face challenges when asking questions about elder abuse. This study aimed to find the most effective and acceptable existing elder abuse screening tool and to create guidelines for using the tool. A rapid review of the literature identified existing validated elder abuse screening tools. Then, 5 tools (Vulnerability to Abuse Screening Scale [VASS], Elder Abuse Suspicion Index [EASI], Elder Assessment Instrument [EAI], Caregiver Abuse Screen [CASE], and Brief Abuse Screen for the Elderly [BASE]), selected based on their internal rigor, were presented to health professionals to assess the tools’ relevance to their practice. Three focus groups were held with 23 health professionals in Victoria, Australia, in 2017. Data were thematically analyzed. None of the tools were deemed suitable by participants for use in their practice. Criticisms of the tools included: using outdated terminology, asking binary questions, asking multiple questions at once, failure to consider the older person’s cognitive status, failure to consider how culture mediates elder abuse, and failure to outline a referral pathway to those administering the tool. Participants emphasized that the screening tool must promote trust and rapport between the assessor and the older person to solicit a story on this sensitive subject. A successful elder abuse screening tool must be concise, easy to use, account for the older person’s health and social vulnerabilities, and outline a referral pathway if elder abuse is suspected.
Publisher: Wiley
Date: 30-08-2011
Publisher: Informa UK Limited
Date: 02-03-2018
Publisher: Springer International Publishing
Date: 2023
Publisher: Wiley
Date: 31-05-2021
DOI: 10.1111/JOCN.15842
Abstract: As places of both residence and work, what constitutes “good quality care” in residential aged care requires consideration of staffs’ perspectives. A meta‐synthesis of the qualitative literature was conducted exploring residential aged care staff perspectives on “quality of care.” Six electronic databases were searched for articles that met the screening inclusion criteria. This meta‐synthesis was informed by the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines, and included studies were critically appraised using JBI SUMARI. Two independent reviewers conducted thematic network mapping and analysis of included articles, with oversight from three additional reviewers. Forty‐seven articles were included, with findings summarised into four organising themes and nine basic themes. The four organising themes about quality care from staff perspectives include direct care, professional values and competence, the care environment and organisational/regulatory factors. Staff describe a wide range of factors that they perceived to influence the quality of care. Some may feel motivated to leave employment in aged care, due to organisational pressures that make staff unable to uphold what they perceive as an acceptable standard of care. There is tension between professional values and organisation/regulatory factors—regulation should be enacted at a level that supports good practice and staff's moral integrity. This review found that while person‐centred care is now well established as the benchmark of quality care in residential aged care homes, achieving it in reality remains challenged by limitations on staff members’ time, resources and sometimes their competencies and the regularity of their employment.
Publisher: SAGE Publications
Date: 31-03-2019
Abstract: The importance of family’s involvement in care planning has been stressed to cater in idualized, person-centered care in residential aged care. However, in reality, there are numerous structural obstacles and barriers that limit opportunities for their involvement. The aim of this article is to explore what they are. The findings based on the 12 focus groups, six groups of care professionals and six groups of family/relatives, reveal that the narrow pathway of communication between staff and families, which is hierarchically structured, one-directional, and clinically driven, enables the former to maintain and control professional boundaries between formal and informal care-giving. Such communication style delimits an opportunity for families to engage in quality discussion about care planning for their loved ones with care staff. Communication within residential aged care facilities embodies complex dynamics of care expectations and responsibilities held by care staff and families.
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/AH070193
Abstract: The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and communitybased care. As one ex le, rehabilitation-in-thehome (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client?s own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers? interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care the intimate, arduous and relentless work of caring lack of consultation about discharge lack of recognition and reimbursement and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
Publisher: Informa UK Limited
Date: 07-2020
Publisher: Informa UK Limited
Date: 02-2013
DOI: 10.5172/CONU.2013.43.2.134
Abstract: This paper describes the evaluation of the Transition Care Cognitive Assessment and Management Pilot (TC CAMP) at a residential care facility in Victoria, Australia. Transition care aims to provide a goal-oriented, time-limited service to older people at the conclusion of an episode of hospital care. The TC CAMP was established to specifically meet the needs of people with cognitive impairment. The purpose of this study was to evaluate the implementation and effectiveness of the TC CAMP. The evaluation sought to explore the perceptions of staff and family carers, and outcomes for the person with dementia. Methods consisted of file audits, focus groups and in idual interviews with nursing staff and carers. This evaluation found that it was possible to provide appropriate transition care to people with cognitive impairment who exhibited behavioural and psychological symptoms of dementia. The TC CAMP achieved length of stay and readmission rates that were comparable with transition care for cognitively intact people. The role of the Clinical Nurse Consultant was highly valued by staff and families involved in TC CAMP. The findings from TC CAMP suggest a suitable environment, availability of trained and resourced nursing and clinical staff and clear roles and expectations for all stakeholders should be considered in implementation of this model of care.
Publisher: Human Kinetics
Date: 10-2019
Abstract: Provision of choice and participation in falls prevention strategies is challenging for people with dementia. This study outlines development of a discussion tool to aid engagement of people with dementia and their caregivers in falls prevention strategies. The tool is based on a literature review of falls prevention and dementia care (1990–2016) and decision aid principles and was trialed over 6 months. A total of 25 community-dwelling people with dementia ( M age = 80 years, SD = 7.7, 52% male) and their caregivers ( M age = 73 years, SD = 12.3, 36% male) underwent falls risk assessment and evaluation of their preparedness to change falls risk behaviors. Most commonly rated, and prioritized for intervention, high falls risk factors were impaired balance/mobility (92%), polypharmacy (60%), and incontinence (56%). This discussion tool facilitated collaboration between people with dementia, their caregivers, and health professionals, to increase uptake of acceptable and feasible evidence-based falls prevention strategies.
Publisher: Informa UK Limited
Date: 08-09-2017
Publisher: Wiley
Date: 10-01-2011
DOI: 10.1111/J.1741-6612.2010.00497.X
Abstract: To validate the de Morton Mobility Index (DEMMI) in community-dwelling older adults who require informal care. Thirty-five consecutively recruited older adults (>65 years) living in the community who required informal care were included from Melbourne and regional Victoria, Australia. Participants were assessed using a battery of questionnaires, the Falls Risk for Older People (Community version), modified Barthel Index, Geriatric Depression Scale, the Medical Outcomes Survey Short Form 36, the Assessment of Quality of Life and the DEMMI. The DEMMI consists of 15 mobility items that are administered by therapist observation of physical performance. Each participant was assessed in their home. The DEMMI is without floor or ceiling effects for community-dwelling older adults who require informal care, and evidence of convergent, discriminant and known groups validity was obtained for the DEMMI. DEMMI data fitted the Rasch model and the minimal clinically important difference was 11 points. The DEMMI has suitable clinimetric properties for application in community-dwelling older adults who require informal care.
Publisher: Informa UK Limited
Date: 02-04-2016
Publisher: Informa UK Limited
Date: 20-10-2019
DOI: 10.1080/08946566.2019.1682098
Abstract: In Australia there is an absence of an elder abuse screening instrument that is widely accepted and that has been designed with, and for, end-users. This study aimed to develop an effective and acceptable elder abuse screening instrument by engaging with frontline professionals through a co-design process. To date, co-design methodologies are recommended to ensure successful adoption and implementation of complex interventions by end-users, but the scholarship is limited on the specific steps to achieve this as well as the pragmatics of such work. Addressing this lacunae, results demonstrate how qualitative methods align with a co-design approach underscore the importance of multidisciplinary perspectives showcase how to streamline complex processes into routine practice and accentuate the importance of good design. These are valuable insights necessary to develop inter-professional and community-based solutions to the challenge of elder abuse.
Publisher: SAGE Publications
Date: 10-2010
DOI: 10.2190/HS.40.4.E
Abstract: As older workers move closer to retirement, they are more likely to take on caring roles. This may affect their health, retirement plans, and income security. Retired men and women experience the caring role differently, with men less likely to be adversely affected and more likely to accept services and to derive satisfaction from caring. Carers make an important contribution to the lives of the people they care for and to the community. Caring is a productive role that can be sustained into older age, as long as the carer's health and well-being are maintained. More research is needed on the relationship between retirement and caring, to explore the extent of caring and its impact on retirement plans, income, and the physical and mental health of retired carers. This information could then be built into retirement planning to better prepare older workers for this important role. Caring roles and retirement intersect in several ways. About 6 million Americans, 2.6 million Australians, and 6 million people in the United Kingdom are informal carers. People (especially men) are more likely to take on caring roles as they get older and leave the paid workforce. The need to care for a spouse or older relative can be an unanticipated outcome or a precipitator of retirement. Retirement may coincide with illness or disability of a parent or spouse, or may be forced by the demands of caring. Caring may bring about major changes to retirement plans. The financial impact of having been a carer during one's working life may also be felt most keenly on retirement, through the lack of opportunities for savings and retirement fund co-contributions.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17056
Abstract: The number of older people in the population is increasing faster than for any other age group. This population growth, while positive, is associated with increasing incidence of chronic and progressive diseases such as dementia. This requires older people to navigate services that may not be designed to meet their needs. This issue can be further lified in culturally and linguistically erse populations who often have limited English language proficiency and limited knowledge of diseases such as dementia. Health literacy, a person’s ability to access, understand, appraise and apply information about their health and health care, including navigating health services, is low among older people and even lower among older people born overseas. This paper describes findings from a recent research study which developed and used the Cultural Exchange Model. The model is based on a process of collaboration, whereby researchers, service providers and community members work together to build evidence about a particular topic, in this case dementia. The study demonstrated that the Cultural Exchange Model facilitates opportunities for researchers, health professionals, community workers and carers to improve their knowledge of conditions such as dementia and rapidly translate evidence into practice. It also showed that it is possible to recruit, engage and generate new knowledge within populations that are traditionally excluded from research but have high prevalence of dementia. This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration. What is known about the topic? We know there is limited health literacy among older people and among older people from culturally and linguistically erse (CALD) backgrounds. We also know that the older CALD population is increasing rapidly and with that comes increased chronic illness and chronic diseases, including mental health issues and dementia. What does this paper add? This case study has added to the knowledge base in relation to health literacy and older people from CALD backgrounds. The use of the Cultural Exchange Model is documented in terms of how it enhances our improved understanding of both the barriers and enablers older Chinese and Vietnamese people with dementia face when seeking help. This paper highlights key findings from a study, which could be used by researchers and practitioners when working with older people from CALD backgrounds more broadly. What are the implications for practitioners? This paper highlights findings from research that has reinforced that health literacy is an evolving process. It requires professionals to recognise the gaps in their own understanding of conditions such as dementia and understand how these gaps might influence help-seeking behaviours of older people and their carers. Access to ongoing education of clinical conditions and the service system is required, but also the cultural elements of the communities they are working with should be considered.
Publisher: Informa UK Limited
Date: 13-05-2020
DOI: 10.1080/07481187.2020.1762263
Abstract: This article explores implications of language used in communicating death and dying in residential aged care, which increasingly emphasizes a "family-centered" approach to end-of-life care. Based on focus groups with care professionals and families, our findings reveal a persistent clinical culture that resists frank discussions of dying, with many staff preferring to use euphemisms for dying. Our results emphasize the importance of end-of-life education for families, which families acknowledged was lacking. Cultural change in institutional control over disclosing dying is imperative in order to gain family trust and support in professional care and promote death literacy.
Publisher: Hindawi Limited
Date: 23-10-2020
DOI: 10.1111/HSC.12880
Abstract: Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive s le, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible.
Publisher: Informa UK Limited
Date: 08-10-2010
DOI: 10.3109/09638280903295482
Abstract: To describe and evaluate the effectiveness of an innovative model of rehabilitation designed to meet the needs of a sparsely populated rural area in South Eastern Australia. Five rural health services collaborated to establish a rehabilitation programme. Evaluation included comparing length of stay (LOS) and improvement in the Modified Barthel Index (BI) with the Victorian State average for Level 2 (non-specialist) rehabilitation. Surveys were conducted with staff, clients and carers in the programme. An inpatient rehabilitation programme was successfully established through cooperation between five health services. Clients admitted to the programme improved functionally at least as well as the Victorian State average for similar client groups (BI change 26.5 compared with 22.3 points, p < 0.001), with a shorter LOS (13.8 compared with 22.3 days) but more were discharged to residential aged care (16.1% compared with 6%). The programme was successful in meeting its stated aims. The model described could be adopted in rural areas sharing similar characteristics. Key enablers to the success of the programme included: collaboration between hospitals a skilled and enthusiastic leader recruitment of allied health staff consistent medical leadership access to training and support from a major regional rehabilitation centre and access to funding to enable the programme to establish itself and demonstrate outcomes for clients.
Publisher: Wiley
Date: 11-03-2016
DOI: 10.1111/AJAG.12257
Abstract: To explore which symptoms led people to seek a memory clinic assessment and what they wanted and expected from that assessment. Did the patient and family want and/or expect diagnostic disclosure and, if so, why? Patients scheduled for memory clinic appoint-ments received two questionnaires by post prior to clinic attendance - one for the patient, one for the next-of- kin - regarding symptomatology, wants, expectations and rationale. Ninety-two per cent of patients (n = 47) and 88% (n = 43) of next-of-kin wanted the patient to be informed of the diagnosis 84% (n = 43) of patients and 86% (n = 42) of next-of-kin expected the patient to be informed. Rationales for diagnostic disclosure were categorised under themes of planning, treatment, information, coping strategies and rights. Patients and families want diagnostic disclosure in order to plan, receive treatment, receive help and learn strategies to cope. This knowledge is seen as the patient's right.
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Cambridge University Press (CUP)
Date: 09-01-2015
DOI: 10.1017/S1041610214002671
Abstract: LGBT is an acronym used to describe people from erse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each in idual “group” constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender erse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people.
Publisher: Cambridge University Press
Date: 16-05-2019
Publisher: Wiley
Date: 19-07-2018
DOI: 10.1111/AJAG.12572
Abstract: There are growing concerns that social isolation presents risks to older people's health and well-being. Thus, the objective of the review was to explore how technology is currently being utilised to combat social isolation and increase social participation, hence improving social outcomes for older people. A systematic review of the literature was conducted across the social science and human-computer interaction databases. A total of 36 papers met the inclusion criteria and were analysed using a four-step process. Findings were threefold, suggesting that: (i) technologies principally utilised social network services and touch-screen technologies (ii) social outcomes are often ill-defined or not defined at all and (iii) methodologies used to evaluate interventions were often limited and small-scale. Results suggest a need for studies that examine new and innovative forms of technology, evaluated with rigorous methodologies, and drawing on clear definitions about how these technologies address social isolation articipation.
Publisher: Cambridge University Press (CUP)
Date: 30-08-2017
DOI: 10.1017/S0144686X16000829
Abstract: Against the background of population ageing and increasing cultural ersity in many Western countries, the study examined differences and similarities between Australian-born people and Chinese immigrants in their relationships with adult children. The specific research questions were: (a) are there differences between these groups in the nature of parent–child relationships and (b) if there were differences, did these differences reflect the Confucian concept of filial piety among older Chinese immigrants. The solidarity–conflict model and the concept of ambivalence were used to quantify parent–child relationships. Data from 122 community-dwelling people aged 65 and over (60 Australian-born and 62 Chinese-born people) were collected using standardised interviews. There were significant differences between the two groups for all relationship dimensions except associative solidarity. Compared to Australian participants, Chinese participants were more likely to live with their children. However, when they did not live with their children, they lived further away. They were also more likely to receive, but less likely to provide, instrumental help. Finally, they reported higher levels of normative solidarity, conflict and ambivalence, and lower levels of affectual and consensual solidarity. The differences in solidarity dimensions persisted when socio-demographic variables were controlled for. The study revealed complex differences in the nature of older parent–child relationships between Australian-born people and Chinese immigrants. Some of these differences, such as more prevalent multigenerational living among older Chinese immigrants, likely reflect the strong influence of filial piety among this group. However, differences in other dimensions, such as lower levels of consensual solidarity, might be associated with the Chinese participants’ experience as immigrants. This study also highlights the usefulness of the solidarity–conflict model as a theoretical framework to understand the nature of parent–child relationships among older Chinese immigrants.
Publisher: JMIR Publications Inc.
Date: 02-06-2022
DOI: 10.2196/38456
Abstract: India is undergoing a demographic transition characterized by population aging and is witnessing a high dementia rate. Although nearly 7 million people live with dementia in India, dementia awareness is poor, and current resources addressing dementia care are basic and often incomplete, duplicated, or conflicting. To address this gap, this study aims to use digital media, which has had a massive technological uptake in India, to improve dementia care in India. The objective of this paper is to describe an intervention study design that examines the feasibility and acceptability of Moving Pictures India, a digital media resource to improve dementia care in India. This study employs a mixed methods design and is ided into 4 phases: (1) video interviews with Indian caregivers and health professionals (2) coproduction of resources (3) pilot randomized controlled trial (RCT) and (4) dissemination and analytics. The pilot RCT will follow an experimental parallel group design with 2 arms aiming to assess the impact, feasibility, and acceptability of the developed resources. The primary outcome measures for the pilot RCT will be feasibility and acceptability, while the secondary outcome measures will be caregiver burden, mood, and quality of life. This study received funding from the Alzheimer’s Association in the United States in July 2021. In 2023, we will enroll 60 dementia caregivers (40 caregivers in the intervention arm and 20 in the control) for the pilot RCT. The study has been approved by the National Institute of Mental Health and Neuro Sciences Ethics Committee (26th IEC (BEH.SC.DIV.)/2020-21 dated November 11, 2020) the Health Ministry's Screening Committee, India (proposal ID 2020-10137) the Curtin University Human Research Ethics Committee (approval number HRE2020-0735) and the NARI Research Governance Office (site-specific approval dated March 17, 2021). This protocol is designed to deliver unique, coproduced, and evidence-based media resources to support caregivers of persons with dementia in India and other countries aiming to utilize digital media for dementia care. If the intervention is found feasible and acceptable, postpiloting analytics and qualitative feedback will be used to develop an implementation trial to evaluate the effectiveness of the potential low-risk high-benefit intervention in practice. Clinical Trials Registry-India CTRI/2021/01/030403 ctri.nic.in/Clinicaltrials maindet2.php?trialid=50794 DERR1-10.2196/38456
Publisher: Wiley
Date: 10-2013
DOI: 10.1111/AJAG.12095
Publisher: Wiley
Date: 22-06-2017
DOI: 10.1111/AJAG.12450
Abstract: Healthcare providers (HCPs) can play an important role in supporting the sexual health of older adults however, we know little about the experiences of older people in talking to HCPs about sex. This article examines older adults' experiences and perceptions of talking to HCPs about sex. Semi-structured interviews were conducted with 30 men and 23 women aged 60 and older recruited from a national, online survey of older Australians. Data were analysed using a thematic approach. Most participants did not discuss sex with their HCP, and their HCP did not raise it. For those who did discuss sex with a HCP, negative and stigmatising responses were common. Positive responses could facilitate access to sexual health care. Older people benefit when HCPs are proactive and ask about sexual health. Education in how to talk about sex with older people would also be beneficial for HCPs.
Publisher: Wiley
Date: 14-01-2018
DOI: 10.1111/AJAG.12493
Abstract: This research explored residential aged care (RAC) workplace design features that influence how RAC staff feel valued, productive, safe, like they belong and connected. A secondary aim was to validate emerging themes about RAC design features with stakeholders. A multistage qualitative study was conducted in one RAC facility with 100 residents in outer metropolitan Melbourne: (i) photo-elicitation - photographs were used to prompt discussions with RAC staff (ii) in idual interviews with RAC directors and (iii) validity testing with the advisory committee occurred. Key workplace design features that influenced how RAC staff feel valued, productive, safe, like they belong and connected included the following: (i) home-like environment (ii) access to outdoor spaces (iii) quality indoor environment and (iv) access to safe, open and comfortable workplaces. Key workplace design features that matter to RAC staff in a 'shared workspace' exist. Increasing demands upon RAC requires evidence-based workplace design policy and evaluation approaches that support RAC staff to work in RAC shared workspaces.
Publisher: Cambridge University Press (CUP)
Date: 25-05-2018
DOI: 10.1017/S104161021800042X
Abstract: Population aging places greater demands on the supply of informal carers. The aims of this study were to examine (1) the types of unmet support needs of carers of older Australians and (2) the association of unmet needs with mental health. Utilizing new data from the 2015 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers, we calculated the prevalence of carers experiencing specific and multiple unmet needs for support, using single and multiple item measures. Logistic regression models were fitted to examine the association between unmet needs and psychological distress (using the Kessler psychological distress scale), once demographic and health factors were controlled for. In 2015, 35% of carers of older Australians cited at least one unmet need for support. Among this group, almost two-thirds cited multiple unmet support needs (64.7%). The most prevalent types of unmet needs included financial (18%), physical (13%), and emotional support (12%), as well as additional respite care and support to improve carer health (12%). After controlling for demographic and health characteristics of the carer, having any unmet need for support increased the odds of psychological distress by twofold (OR = 2.20, 95% CI = 1.65, 2.94). With each successive unmet need for support, the odds of psychological distress increased 1.37 times (OR = 1.36, 95% CI = 1.22, 1.54). Those who had received assistance with care, but required further support were 1.95 times more likely (OR = 1.95, 95% CI = 1.17, 3.24) to be in distress and those who had not received care assistance were about 2.4 times more likely (OR = 2.38 95% OR = 1.56, 3.62) to be in distress relative to those with no unmet need. Addressing unmet support needs of carers is important, not only for the planning of services for carers in an aging population, but also because of the association between unmet support needs and carers mental health.
Publisher: Wiley
Date: 16-09-2010
DOI: 10.1002/GPS.2549
Abstract: To explore the perceptions of family carers, older people and health professionals in Australia about what constitutes elder abuse. The Caregiving Scenario Questionnaire (CSQ) was disseminated to health professionals from two metropolitan hospitals, older volunteers and carers of older people with dementia recruited for other studies. One hundred and twenty health professionals, 361 older people and 89 carers returned the surveys. χ(2) analyses indicated that significantly more health professionals than older people identified locking someone in the house alone all day (χ(2) (2) = 10.20, p = 0.006, Cramer's V = 0.14), restraining someone in a chair (χ(2) (2) = 19.984, p = 0.0005, Cramer's V = 0.19) and hiding medication in food (χ(2) (2) = 8.72, p = 0.013, Cramer's V = 0.13) as abusive. There were no significant differences between healthy volunteer older people and carers in their perceptions of elder abuse. A significant minority (40.8%) of health professionals and over 50% of carers did not identify locking the care recipient alone in the house all day as abusive. In Australia, there is limited consensus between older people, carers and health professionals regarding what constitutes elder abuse. Health professionals were more likely to identify abusive and potentially abusive strategies correctly than carers or healthy older people, but nonetheless between one quarter and two-fifths [correction made here after initial online publication] of health professionals did not identify the abusive strategies.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
Publisher: Elsevier BV
Date: 10-2020
Publisher: Wiley
Date: 17-10-2013
DOI: 10.1111/J.1741-6612.2011.00585.X
Abstract: The aim of this study was to develop the evidence-based Healthy Ageing Quiz (HAQ). Phase 1 activities (focus groups with 33 older adults, literature review and discussion with an advisory panel) informed the development of a draft HAQ. Phase 2 involved assessing the quiz's psychometric properties and collecting respondent feedback. Phase 1 provided broad topics for formulating quiz questions. In Phase 2, 297 and 122 respondents returned a quiz for validity and reliability testing respectively (over 70% response rate). The HAQ was found to be both valid (r =-0.7 to 0.6) and reliable (r = 0.8). The development of the HAQ was guided by the literature and input from older people and experts in healthy ageing. The quiz showed good psychometric properties and was acceptable to respondents. It allows older adults and people approaching old age to evaluate their current lifestyle in order to maximise their chances of ageing well.
Publisher: Wiley
Date: 12-2015
DOI: 10.1111/AJAG.12291
Publisher: Wiley
Date: 15-04-2018
DOI: 10.1002/HPJA.60
Abstract: Exercising outdoors provide beneficial effect on mental and physical health for all ages. However, few older people exercise outdoors other than walking. While outdoor gyms have become increasingly common in Australia, limited outdoor exercise equipment specifically designed for older people is available in public spaces. We have set up and evaluated a unique purpose-built outdoor exercise park for older people in the community setting and demonstrated positive physical and wellbeing outcomes associated with the provision of this unique exercise mode and social program. This study is a reflective narrative describing this innovative exercise approach and reports challenges associated with establishment of the exercise park, conducting the randomised trial, strategies adopted to address these challenges and recommendations for future implementation of this approach in the community. Many challenges were encountered, including securing appropriate land to locate the exercise park, control of environmental factors for safety (non-slippery ground and equipment) as well as logistics in running the exercise program itself. Several adjustments in the equipment were also required to ensure safe use by older people. The inclusion of outdoor equipment for older people in public spaces or urban parks is important and careful consideration needs to be taken by local ublic authorities to provide access, amenities and safety for all as well as activities to suit all ages. SO WHAT?: Seniors' exercise parks can be installed in public places and may provide an enjoyable and effective approach to engage older in iduals in a more active and healthier lifestyle.
Publisher: Springer Science and Business Media LLC
Date: 18-01-2014
DOI: 10.1007/S10823-014-9222-0
Abstract: The prevalence of dementia is increasing in Australia. Limited research is available on access to Cognitive Dementia and Memory Services (CDAMS) for people with dementia from Culturally and Linguistically Diverse (CALD) communities. This study aimed to determine the barriers and enablers to accessing CDAMS for people with dementia and their families of Chinese and Vietnamese backgrounds. Consultations with community members, community workers and health professionals were conducted using the "Cultural Exchange Model" framework. For carers, barriers to accessing services included the complexity of the health system, lack of time, travel required to get to services, language barriers, interpreters and lack of knowledge of services. Similarly, community workers and health professionals identified language, interpreters, and community perceptions as key barriers to service access. Strategies to increase knowledge included providing information via radio, printed material and education in community group settings. The "Cultural Exchange Model" enabled engagement with and modification of the approaches to meet the needs of the targeted CALD communities.
Publisher: CSIRO Publishing
Date: 2004
DOI: 10.1071/AH040260
Abstract: This article tells the stories of two family carers, each of whom is caring for someone who has been discharged early from hospital to have their rehabilitation at home. These stories illustrate the personal impact of early discharge for rehabilitation. The article argues that through its policy of early discharge from hospital, the state has shifted care from hospital to home, resulting in the work of caring and its associated costs being rendered invisible. This is possible because the prevailing ideology on both sides of politics is that in iduals ? rather than the state ? should be responsible for their own and their family?s well-being.
Publisher: SAGE Publications
Date: 09-2019
Abstract: Interventions based on comprehensive geriatric assessment (CGA) have been implemented in many countries. These interventions, based on the premise that such assessment will delay in idual decline and reduce demand on medical and institutional care, generally result in equivocal or modest outcomes. This article presents findings from a critical realist review of a s le of reported interventions to offer insights into the macro- and micro-factors that affect the implementation and outcomes of CGA-based endeavours. The findings hold particular relevance for informing Australian policy which provides for annual, clinical assessment of people above the age of 75.
Publisher: Cambridge University Press (CUP)
Date: 12-01-2012
DOI: 10.1017/S1041610211002584
Abstract: Elder abuse is generally understood in terms of the types of abuse that older people can be subjected to – financial, physical, psychological, sexual, and neglect. However, these definitions often fail to take into account the broader social context in which elder abuse is allowed to occur. Older people are rarely asked about what elder abuse means to them but when they are, they define it in societal terms – social exclusion, the belittling of their views and contribution, and violation of their rights. An effective approach to elder abuse requires intervention at a societal level to combat ageism and age discrimination.
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/AH09790
Abstract: Objectives. The study aimed to develop a set of clinical indicators to minimise the risk and adverse outcomes of functional decline in older hospitalised people. Methods. Existing Australian and international clinical indicators relevant to cognition and emotional health, mobility, vigour and self care, continence, nutrition, skin integrity, person-centred care, assessment and medication management were identified by literature and electronic website review. A multidisciplinary expert advisory group used modified Delphi methods, including two anonymous voting rounds and a group discussion, to gain consensus for a prioritised set of clinical indicators. For each indicator, experts voted on a scale of 1 (low level of prioritisation) to 9 (high level of prioritisation) based on measurement attributes and utility for use at the level of clinical teams, hospital managers and jurisdictional policy makers. Results. There were 55 existing clinical indicator sets identified, from which 63 relevant indicators were extracted. The final prioritised set covered all domains and included 19 indicators of which 17 were process indicators and 2 were outcome indicators. Scores for scientific measurement attributes and practicality for implementation were only moderate. Conclusion. These clinical indicators offer a consistent basis for monitoring hospital performance and improving care of older people in Victoria and other jurisdictions. What is known about the topic? Older hospitalised patients are at risk of functional decline and associated adverse outcomes such as falls and pressure ulcers. Clinical indicators to measure healthcare structures, processes and outcomes can be used to monitor quality of care among this vulnerable patient group. What does this paper add? This paper describes the process used to identify and select indicators for the Victorian government’s Council of Australian Governments Long Stay Older Persons initiative. It presents the use of a modified Delphi technique to gain group consensus for the indicator selection process a technique being increasingly used in healthcare. What are the implications for practitioners? The indicators provide a set of measures that can be used by organisations, clinical teams and government level to assess the effect of quality improvement activities and initiatives aimed at minimising functional decline.
Publisher: Wiley
Date: 07-07-2015
DOI: 10.1002/GPS.4323
Abstract: Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated. We conducted a cross-sectional analysis of 202 older carers using the Geriatric Depression scale, demographics, personality traits, attitudes to ageing and other carer characteristics. Increased hours spent caring and higher levels of neuroticism were all factors associated with depression. The care-recipient diagnosis, other personality traits, attitudes to ageing, leisure-physical activity (PA) and domestic-PA were not significantly associated with depression. These findings have important implications for interventions to target at-risk carers.
Publisher: Cambridge University Press (CUP)
Date: 15-06-2015
DOI: 10.1017/S1041610215000873
Abstract: Attitudes to aging have been investigated in non-carer populations and found to have important relationships with physical and mental health. However, these have not been explored in an older carer s le, although it is becoming increasingly important to clarify variables which are linked with positive carer outcomes. This is one of the first studies to report on older carers, their attitudes to aging, and the relationship with carer-related factors. A cross-sectional study of 202 carers with a mean age of 70.8 years was conducted in Victoria, Australia, using carer demographic data, carer factors such as depression (using the Geriatric Depression Scale), burden (using the Zarit Burden Inventory, ZBI), physical health, personality, and attitudes to aging (using the Attitudes to Aging Questionnaire, AAQ). Spearman rank correlation and hierarchical regression analyses were used. This study showed that carers had overall positive attitudes to aging inspite of their caring role. It also identified that carer factors including depression and burden contributed a significant amount of the variance to attitudes to aging in terms of physical change and psychosocial loss. Personality traits, specifically neuroticism, and extraversion, were also important contributors to attitudes to aging. Results from this study demonstrated that inspite of moderate levels of depression and spending significant time caring, carers reported positive attitudes to aging. Treating depression, decreasing burden, and investigating the benefits of caring may assist older carers maintain their well-being.
Start Date: 2016
End Date: 2018
Funder: Australian Research Council
View Funded ActivityStart Date: 2018
End Date: 2022
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2019
Funder: Economic and Social Research Council
View Funded ActivityStart Date: 2015
End Date: 2017
Funder: Australian Research Council
View Funded ActivityStart Date: 2012
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2017
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 05-2015
End Date: 12-2018
Amount: $321,950.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2016
End Date: 12-2019
Amount: $340,000.00
Funder: Australian Research Council
View Funded Activity