Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A Scoping Review

Author(s):  
Olga Birchall ◽  
Michelle Bennett ◽  
Nadine Lawson ◽  
Susan M. Cotton ◽  
Adam P. Vogel
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica A. L. Borbasi ◽  
Allison Tong ◽  
Alison Ritchie ◽  
Christopher J. Poulos ◽  
Josephine M. Clayton

Abstract Background End of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia. Methods Focus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis. Results 20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding. Conclusion Aged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.


2018 ◽  
Vol 74 (8) ◽  
pp. 1975-1983
Author(s):  
Julie M. Ellis ◽  
Beatriz Paulina Ayala Quintanilla ◽  
Louise Ward ◽  
Fergus Campbell ◽  
Stav Hillel ◽  
...  

2016 ◽  
Vol 18 (4) ◽  
pp. 431-450 ◽  
Author(s):  
Mark Hughes ◽  
Christine Bigby ◽  
Clare Tilbury

Summary Little is known about the quantity, nature and range of Australian social work research on ageing and aged care. This scoping review involved a comprehensive search of seven online bibliographic databases. The review identified 108 peer-reviewed journal articles, published between January 2007 and June 2014, that reported Australian social work research on ageing and aged care. Findings The average number of authors per paper was 2.10 with most social work researchers co-authoring papers with non-social workers. The main topics of research focus were health and rehabilitation, elder abuse, asset management, community services and caregiving, housing and residential aged care, and ageing with an intellectual disability. The findings highlight the contribution social work researchers make to multidisciplinary gerontological research, and to understanding the lived experiences of older people and the provision of services. However, they also point to the relative paucity of research focusing on direct social work practice with older people, and the little evidence of the participation of older people and carers in the design and delivery of research. Applications The findings indicate the need for capacity-building strategies, such as developing networks of Australian social work researchers on ageing and aged care, to improve research outputs in this area.


2019 ◽  
Author(s):  
Suzanne Marie Dyer ◽  
Enwu Liu ◽  
Emmanuel Gnanamanickam ◽  
Stephanie Louise Harrison ◽  
Rachel Milte ◽  
...  

Abstract Background The value of providing access to outdoor areas for people living in residential aged care, including those living with dementia, in terms of mood, behaviour and well-being is increasingly acknowledged. This study examines associations between provision of independent access to outdoor areas and frequency of residents going outdoors with the quality of life (QoL) of nursing home residents and compares use of outdoor areas between alternative models of residential aged care. Methods A cross-sectional study was conducted including 541 participants from 17 residential aged care homes in four states in Australia, mean age 85 years, 84% with cognitive impairment. Associations between having independent access to outdoors and the frequency of going outdoors and QoL (EQ-5D-5L) were examined using multi-level models. The odds of going outdoors in a small-scale home-like model of care compared to standard Australian models of care were examined. Results After adjustment for potential confounders (including comorbidities and facility level variables), living in an aged care home with independent access to the outdoors was not significantly associated with QoL (β=-0.01, 95% Confidence Interval (CI) -0.09 to 0.07, P=0.80). However, going outdoors daily (β=0.13 95%CI 0.06 to 0.21), but not multiple times a week (β=0.03, 95%CI -0.03 to 0.09), was associated with a better QoL. Residents living in a home-like model of care had greater odds of going outdoors daily (odds ratio 15.1, 95%CI 6.3 to 36.2). Conclusions Going outdoors frequently is associated with higher QoL for residents of aged care homes and residents are more likely to get outside daily if they live in a small-scale home-like model of care. However, provision of independent access to outdoor areas alone may be insufficient to achieve these benefits. Increased availability of models of residential aged care with staffing structures, training and design which increases support for residents to venture outdoors frequently is needed to maximise resident quality of life.


2020 ◽  
Vol 18 (11) ◽  
pp. 2302-2334
Author(s):  
Rose McCloskey ◽  
Lisa Keeping-Burke ◽  
Cindy Donovan ◽  
Jessica Cook ◽  
Richelle Witherspoon ◽  
...  

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Joanne Tropea ◽  
Christina E. Johnson ◽  
Debra Nestel ◽  
Sanjoy K. Paul ◽  
Caroline A. Brand ◽  
...  

Abstract Background Many people with advanced dementia live in residential aged care homes. Care home staff need the knowledge and skills to provide high-quality end-of-life (EOL) dementia care. However, several studies have found EOL dementia care to be suboptimal, and care staff have reported they would benefit from training in palliative care and dementia. Simulation offers an immersive learning environment and has been shown to improve learners’ knowledge and skills. However, there is little research on simulation training for residential care staff. This article presents the development and evaluation protocol of IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) - a screen-based simulation training program on palliative dementia care, targeted at residential care staff. IMPETUS-D aims to improve the quality of palliative care provided to people living with dementia in residential care homes, including avoiding unnecessary transfers to hospital. Methods A cluster RCT will assess the effect of IMPETUS-D. Twenty-four care homes (clusters) in three Australian cities will be randomised to receive either the IMPETUS-D intervention or usual training opportunities (control). The primary outcome is to reduce transfers to hospital and deaths in hospital by 20% over 6-months in the intervention compared to the control group. Secondary outcomes include uptake of goals of care plans over 6 and 12 months, change in staff knowledge and attitudes towards palliative dementia care over 6 months, change in transfers to hospital and deaths in hospital over 12 months. For the primary analysis logistic regression models will be used with standard errors weighted by the cluster effects. A mixed methods process evaluation will be conducted alongside the cluster RCT to assess the mechanisms of impact, the implementation processes and contextual factors that may influence the delivery and effects of the intervention. Discussion In Australia, the need for high-quality advanced dementia care delivered in residential aged care is growing. This study will assess the effect of IMPETUS-D a new simulation-based training program on dementia palliative and EOL care. This large multisite trial will provide robust evidence about the impact of the intervention. If successful, it will be distributed to the broader residential care sector. Trial registration ANZCTR, ACTRN12618002012257. Registered 14 December 2018.


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