scholarly journals Acute Transition Allliance: rehabilitation at the acute/aged care interface

2004 ◽  
Vol 28 (3) ◽  
pp. 266 ◽  
Author(s):  
Dawn J Kroemer ◽  
Geoffrey Bloor ◽  
Jeff Fiebig
Keyword(s):  
Residential Care ◽  
Public Hospital ◽  
Community Care ◽  
South Australia ◽  
Integrated Approach ◽  
Aged Care ◽  
Residential Aged Care ◽  
Acute Admissions ◽  
Made In

The acute/aged care interface has presented many challenges to funders, providers and planners in the health and aged care sectors. Concerns have long been expressed in the aged care sector about the changing needs of clients admitted permanently into residential aged care from hospitals where the decision for placement would often have been made in a crisis situation, without the opportunity to explore appropriate options. This article describes the process and outcomes to date of a collaborative effort between the acute care and aged care sectors in South Australia to develop a more integrated approach to discharge opportunities for older people. The program involves both residential and community care elements and seeks to provide rehabilitation, to restore function and to avoid inappropriate permanent residential care for older Australians following acute admissions to a public hospital. Interim outcomes are promising and show only 17% of those admitted to the program are discharged to long-term residential care.

scholarly journals The Impact of Musculoskeletal Conditions on Assessed Levels of Care Required by Older Australians

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Tiffany K Gill ◽  
Steve Wesselingh ◽  
Maria C Inacio
Keyword(s):  
Risk Factors ◽  
Residential Care ◽  
Chronic Conditions ◽  
Community Care ◽  
Care Service ◽  
Functional Limitations ◽  
Aged Care ◽  
Residential Aged Care ◽  
Musculoskeletal Conditions ◽  
The Impact

IntroductionMusculoskeletal problems, including conditions such as back pain, neck pain, rheumatoid arthritis, gout and osteoarthritis are common in the population and significant contributors to global disease burden. Age is one of the most common risk factors for musculoskeletal conditions and over 40% of older people accessing residential aged care have a musculoskeletal condition. It is not known whether individuals living in the community with musculoskeletal conditions have similar needs to those in permanent care and this is important to know in order to provide appropriate care. Objectives and ApproachThe objective of this study was to profile individuals with musculoskeletal conditions in different aged care service settings (i.e. permanent care, community care only, transition/ respite care, or no services). Specifically, we examined the concurrent chronic conditions, health risk factors and functional limitations of individuals by service setting. A cross-sectional evaluation of individuals in the National Historical Cohort of the Registry of Senior Australians (ROSA) between 2004 and 2014 was conducted. Multivariable logistic regression models estimated the factors associated with being in different aged care settings. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Results401,026 (42.5%) individuals with musculoskeletal conditions were assessed for aged care service eligibility during the study period. Of these 197,181 (49.2%) accessed permanent care, 37,003 (9.2%) accessed home care, 54,826 (13.7%) transition/respite, and 112,016 (27.9%) - no care. Individuals accessing community care compared to residential care were more likely to be female, have pain and have difficulty maintaining their home, as were individuals accessing no services compared to residential care. Conclusion / ImplicationsCompared to those in residential care, individuals with musculoskeletal conditions in the community with or without assistance had few differences related to other chronic conditions and functional limitations. But the reasons why some had support, while others did not, are unclear.

Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999-2005)

2010 ◽  
Vol 30 (4) ◽  
pp. 202-207 ◽  
Author(s):  
Jodie B Hillen ◽  
Richard L Reed ◽  
Richard J Woodman ◽  
Deborah Law ◽  
Paul H Hakendorf ◽  
...  
Keyword(s):  
Public Hospital ◽  
Hospital Admissions ◽  
South Australia ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

“Consideration of patients as networked units to identify opportunities and motivation to enhance capability”: A mixed methods study to explore a personalised Digital Health Hub Model of Care for hip fractures in South Australia (Preprint)

2021 ◽  
Author(s):  
Lalit Yadav ◽  
Tiffany K Gill ◽  
Anita Taylor ◽  
Jen DeYoung ◽  
Mellick J Chehade
Keyword(s):  
Hip Fractures ◽  
Digital Health ◽  
Family Members ◽  
South Australia ◽  
Aged Care ◽  
Mixed Methods Study ◽  
Residential Aged Care ◽  
Model Of Care ◽  
Factors Influencing

UNSTRUCTURED Introduction Majority of older people with hip fractures once admitted to acute hospital care are unable to return to their pre-fracture level of independence and a significant number are either newly admitted or return to residential aged care. Patient education involves family members and/or residential aged care staff as networked units, crucial for empowerment through improving health literacy. Advancement of digital technology has led to evolving solutions around optimising health care including self-management of chronic disease conditions and telerehabilitation. The aim of this study is to understand perspectives of older patients with hip fractures, their family members and residential aged carers, to inform the development of a digitally enabled model of care using a personalised digital health hub (pDHH). Methods A mixed methods study was conducted at a public tertiary care hospital in South Australia involving patients aged 50 years and above along with their family members and residential aged carers. Quantitative data, including basic demographic characteristics, access to computers and Internet were analysed using descriptive statistics. Spearman’s Rank Order Correlation was used to examine correlations between the perceived role of a pDHH in improving health and likelihood of subsequent usage. Whereas qualitative data included series of open-ended questions and findings were interpreted using constructs of capability, opportunity and motivation to help understand the factors influencing the likelihood of potential pDHH use Results Overall, 100 people were recruited in the study, representing 55 patients, 13 family members and 32 residential aged carers. The mean age of patients was 76.4 years (SD-8.4, age range 54-88) and females represented 60% of patients. Although a moderate negative correlation existed with increasing age and likelihood of pDHH usage (ρ= -0.50, p<0.001) the perceived role of the DHH in improving health had a strong positive correlation with the likelihood of pDHH usage by self (ρ=0.71, p<0.001) and by society, including friends and family members (ρ=0.75, p<0.001). Of particular note, almost all the patients (98%) believed they had a family member or friend /carer who would be able to help them to use a digital health platform. Whereas our qualitative findings suggest emphasising on complex interplay of capability, opportunity and motivation as crucial factors while designing a pDHH enabled model of care for hip fractures at a local context level. Conclusion Findings from this study contributed to understand the dynamics around capabilities, motivation and opportunities of patients, family members and formal carers as a “patient networked unit”. Future research recommendation must involve co-creation guided by iterative processes through improving understanding of factors influencing development and successful integration of complex digital healthcare interventions in real-world scenarios.

scholarly journals Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review (Preprint)

2018 ◽  
Author(s):  
Phoebe Chan ◽  
Sunil Bhar ◽  
Tanya E. Davison ◽  
Colleen Doyle ◽  
Bob G. Knight ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Residential Care ◽  
Behavioral Therapy ◽  
Late Life ◽  
Aged Care ◽  
Residential Aged Care ◽  
Late Life Depression ◽  
Residential Settings

BACKGROUND The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. OBJECTIVE The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. METHODS This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. RESULTS Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. CONCLUSIONS In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. CLINICALTRIAL PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54) REGISTERED REPORT IDENTIFIER RR1-10.2196/9902

scholarly journals Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035339 ◽  
Author(s):  
Mandy Archibald ◽  
Michael Lawless ◽  
Rachel C Ambagtsheer ◽  
Alison Kitson
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
South Australia ◽  
Care Facility ◽  
Health Behaviours ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Group ◽  
Static State ◽  
Consumer Perspective

ObjectivesDespite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive–descriptive qualitative study.SettingAged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia.Participants39 non-frail, prefrail, frail and very frail South Australian older adults.MethodsSeven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators.ResultsFrailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail.ConclusionsAside from a disability model, views of frailty as unmodifiable permeated older persons’ diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.

scholarly journals Young people in aged care: progress of the current national program

2011 ◽  
Vol 35 (3) ◽  
pp. 320 ◽  
Author(s):  
Dianne F. Winkler ◽  
Louise J. Farnworth ◽  
Sue M. Sloan ◽  
Ted Brown
Keyword(s):  
Young People ◽  
Service Providers ◽  
Systemic Change ◽  
Care Program ◽  
Aged Care ◽  
Residential Aged Care ◽  
National Program ◽  
Public Servants ◽  
Active Involvement

Objective. The aim of this paper is to examine the progress and effect of the current 5-year $244 million national Young People in Residential Aged Care program on the reduction of young people in aged care. Method. Semi-structured telephone interviews with 20 service providers, 10 advocacy organisations and 6 public servants across Australia actively involved in the implementation of the program. Results. The development of new accommodation options has been slow. The 5-year program aims to move 689 young people out of nursing homes; in the first 4 years of the initiative only 139 people had moved out. The lives of those who have been helped by the program have been enormously improved. Conclusions. This study highlights the challenges of achieving a long-term reduction in the number of young people in residential aged care, including the challenge of achieving systemic change to prevent new admissions. Implications. The accommodation options currently being developed for this target group will soon be at capacity. Without sustained investment in developing alternative accommodation options and resources to implement systemic change ~250 people under 50 are likely to continue to be admitted to aged care each year in Australia. What is known about the topic? Prior to the current 5-year, $244 million, national Young People in Residential Aged Care program there were more than 1000 Australians under 50 years of age who lived in aged care facilities. Aged care is not designed or resourced to facilitate the active involvement of young people with high clinical needs in everyday activities or support their continued participation in the life of their community. What does this paper add? In the first 4 years of the national program only 139 people moved out of aged care. The lives of those who have been helped by the program have been enormously improved. The program is unlikely to result in a long-term reduction in the number of young people in aged care. What are the implications for practitioners? Systemic change and sustained investment in accommodation options is required to resolve the issue of young people in aged care.

scholarly journals Dry Eyes, Ocular Lubricants, and Use of Systemic Medications Known or Suspected to Cause Dry Eyes in Residents of Aged Care Services

2020 ◽  
Vol 17 (15) ◽  
pp. 5349
Author(s):  
Muhamad Aljeaidi ◽  
Claire Keen ◽  
J. Simon Bell ◽  
Tina Cooper ◽  
Leonie Robson ◽  
...  
Keyword(s):  
Primary Outcome ◽  
South Australia ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Residential Aged Care ◽  
Cross Sectional ◽  
Dry Eyes ◽  
Care Services ◽  
Medical Histories ◽  
Possible Cause

Ocular issues are common, burdensome, and under-researched among residents of aged care services. This study aims to investigate the prevalence of dry eyes or use of ocular lubricants among residents, and the possible association with systemic medications known or suspected to cause dry eyes. A cross-sectional study of 383 residents of six aged care services in South Australia was conducted. Data were extracted from participants’ medical histories, medication charts, and validated assessments. The main exposure was systemic medications known to cause, contribute to, or aggravate dry eyes. The primary outcome was documented dry eyes or regular administration of ocular lubricants. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between systemic medications and dry eyes/use of ocular lubricants. Dry eyes were documented for 53 (13.8%) residents and 98 (25.6%) residents were administered ocular lubricants. Overall, 116 (30.3%) residents had documented dry eyes/used ocular lubricants. Of these, half (n = 58) were taking a medication known to cause, contribute to, or aggravate dry eyes. Taking one or more medications listed as known to cause dry eyes was associated with having dry eyes/use of ocular lubricants (OR 1.83, 95% CI 1.15–2.94). In sub-analyses, no individual medication was associated with dry eyes/use of ocular lubricants. Dry eyes and use of ocular lubricants are common in residential aged care. Our hypothesis generating findings suggest the need for further research into the clinical significance of systemic medications as a possible cause of dry eyes.

scholarly journals Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Residential Care ◽  
Informal Care ◽  
Daily Living ◽  
Long Term Care ◽  
Community Care ◽  
Term Care ◽  
Care Arrangement

Abstract At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p&lt;.05) or residential care (OR=2.19, p&lt;.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.

scholarly journals Corrigendum to: Who uses residential aged care now, how has it changed and what does it mean for the future?

2020 ◽  
Vol 44 (6) ◽  
pp. 983
Author(s):  
Diane Gibson
Keyword(s):  
Residential Care ◽  
Average Length ◽  
Age Groups ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing Population ◽  
The Past ◽  
The Future ◽  
Australian Bureau Of Statistics ◽  
Care System

ObjectiveThis paper presents past trends in resident characteristics and usage patterns in residential aged care and explores implications for the future.MethodsTime series analyses were undertaken of national aged care administrative datasets and the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers.ResultsAlthough the number of people in residential care has continued to increase, resident profiles have changed as a result of higher growth rates in the number of men and of people aged 65–74 years and 90 years and over, and a decline in the number of women aged 75–89 years. Relative to population size, usage rates are declining across all age groups, the average length of stay is shortening, and dependency levels appear to be rising.ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future.What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns.What does this paper add?The analyses in this paper demonstrate patterns of change and continuity in the use of residential care over the past decade, and locate those changes in the context of broader trends in the ageing population. Together, this provides useful insights into current and likely future trends, as well as a basis for imagining an improved residential aged care system in the future.What are the implications for practitioners?These analyses illustrate how data on aged care services, demographic trends and disease patterns can be used to consider the challenges that have affected our residential aged care system in the past and how that may be addressed in the future.

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