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

2020 ◽  
Vol 44 (6) ◽  
pp. 820
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.

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.

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 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.

Progressing Towards a Freer Market in Australian Residential Aged Care

2021 ◽  
pp. 1-25
Author(s):  
Susan F Cochrane ◽  
Alice L Holmes ◽  
Joseph E Ibrahim
Keyword(s):  
Current System ◽  
Aged Care ◽  
Care Quality ◽  
Cultural Safety ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Care Providers ◽  
Fit For Purpose ◽  
Market Driven ◽  
Care System

The Royal Commission into Aged Care Quality and Safety has again focussed attention on the failings of the Australian aged care system. Residential aged care in Australia has become increasingly market-driven since the major reforms of 1997. The aims of increased marketisation include providing residents with greater choice, higher quality services, and increasing providers’ efficiency and innovation. However, marketisation is not meeting these aims, predominantly due to asymmetries of knowledge and power between residents and aged care providers. These asymmetries arise from inadequate provision of information, geographic disparities, urgency for care as needs arise acutely, and issues surrounding safety, including cultural safety. We propose a human rights framework, supported by responsive regulation, to overcome the failings of the current system and deliver an improved aged care system which is fit for purpose.

Residential care in Australia, Part I: Service trends, the young people in care, and needs-based responses

2008 ◽  
Vol 33 (2) ◽  
pp. 6-17 ◽  
Author(s):  
Howard Bath
Keyword(s):  
Young People ◽  
Service Delivery ◽  
Residential Care ◽  
The Past ◽  
Care Services ◽  
The Future

This is the first of a two-part discussion of the place of residential care services in Australia, which highlights the issues that are likely to influence the development of these services into the future. This paper explores service trends over the past few decades, the current place and focus of residential care services, the nature of the young people being placed into such services, and the imperative for developing a more needs-based approach to service delivery. It concludes with a review of recent calls for the development of therapeutic or treatment-orientated models and the initial steps in this direction that have been taken around the country.

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 A screen-based simulation training program to improve palliative care of people with advanced dementia living in residential aged care facilities and reduce hospital transfers: study protocol for the IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) cluster randomised controlled trial

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Joanne Tropea ◽  
Christina E. Johnson ◽  
Debra Nestel ◽  
Sanjoy K. Paul ◽  
Caroline A. Brand ◽  
...  
Keyword(s):  
Palliative Care ◽  
Training Program ◽  
Residential Care ◽  
Simulation Training ◽  
Aged Care ◽  
Dementia Care ◽  
Care Staff ◽  
Care Homes ◽  
Residential Aged Care ◽  
Advanced Dementia

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.

Older People With Alcohol-Related Brain Injury and Associated Complex Behaviors: A Psychosocial Model of Residential Care (The Wicking Project)

2010 ◽  
Vol 11 (2) ◽  
pp. 112-121 ◽  
Author(s):  
Alice Rota-Bartelink ◽  
Bryan Lipmann
Keyword(s):  
Brain Injury ◽  
Older People ◽  
Residential Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Model ◽  
Care Services ◽  
Synthesis Design ◽  
Psychosocial Model ◽  
One Step

The increasing need for specialist residential aged care services to support older people with complex behaviors resulting from dementia and alcohol-related brain injury was the impetus for the development of an exploratory action research trial. Affected individuals are commonly characterized by a unique set of needs and life circumstances that are not adequately or appropriately supported by currently available mainstream services. We discuss the synthesis, design, and key features of the research trial’s specialized model, which commenced in 2008 in Wintringham, Australia. The trial was recently completed in November 2009. Through the development of a specialized residential care model, we aim to move one step closer to providing appropriate support to one of the most needing yet highly marginalized group of people.

007 The impact of demographic changes on the presentation and outcome of stroke: experiences of the oldest old in the murrumbidgee region

2018 ◽  
Vol 89 (6) ◽  
pp. A4.2-A4
Author(s):  
Alice Powell ◽  
Paul Finucane ◽  
Martin Jude ◽  
Jenna Mewburn ◽  
Katherine Mohr ◽  
...  
Keyword(s):  
Functional Status ◽  
Older Patients ◽  
Oldest Old ◽  
Residential Aged Care ◽  
Ageing Population ◽  
Demographic Changes ◽  
Stroke Treatment ◽  
Demographic Groups ◽  
The Future ◽  
The Impact

IntroductionDemographic changes are leading to an ageing population with a disproportionate increase in the oldest old. Stroke is a leading cause of death and disability in Australia and is particularly prevalent in the elderly. The Murrumbidgee region has a population profile that is 14 years ahead of national Australia and therefore data from this population portends how stroke may present nationally in the future. Existing research suggests that stroke risk factors, subtype, treatment provided and outcomes differ between younger and older demographic groups. This study seeks to build a profile of the experiences of stroke in the oldest old and compare variables with two younger cohorts to test a number of hypotheses about background, treatment and outcomes.MethodsData was collected retrospectively from the electronic medical records of 100 stroke patients consecutively admitted to the Wagga Wagga Rural Referral Hospital Acute Stroke Unit. They were split into three demographic groups; young old, 65–74 old (75 to 84) and oldest old (85 and older) and comparisons were made of baseline functional status and risk factor profile, stroke type, stroke treatment and outcomes.ResultsOlder people admitted with stroke were more likely to be female with poorer premorbid functional status and higher numbers living in residential care. Atrial fibrillation (p=0.008) and hypertension (p=0.01) were significantly more common with advancing age while rates of smoking (p=0.006) were higher in younger patients. Stroke mechanism was predominantly cardioembolic in older patients and embolic stroke of undetermined source (ESUS) in the youngest group. Stroke severity and stroke treatment did not vary according to age. However, outcomes were poorer with rates of dependency (p=0.03) and residential aged care facility placement (p=0.06) increased among older patients post stroke.ConclusionThese data provide an indication of how stroke may manifest in our ageing population in the future.

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