scholarly journals Comfort Among Older Lesbian and Gay People in Disclosing Their Sexual Orientation to Health and Aged Care Services

2020 ◽  
pp. 073346482092533 ◽  
Author(s):  
Anthony Lyons ◽  
Beatrice Alba ◽  
Andrea Waling ◽  
Victor Minichiello ◽  
Mark Hughes ◽  
...  

Being comfortable in disclosing one’s sexual orientation to health and aged care providers is important for older lesbian and gay adults, given that nondisclosure is associated with poorer health and well-being outcomes. In a sample of 752 lesbian and gay adults aged 60 years and older living in Australia, we found only 51% of lesbian women and 64% of gay men felt fully comfortable to disclose their sexual orientation to health and aged care service providers. For both the women and the men, those who felt fully comfortable to disclose reported significantly less internalized homophobia; had fewer experiences of discrimination in the past year; and reported greater lesbian, gay, bisexual, transgender, and intersex (LGBTI) community connectedness. Feeling fully comfortable was also predicted by fewer experiences of lifetime discrimination among the men. These findings may help those seeking to assist older lesbian and gay people in feeling comfortable and being open with health and aged care service providers.

2021 ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  

Abstract Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets.Methods A retrospective sample of 1141 Australians aged ≥ 60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e.sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression.Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets.Results Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0–1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected.Conclusion Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support.Trial registration: Australian and New Zealand clinical trial registry number: ACTRN12617001212347. Registered 18/08/2017


2021 ◽  
Author(s):  
Qing Zhang ◽  
Marlien Varnfield ◽  
Liesel Higgins ◽  
Vanessa Smallbon ◽  
Julia Bomke ◽  
...  

BACKGROUND An ageing population, accompanied by the prevalence of age-related diseases, present significant burden to health systems. This is exacerbated by an increasing shortage of aged care staff due to existing workforce entering their retirement and fewer young people being attracted to work in aged care. In line with consumer preferences and potential cost-efficiencies, government and aged care providers are increasingly seeking options to move care and support to the community or home, as opposed to residential care facilities. However, compared to residential care, home environments may provide limited opportunity for monitoring patients progression/decline in functioning and therefore limited opportunity to provide timely intervention. To address this, the Smarter Safer Homes (SSH) platform was designed to enable self-monitoring and/or management, and to provide aged care providers with support to deliver their services. The platform uses open Internet of Things (IoT) communication protocols to easily incorporate commercially available sensors into the system. OBJECTIVE Our research aims to detail the benefits of utilising the SSH platform as a service in its own right as well as a complimentary service to more traditional/historical service offerings in aged care. It is anticipated to validate the capacity and benefits of the SSH platform to enable older people to self-manage, and aged care service providers to support their clients to live functionally and independently in their own home, for as long as possible. METHODS A single-blinded, stratified, 12-month randomized controlled trial with participants recruited from three aged care providers, in Queensland, Australia. The study aimed to recruit 200 people, including 145 people from metropolitan- and 55 from regional areas. Participants were randomised to the intervention group (having SSH platform installed to assist age care service providers to monitor and provide timely supports) and the control group (receiving their usual aged care services from providers). Data on community care, health and social related quality of life, health service utilization, care giver burden and user experience of both groups were collected at the start, the middle (6 month) and the end of the trial (12 month). RESULTS The trial recruited its first participant in April 2019, and finished data collection of the last participant in November 2020. The study also received participants’ health service data from government data resources in June 2021. CONCLUSIONS A crisis is looming to support the ageing population. Digital solutions, such as the SSH platform, has the potential to address this crisis and support aged care in the home and community. The outcomes of this study could improve and support the delivery of aged care services and provide better quality of life to older Australians in various geographical locations. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12618000829213


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  

Abstract Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets. Methods A retrospective sample of 1141 Australians aged ≥60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e. sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression. Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets. Results Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0–1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected. Conclusion Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support. Trial registration Australian and New Zealand clinical trial registry number: ACTRN12617001212347. Registered 18/08/2017.


2020 ◽  
Vol 2 ◽  
pp. 5-16
Author(s):  
Abdul Kader Mohiuddin

Patient satisfaction is a useful measure for providing quality indicators in health-care services. Concern over the quality of health-care services in Bangladesh has resulted in a loss of faith in health-care providers, low use of public health facilities, and increased outflows of patients from Bangladesh to hospitals abroad. The main barriers to accessing health services are inadequate services and poor quality of existing facilities, shortage of medicine supplies, busyness of doctors due to high patient load, long travel distance to facilities, and long waiting times once facilities were reached, very short consultation time, lack of empathy of the health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and occasionally, disregard for the suffering that patients endure without being able to voice their concerns. All of these service failures are frequently reported in the print media. Such failures can play a powerful role in shaping patients’ negative attitudes and dissatisfaction with health-care service providers and health-care itself.


Author(s):  
R Atwell ◽  
I Correa‐Velez ◽  
S Gifford

Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well‐being, and many challenges in accessing services. This paper reports on a project undertaken in Victoria, Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy‐makers and service providers can better respond to these small but deserving communities.


2020 ◽  
pp. 089826432095291
Author(s):  
Anthony Lyons ◽  
Beatrice Alba ◽  
Andrea Waling ◽  
Victor Minichiello ◽  
Mark Hughes ◽  
...  

Objectives: Volunteering is associated with positive well-being among older people, providing opportunities to stay active and socially connected. This may be especially relevant for older lesbian and gay people, who are less likely than heterosexual people to have a partner, children or support from their family of origin. Methods: Patterns of volunteering and mental, physical and social well-being were examined in a sample of 754 lesbian and gay adults in Australia aged 60 years and older who completed a nationwide survey. Results: Volunteers reported greater positive mental health than non-volunteers. Among the gay men, volunteers additionally reported higher self-rated health and social support and lower psychological distress. Both the lesbian women and gay men who volunteered for lesbian, gay, bisexual, transgender or intersex (LGBTI) organisations also reported greater LGBTI community connectedness than volunteers for non-LGBTI organisations. Discussion: These findings provide further insight into potential factors associated with the well-being of older lesbian and gay adults.


2005 ◽  
Vol 11 (2) ◽  
pp. 9
Author(s):  
Lisa Crossland ◽  
Craig Veitch

This paper outlines the key features of after-hours primary medical care service sustainability in Queensland. It describes the development of these into a practical framework designed to assist either those in the early stages of service development or the evaluation of existing service models. A representative sample was drawn from over 120 separate formal after-hours services identified across Queensland. Semi-structured interviews were held with staff and key informants from 16 services and other local service providers in Queensland. Reviews of documents relating to operating and management procedures and protocols were also completed. Data were assembled and thematically analysed using the QSR NUD.IST qualitative data analysis package. Five key factors related to sustainability commonly featured in the after-hours primary medical care services studied: business management and promotion; collaborative service arrangements; effective protocols and guidelines; recruitment and retention strategies; and remuneration. These issues can be summarised in a table format that demonstrates the interaction between the identified key factors of sustainability and the various model types. The purpose of the diagram is to illustrate the interplay of factors which impact on the development and sustainability of after-hours primary medical care services currently extant in Queensland. It is the complex interaction of all these factors that ultimately determines the sustainability of an after-hours service model.


2000 ◽  
Vol 6 (2) ◽  
pp. 57-66
Author(s):  
Lindsay Gething

Both the life expectancy and numbers of older people with intellectual disabilities are growing. Until recently, ageing with a disability had not been a major consideration for Australian policy makers and service providers. The situation was similar in countries such as the United States of America and United Kingdom where, unlike aged care, disability policy and practice had not evolved to meet needs. Ageing with long standing disability has now been specified by the Australian government as a priority area. This paper reports results of consultations held with consumers, their organisations, service providers and government in order to explore quality of life and service provision issues for people with long standing disabilities. It reports these issues and uses themes emerging from consultations to structure previously published information specifically related to ageing with an intellectual disability. Seven broad themes are discussed which relate to: life experiences; attitudes, skills and knowledge of consumers; attitudes skills and knowledge of community and service providers, the nature of service provision; the ageing of family care givers; financial security; and ageing in place. It is concluded that disadvantages and barriers experienced throughout life influence well being and quality of life in old age.


2020 ◽  
pp. 073346482093897
Author(s):  
Joyce Siette ◽  
Helen Berry ◽  
Mikaela Jorgensen ◽  
Lindsey Brett ◽  
Andrew Georgiou ◽  
...  

Aged care services have the potential to support social participation for the growing number of adults aging at home, but little is known about the types of social activities older adults in community care are engaged in. We used cluster analysis to examine the current profiles of social participation across seven domains in 1,114 older Australians, and chi-square analyses to explore between-group differences in social participation and sociodemographic and community care service use. Two distinct participation profiles were identified: (a) connected, capable, older rural women and (b) isolated, high-needs, urban-dwelling men. The first group had higher levels of engagement across six social participation domains compared with the second group. Social participation among older adults receiving community care services varies by gender, age, individual care needs, and geographical location. More targeted service provision at both the individual and community levels may assist older adults to access social participation opportunities.


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