Council of Australian Governments' (COAG) Initiative for Young People With Disability in Residential Aged Care: What Are the Issues for Acquired Brain Injury?

2007 ◽  
Vol 8 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Michele Foster ◽  
Jennifer Fleming ◽  
Cheryl Tilse

AbstractPeople surviving severe acquired brain injury (ABI) may potentially benefit from the Council of Australian Governments' (COAG) 5-year initiative for young people with disability in residential aged-care facilities. Yet critical examination of this policy initiative for ABI population is warranted for 2 reasons. First, reliance on the disability sector to resolve the complexities of long-term care for people with ABI detracts attention from systemic failures at the health/disability sector interface, and notably, debate concerning the role of, and right to rehabilitation. Second, the COAG initiative is being pursued within an extraordinarily complex and variable contemporary care environment, involving multiple services and sectors, and historically, high unmet need. This raises questions as to the adequacy and sustainability of care provided under the responsibility of state-based disability services. In this article, it is argued that long-term care for young people with severe ABI is better served by incorporating a health and rehabilitation perspective alongside a disability support approach. Although the effectiveness of rehabilitation may be contested in some instances of very severe ABI, nevertheless the role of rehabilitation in seeking to reduce the number of young people at risk of entering residential aged care needs to be addressed in policy solutions. It is also suggested that provision of long time care in the contemporary care environment involves a number of challenges due to the complex and changing patterns of need, diverse funding arrangements and mix of government and nongovernment services, and the increasing demand for care.

2016 ◽  
Vol 24 (6) ◽  
pp. 744-751 ◽  
Author(s):  
Jennifer Kane ◽  
Kay de Vries

Background: The concept of dignity is recognised as a fundamental right in many countries. It is embedded into law, human rights legislation and is often visible in organisations’ philosophy of care, particularly in aged care. Yet, many authors describe difficulties in defining dignity and how it can be preserved for people living in long term care. Objectives: In this article, Nordenfelt’s ‘four notions of dignity’ are considered, drawing on research literature addressing the different perspectives of those who receive, observe or deliver care in the context of the long-term care environment. Methods: A review of the literature was undertaken using the terms ‘nursing homes’, ‘residential care’ or ‘long-term care’. The terms were combined and the term ‘human dignity’ was added. A total of 29 articles met the inclusion criteria from the United Kingdom (14), United States (2), Australia (1), Sweden (3), Hong Kong (2), Norway (3), Nordic (1), Taiwan (1), Netherlands (1). Ethical Considerations: Every effort has been made to ensure an unbiased search of the literature with the intention of an accurate interpretation of findings. Discussion: The four notions of dignity outlined by Nordenfelt provide a comprehensive description of the concept of dignity which can be linked to the experiences of people living in long-term care today and provide a useful means of contextualising the experiences of older people, their families and significant others and also of staff in long-term care facilities. Of particular interest are the similarities of perspectives of dignity between these groups. The preservation of dignity implies that dignity is a quality inherent in us all. This links directly to the exploration and conclusions drawn from the literature review. Conversely, promoting dignity implies that dignity is something that can be influenced by others and external factors. Hence, there are a number of implications for practice. Conclusion: We suggest that two of Nordenfelt’s notions, ‘dignity of identity’ and ‘dignity of Menschenwüde’, are a common thread for residents, family members and staff when conceptualising dignity within long-term care environments.


2015 ◽  
Vol 16 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Dianne Winkler ◽  
Libby Callaway ◽  
Sue Sloan ◽  
Nadine Holgate

Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.


2020 ◽  
Vol 35 (10) ◽  
pp. 419-433 ◽  
Author(s):  
Janet K. Sluggett ◽  
Stephanie L. Harrison ◽  
Leona A. Ritchie ◽  
Alexander J. Clough ◽  
Debbie Rigby ◽  
...  

Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.


2020 ◽  
Vol 35 (10) ◽  
pp. 419-433
Author(s):  
Janet K. Sluggett ◽  
Stephanie L. Harrison ◽  
Leona A. Ritchie ◽  
Alexander J. Clough ◽  
Debbie Rigby ◽  
...  

Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.


2019 ◽  
Vol 75 (12) ◽  
pp. 3715-3725
Author(s):  
Roy Kohnen ◽  
Jan Lavrijsen ◽  
Odile Smals ◽  
Debby Gerritsen ◽  
Raymond Koopmans

2019 ◽  
Vol 13 (3) ◽  
pp. 84-98
Author(s):  
David Brodsky ◽  
Mardelle McCuskey Shepley

Aim: This study focused on long-term care (LTC) settings for individuals with acquired brain injury (ABI). The goals were (1) to assess the impact of facility configuration on social interactions between residents and staff and (2) obtain a better understanding of staff and resident perceptions of the built environment. Background: A few studies have explored the relationship between the built environment and social interaction in LTC facilities, but there is little empirical data about ABI-specific LTC facilities. Methods: A literature review was conducted on the impact of the built environment on the LTC of brain injury survivors. Via a questionnaire, staff and residents in two settings, one with patient rooms off corridors and the other with patient rooms surrounding a common space, rated the effectiveness of the built environment in promoting social interaction. Behavioral observation was conducted on 18 residents for a duration of 4 hr per resident. Results: Via questionnaires, staff rated the corridor facility as more effective in promoting social interaction, but no significant differences were found between the assessments of the two resident populations. Contrary to staff questionnaire results, residents in the open configuration facility exhibited more social behaviors. Conclusions: Building configuration may impact social interaction between staff and residents in ABI-specific LTC facilities and potentially impact staff and resident quality of life. However, configuration cannot be viewed in a vacuum; residents’ physical and mental limitations, demographic information, and staff engagement must be also considered.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Md. Mijanur Rahman ◽  
Jimmy T. Efird ◽  
Julie E. Byles

Abstract Background Over two-thirds of older Australians use different types/levels of aged care at some point in later life. Our aims were to estimate transitional probabilities and to identify risk factors influencing the movement between different levels of long-term care. Methods The sample consisted of 9007 women from the 1921-26 birth cohort of the Australian Longitudinal Study on Women’s Health. Transitional probabilities between different levels of long-term care were estimated using a continuous-time Markov model. Results An 11-fold transition rates ratio was observed for the movement from non-user to home and community care (HACC) versus non-user to residential aged care (RAC). The predicted probabilities of remaining in the non-user state, HACC, and RAC after 10 years from the baseline were .28, .24, and .11, respectively. While the corresponding probabilities of dying from these states were .36, .65, and .90. The risk of transitioning from the non-user state to either HACC or RAC was greater for participants who were older at baseline, widowed, living outside of major cities, having difficulties in managing income, or having chronic condition, poor/fair self-rated health, or lower SF-36 scores (p < .05). Conclusion Women spend a substantial period of their later life using long-term care. Typically, this will be in the community setting with a low level of care. The transition to either HACC or RAC was associated with several demographic and health-related factors. Our findings are important for the planning and improvement of long-term care among future generations of older people. Trial registration Not applicable.


Brain Injury ◽  
2018 ◽  
Vol 32 (13-14) ◽  
pp. 1591-1600 ◽  
Author(s):  
Roy F. Kohnen ◽  
Debby L. Gerritsen ◽  
Odile M. Smals ◽  
Jan C.M. Lavrijsen ◽  
Raymond T.C.M. Koopmans

2001 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Carol Winchester ◽  
Cathy Pelletier ◽  
Pete Johnson

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