Quality of life measurement in community-based aged care – understanding variation between clients and between care service providers

2021 ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Participation ◽  
Service Providers ◽  
Care Service ◽  
Aged Care ◽  
Care Quality ◽  
Care Providers ◽  
Community Based ◽  
Care Services

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

scholarly journals Quality of life measurement in community-based aged care – understanding variation between clients and between care service providers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Participation ◽  
Service Providers ◽  
Care Service ◽  
Aged Care ◽  
Trial Registration ◽  
Care Providers ◽  
Community Based ◽  
Care Services

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.

Smarter Safer Homes Solution to Support Older People Living in Their Own Homes through Enhanced Care Models: Methodologies for a Stratified Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Qing Zhang ◽  
Marlien Varnfield ◽  
Liesel Higgins ◽  
Vanessa Smallbon ◽  
Julia Bomke ◽  
...  
Keyword(s):  
Service Providers ◽  
Care Service ◽  
Controlled Trial ◽  
Aged Care ◽  
Ageing Population ◽  
Care Providers ◽  
Randomized Controlled ◽  
Care Services ◽  
Limited Opportunity

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

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 ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Service Providers ◽  
Care Service ◽  
Internalized Homophobia ◽  
Well Being ◽  
Aged Care ◽  
Care Providers ◽  
Community Connectedness ◽  
Lesbian And Gay ◽  
Care Services

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.

An extensive review of patient health-care service satisfaction in Bangladesh

2020 ◽  
Vol 2 ◽  
pp. 5-16
Author(s):  
Abdul Kader Mohiuddin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Service Providers ◽  
Care Service ◽  
Waiting Times ◽  
Health Care Service ◽  
Care Providers ◽  
Care Services

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.

scholarly journals Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e050892
Author(s):  
Joyce Siette ◽  
Gilbert Thomas Knaggs ◽  
Yvonne Zurynski ◽  
Julie Ratcliffe ◽  
Laura Dodds ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Social Care ◽  
Aged Care ◽  
Care Quality ◽  
Cochrane Library ◽  
Term Care ◽  
Care Services

BackgroundQuality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults’, providers’ and policymakers’ needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services.DesignSystematic review.Data sourcesMEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021.Eligibility criteriaInstruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics.Data extraction and synthesisTwo researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments.Results292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status.ConclusionsA comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users.

Growing Older with an Intellectual Disability

2000 ◽  
Vol 6 (2) ◽  
pp. 57-66
Author(s):  
Lindsay Gething
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Service Provision ◽  
Service Providers ◽  
Family Care ◽  
Well Being ◽  
The United States ◽  
Aged Care ◽  
Policy And Practice

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.

Impact of multiple impairments on quality of life, hospitalisations and use of aged‐care services

2006 ◽  
Vol 184 (9) ◽  
pp. 478-479 ◽  
Author(s):  
Ee‐Munn Chia ◽  
Jie Jin Wang ◽  
Elena Rochtchina ◽  
Paul Mitchell
Keyword(s):  
Quality Of Life ◽  
Aged Care ◽  
Care Services

Social Participation Among Older Adults Receiving Community Care Services

2020 ◽  
pp. 073346482093897
Author(s):  
Joyce Siette ◽  
Helen Berry ◽  
Mikaela Jorgensen ◽  
Lindsey Brett ◽  
Andrew Georgiou ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Participation ◽  
Rural Women ◽  
Service Use ◽  
Community Care ◽  
Care Service ◽  
Geographical Location ◽  
Aged Care ◽  
Care Needs ◽  
Care Services

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.

Vision-Related Quality of Life and Its Sociodemographic Correlates Among Individuals With Visual Impairments

2021 ◽  
pp. 0145482X2110289
Author(s):  
Ansuman Panigrahi ◽  
G. Nageswar Rao ◽  
Amrita Kumari Konar
Keyword(s):  
Quality Of Life ◽  
Health Care Providers ◽  
Dietary Habits ◽  
Service Providers ◽  
Visual Impairments ◽  
Well Being ◽  
Health Concern ◽  
Care Providers ◽  
Sociodemographic Correlates

Introduction: Visual impairment is an important public health concern worldwide that negatively affects quality of life (QOL). We aimed to assess the vision-related QOL and determine its sociodemographic correlates among individuals with visual impairments. Methods: We carried out a cross-sectional study during the years 2016–2017 among 201 individuals with visual impairments aged ≥ 40 years. After obtaining informed consent, we collected relevant information regarding sociodemographic characteristics using a pretested questionnaire and assessed vision-related QOL using the National Eye Institute Visual Function Questionnaire (VFQ-25). An ophthalmologist conducted comprehensive ophthalmic examinations of all the eligible study participants. Results: The mean VFQ-25 composite score was 52.91 + 7.61. The subscale score was highest for color vision (72.39 + 21.71) and worst in the dependency subscale (31.43 + 25.2). Multivariable ordinal regression revealed that variables such as gender, place of residence, household overcrowding, dietary habits, practicing exercise or yoga, and type of eye disorder were significantly ( p< .05) associated with the QOL of individuals with visual impairments. Discussion: The QOL among individuals with visual impairments was poor in our study. Further research is needed to establish associations of various factors with the QOL. Implications for practitioners: Incorporating these determinants of vision-related QOL in the existing strategies could be useful for health care providers and social service providers in promoting the well-being of individuals with visual impairments.

scholarly journals The impact of social care services on carers’ quality of life

2020 ◽  
Vol 4 (2) ◽  
pp. 235-259 ◽  
Author(s):  
Stacey Rand ◽  
Florin Vadean ◽  
Julien Forder
Keyword(s):  
Quality Of Life ◽  
Social Care ◽  
Well Being ◽  
Care Recipient ◽  
Community Based ◽  
Term Care ◽  
Care Services ◽  
The Impact ◽  
Health And Well Being

Unpaid care is an important part of long-term care systems. It is increasingly recognised that carers have their own health and well-being needs. Carer-specific interventions, as well as support for the care-recipient, may enable carers to maintain their own health and well-being alongside caring. This study seeks to establish whether and how community-based care services affect carers’ quality of life. The Adult Social Care Outcomes Toolkit for Carers was used to capture carers’ social care-related quality of life through qualitative interviews and a survey of carers in England in order to provide insights into the impact of community-based care services on carers’ quality of life outcomes.

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