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

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.

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 INTERVENSI KEPERAWATAN PADA PENDERITA GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS: SYSTEMATIC REVIEW

2020 ◽  
Vol 6 (1) ◽  
pp. 108-118
Author(s):  
Hayyu Sitoresmi ◽  
Andi Masyitha Irwan ◽  
Elly Lilianty Sjattar
Keyword(s):  
Controlled Trial ◽  
Nursing Intervention ◽  
Inhalation Therapy ◽  
Nursing Interventions ◽  
Care Providers ◽  
Randomized Controlled ◽  
Research Article ◽  
Therapy Training ◽  
Quality Of Nursing

Background : Nursing intervention is very important for care providers to achieve adequacy in hemodialysis (HD) process. Nurses as the front line in services need to know precisely the nursing interventions that can reduce the mortality rate of HD patients. Objective: to identify  what kind of nursing interventions can be done during hemodialysis. Methods:  Pubmed, Science Direct, Wiley Online, Proquest, and Google Scholar are databases used in collecting articles with relevant keywords and PRISMA guidelines. Results: obtained six randomized controlled trial articles according to the inclusion criteria. The research article presents nursing interventions such as inhalation therapy, training programs, foot massage, acupressure, cold dialysate use, and music therapy. The intervention can reduce complications that often occur in HD patients and have appropriate duration to be applied during intradialytic phase. Conclusion:  nursing intervention can be witnessed to overcome complaints of nausea, vomiting, pain, pruritus, physical weakness, cramps, and psychological disorders. But it needs to be adjusted to the patient's condition and coordination with other medical officers in improving the quality of nursing care.

scholarly journals Study protocol for a randomized controlled trial of humor therapy in residential care: the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE)

2012 ◽  
Vol 24 (12) ◽  
pp. 2037-2044 ◽  
Author(s):  
Belinda Goodenough ◽  
Lee-Fay Low ◽  
Anne-Nicole Casey ◽  
Lynn Chenoweth ◽  
Richard Fleming ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Aged Care ◽  
Residential Aged Care ◽  
Pharmacological Intervention ◽  
Elderly Subjects ◽  
Randomized Controlled

ABSTRACTBackground: Humor therapy is a non-pharmacological intervention with potential to improve mood and quality of life for institutionalized older persons, including those with dementia. The primary aims of the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) are to examine the effects of humor therapy on residents’ mood, quality of life, social engagement, and agitation.Methods: SMILE is a single-blinded cluster-randomized controlled trial where 398 consented residents in 35 residential aged care facilities will be allocated to receive humor therapy or usual care. Residents allocated to the intervention group will engage in humor therapy with professional performers (ElderClowns) and trained facility staff (LaughterBosses) for a minimum of nine two-hour sessions over 12 weeks as well as engaging humorously with LaughterBosses during the course of daily care. The usual care control group will not engage in any formal humor therapy. Researchers, blind to treatment allocation, will assess residents at baseline (week 0), post-intervention (week 13), and follow-up (week 26). The measurement suite includes the Cornell Scale for Depression in Dementia, the Dementia Quality of Life Scale, the Multidimensional Observation Scale for Elderly Subjects, the Cohen-Mansfield Agitation Inventory, and the Neuropsychiatric Inventory. Observations of residents’ engagement will be recorded at each humor therapy session.Conclusions: SMILE is the first large rigorous study of humor therapy in aged care.

A randomized controlled trial examining the impact of aged care residents’ written life-stories on aged care staff knowledge and attitudes

2017 ◽  
Vol 30 (9) ◽  
pp. 1291-1299 ◽  
Author(s):  
Michelle Dennerstein ◽  
Sunil S. Bhar ◽  
Jencie J. Castles
Keyword(s):  
Life Stories ◽  
Positive Impact ◽  
Care Service ◽  
Controlled Trial ◽  
Aged Care ◽  
Care Staff ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Knowledge And Attitudes ◽  
The Impact

ABSTRACTBackground:The unprecedented increase in the number of older adults moving into aged care facilities has created a challenge for quality person-centered care service provision. This study examined the impact of written life-stories on knowledge and attitudes of care staff about the residents when compared to usual file notes.Methods:A randomized controlled study was carried out with 40 staff working in an aged care residential facility. Staff were randomly assigned to a control condition, in which they read file notes (n = 21) or to an experimental condition, in which they read life stories (n = 19) about residents who they knew, and completed the Knowledge of Resident Scale (KRS) before and after their assigned reading.Results:A main effect for time was found for eight of the ten questions on the KRS, suggesting that irrespective of whether a participant read life stories or file notes, there was a significantly positive impact on knowledge and attitudes toward residents. However, significantly greater improvement was shown for one item on the KRS in the experimental condition when compared to the control condition, indicating that historical knowledge of residents was greater when staff read life stories than when they read file notes, F (1,38) = 6.50, p = 0.02.Conclusion:These results provide preliminary evidence that knowledge and attitudes of care staff can increase about the residents for whom they care following reading file notes and life stories. The increase is similar, except in the area of historical information, where it is greater for the group who read life stories.

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