scholarly journals Dry Eyes, Ocular Lubricants, and Use of Systemic Medications Known or Suspected to Cause Dry Eyes in Residents of Aged Care Services

2020 ◽  
Vol 17 (15) ◽  
pp. 5349
Author(s):  
Muhamad Aljeaidi ◽  
Claire Keen ◽  
J. Simon Bell ◽  
Tina Cooper ◽  
Leonie Robson ◽  
...  
Keyword(s):  
Primary Outcome ◽  
South Australia ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Residential Aged Care ◽  
Cross Sectional ◽  
Dry Eyes ◽  
Care Services ◽  
Medical Histories ◽  
Possible Cause

Ocular issues are common, burdensome, and under-researched among residents of aged care services. This study aims to investigate the prevalence of dry eyes or use of ocular lubricants among residents, and the possible association with systemic medications known or suspected to cause dry eyes. A cross-sectional study of 383 residents of six aged care services in South Australia was conducted. Data were extracted from participants’ medical histories, medication charts, and validated assessments. The main exposure was systemic medications known to cause, contribute to, or aggravate dry eyes. The primary outcome was documented dry eyes or regular administration of ocular lubricants. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between systemic medications and dry eyes/use of ocular lubricants. Dry eyes were documented for 53 (13.8%) residents and 98 (25.6%) residents were administered ocular lubricants. Overall, 116 (30.3%) residents had documented dry eyes/used ocular lubricants. Of these, half (n = 58) were taking a medication known to cause, contribute to, or aggravate dry eyes. Taking one or more medications listed as known to cause dry eyes was associated with having dry eyes/use of ocular lubricants (OR 1.83, 95% CI 1.15–2.94). In sub-analyses, no individual medication was associated with dry eyes/use of ocular lubricants. Dry eyes and use of ocular lubricants are common in residential aged care. Our hypothesis generating findings suggest the need for further research into the clinical significance of systemic medications as a possible cause of dry eyes.

Preferred Place of Death—A Study of 2 Specialist Community Palliative Care Services in Australia

2021 ◽  
pp. 082585972110180
Author(s):  
Emily Saurman ◽  
Sam Allingham ◽  
Kylie Draper ◽  
Julie Edwards ◽  
Jeanette Moody ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Facility ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Place Of Death ◽  
Residential Aged Care ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Individual Variables

Choice and preference are fundamental to person-centered care and supporting personal choice at the end of life should be a priority. This study analyzed the relationship between a person’s preferred place of death and other individual variables that might influence their actual place of death by examining the activity of 2 specialist community palliative care services in Australia. This was a cross-sectional study of 2353 people who died between 01 August 2016-31 August 2018; 81% died in their preferred place. Sex, type of life-limiting illness, and length of time in care were the only variables significantly related to dying in one’s preferred place. Women were more likely to die in their preferred place than men (84% v 78%) and people with a non-cancer diagnosis were 7% more likely to die in their preferred place than those with cancer, particularly when that place was their private residence (74% v 60%) or Residential Aged Care Facility (98% v 89%). Someone in care for 0-7 days had 4.2 times greater odds of dying in their preferred place (OR = 4.18, 2.20-7.94), and after 21 days in care, people had 4.6 greater odds of having a preference to die in a hospital (OR = 4.63, 3.58-5.99). Both community palliative care services have capacity and a model of care that is responsive to choice. These findings align with known referral patterns and disease trajectories and demonstrate that it is possible to support the majority of people in the care of community palliative care services to die in their preferred place.

scholarly journals Patterns of High-Dose and Long-Term Proton Pump Inhibitor Use: A Cross-Sectional Study in Six South Australian Residential Aged Care Services

2019 ◽  
Vol 6 (3) ◽  
pp. 105-113 ◽  
Author(s):  
Ivanka Hendrix ◽  
Amy T. Page ◽  
Maarit J. Korhonen ◽  
J. Simon Bell ◽  
Edwin C. K. Tan ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Residential Aged Care ◽  
High Dose ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Senior staff perspectives of a quality indicator program in public sector residential aged care services: a qualitative cross-sectional study in Victoria, Australia

2016 ◽  
Vol 40 (1) ◽  
pp. 54 ◽  
Author(s):  
Liam M. Chadwick ◽  
Aleece MacPhail ◽  
Joseph E. Ibrahim ◽  
Linda McAuliffe ◽  
Susan Koch ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Public Sector ◽  
Data Collection ◽  
Aged Care ◽  
Residential Aged Care ◽  
Successful Implementation ◽  
Front Line ◽  
Cross Sectional ◽  
Executive Staff ◽  
Care Services

Objective The aims of the present study were to describe the views of senior clinical and executive staff employed in public sector residential aged care services (RACS) about the benefits and limitations of using quality indicators (QIs) for improving care, and to identify any barriers or enablers to implementing the QI program. Methods A cross-sectional qualitative study using semistructured interviews and direct observation of key informants involved in the QI program was performed across 20 public sector RACS in Victoria, Australia. Participants included senior clinical, executive and front-line staff at the RACS. The main outcome measures were perceived benefits and the enablers or barriers to the implementation of a QI program. Results Most senior clinical and executive staff respondents reported substantive benefits to using the QIs and the QI program. A limited number of staff believed that the QI program failed to improve the quality of care and that the resource requirements outweighed the benefits of the program, resulting in disaffected staff. Conclusions The QIs and QI program acted as a foundation for improving standards of care when used at the front line or point of care. Senior executive engagement in the QI program was vital to successful implementation. What is known about this topic? QIs measure the structures, processes or outcomes of care and identify issues that need further investigation or improvement. QIs are increasingly being adopted throughout the world. In Australia, the public sector RACS QIs project was implemented in 2006. It is yet to be formally evaluated. What does this paper add? Perceived benefits and limitations of the QI program were identified, together with barriers to successful implementation of the program and recommendations for future improvements. QI data were reported to improve quality culture and assist with identifying clinical areas for improvement. However, the QI program was associated with significantly increased workload and some stakeholders questioned its usefulness. The QI program studied could be improved through better access to education and training for those responsible for data collection and results dissemination to appropriate training and resources; and revision of the QI definitions and reporting methods. What are the implications for clinicians? QI data are useful for identifying opportunities for quality improvement. Despite data limitations, public sector RACS can use data for internal benchmarking, staff education and targeting of quality improvement interventions. At the policy level, revising the QI definitions and simplifying data collection and reporting would improve and strengthen the program. At the clinician and executive level, there is also a strong preference for QI data that allow comparison and benchmarking between facilities.

scholarly journals People living in residential aged care need to BE outside not just SEE outside: associations between quality of life and outdoor access: a cross-sectional study

2019 ◽  
Author(s):  
Suzanne Marie Dyer ◽  
Enwu Liu ◽  
Emmanuel Gnanamanickam ◽  
Stephanie Louise Harrison ◽  
Rachel Milte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Care Homes ◽  
Residential Aged Care ◽  
Small Scale ◽  
Sectional Study ◽  
Model Of Care ◽  
Cross Sectional

Abstract Background The value of providing access to outdoor areas for people living in residential aged care, including those living with dementia, in terms of mood, behaviour and well-being is increasingly acknowledged. This study examines associations between provision of independent access to outdoor areas and frequency of residents going outdoors with the quality of life (QoL) of nursing home residents and compares use of outdoor areas between alternative models of residential aged care. Methods A cross-sectional study was conducted including 541 participants from 17 residential aged care homes in four states in Australia, mean age 85 years, 84% with cognitive impairment. Associations between having independent access to outdoors and the frequency of going outdoors and QoL (EQ-5D-5L) were examined using multi-level models. The odds of going outdoors in a small-scale home-like model of care compared to standard Australian models of care were examined. Results After adjustment for potential confounders (including comorbidities and facility level variables), living in an aged care home with independent access to the outdoors was not significantly associated with QoL (β=-0.01, 95% Confidence Interval (CI) -0.09 to 0.07, P=0.80). However, going outdoors daily (β=0.13 95%CI 0.06 to 0.21), but not multiple times a week (β=0.03, 95%CI -0.03 to 0.09), was associated with a better QoL. Residents living in a home-like model of care had greater odds of going outdoors daily (odds ratio 15.1, 95%CI 6.3 to 36.2). Conclusions Going outdoors frequently is associated with higher QoL for residents of aged care homes and residents are more likely to get outside daily if they live in a small-scale home-like model of care. However, provision of independent access to outdoor areas alone may be insufficient to achieve these benefits. Increased availability of models of residential aged care with staffing structures, training and design which increases support for residents to venture outdoors frequently is needed to maximise resident quality of life.

scholarly journals Antipsychotic polypharmacy in older Australians

2017 ◽  
Vol 30 (4) ◽  
pp. 539-546 ◽  
Author(s):  
Lisa M. Kalisch Ellett ◽  
Nicole L. Pratt ◽  
Mhairi Kerr ◽  
Elizabeth E. Roughead
Keyword(s):  
Adverse Events ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Residential Aged Care ◽  
Administrative Claims ◽  
Elderly Persons ◽  
Department Of Veterans Affairs ◽  
Cross Sectional ◽  
Younger Adults ◽  
Antipsychotic Side Effects

ABSTRACTBackground:Antipsychotics are commonly used, and the rate of use is highest, among those aged 65 years or over, where the risk of adverse events is also high. Up to 20% of younger adults use more than one antipsychotic concurrently; however there are few studies on the prevalence of antipsychotic polypharmacy in older people. We aimed to analyze antipsychotic use in elderly Australians, focusing on the prevalence of antipsychotic polypharmacy and the use of medicines to manage adverse events associated with antipsychotics.Methods:A cross-sectional study was conducted using Australian Department of Veterans’ Affairs (DVA) administrative claims data for the period 1 March 2014 to 30 June 2014. Veterans dispensed at least one antipsychotic medicine during the study period was included. We determined the number of participants dispensed antipsychotic polypharmacy and the number of participants dispensed medicines to manage antipsychotic side effects.Results:There were 7,412 participants with a median age of 86 years. Fifty-one percent (n=3,784) were women and 48% (n=3,569) lived in residential aged-care. Fifty one participants (0.7%) were dispensed anticholinergic medicines indicated for the management of antipsychotic-associated extrapyramidal movement disorders and eight (0.1%) were dispensed medicines for the management of hyperprolactinemia. Five percent of participants (n=365) received dual antipsychotics. Dual antipsychotic users were more likely to be under the care of a psychiatrist or to have had a mental health hospitalization than those using a single antipsychotic.Conclusions:Antipsychotic polypharmacy occurred in one in 20 elderly persons, indicating that there is room for improvement in antipsychotic use in elderly patients.

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