scholarly journals Choosing and Managing Aged Care Services from Afar: What Matters to Australian Long-Distance Care Givers

Author(s):  
Kate M. Gunn ◽  
Julie Luker ◽  
Rama Ramanathan ◽  
Xiomara Skrabal Ross ◽  
Amanda Hutchinson ◽  
...  

This research aims to identify the factors that influence caregivers’ decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively sampled and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A sample of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.

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


Author(s):  
Christian K. Alch ◽  
Christina L. Wright ◽  
Kristin M. Collier ◽  
Philip J. Choi

Objectives: Though critical care physicians feel responsible to address spiritual and religious needs with patients and families, and feel comfortable in doing so, they rarely address these needs in practice. We seek to explore this discrepancy through a qualitative interview process among physicians in the intensive care unit (ICU). Methods: A qualitative research design was constructed using semi-structured interviews among 11 volunteer critical care physicians at a single institution in the Midwest. The physicians discussed barriers to addressing spiritual and religious needs in the ICU. A code book of themes was created and developed through a regular and iterative process involving 4 investigators. Data saturation was reached as no new themes emerged. Results: Physicians reported feeling uncomfortable in addressing the spiritual needs of patients with different religious views. Physicians reported time limitations, and prioritized biomedical needs over spiritual needs. Many physicians delegate these conversations to more experienced spiritual care providers. Physicians cited uncertainty into how to access spiritual care services when they were desired. Additionally, physicians reported a lack of reminders to meet these needs, mentioning frequently the ICU bundle as one example. Conclusions: Barriers were identified among critical care physicians as to why spiritual and religious needs are rarely addressed. This may help inform institutions on how to better meet these needs in practice.


Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 444 ◽  
Author(s):  
Sarity Dodson ◽  
Roy Batterham ◽  
Karalyn McDonald ◽  
Julian H. Elliott ◽  
Richard H. Osborne ◽  
...  

Background: The HealthMap project is developing an intervention to reduce cardiovascular risk in people living with HIV. As part of the formative stages of the intervention design, we sought to understand the needs of people with HIV (PWHIV). Methods: Two concept-mapping workshops with PWHIV (n = 10), and one with HIV care providers (n = 6) were conducted. The workshop findings were consolidated into a questionnaire administered to PWHIV (n = 300) and HIV care providers (n = 107). Participants were asked to rate the importance of each of 81 presented needs and the degree to which it was currently being met. Results: Workshops provided insights into what PWHIV perceive they need, to live with and manage their condition, and its impact on their life; these included: (1) clinical science research and development; (2) information and support; (3) personal situation; (4) healthcare quality; (5) access to services; (6) access to services specific to ageing; and (7) social justice. Questionnaire results revealed that PWHIV considered information and support, and research and development most important. For providers, healthcare quality, clients’ personal situation, and social justice were most important. In terms of unmet needs, PWHIV and providers both highlighted issues in the areas of social justice, and access to aged care services. Conclusions: PWHIV and HIV providers continue to report unmet needs in the areas of social justice and emerging concerns about access to aged care services. Services must continue to address these issues of access and equity.


2015 ◽  
Vol 21 (2) ◽  
pp. 148 ◽  
Author(s):  
Lydia Hearn ◽  
Linda Slack-Smith

The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved.


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.


2021 ◽  
Vol 12 ◽  
pp. 215013272110292
Author(s):  
Breanne Hobden ◽  
Jamie Bryant ◽  
Megan Freund ◽  
Matthew Clapham ◽  
Rob Sanson-Fisher

Introduction Community aged care services provide support to older adults living in their own homes. Cognitive impairment may increase the complexity of the support required. There is a need to ensure suitable brief screening tools are available to community aged care providers to assess possible cognitive impairment. This study aimed to examine the agreement between 2 validated cognitive impairment screening tools, the Mini-Cog, and Abbreviated Mental Test Score (AMTS), and the perceptions the individuals case manager of Case Manager’s. Methods A cross-sectional survey study was undertaken with clients of a community aged care provider. Clients were administered both the screening tools via an electronic survey by their Case Manager. Results In total, 158 (54%) eligible participants consented to participate. There was a 70% agreement between the Mini-Cog and AMTS measures, indicating a moderate agreement which was not statistically different from chance (Kappa 0.08, 95% CI −0.04-0.19). Case Managers identified 37% (n = 48/130) of participants as possibly having cognitive impairment, of which, 15% (n = 20) were also identified via a screening tool. Conclusions The findings indicate poor agreement across the 3 measures. To ensure adequate supports are offered to those with cognitive impairment, the use of validated tools that can be administered by non-medical staff in a community setting is a priority. This study highlights a need for further work to determine the most suitable tool for use by community-based aged care services.


Author(s):  
MKD Lalitha Meegoda ◽  
Sharaine Fernando ◽  
S Sivayogan ◽  
NOS Atulomah

Background: Palliative care for pain relief and management of other distressing symptoms of cancer patients specially through non-pharmacological approach by family care givers (FCGs) improves the quality of life of patients. Preparedness of FCGs for this role needs to be explored. Methodology: Descriptive qualitative design was adopted to explore the FCGs readiness on providing cancer palliative care for their cancer survivors. Focus Group Discussions were conducted in public sector, private sector and cancer care institutions which are managed by the Cancer Society in the Colombo area until data saturation was achieved between September 2011 to January 2012. Results: Most of the FCGs were females and the mean (SD) age was 39(±10) years. The average educational level of the FCGs/domiciliary care providers was at primary level. Thematic analysis of their data on the readiness to provide cancer PC emerged four key themes; readiness in providing care, need relaxation, need psychosocial support and inadequate knowledge. Conclusion: FCGs had the readiness to provide care for their patients amidst challenges they face during the time of care giving. Family care givers were of the view that having knowledge and experience as an FCG will facilitate in continuing to care effectively.


2016 ◽  
Vol 17 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Serena Mackenzie Jones ◽  
Paul Willis

Purpose – For the vast majority of cisgendered people who experience alignment between the sex they were assigned at birth, the body they have and their gender identity they are comfortable with (Schilt and Westbrook, 2009), the experience of trans people is a distant one. More of us share an experience of aging and the associated concerns about reduced independence, deterioration of health and increased need for care and support. The paper aims to discuss these issues. Design/methodology/approach – For trans elders, the experience of aging has specific features that have a major impact on their lives if not understood, planned for and responded to appropriately. This paper presents findings from a qualitative study exploring trans peoples experiences, concerns and suggestions for how agencies providing elder care can better meet their expectations (Jones, 2013). Findings – The research revealed low confidence in the ability of current aged care services to meet the needs of trans elders due to a limited understanding of the relationship between health and social care specific to trans people; undervaluing the networks in trans people’s lives; the need to demonstrate culturally competent services and real concerns regarding tackling discrimination and abuse. Despite legislative advancements, there was a sense that activism is central to tackling these issues and trans people are articulating their demands for shaping future provision. The research identifies a number of recommendations for care providers and future areas of research. Originality/value – In response to identifying an absence of trans voices being heard on the subject of trans elder care, this study sought to understand expectations of services, amplify the voices of the participants and share the priorities they articulated to influence future service design and practice.


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