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Aged Care (aged + care)
Kinds of Aged Care Terms modified by Aged Care Selected AbstractsECONOMIC AND FINANCIAL ASPECTS OF AGED CAREECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2005Warren P. Hogan The focus of this article is on the Report of the inquiry into residential aged care in Australia. Consideration is given to the results of a confidential survey of financial submissions from providers of aged care. Most attention is given to labour costs and earnings before interest, taxes, depreciation and amortization (EBITDA). The most important result is the evidence showing providers whatever their size, location, ownership and resident mix, can perform in the top 10 per cent and 25 per cent of providers as measured by EBITDA. Management is vital to the performance of entities whether they be ,for-profit' or ,not-for-profit' entities. Attention is also directed to other studies about efficiency and productivity and modelling. Treating technical efficiency as a measure by which the industry lags behind best practice, the analysis of regulatory efficiency explains much about ways to secure gains in efficiency. [source] The acute,aged care interface: Exploring the dynamics of ,bed blocking'AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2008Catherine M Travers Objective: To understand the dynamics underlying ,bed-blocking' in Australian public hospitals that is frequently blamed on older patients. Methods: Analysis of primary and secondary data of utilisation patterns of hospital and aged care services by older Australians. Results: A model of the dynamics at the acute,aged care interface was developed, in which the pathway into permanent high-care Residential Aged Care (RAC) is conceptualised as competing queues for available places by applicants from the hospital, the community and from within RAC facilities. The hospital effectively becomes a safety net to accommodate people with high-care needs who cannot be admitted into RAC in a timely manner. Conclusion: The model provides a useful tool to explore some of the issues that give rise to access-block within the public hospital system. Access-block cannot be understood by viewing the hospital system in isolation from other sectors that support the health and well-being of older Australians. [source] Innovations in Aged Care: Hip protectors: promising but no panaceaAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2002I.D. Cameron Research indicates that almost all hip fractures occur after a fall onto the hip region and a number of hip protectors have been designed to reduce the force of the fall. Wearing of hip protectors has been shown to be effective in randomised trials in nursing homes with residents at high risk of hip fracture. However, adherence with use of hip protectors is incomplete and hip fracture can still occasionally occur while wearing hip protectors. No published studies have examined the effectiveness of hip protectors in people living in the community rather than in residential aged care facilities. [source] Australian Society for Geriatric Medicine Position Statement No. 10: Residential Aged Care from the Geriatrician's PerspectiveAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2002Article first published online: 5 DEC 200 First page of article [source] The Clinical Value Compass: Achieving Benchmarking and Quality Improvement in Aged CareAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2000Michael Woodward Quality measurement and benchmarking in aged care presents several challenges. A model which addresses this by linking four dimensions of outcomes has been developed - the Clinical Value Compass (CVC). A CVC was developed for stroke rehabilitation and measured across four sites. The CVC was well accepted by the treatment teams and proved practical to measure. The results revealed differences in practices and client groups that led to a closer analysis of processes and subsequent changes in these processes. Remeasuring of the CVC is required to demonstrate improved outcomes arising from these process changes. [source] ECONOMIC AND FINANCIAL ASPECTS OF AGED CAREECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2005Warren P. Hogan The focus of this article is on the Report of the inquiry into residential aged care in Australia. Consideration is given to the results of a confidential survey of financial submissions from providers of aged care. Most attention is given to labour costs and earnings before interest, taxes, depreciation and amortization (EBITDA). The most important result is the evidence showing providers whatever their size, location, ownership and resident mix, can perform in the top 10 per cent and 25 per cent of providers as measured by EBITDA. Management is vital to the performance of entities whether they be ,for-profit' or ,not-for-profit' entities. Attention is also directed to other studies about efficiency and productivity and modelling. Treating technical efficiency as a measure by which the industry lags behind best practice, the analysis of regulatory efficiency explains much about ways to secure gains in efficiency. [source] From retirement village to residential aged care: what older people and their families sayHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2007Julianne Cheek PhD BEd DipT Abstract The majority of older Australians, some of whom live in retirement villages, wish to remain living in their own home, receiving care in the community when their health and/or other circumstances change. Current statistics show that 3.7% of people aged 65 years and over live in a retirement village in Australia. However, residential aged care will still be required for some highly dependent members of the older population. This qualitative Australian study examined the transition into residential care from one form of community housing, the retirement village. In-depth interviews with 33 older people and 48 family members were conducted to illuminate the key issues and factors which influence the move of older people from retirement villages to residential aged care. Analysis of the data revealed the move to be influenced by: health-related crises; the creation of doubt as to ability to cope in the retirement village; the need for more or different care or support services; the desire for independence; assumptions about being able to move into the residential aged care facility co-located with the retirement village; availability of a place; navigating the system; and desirable aspects of a residential aged care facility. The findings of the study provide a description of the transition process from the perspectives of those directly affected, and contribute to the development of best practice in the provision of support to residents living in retirement villages and the community in general. [source] Implementation of oral health recommendations into two residential aged care facilities in a regional Australian cityINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2006Tony Fallon BAppSc(Hons) PhD Abstract Background, Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives, The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods, Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results, The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion, The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care. [source] Developing clinical leaders in Australian aged care homesINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2006Alan Pearson RN PhD FRCNA FAAG FRCN Abstract The role of clinical leadership in implementing evidence based practice is increasingly recognised in the health and social care fields. This paper briefly reviews the literature on clinical leadership and evidence-based practice in aged care and describes the established of an aged care clinical fellowship program in Australia. The purpose of this paper is to introduce the reports of four aged care clinical fellows reported elsewhere in this issue of the International Journal of Evidence-Based Healthcare. [source] The Tri-focal model of care: Advancing the teaching-nursing home conceptINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2008Beverly O'Connell RN PhD FRCNA Providing residential aged care is challenging because of the complexity of residents' health status, difficulties recruiting and retaining skilled staff, and financial and regulatory constraints. This paper discusses some of these challenges and describes an innovative model of care, termed ,The Tri-focal model of care'. This model was developed based on the concepts of ,partnership-centred care', ,positive work environment' and the need for evidence-based practice to underpin all aspects of care. It is envisaged that the implementation of this model will provide a rich learning environment that advances the teaching-nursing home concept and the quality of residential aged care. [source] Facilitating best practice in aged care: exploring influential factors through critical incident techniqueINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2009Nadine Janes GNC(C) Aim., The focus of this study is on the perspective of facilitators of evidence-based aged care in long-term care (LTC) homes about the factors that influence the outcome of their efforts to encourage nursing staff use of best practice knowledge. Design., Critical incident technique was used to examine facilitators' experiences. Methods., Thirty-four participants submitted critical incident stories about their facilitation experiences through face-to-face interviews, telephone interviews, and/or a web-based written questionnaire. The resultant 123 stories were analysed using an inductive qualitative approach. Results., Factors at individual and contextual levels impacted the success of facilitators' work. The approaches and traits of facilitators as well as the emotionality and intellectual capacity of nursing staff were the individual factors of influence. On a contextual level, the inherent leadership, culture, and workload demands within LTC homes, as well as externally imposed standards were influential. Conclusions., Primary factors influencing the facilitation of best aged care in LTC homes appear to be largely relational in nature and intimately connected to the emotionality of those who work within these settings. Enhancing the interactional patterns amongst staff and leaders as well as promoting a positive emotional climate may be particularly effective in promoting better aged care nursing practice. [source] Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital TerritoryJOURNAL OF CLINICAL NURSING, Issue 2 2009Paul Arbon Aim., This paper reports a project investigating the potential role of the nurse practitioner in aged care across residential, community and acute care venues in the Australian Capital Territory. Background., Australia, like many other countries, faces unprecedented challenges in the provision of health care. Escalating health care costs, an ageing population, increasing prevalence of comorbidities and chronic illnesses, inefficient health care delivery, changing models of health care and shifting professional role boundaries are factors that have contributed to the development of advanced practice roles for nursing. Design., This was a mixed methods study using multiple data sources. Methods., Student aged care nurse practitioners were examined across the continuum of care in the acute, community and residential aged care settings. The potential role of the nurse practitioner in these areas was evaluated qualitatively and quantitatively to identify a model of care to enhance the delivery of efficient and effective health care. Results., The project findings have demonstrated that there is potential for significant improvement in client outcomes arising from a transboundary aged care nurse practitioner model. The improved outcomes are associated with a decrease in acute hospital admissions for residential care clients, timely intervention for a range of common conditions and strengthened multidisciplinary approaches to care provision for older people. Conclusions., Overall the project findings strongly support the potential of a transboundary aged care nurse practitioner role. This role would focus on skilled assessment, timely assessment and intervention, brokering around access to care and clinical leadership and education for nurses. Relevance to clinical practice., This paper offers further evidence of support for the role of nurse practitioners in complementing existing health services and improving delivery of care. [source] The Eden model: Innovation in Australian aged care?AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2010Maree Petersen Aim:, The Eden model of care is part of discourse associated with innovation in aged care. There is, however, limited rigorous research to identify its essential claims. This paper examines the implementation of the Eden model in one integrated health service in rural Australia. Methods:, Data are derived from a small qualitative study that explored the views of staff. Results:, Findings highlight that while the discourse of the Eden model is accessible to all staff within aged care and is linked to person-centred care, there is tension with this practice of aged care within the Australian context. Conclusion:, It is appropriate to ask if this form of care is innovative; what constitutes innovation and the importance of accounting for wider contextual factors. There is a need to build on this exploratory study with dialogue and research of not only the Eden model, but innovation in aged care within Australia. [source] Leadership and management in the aged care sector: A narrative synthesisAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2010Yun-Hee Jeon The aim of this study is to examine the issues and the progress being made in leadership and management with relevance for the residential aged care workforce. A systematic review was conducted using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts. After a seven-tiered culling process, we conducted a detailed review of 153 papers relevant to leadership and management development in aged care. Strong, effective leadership and management promotes staff job satisfaction and retention, high care quality and the well-being of care recipients, and reduces associated costs. Good leadership and effective management also play a key role in bringing about a successful change to a positive workplace culture through innovative programs and research projects. Organisational investment in improving leadership and management skills and capabilities can only improve outcomes for staff stability and productivity, care quality and budgets, and better prepare the aged care sector. [source] Transitions from hospital to residential aged care in AustraliaAUSTRALASIAN JOURNAL ON AGEING, Issue 4 2009Rosemary Karmel Aim:, To investigate movement of people from hospital into residential aged care. Methods:, An innovative record linkage method was implemented to create a national database to investigate transitions from hospital into aged care. Results:, In 2001,2002, 3.2% of hospitalisations for people aged 65+ ended with admission into residential aged care. A further 5.5% were for people already living permanently in care. Nationally, more people were admitted into permanent care from hospital than from the community. Factors important in predicting admission to aged care from hospital included length of hospital stay, diagnoses, region of usual residence and hospital jurisdiction. Conclusion:, Individually, national hospital and aged care datasets do not provide adequate information on movement between the sectors. Linking the data allowed the first national investigation into movement from hospital into aged care. Results indicate the importance of investigating interactions of service provision (both supply and demand driven) at the local level. [source] Four-item fall risk screening tool for subacute and residential aged care: The first step in fall preventionAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2009Caroline Stapleton Aim:, To report the reliability, accuracy and compliance of a brief fall risk screening tool in subacute and residential aged care. Method:, A 9-item tool, developed by expert and literature review, was administered to 291 persons admitted to subacute and residential aged care at Peninsula Health (PH) Victoria, Australia. Items were analysed for their ability to predict falls and the four strongest incorporated into a screening tool. Reliability was assessed on six nurses. Results:, Most predictive items were recent falls (0.82), psychological status (0.55), medications (0.46) and cognition (0.41) ,2 (4, n= 291) = 89.89, P < 0.0001. The final 4-item tool (PH-FRAT) provides 80% accuracy (sensitivityER 70.2%, specificityER 68.8%) and high reliability (ICC = 0.79). The PH-FRAT is now used in 50 local subacute and residential facilities. Conclusion:, The 4-item PH-FRAT is a popular, moderately predictive, reliable and brief method of screening fall risk in subacute and residential aged care. [source] Future research on dementia relating to culturally and linguistically diverse communitiesAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2009Lee-Fay Low About one in five older Australians were born overseas. However, there has been very little information published in Australia or internationally about dementia in persons from culturally and linguistically diverse (CALD) backgrounds. This limits our ability to plan for and provide evidence-based medical care, social care and aged care services to persons from CALD backgrounds. This paper describes challenges to conducting CALD dementia research; these include sampling, having valid instruments and costs. Nine key research recommendations in the areas of epidemiology, community knowledge, carers, service delivery, screening and assessment, medical management, residential aged care and minority CALD reached by consensus by an expert group are presented. The paper closes with some strategies to encourage CALD research. The material presented here will provide guidance for future research endeavours. [source] The impact of ageing-in-place policies on structural change in residential aged careAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2009Bev Richardson Objectives:,This paper reports findings from a study to investigate the impact of ageing-in-place policies on resident dependency levels and to explore the relationship between structural variables and outcome ratings. Methods:,The study involved a time series data collection of high- and low-care places and accreditation ratings from both the first and the second accreditation cycles in Queensland (N = 482 and 499). Paired-samples t-tests were also conducted on a sample of homes providing both high- and low-level care to assess changing dependency levels over the two time periods. Results:,A statistically significant increase (0.005) was found in the proportion of residents classified as high care living in low-care homes between the first and the second accreditation cycles. Conclusions:,The findings suggest that the ageing-in-place regulatory intervention achieved the intended policy goal and homes have effectively implemented staffing and quality control strategies to accommodate the changes. [source] Developing recommendations for implementing the Australian Pain Society's pain management strategies in residential aged careAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2008Ruth McConigley Objective:,This study aimed to develop recommendations and a related implementation resource ,toolkit' to facilitate implementation of pain management strategies in Australian Residential Aged Care Facilities (RACFs). Methods:,This qualitative study used written materials, focus groups and individual interviews to gather data from participants. Thirty-four health-care professionals with experience in the aged care sector were recruited from five Western Australian RACFs. General practitioners who had an interest in aged care were contacted via local general practice networks. Results:,Findings indicated that focused education sessions were needed to support implementation. A tailored toolkit was developed to assist the process. Funding and workforce constraints were found to be threats to complete implementation in some facilities. Conclusions:,A multifaceted approach is needed to promote the implementation of pain management strategies in RACFs. In particular, unlicensed care workers, who may have responsibility for recognising and reporting signs of pain, require further education to support their role in the pain management process. [source] The reclassification of elderly people following admission to residential aged careAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2006Andrew Robinson Objectives:,To determine the incidence of, and factors associated with, the reclassification of level of care needs of older people following admission to a residential aged care facility (RACF) in Tasmania. Method:,Focus group discussions with 11 Directors of Nursing of RACFs were conducted to inform the development of a questionnaire, which was administered to all residential aged care providers in the State. Results:,More than 10% of elderly people admitted to a RACF in Tasmania are subject to a reclassification from high to low care or vice versa within 60 days of admission. The study also revealed a number of variables associated with reclassification. Conclusions:,Reclassification of residents is often considered to be a ,significant problem'. To reduce the incidence of reclassification many RACFs conduct their own assessments. Dementia, admission of hospital inpatients and greater than 6 months since an ACAT assessment represent the key predictors of reclassification. [source] Strategy of the reviewAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2005Warren P Hogan This offering is about the ways in which the work of the recent review into aged care was conducted. The account is not exhaustive but is illustrative of some of the major issues experienced. Some of the policy themes and outcomes were explored in the recent Shann Memorial Lecture [1]. The circumstances with which the review was confronted are treated in the second part of the paper. This comes in two segments with the first explaining the measures in place and the second exploring some of the important questions arising from initial considerations of those measures. The onerous nature of the queries should be acknowledged. The following part is about the activities of the review in an effort to cast light on questions raised by the measures in place in relation to the Terms of Reference. The dual task of the review reflected the very substantial lack of empirical work on the aged care industry as well as evidence on the efforts of boards and managements of entities providing aged care services. This coverage is taken further in the final segment which deals with some of the major issues which the review was seeking to address. Some are of the greatest strategic moment. [source] The Clinical Value Compass: Achieving Benchmarking and Quality Improvement in Aged CareAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2000Michael Woodward Quality measurement and benchmarking in aged care presents several challenges. A model which addresses this by linking four dimensions of outcomes has been developed - the Clinical Value Compass (CVC). A CVC was developed for stroke rehabilitation and measured across four sites. The CVC was well accepted by the treatment teams and proved practical to measure. The results revealed differences in practices and client groups that led to a closer analysis of processes and subsequent changes in these processes. Remeasuring of the CVC is required to demonstrate improved outcomes arising from these process changes. [source] | ||||||||||