scholarly journals Reflections of executive staff using the SaferCare Victoria COVID-19 clinical screening tool in a residential aged care service during the pandemic in Victoria, Australia

2021 ◽  
Vol 38 (4) ◽  
Author(s):  
Sonali Pinto ◽  
Zoe Wainer ◽  
Susan Oliver ◽  
Joseph E Ibrahim
Keyword(s):  
Screening Tool ◽  
Care Service ◽  
Aged Care ◽  
Residential Aged Care ◽  
Clinical Screening ◽  
Executive Staff

scholarly journals Developing a clinical screening tool for identifying COVID‐19 infection in older people dwelling in residential aged care services

2020 ◽  
Author(s):  
Kavitha Gnanasambantham ◽  
Georgia Aitken ◽  
Brett Morris ◽  
Jessica Simionato ◽  
Eu‐Hua Chua ◽  
...  
Keyword(s):  
Older People ◽  
Screening Tool ◽  
Aged Care ◽  
Residential Aged Care ◽  
Clinical Screening ◽  
Care Services

scholarly journals Housing and Care for Older Women in Australia

2021 ◽  
Vol 9 ◽  
Author(s):  
Julie E. Byles ◽  
Emily M. Princehorn ◽  
Peta M. Forder ◽  
Md Mijanur Rahman
Keyword(s):  
Service Use ◽  
Care Service ◽  
Later Life ◽  
Aged Care ◽  
Community Services ◽  
Residential Aged Care ◽  
Institutional Setting ◽  
Care Needs ◽  
Housing Type ◽  
Care Assessment

Background: Housing is essential for healthy ageing, being a source of shelter, purpose, and identity. As people age, and with diminishing physical and mental capacity, they become increasingly dependent on external supports from others and from their environment. In this paper we look at changes in housing across later life, with a focus on the relationship between housing and women's care needs.Methods: Data from 12,432 women in the 1921–26 cohort of the Australian Longitudinal Study on Women's Health were used to examine the interaction between housing and aged care service use across later life.Results: We found that there were no differences in access to home and community care according to housing type, but women living in an apartment and those in a retirement village/hostel were more likely to have an aged care assessment and had a faster rate of admission to institutional residential aged care than women living in a house. The odds of having an aged care assessment were also higher if women were older at baseline, required help with daily activities, reported a fall, were admitted to hospital in the last 12 months, had been diagnosed or treated for a stroke in the last 3 years, or had multiple comorbidities. On average, women received few services in the 24 months prior to admission to institutional residential aged care, indicating a potential need to improve the reach of these services.Discussion: We find that coincident with changes in functional capacities and abilities, women make changes to their housing, sometimes moving from a house to an apartment, or to a village. For some, increasing needs in later life are associated with the need to move from the community into institutional residential aged care. However, before moving into care, many women will use community services and these may in turn delay the need to leave their homes and move to an institutional setting. We identify a need to increase the use of community services to delay the admission to institutional residential aged care.

scholarly journals Identifying the Association Between Older Adults' Characteristics and Their Health-Related Outcomes in a Transition Care Setting: A Retrospective Audit

2021 ◽  
Vol 9 ◽  
Author(s):  
Jo-Aine Hang ◽  
Jacqueline Francis-Coad ◽  
Chiara Naseri ◽  
Angela Jacques ◽  
Nicholas Waldron ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Care Service ◽  
Aged Care ◽  
Functional Improvement ◽  
Residential Aged Care ◽  
Discharge Destination ◽  
Transition Care ◽  
Retrospective Audit ◽  
Health Related

Introduction: Continued evaluation of Transition Care Programs (TCP) is essential to improving older adults' outcomes and can guide which older adults may benefit from undertaking TCP. The aim of this study was to audit a transition care service to identify the association between the characteristics of older adults undertaking a facility-based TCP and (i) discharge destination and (ii) functional improvement.Materials and methods: An audit (n = 169) of older adults aged 60 years and above who completed a facility-based TCP in Australia was conducted. Outcomes audited were performance of activities of daily living (ADL) measured using the Modified Barthel Index (MBI) and discharge destination. Data were analyzed using logistic regression and linear mixed modeling.Results: Older adults [mean age 84.2 (±8.3) years] had a median TCP stay of 38 days. Fifty-four older adults (32.0%) were discharged home, 20 (11.8%) were readmitted to hospital and 93 (55%) were admitted to permanent residential aged care. Having no cognitive impairment [OR = 0.41 (95% CI 0.18-0.93)], being independent with ADL at admission [OR = 0.41 (95% CI 0.16-1.00)] and a pre-planned team goal of home discharge [OR = 24.98 (95% CI 5.47-114.15)] was significantly associated with discharge home. Cases discharged home showed greater improvement in functional ability [MBI 21.3 points (95% CI 17.0-25.6)] compared to cases discharged to other destinations [MBI 9.6 points (95% CI 6.5-12.7)].Conclusion: Auditing a facility-based TCP identified that older adults who were independent in ADL and had good cognitive levels were more likely to be discharged home. Older adults with cognitive impairment also made clinically significant functional improvements.

scholarly journals The Impact of Musculoskeletal Conditions on Assessed Levels of Care Required by Older Australians

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Tiffany K Gill ◽  
Steve Wesselingh ◽  
Maria C Inacio
Keyword(s):  
Risk Factors ◽  
Residential Care ◽  
Chronic Conditions ◽  
Community Care ◽  
Care Service ◽  
Functional Limitations ◽  
Aged Care ◽  
Residential Aged Care ◽  
Musculoskeletal Conditions ◽  
The Impact

IntroductionMusculoskeletal problems, including conditions such as back pain, neck pain, rheumatoid arthritis, gout and osteoarthritis are common in the population and significant contributors to global disease burden. Age is one of the most common risk factors for musculoskeletal conditions and over 40% of older people accessing residential aged care have a musculoskeletal condition. It is not known whether individuals living in the community with musculoskeletal conditions have similar needs to those in permanent care and this is important to know in order to provide appropriate care. Objectives and ApproachThe objective of this study was to profile individuals with musculoskeletal conditions in different aged care service settings (i.e. permanent care, community care only, transition/ respite care, or no services). Specifically, we examined the concurrent chronic conditions, health risk factors and functional limitations of individuals by service setting. A cross-sectional evaluation of individuals in the National Historical Cohort of the Registry of Senior Australians (ROSA) between 2004 and 2014 was conducted. Multivariable logistic regression models estimated the factors associated with being in different aged care settings. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Results401,026 (42.5%) individuals with musculoskeletal conditions were assessed for aged care service eligibility during the study period. Of these 197,181 (49.2%) accessed permanent care, 37,003 (9.2%) accessed home care, 54,826 (13.7%) transition/respite, and 112,016 (27.9%) - no care. Individuals accessing community care compared to residential care were more likely to be female, have pain and have difficulty maintaining their home, as were individuals accessing no services compared to residential care. Conclusion / ImplicationsCompared to those in residential care, individuals with musculoskeletal conditions in the community with or without assistance had few differences related to other chronic conditions and functional limitations. But the reasons why some had support, while others did not, are unclear.

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 Comparison of Time-Varying and Landmark Analysis Methods in Estimating the Association Between Medication Adherence and Outcomes: A Heart Failure Cohort

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Benjumin Hsu ◽  
Louisa Jorm
Keyword(s):  
Heart Failure ◽  
Service Use ◽  
Cox Regression ◽  
Care Service ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing In Place ◽  
Care Services ◽  
Relative Risks ◽  
Hospital Stays

IntroductionCardiovascular disease (CVD) is a leading contributor to disease burden worldwide. Older people hospitalized with CVD might experience significant decline in physical function and loss of independence. Objectives and ApproachThe aim of this study was to investigate the use of community aged care (CAC) and permanent residential aged care (PRAC) services 3 months, 6 months and 12 months after hospital admission for myocardial infarction (MI), stroke and congestive heart failure (CHF). Survey data from the 45 and Up Study (2006-09) for 266,942 people aged 45+ was linked with records for hospital stays (APDC), aged care service use (NACDC), and deaths (RBDM) for 2006-14 through CHeReL and AIHW. Relative risks of using aged care (CAC or PRAC) after MI, stroke or CHF hospitalization were estimated using Cox regression. We described and visualized sequences of health service states (none, re-hospitalization, CAC, PRAC, death) after the index hospitalization. ResultsCompared with people without MI, people hospitalized with a principal diagnosis of MI (multivariable-adjusted HR:1.11, 95%CI:1.04-1.18), stroke (HR:1.52, 95%CI:1.43-1.61) and CHF (HR:1.12, 95%CI:1.06-1.19) were more likely to use CAC within 3 months of the hospital discharge. Likewise, people with MI (HR:1.16, 95%CI:1.03-1.29), stroke (HR:2.81, 95%CI:2.58-3.05) and CHF (HR:1.36, 95CI:1.24-1.49) were more likely to enter PRAC within 3 months of discharge. Similar findings were observed for 6 months and 12 months. MI, stroke and CHF patients were more likely to die but less likely to be re-hospitalized after the first 3 months. The number use of CAC and PRAC remains unchanged over 12 months. While this study provides a broadly representative sample of the older population, participants may be healthier than the general population. Conclusion / ImplicationsCVD increases use of community and residential care services. Coordination of cardiac and stroke rehabilitation is warranted to maximize ageing in place.

scholarly journals Characteristics associated with residential aged care, respite and transitional aged care placement for older people following an injury-related hospitalisation in Australia

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Rebecca Mitchell ◽  
Lara Harvey ◽  
Brian Draper ◽  
Henry Brodaty ◽  
Jacqui Close
Keyword(s):  
Service Use ◽  
Transitional Care ◽  
Care Service ◽  
Aged Care ◽  
Personal Hygiene ◽  
Residential Aged Care ◽  
Older Individuals ◽  
Leg Injuries ◽  
Arm Injuries ◽  
Related Hospitalisation

Objective: This study examines characteristics associated with permanent residential aged care (RAC), respite RAC and transitional care (TC) placement for older individuals following an injury-related hospitalisation. Method: A retrospective analysis of individuals aged ≥65 years who had an injury-related hospitalisation and who had a linked record in RAC, TC or activities of daily living (ADL) data between 1 July 2008 and 30 June 2013 in New South Wales, Australia. Comorbidities were identified using diagnosis classifications and a 1-year lookback period. All hospital episodes of care related to the injury were linked to form a period of care. Both new and existing admissions to RAC were examined. Multinominal logistic regression was used to examine the factors associated with new admissions to permanent RAC, respite RAC and TC compared to return to the community. Results: Of 191,301 injury-related hospitalisations, 41,085 (21.5%) individuals either returned or were new admissions to permanent (87.2%) or respite (12.8%) RAC and 3,218 (1.7%) individuals were admitted to TC. There were 3,864, 4,314 and 2,630 new admissions to permanent RAC, respite RAC and TC, respectively. Of the injury hospitalisations, 70,796 (37.0%) individuals had an ADL assessment. Compared to individuals who returned to the community, individuals newly admitted to permanent RAC were four times as likely to have dementia (OR: 4.36; 95%CI 4.15-4.57), those admitted to respite RAC were twice as likely to have dementia (OR: 2.37; 95%CI 2.21-2.54) and people admitted to TC people were less likely to have dementia (OR: 0.60; 95%CI 0.53-0.68). Individuals with shoulder and upper arm injuries were twice as likely (OR: 2.31; 95%CI 1.98-2.68) and individuals with knee and lower leg injuries were one and a half times as likely (OR: 1.87; 95%CI 1.60-2.18) to be admitted to TC. Overall, individuals who were admitted to permanent or respite RAC had a higher likelihood of experiencing limitations associated with their physical, cognitive or social abilities, with individuals admitted to TC having a higher likelihood of having limitations maintaining personal hygiene and mobility compared to individuals returning to the community. Conclusion: An understanding of the profile of which older individuals are using RAC (permanent or respite) or TC services can usefully inform current and future aged care service use.

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