People Under 50 With Acquired Brain Injury Living in Residential Aged Care

2010 ◽  
Vol 11 (3) ◽  
pp. 299-312 ◽  
Author(s):  
Dianne Winkler ◽  
Sue Sloan ◽  
Libby Callaway
Keyword(s):  
Brain Injury ◽  
Community Integration ◽  
Acquired Brain Injury ◽  
Aged Care ◽  
Support Networks ◽  
Residential Aged Care ◽  
Service Development ◽  
Support Needs ◽  
Diverse Group ◽  
Care Needs

AbstractObjectives:The aim of this article is to describe the characteristics, needs and preferences of people under 50 with an acquired brain injury (ABI) living in residential aged care in Victoria and examine implications for service development.Participants:Sixty-one people under 50 with an ABI living in residential aged care in the state of Victoria.Measures:Care and Needs Scale, Community Integration Questionnaire, Overt Behaviour Scale, Health of the Nation Outcome Scale — ABI Version, Role Checklist, Resident Choice Scale.Results:The younger people with ABI in this study were a diverse group with a complex range of health and support needs that were not being adequately met within residential aged care. Many people (44%) required the highest level of support, indicating they could not be left alone while 26% could be left for part of the day and overnight. Most people (81%) and their support networks indicated they would like to explore moving out from residential aged care into community accommodation settings.Conclusions:This article provides clear direction for the development of services to meet the care needs of this group, to enable them to participate in the life of the community and to pursue a lifestyle of choice.

Comparison of People With ABI Living in Two Accommodation Settings: Shared Supported Accommodation and Residential Aged Care

2010 ◽  
Vol 11 (3) ◽  
pp. 313-325 ◽  
Author(s):  
Dianne Winkler ◽  
Louise Farnworth ◽  
Sue Sloan ◽  
Ted Brown ◽  
Libby Callaway
Keyword(s):  
Community Integration ◽  
Leisure Activities ◽  
Social Contact ◽  
Aged Care ◽  
Residential Aged Care ◽  
Support Needs ◽  
Care Needs ◽  
Supported Accommodation ◽  
Severe Acquired Brain Injury ◽  
Significant Difference

AbstractBackground:People with severe acquired brain injury (ABI) often require high and ongoing levels of paid support, which is sometimes provided within a shared supported accommodation service (SSA). In Victoria there are more than 140 people with severe ABI living in shared supported accommodation services who have a similar level of disability as young people with ABI in residential aged care (RAC).Objectives:The aims of this article are twofold: (1) to describe the characteristics, support needs and level of community inclusion of people with an ABI living in shared SSA in Victoria and (2) to compare the characteristics, support needs, social contact, community integration and leisure participation of this group with a group of people with ABI under 50 years old living in RAC reported in a previous study.Participants:Information was obtained from SSA managers on 128 residents with an ABI, aged under 60 years, who were living in shared supported accommodation.Measures:Questionnaires were used to obtain information about the characteristics, support needs and occupational participation of participants. Support needs were measured utilising the Care and Needs Scale (CANS).Method:Questionnaires were sent to and completed by SSA managers.Results:Of the 39 SSA managers contacted, 32 provided information about the characteristics of 128 residents with ABI living in their facilities. While 72% of SSA residents accessed the community almost everyday or more often, 40% of this sample received a visit from a friend less often than once per year. Results of the CANS indicated that the SSA group required a similar level of support to the comparison group of people with ABI living in RAC, but went outside, participated in community based leisure activities, and visited friends significantly more often. There was no significant difference between the two groups in the frequency of visits to the facility from relatives or friends.Conclusion:Although the relationship between client outcomes and accommodation is a complex one, this study suggests that the type of accommodation and support has a significant impact on the frequency of community participation experienced people with ABI and high care needs.

Everyday Choice Making: Outcomes of Young People with Acquired Brain Injury After Moving from Residential Aged Care to Community-Based Supported Accommodation

2015 ◽  
Vol 16 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Dianne Winkler ◽  
Libby Callaway ◽  
Sue Sloan ◽  
Nadine Holgate
Keyword(s):  
Brain Injury ◽  
Young People ◽  
Acquired Brain Injury ◽  
Aged Care ◽  
Residential Aged Care ◽  
Small Scale ◽  
Structured Interviews ◽  
Community Based ◽  
Choice Making ◽  
Supported Accommodation

Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.

Council of Australian Governments' (COAG) Initiative for Young People With Disability in Residential Aged Care: What Are the Issues for Acquired Brain Injury?

2007 ◽  
Vol 8 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Michele Foster ◽  
Jennifer Fleming ◽  
Cheryl Tilse
Keyword(s):  
Brain Injury ◽  
Young People ◽  
Long Term Care ◽  
Acquired Brain Injury ◽  
Aged Care ◽  
Residential Aged Care ◽  
Term Care ◽  
Care Environment

AbstractPeople surviving severe acquired brain injury (ABI) may potentially benefit from the Council of Australian Governments' (COAG) 5-year initiative for young people with disability in residential aged-care facilities. Yet critical examination of this policy initiative for ABI population is warranted for 2 reasons. First, reliance on the disability sector to resolve the complexities of long-term care for people with ABI detracts attention from systemic failures at the health/disability sector interface, and notably, debate concerning the role of, and right to rehabilitation. Second, the COAG initiative is being pursued within an extraordinarily complex and variable contemporary care environment, involving multiple services and sectors, and historically, high unmet need. This raises questions as to the adequacy and sustainability of care provided under the responsibility of state-based disability services. In this article, it is argued that long-term care for young people with severe ABI is better served by incorporating a health and rehabilitation perspective alongside a disability support approach. Although the effectiveness of rehabilitation may be contested in some instances of very severe ABI, nevertheless the role of rehabilitation in seeking to reduce the number of young people at risk of entering residential aged care needs to be addressed in policy solutions. It is also suggested that provision of long time care in the contemporary care environment involves a number of challenges due to the complex and changing patterns of need, diverse funding arrangements and mix of government and nongovernment services, and the increasing demand for care.

Long-Term Outcome Following Traumatic Brain Injury

2007 ◽  
Vol 8 (3) ◽  
pp. 251-261 ◽  
Author(s):  
Sue Sloan ◽  
Dianne Winkler ◽  
Katie Anson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Community Integration ◽  
Functional Independence ◽  
Cost Of Care ◽  
Support Needs ◽  
Care Needs ◽  
Life Roles ◽  
Over Time

AbstractObjectives: To investigate care needs, functional outcome, role participation and community integration approximately nine years following severe brain injury. To gain an understanding of the ongoing cost of care and support needs for this group. Participants: 13 individuals who had sustained an extremely severe traumatic brain injury (TBI), between 8 and 9 years previously participated in the study. These individuals were the remaining participants of a larger sample of consecutive admissions between 1996 and 1998 at Ivanhoe Manor Rehabilitation Hospital. Measures: Structured Interview, Functional Independence Measure, Community Integration Questionnaire, Care and Needs Scale and Role Checklist. Results: The majority of the participants were reported to have high support needs, with 6 participants (46%) requiring 24-hour support. Four participants were reported to able to be left alone for between a few hours per day to almost all week. Three participants reported that they were completely independent. The participant's characteristics are described in terms of functional independence, community integration and role participation. Overall care needs appear to have remained relatively stable between 2 and 9 years postinjury. However, there was a shift in the proportion of paid and gratuitous care over time, with a decrease in paid care and increased gratuitous care noted from the 2-year to long-term follow-up time points. Conclusions: Severe TBI has a long term influence on life roles, care needs and functional independence. The current study suggests that high care needs do not necessarily preclude participants from leading active lives and participating in valued life roles. The importance of social support in facilitating participation in activity and the potential issues for caregiver burden, given the increase in gratuitous care over time, should be acknowledged and further research in this area is recommended.

Changes in Care and Support Needs Following Community-Based Intervention for Individuals With Acquired Brain Injury

2009 ◽  
Vol 10 (3) ◽  
pp. 295-306 ◽  
Author(s):  
Sue Sloan ◽  
Libby Callaway ◽  
Dianne Winkler ◽  
Kirsten McKinley ◽  
Carlo Ziino ◽  
...  
Keyword(s):  
Brain Injury ◽  
Community Integration ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Support Needs ◽  
Intervention Period ◽  
Post Injury ◽  
Community Based ◽  
Care And Support ◽  
Life Roles

AbstractObjective:To examine the care and support and participation outcomes for individuals with severe Acquired Brain Injury (ABI) provided with three consecutive years of Community Approach to Participation (CAP) intervention.Method:A case series study design was undertaken with a total of 43 participants from two private occupational therapy practices specialising in community-based, CAP rehabilitation for people with severe ABI. Data were collected at four time points: January 2004 (Baseline), January 2005 (T1), January 2006 (T2), and January 2007 (T3) and included rating on the Care and Needs Scale (CANS); number of hours of paid and gratuitous weekly support; FIM™ and Community Integration Questionnaire scores; and number of current life roles (as recorded on Part 1 of the Role Checklist). Participants were an average of 6.73 years post injury and were living in a range of community environments and residential facilities.Results:There was considerable change in participants' CANS rating across the intervention period, with statistically significant decreases occurring from Baseline to T1 and T1 to T2. Ninety-five per cent of participants received some level of weekly paid support throughout the intervention period, with the amount varying considerably. Paid care decreased by an average of 10.78 hours per week from 85.85 hours per week at Baseline to 75.06 at T3. Although not statistically significant, this equated to an average cost saving of AU$324.84 per participant per week by the end of CAP intervention. There was an overall mean reduction of 4.96 hours of gratuitous care per week per participant over the intervention period, which was statistically significant. Increases in functional independence, community integration, and role participation were also found. On the FIM™, statistically significant improvement occurred between Baseline and T1 and on the CIQ between Baseline and T1 and T1 and T2. Significant increase on the Role Checklist occurred between Baseline and T1 and between T2 and T3. The number of life roles in which participants engaged increased by an average of 1.65 roles by the end of the intervention period. A reduction in care and support needs (measured by the CANS) was significantly associated with: (1) a reduction in total care hours, (2) and an increase in functional independence on the FIM™, and (3) an increase in community integration on the CIQ.Conclusion:With a long term approach and contextualised intervention targeted at skill development in the areas that underpin personally valued participation, increased role performance and community integration can be achieved by people with severe ABI, even many years post injury. This increased capacity has been found to be associated with a reduction in care and support needs, including paid and gratuitous care hours, over time.

scholarly journals Factors impacting hospital avoidance program utilisation in the care of acutely unwell residential aged care facility residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Luke Testa ◽  
Tayhla Ryder ◽  
Jeffrey Braithwaite ◽  
Rebecca J. Mitchell
Keyword(s):  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Nurse Specialist ◽  
Structured Interviews ◽  
Care Needs ◽  
Aged Care Facility ◽  
Enabling Factors ◽  
Clinical Nurse ◽  
Residential Aged Care Facility

Abstract Background An existing hospital avoidance program, the Aged Care Rapid Response Team (ARRT), rapidly delivers geriatric outreach services to acutely unwell or older people with declining health at risk of hospitalisation. The aim of the current study was to explore health professionals’ perspectives on the factors impacting ARRT utilisation in the care of acutely unwell residential aged care facility residents. Methods Semi-structured interviews were conducted with two Geriatricians, two ARRT Clinical Nurse Consultants, an ED-based Clinical Nurse Specialist, and an Extended Care Paramedic. Interview questions elicited views on key factors regarding care decisions and care transitions for acutely unwell residential aged care facility residents. Thematic analysis was undertaken to identify themes and sub-themes from interviews. Results Analysis of interviews identified five overarching themes affecting ARRT utilisation in the care of acutely unwell residents: (1) resident care needs; (2) family factors; (3) enabling factors; (4) barriers; and (5) adaptability and responsiveness to the COVID-19 pandemic. Conclusion Various factors impact on hospital avoidance program utilisation in the care of acutely unwell older aged care facility residents. This information provides additional context to existing quantitative evaluations of hospital avoidance programs, as well as informing the design of future hospital avoidance programs.

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 DOMICILIARY SERVICES IMPROVE ACCESS TO DENTAL CARE FOR FUNCTIONALLY DEPENDENT OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S492-S492
Author(s):  
Mathew A Lim ◽  
Gelsomina L Borromeo
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Oral Health ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Needs ◽  
Dental Services ◽  
Unique Challenge ◽  
Care Facilities ◽  
Aged Care Facilities

Abstract There is growing evidence demonstrating links between oral diseases and general health. The increased retention of teeth among functionally-dependent older adults presents a unique challenge in maintaining the oral health of these individuals from basic oral hygiene to accessing dental services. The results of our cross-sectional study demonstrate the important role domiciliary dental services play in reducing the barriers to accessing oral health care in this cohort. In our study, most individuals treated by domiciliary services lived in residential aged care facilities and were significantly older than those treated by hospital and community-based dental services dedicated to the specialized care of individuals with additional health care needs. A significantly higher number of those receiving domiciliary care were unable to self-consent for treatment compared to those managed in other settings. 27.4% of these patients had a diagnosis of dementia. More than half (56.9%) of patients treated by domiciliary services received some form of treatment with almost half (48.1%) of these requiring a dental extraction. Only two of these patients were not diagnosed with a chronic condition known to affect oral health (dementia, Parkinson’s disease, diabetes mellitus, arthritis, stroke, osteoporosis). 23.7% of domiciliary appointments were used for denture fabrication. The results depict the worrying level of unmet treatment need in residents of aged care facilities. However, they also demonstrate the potential for domiciliary dental services to play a role in developing partnerships between carers and oral health professionals to improve the oral health of functionally-dependent older adults.

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