scholarly journals Clustered domestic residential aged care in Australia: fewer hospitalisations and better quality of life

2018 ◽  
Vol 208 (10) ◽  
pp. 433-438 ◽  
Author(s):  
Suzanne M Dyer ◽  
Enwu Liu ◽  
Emmanuel S Gnanamanickam ◽  
Rachel Milte ◽  
Tiffany Easton ◽  
...  
2019 ◽  
Author(s):  
Suzanne Marie Dyer ◽  
Enwu Liu ◽  
Emmanuel Gnanamanickam ◽  
Stephanie Louise Harrison ◽  
Rachel Milte ◽  
...  

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.


2017 ◽  
Vol 18 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Anne Hogden ◽  
David Greenfield ◽  
Mark Brandon ◽  
Deborah Debono ◽  
Virginia Mumford ◽  
...  

Purpose Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme. Design/methodology/approach Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views. Findings Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life. Research limitations/implications For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question. Originality/value This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lucy K. Lewis ◽  
Tim Henwood ◽  
Jo Boylan ◽  
Sarah Hunter ◽  
Belinda Lange ◽  
...  

Abstract Background The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults’ physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness). Method This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored. Results Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness. Conclusions There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted. Trial registration Prospectively registered review protocol (Open Science Framework: DOI 10.17605/OSF.IO/7NX9M).


2019 ◽  
Author(s):  
Amanda Timler ◽  
Caroline Bulsara ◽  
Max Bulsara ◽  
Alistair Vickery ◽  
Jill Smith ◽  
...  

Abstract Background: Dementia is a neurological condition that affects the cognitive and functional ability of the brain and is the leading cause of disability among those aged 65-years and above. More effective ways to manage dementia symptoms are needed as current treatment options (anti-depressant and antipsychotic) can be ineffective and associated with substantial side-effects, including increased rate of mortality. Cannabinoid-based medicines (CBM) has shown to inhibit some symptoms associated with dementia and the adverse effects are often minimal, yet little research has explored the use of CBM among this population. Aim. To monitor the safety of a purified dose of CBM oil (3:2 THC:CBD) on behaviour symptoms, Quality of life (QOL), and discomfort caused by pain. Methods/Design: We will carry out an 18-week randomised, double-blinded, crossover trial that consists of a 2-week eligibility period, two, 6-week treatment cycles and two, 2-week washout periods (between both cycles, and after the second treatment cycle). We aim to recruit 50 participants with dementia who are living in residential aged-care facilities. The participants will be randomised into two groups, and receive a dose of either CBM oil or placebo for the first treatment cycle and receive the opposite medication for the second. The Neuropsychiatric Inventory Questionnaire, Cohen Mansfield Agitation Inventor, Quality of Life-Alzheimer’s Disease questionnaire, and the Abbey Pain Scale will be collected on seven occasions, and completed by the participants, aged-care staff, and nominated next of kin or family member. The participant’s heart rate and blood pressure will be monitored weekly and their body composition and weight will be monitored fortnightly by a research nurse to assess individual dose response and frailty. In addition, pre- and post-surveys will be administered to aged-care staff and family members to understand their perceptions towards CBM, and to inform proposed focus groups consisting of the aged care staff and next of kin. Discussion: The study design has been informed by medical professionals and key stakeholders including those working in the residential aged-care industry to ensure patient safety, collection of non-invasive measures, and methodological rigor and study feasibility.


10.29007/brpj ◽  
2018 ◽  
Author(s):  
Trevor Hilaire ◽  
Kim Maund

Currently in many developed countries populations are ageing due to a number and combination of circumstances. Residential aged care (RAC) provides a role in addressing the associated need to care for ageing people but the potential for increased demand means RAC providers must look to further efficiencies for sustainability. The care team provides hands on care in RAC and work stress/satisfaction within the care team can be affected the quality of care and directly impacts the resident’s quality of life. The work stress/satisfaction within the care team is can also be affected by the built environment. Appropriate design of the built environment can optimise work stress/satisfaction and this paper will propose that maintenance of that environment can also have an impact. This paper will report on a study comprising semi structured interviews with care team members and management representatives from three facilities. Content analysis was carried out on interview scripts. The study revealed building maintenance was not only important to preserve an asset and reduce hazards, it also revealed building maintenance to have a bearing on a number of factors which impacted the care team’s work stress/satisfaction. This paper will suggest that strategies to improve perceived control of building maintenance may increase a view of self-worth and go towards optimisation of work stress/satisfaction amongst the care team thus promoting a level of social sustainability.


2012 ◽  
Vol 24 (12) ◽  
pp. 2037-2044 ◽  
Author(s):  
Belinda Goodenough ◽  
Lee-Fay Low ◽  
Anne-Nicole Casey ◽  
Lynn Chenoweth ◽  
Richard Fleming ◽  
...  

ABSTRACTBackground: Humor therapy is a non-pharmacological intervention with potential to improve mood and quality of life for institutionalized older persons, including those with dementia. The primary aims of the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) are to examine the effects of humor therapy on residents’ mood, quality of life, social engagement, and agitation.Methods: SMILE is a single-blinded cluster-randomized controlled trial where 398 consented residents in 35 residential aged care facilities will be allocated to receive humor therapy or usual care. Residents allocated to the intervention group will engage in humor therapy with professional performers (ElderClowns) and trained facility staff (LaughterBosses) for a minimum of nine two-hour sessions over 12 weeks as well as engaging humorously with LaughterBosses during the course of daily care. The usual care control group will not engage in any formal humor therapy. Researchers, blind to treatment allocation, will assess residents at baseline (week 0), post-intervention (week 13), and follow-up (week 26). The measurement suite includes the Cornell Scale for Depression in Dementia, the Dementia Quality of Life Scale, the Multidimensional Observation Scale for Elderly Subjects, the Cohen-Mansfield Agitation Inventory, and the Neuropsychiatric Inventory. Observations of residents’ engagement will be recorded at each humor therapy session.Conclusions: SMILE is the first large rigorous study of humor therapy in aged care.


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