Australasian Journal on Ageing最新文献

{"title":"Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines","authors":"Hargun Bhalla,&nbsp;Guogui Huang,&nbsp;Karla Seaman,&nbsp;S. Sandun Malpriya Silva,&nbsp;Bosco Wu,&nbsp;Nasir Wabe,&nbsp;Johanna I. Westbrook,&nbsp;Amy D. Nguyen","doi":"10.1111/ajag.13351","DOIUrl":"10.1111/ajag.13351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the <i>use of medications with significant adverse effects in older adults</i> (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"792-801"},"PeriodicalIF":1.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value co-creation to improve ageing-in-place programs in China","authors":"Shiufai Wong","doi":"10.1111/ajag.13343","DOIUrl":"10.1111/ajag.13343","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"236-238"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is social frailty?","authors":"Jed Montayre","doi":"10.1111/ajag.13347","DOIUrl":"10.1111/ajag.13347","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"234-235"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is the frail consumer and how do we reach them? Engaging consumers in frailty research","authors":"Adrienne Young,&nbsp;Anja Christoffersen,&nbsp;Kenneth Rockwood","doi":"10.1111/ajag.13342","DOIUrl":"10.1111/ajag.13342","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"231-233"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My parents are ageing, what the heck do I do?—Understanding Australia's aged care system to support older loved ones at home By C. Wilkinson, See Me Aged Care Consulting Pty Ltd. 2022. $26.91. Kindle edition $13.99. ISBN-13: 9781922764263","authors":"Gillian Stockwell-Smith","doi":"10.1111/ajag.13328","DOIUrl":"https://doi.org/10.1111/ajag.13328","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"432"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing falls onsite in residential aged care homes reduced hospitalisation: Mixed methods results from the Falls Outreach and Residential Mobile Assessment Team (FORMAT) pilot study","authors":"Joseph Miller,&nbsp;Andrea Bee,&nbsp;Donna Pattison,&nbsp;Megan Walker,&nbsp;Emogene Aldridge,&nbsp;Liam Hackett,&nbsp;Patrick J. Owen,&nbsp;Renee Marangon-Elliott,&nbsp;Paul Buntine","doi":"10.1111/ajag.13336","DOIUrl":"10.1111/ajag.13336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Falls are the leading cause of hospital transfer from residential aged care homes (RACHs). However, many falls do not result in significant injury, and ageing patients are exposed to complications while hospitalised. Inreach services are designed to reduce hospital transfer by providing care, support and assessment to residents at the RACH. This study evaluated a pilot inreach program targeting ageing patients following a fall.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective, mixed methods evaluation of a 5-month (May–September 2022) pilot implementation across 108 government-funded RACHs within a single health-care network in Melbourne, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 123 residents (median [interquartile range] age: 88 [82, 94] years, female: 49%) were included in the intervention. The majority (<i>n</i> = 116, 94%) of residents were managed onsite and required no further investigation (<i>n</i> = 80, 69%) or treatment (<i>n</i> = 63, 54%). Among the seven residents referred to the emergency department (ED), two received hospital admission and five were transferred back to residential care. In the 7 days following referral to the intervention, four additional residents were referred to the ED and one received hospital admission. Qualitative feedback (<i>n</i> = 40) included specific comments relating to themes of general satisfaction (<i>n</i> = 20, 50%), compliments for staff (<i>n</i> = 16, 40%) and acknowledgement of comprehensiveness (<i>n</i> = 9, 23%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implementation of a specialised fall assessment team to complement an existing geriatric-led RACH assessment service meant that a high rate of eligible residents were managed onsite, with very low need for subsequent hospitalisation. Residents, family members and caregivers expressed high rates of satisfaction with the service.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"773-781"},"PeriodicalIF":1.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between medication safety-related processes and medication use in residential aged care facilities","authors":"Ramesh Sharma Poudel,&nbsp;Kylie A. Williams,&nbsp;Lisa G. Pont","doi":"10.1111/ajag.13352","DOIUrl":"10.1111/ajag.13352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the association between the implementation of medication safety-related processes measured with the Medication Safety Self-Assessment for Long-Term Care (MSSA-LTC) tool and medication use in residential aged care facilities (RACFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive cross-sectional study was conducted in Australian RACFs. Data on facility characteristics, aggregated medication use at the facility level for selected medications commonly associated with a high risk of harm and the MSSA-LTC were completed by clinical pharmacists providing clinical pharmacy services. The Spearman's correlation test was used to evaluate the association between the MSSA-LTC score and medication use. A scatter plot between the MSSA-LTC score and medication use data was generated, and a linear trend line was plotted using the least squares method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were collected from 31 RACFs servicing 2986 residents. Most medication safety-related processes were implemented in Australian RACFs. A higher facility MSSA-LTC score was associated with a lower proportion of residents with polypharmacy (<i>r</i> = −.48, <i>p</i> = .01) and one or more benzodiazepines (<i>r</i> = −.41, <i>p</i> = .03). In addition, a negative linear trend was observed between the MSSA-LTC score and the average number of medications per resident, the proportion of residents with one or more anticonvulsants and the proportion of residents using one or more opioid analgesics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study indicates that implementing medication safety-related processes may improve medication use in RACFs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"802-810"},"PeriodicalIF":1.4,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A heutagogical approach to building the residential aged care workforce capability and capacity","authors":"Anne-Marie Mahoney,&nbsp;Deirdre Fetherstonhaugh,&nbsp;Jo-Anne Rayner","doi":"10.1111/ajag.13348","DOIUrl":"10.1111/ajag.13348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This paper reports on the design and implementation of an interactive online education package for the diverse Australian residential aged care workforce, in response to the findings of the Royal Commission into Aged Care Quality and Safety. A decade of reports has consistently highlighted the need for an educated workforce to care for the increasingly frail older people with complex care needs living in residential aged care. Cost, availability and timing of education have been identified as barriers to uptake of education for this workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A heutagogical approach was used to design an evidence-based, modular, online education package for nurses, care workers and allied health practitioners working in the residential aged care sector. The subject matter was developed by experts and the education divided into modules. A key challenge was to design a package that was inclusive of the diversity of educational needs in this workforce. The package does not provide assessments on completion of the modules, relying solely on the motivation of the individual learner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This online education package provides choice and self-determination for users in their learning journey. Collaborating with experts to develop an online education program that is learner-driven, challenges the conventions of education. Users can navigate the package at their pace; choose the modules they have identified as knowledge gaps or are of interest; and complete the education in their own time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As expected, most users are care workers and nurses and the five modules of the Dementia program are the most popular.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"837-843"},"PeriodicalIF":1.4,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating potential palliative care needs for residential aged care: A population-based retrospective cohort study","authors":"Greer B. Humphrey,&nbsp;Maria C. Inacio,&nbsp;Catherine Lang,&nbsp;Owen F. Churches,&nbsp;Janet K. Sluggett,&nbsp;Helena Williams,&nbsp;Deidre D. Morgan,&nbsp;Timothy H. M. To,&nbsp;Andrew Kellie,&nbsp;Steve Wesselingh,&nbsp;Gillian E. Caughey","doi":"10.1111/ajag.13345","DOIUrl":"10.1111/ajag.13345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Population-based data on the required needs for palliative care in residential aged care have been highlighted as a key information gap. This study aimed to provide a comprehensive estimate of palliative care needs among Australia's residential aged care population using a validated algorithm based on causes of death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based retrospective cohort study was conducted using data from the Registry of Senior Australians of non-Indigenous residents of residential aged care services in New South Wales, Victoria, and South Australia aged older than 65 years, who died between 2016 and 2017 (<i>n</i> = 71,677). An internationally validated algorithm was used to estimate and characterise potential palliative care needs based on causes of death. This estimate was compared to palliative care needs identified from funding-based care needs assessment data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety two per cent (<i>n</i> = 65,949) were estimated to have had potential palliative care needs prior to their death. Of these, 19% (<i>n</i> = 12,467) were assigned an end-of-life trajectory related to cancer, 61% (<i>n</i> = 40,511) to organ failure and 20% (<i>n</i> = 12,971) to frailty and dementia. By comparison, only 6% (<i>n</i> = 4430) of residents were assessed as needing palliative care by the funding-based care needs assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Over 90% of individuals dying in residential aged care may have benefited from a palliative approach to care. This need is substantially underestimated by the funding-based care needs assessment, which utilises a narrow definition of palliative care when death is imminent. There is a clear imperative to distinguish between palliative and end-of-life care needs within residential aged care to ensure appropriate and equitable access to palliative care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"782-791"},"PeriodicalIF":1.4,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The quality of residential aged care in the context of the Australian aged care reforms: A scoping review","authors":"Cathy Monro,&nbsp;Lynette Mackenzie,&nbsp;Sanetta duToit","doi":"10.1111/ajag.13349","DOIUrl":"10.1111/ajag.13349","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Australia has been undergoing a major aged care reform process since 2012 focused on consumer-oriented home and community-supported care, but little is known about the impact of these reforms on residential aged care delivery. This study aimed to review research about the quality of residential aged care service delivery during the implementation period of these reforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review followed a five-stage scoping review framework and searched five databases for articles published between 2012 and February 2022 (the 10-year implementation period of the reforms). Initial searches identified 495 articles. Articles were imported to Covidence™ for title, abstract and full-text screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two articles were included in the review. Articles were framed using the micro (residents and families)/meso (staff)/macro (governance, government) continuum in the operation of residential aged care facilities. Most articles focused on workforce perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Attention was paid to workforce issues and a limited focus was on consumer experience and expectations. There is a need for an evaluation of the reforms as a vehicle for promoting consumer empowerment. Many contributing factors to quality of care were identified, and there were some quality issues that were contrary to the intended objectives of the reforms. These warrant closer attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"454-462"},"PeriodicalIF":1.4,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}