Australasian Journal on Ageing最新文献

{"title":"Strategies adopted by informal carers to enhance participation in daily activities for persons with dementia","authors":"Gemma Burridge,&nbsp;Carmen Amato,&nbsp;Rosalind Bye,&nbsp;David Basic,&nbsp;Danielle Ní Chróinín,&nbsp;Susanna Hill,&nbsp;Kaitlin Howe,&nbsp;Karen P. Y. Liu","doi":"10.1111/ajag.13341","DOIUrl":"10.1111/ajag.13341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Carers for people with dementia commonly experience difficulty assisting the care-recipients with their daily activities and may adopt specific strategies to decrease the difficulties experienced. The objective of this qualitative study was to explore and understand the strategies used by carers to assist with daily activities for persons living with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individual semi-structured interviews via face-to-face or telephone mode were conducted with 62 carers of persons living with dementia in Australia. Carers were asked about the strategies they have used previously, or are currently using, to assist with daily activity completion. Data were analysed via constant comparison and thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All carers reported the need for strategies to accommodate the varying behaviour and functioning of the care-recipients. Participants reported a total of 207 strategies that fell into four main categories: (i) engage; (ii) adapt; (iii) orientate; and (iv) sense. The most used strategies were reported as those aimed at adapting the activity by using equipment to facilitate completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Carers help persons living with dementia complete their daily activities by developing their own strategies based on the care-recipients' needs and personal preferences through a trial-and-error process. Carers can benefit if more advice is provided to them by health/social care professionals regarding what strategies may be helpful. Further studies are needed to develop these strategies into an educational package so that carers can be guided to use these strategies appropriately.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"683-691"},"PeriodicalIF":1.4,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158865","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":"Hospital and out-of-hospital services provided by public geriatric medicine departments in Australia and New Zealand","authors":"Eleni Azarias,&nbsp;Janani Thillainadesan,&nbsp;Carl Hanger,&nbsp;John Scott,&nbsp;Amanda Boudville,&nbsp;Chris Moran,&nbsp;Robert O'Sullivan,&nbsp;John Maddison,&nbsp;Kathy Eagar,&nbsp;Gillian Harvey,&nbsp;Alison King,&nbsp;Leanne Kearney,&nbsp;Vasi Naganathan","doi":"10.1111/ajag.13331","DOIUrl":"10.1111/ajag.13331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the types of hospital and out-of-hospital services provided by public geriatric medicine departments in Australia and New Zealand, and to explore head of department (HOD) views on issues in current and future service provision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic survey was sent to HODs of public geriatric medicine departments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-six (89%) of 85 identified HODs completed the survey. Seventy-one (93%) departments admit inpatients and 51 (67%) admit acute inpatients, with variable admission criteria. Sixty-four (84%) have hospitals with an inpatient general medicine service, and 58 (91%) of these admit older patients with acute geriatric issues. Sixty (79%) departments provide inpatient rehabilitation. Forty (53%) have beds for behavioural symptoms of dementia and/or delirium. Seventy (92%) provide a proactive orthogeriatric service. In terms of out-of-hospital services, 74 (97%) departments have outpatient clinics, 59 (78%) have telehealth and 68 (89%) perform home visits. Forty-five (59%) provide an inreach/outreach service to nursing homes. The most frequent gaps in service provision identified by HODs were acute geriatrics, surgical liaison, a designated dementia/delirium behavioural management unit, geriatricians in Emergency, outreach/inreach to residential care and shared care with some medical specialities. Increasing staff numbers and government policy change were the most frequently identified ways to address these gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Geriatric medicine service provision is variable across Australia and New Zealand, with key gaps identified. These findings will inform future directions in implementation of geriatric medicine models of care and discussions with various levels of government about the ongoing development of geriatric medicine services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"748-761"},"PeriodicalIF":1.4,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155871","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":"Frailty evidence-practice gaps in acute care hospitals","authors":"Heather Block,&nbsp;Rosanna Tran,&nbsp;Keri Lockwood,&nbsp;Kisani Manuel,&nbsp;Kate Laver,&nbsp;Maria Crotty,&nbsp;Ian D. Cameron,&nbsp;Susan E. Kurrle","doi":"10.1111/ajag.13330","DOIUrl":"10.1111/ajag.13330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Frailty is common in hospitalised older people. Clinical practice guidelines for the management of frailty provide recommendations for identification and management; however, adoption into practice in hospitals is limited. This study identified and quantified the evidence-practice gap between frailty guidelines and clinical practice in two hospitals using an audit tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional audit of medical records of frail older patients admitted to two hospitals was conducted. Data were collected using an audit tool based on the Asia Pacific Clinical Practice Guidelines for frailty management. Data were analysed using descriptive statistics and inter-rater reliability of the tool was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Auditing of <i>n</i> = 70 electronic medical records showed that assessment of frailty in the acute setting did not regularly occur (17%). Few participants received guideline-recommended interventions. Physiotherapy treatment was limited, with 23% of participants receiving progressive resistance strength training. Gaps exist in provision of nutritional supplementation (26%) with limited recordings of weight during the admission for 10% of participants. Pharmacy review of medications was consistently documented on admission (84%) and discharge (93%). Vitamin D was prescribed for 57% of participants. Inter-rater reliability showed a high level of agreement using the audit tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An audit tool was feasible to assess frailty evidence-practice gaps in the hospital setting. Further understanding of the contextual barriers is needed to inform implementation strategies (dedicated staffing, education and training and ongoing audit of practice cycles) for the uptake of frailty guidelines in hospital settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"420-425"},"PeriodicalIF":1.4,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155867","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 comparison of changes in drug burden index between older inpatients who fell and people who have not fallen: A case–control study","authors":"Claire E. T. O'Leary,&nbsp;Timothy J. Wilkinson,&nbsp;H. Carl Hanger","doi":"10.1111/ajag.13333","DOIUrl":"10.1111/ajag.13333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Older inpatients who fall are often frail, with multiple co-morbidities and polypharmacy. Although the causes of falls are multifactorial, sedating and delirium-inducing drugs increase that risk. The aims were to determine whether people who fell had a change in their sedative and anticholinergic medication burden during an admission compared to people who did not fall. A secondary aim was to determine the factors associated with change in drug burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, observational, case–control study of inpatients who fell. Two hundred consecutive people who fell were compared with 200 randomly selected people who had not fallen. Demographics, functional ability, frailty and cognition were recorded. For each patient, their total medications and anticholinergic and sedative burden were calculated on admission and on discharge, using the drug burden index (DBI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People who fell were more dependent and cognitively impaired than people who did not fallen. People who fell had a higher DBI on admission, than people who had not fall (mean: .69 vs .43, respectively, <i>p</i> &lt; .001) and discharge (.66 vs .38, <i>p</i> &lt; .001). For both cohorts, the DBI decreased between admission and discharge (−.03 and −.05), but neither were clinically significant. Higher total medications and a higher number DBI medications on admission were both associated with greater DBI changes (<i>p</i> = .003 and &lt;.001, respectively). However, the presence (or absence) of cognitive impairment, dependency, frailty and single vs multiple falls were not significantly associated with DBI changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In older people, DBI medications and falls are both common and have serious consequences, yet this study was unable to demonstrate any clinically relevant reduction in average DBI either in people who fell or people who had not fallen during a hospital admission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"706-714"},"PeriodicalIF":1.4,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072231","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":"Introduction of enhanced weekend physiotherapy for patients with hip fracture is associated with improved early mobility outcomes","authors":"Danielle Ní Chróinín,&nbsp;Ram Ghimire,&nbsp;Lynette McEvoy,&nbsp;David Lieu,&nbsp;Matt Jennings,&nbsp;Kristen Gallagher,&nbsp;Anubhav Katyal,&nbsp;Daniel Mahmood,&nbsp;Jonathan Boey,&nbsp;Elise Tcharkhedian","doi":"10.1111/ajag.13317","DOIUrl":"10.1111/ajag.13317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess whether enhanced daily weekend physiotherapy (EWP) for patients with hip fracture was associated with improved clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analysed all previously ambulatory adults admitted with hip fracture to our tertiary hospital, comparing ‘usual’ (‘control’) care (09/19–03/20) to EWP (09/20–03/21). Outcomes included Day-7 mobility ≥20 m (primary), additional mobility measures, specified postoperative complications, new residential facility placement, acute length-of-stay (LOS) and 30-day death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amongst 235 eligible patients (128 control, 107 EWP), 66% were female, mean age was 80.4 years (SD 10.5), 20% from residential care and 49% (114/235) were mobilising without aid at baseline (no between-group differences; all <i>p</i> ≥ .20). Median acute LOS was 10 days (IQR 6–15), total hospital LOS was 21 days (IQR 12–37) and 3% (<i>n</i> = 6) died by Day 30. Median Day-7 distance mobilised was 25 m (IQR 7–50) with EWP versus 10 m (3–40) (<i>p</i> = .06). No EWP patients developed pressure injury (0 vs. 6, <i>p</i> = .02); other outcomes were similar between groups. Adjusting for age, residence, baseline cognitive impairment, American Society of Anesthesiologist score and preadmission mobilisation without aids, EWP was independently associated with increased likelihood of mobilising ≥20 m at Day 7 (aOR 1.83, 95% CI 1.04–3.23, <i>p</i> = .03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Enhanced daily weekend physiotherapy was associated with improvement in early mobility, but not other outcomes assessed. These data would be strengthened by randomised controlled trial data exploring more intense physiotherapy, cost–benefit analysis and patient experience measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"700-705"},"PeriodicalIF":1.4,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077151","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":"Organising Committee","authors":"","doi":"10.1111/ajag.13322","DOIUrl":"10.1111/ajag.13322","url":null,"abstract":"<p>\u0000 \u0000 </p><p>ANZSGM ASM 2024 Conference Organiser</p><p>Conference Innovators</p><p>228 Papanui Road</p><p>Merivale, Christchurch</p><p>New Zealand</p><p>Phone: 03 379 0390</p><p><span>[email protected]</span> | https://conference.nz/</p><p>Christchurch | Auckland</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 S1","pages":"4"},"PeriodicalIF":1.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072294","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":"Poster Presentations","authors":"","doi":"10.1111/ajag.13324","DOIUrl":"10.1111/ajag.13324","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 S1","pages":"25-58"},"PeriodicalIF":1.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072298","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":"Poster List","authors":"","doi":"10.1111/ajag.13325","DOIUrl":"10.1111/ajag.13325","url":null,"abstract":"<p>\u0000 \u0000 </p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 S1","pages":"59-63"},"PeriodicalIF":1.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072302","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":"Oral Presentations","authors":"","doi":"10.1111/ajag.13323","DOIUrl":"10.1111/ajag.13323","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 S1","pages":"5-24"},"PeriodicalIF":1.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072296","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":"Welcome Message","authors":"","doi":"10.1111/ajag.13321","DOIUrl":"10.1111/ajag.13321","url":null,"abstract":"<p>Haere Mai! Welcome to ANZSGM ASM 2024!</p><p>On behalf of the Local Organising Committee, we are excited to welcome you to the 2024 Annual Scientific Meeting of the Australian and New Zealand Society for Geriatric Medicine (ANZSGM), held from 22 to 24 May 2024 at the Te Pae Christchurch Convention Centre, Christchurch, New Zealand. We are still standing. Christchurch has rebuilt, recovered and regenerated after adversity. We strive to keep our older people standing strong, just like our city.</p><p>We'll bring together top academics including Professor Andy Clegg and Professor Cathie Sherrington for keynote addresses highlighting the latest research in the promotion of physical activity, fall prevention and share findings from major frailty trials. We'll learn how to use this knowledge to lead and implement change within health care and at the political interface. We'll share passion for advocacy work with older people, understand cultural perspectives on quality care and discuss how to keep older people standing as valued members of our community.</p><p>Our committee and our speakers are committed to showcasing a strong scientific program, with a special focus on encouraging our next generation of researchers. We hope you will leave with a wealth of new knowledge and ideas to apply in your practice, and we thank you for your ongoing support of the ANZSGM.</p><p>Ngā mihi | Kind regards</p><p><b>Dr Emma Losco</b> and <b>Dr Holly Bills</b></p><p>\u0000 <i>2024 Conference Convenors</i>\u0000 </p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 S1","pages":"3"},"PeriodicalIF":1.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072233","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}