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Published: 10 December 2022
Last updated: 28 January 2023

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1

Staffan, Johanna, and Oldgren Sofia Tucan. "Effekter av att använda musik som omvårdnadsåtgärd för personer med demenssjukdom – En litteraturöversikt." Thesis, Högskolan Dalarna, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:du-27665.

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Bakgrund: Människor blir idag allt äldre och demenssjukdomar förväntas bli ett växande problem. Inget bot finns men symtom kan hämmas genom farmakologiska behandlingar, dock ofta med flera biverkningar. Personer med demenssjukdom utvecklar ofta beteendeförändringar som kan vara svåra att bemöta för vårdgivare. I och med sjukdomens karaktär och olika förekommande symtom är en god och personcentrerad vård att föredra för att främja vårdtagarens delaktighet och integritet. Syfte: Att sammanställa och beskriva aktuell forskning om vilka effekter musik har som omvårdnadsåtgärd inom demensvård. Metod: Studien är en litteraturöversikt baserad på (n=18) artiklar från tio länder. Databaserna CINAHL, Pubmed och Web of Science användes och de artiklar som inkluderats är av kvantitativ ansats (n=12), kvalitativ ansats (n=5) samt Mixed method (n=1). Efter analys har skillnader och likheter i artiklarnas resultat skapat teman och subteman. Resultat: Musikinterventioner hade positiva effekter, bland annat gällande BPSD, kognitiva funktioner och psykofarmakologisk behandling. Musik kunde även bidra till en ökad samhörighet mellan vårdgivare och personer med demenssjukdom. Anhörigas och vårdgivares uppfattningar om musikens effekter var blandade, åsikterna var dock samstämmiga om att musik bör användas som omvårdnadsåtgärd. Slutsats: Musik har en positiv påverkan på personer med demenssjukdom och BPSD genom att fungera som en personcentrerad åtgärd inom omvårdnaden och bör implementeras mer.
Background: People are growing older and dementia is expected to become an increasing problem. There is no available cure, but symptoms can be inhibited by pharmacological treatments, often with side effects. People with dementia often develop behavioral changes that are difficult to respond to for caregivers. With the nature of the disease and the different symptoms occuring, a person-centered care is preferable to promote participation and integrity. Aim: To conclude current research on the effects of music in the nursing care of people with dementia. Method: A literature review based on (n=18) articles from ten countries. Quantitative (n=12), qualitative (n=5) and mixed method (n=1) articles were used from CINAHL, Pubmed and Web of Science. After the analysis, differences and similarities in the articles created themes and subthemes. Results: Music interventions proved to have positive effects, regarding BPSD, cognitive functions and psychopharmacological treatment. Music could contribute to increased association between caregivers and people with dementia. The caregivers and family members' perceptions of the effects of music were mixed, however, the views were consistent that music should be used as a nursing measure. Conclusion: Music has a positive impact on people with dementia and BPSD by acting as a person-centered nursing measure and should be implemented more.
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2

Holm, Emilia, and Julia Comstedt. "Musikens effekt på beteendet hos äldre med demenssjukdom." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-439747.

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Bakgrund: Demenssjukdom är ett samlingsnamn för symtom orsakade av någon form avhjärnskada. Beroende på var skadan sitter, kan sjukdomsbild variera. Några symtom viddemenssjukdom kan försämring av minne, oro, agiterat beteende och depressiva symtom.Dessa behandlas ofta med läkemedel. Alternativa behandlingar, såsom musik, har visat siganvändbara inom både demensvården och övriga vården och givit positiva effekter på hälsan. Syfte: Syftet med studien var att beskriva vad musik kan ha för effekt gällande beteende hosäldre personer med demenssjukdom, enligt den vetenskapliga litteraturen. Metod: Beskrivande kvantitativ litteraturöversikt. Resultat: Av tio studier studerade åtta musikenseffekt på agiterat beteende, varav fem av dessa kunde påvisa en minskning. Tre studierundersökte musikens effekt på oro, samtliga redovisade minskad oro. Två studier studeradeom musik hade effekt på depressiva symtom. I en av dem minskade detta efter interventionermed musik. Slutsats: Genom att tillämpa musik inom vården för äldre personer meddemenssjukdom kan det bidra till positiva effekter på hälsan såsom minskat agiterat beteende,minskad oro och minskade depressiva symtom. Det ska dock tas hänsyn till att musiken ivarje enskild studie haft en varierad effekt på beteendemässiga och psykiska symtom. Trotspositiva resultat behövs mer forskning kring musik som en alternativ behandling dåforskningen inom området är begränsad. Det läsaren kan ha i åtanke är att musik inte skadar,därför uppmuntras personer i demenssjukas närhet att spela musik - en insats som sannoliktkan medföra positiva följder för alla inblandade.
Background: Dementia is a general term for symptoms caused by abnormal brain changes.Depending on where the changes are located, the clinical picture varies. Symptoms ofdementia could be memory loss, anxiety, agitated behaviour and depressive symptoms.These are frequently treated with medication. Alternative treatments, such as music, havebeen proven to be useful in both dementia care and other health care sectors and have hadpositive effects on health. Aim: The aim of this study was to describe what effect music canhave regarding the behaviour of aged people with dementia, according to the scientificliterature. Method: A descriptive quantitative literature review. Result: Eight articles studiedthe effect of music on agitated behaviour, five demonstrated a decrease. Three studiesexamined the effect of music on anxiety, all decreased anxiety. Two studies examined theeffect of music on depressive symptoms, one reported decreased depressive symptoms. Conclusion: By applying music in dementia care, it can contribute to positive effects onhealth such as reduced agitated behaviour, anxiety and depressive symptoms. However, itmust be considered that the music interventions in each study had a varied effect onbehavioural and psychological symptoms. Despite positive results, more research on music asan alternative treatment is needed, as research in the area is limited. The reader should keepin mind that music does not harm, therefore people in the vicinity of elderly with dementiaare encouraged to play music - an effort that is most likely to have positive consequences foreveryone involved.
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3

Santos, Camila Medeiros dos. "Autocuidado e processo educativo de idosos com doenças crônicas não transmissíveis que demandam cuidados de enfermagem no domicílio." Universidade Federal de Juiz de Fora, 2014. https://repositorio.ufjf.br/jspui/handle/ufjf/838.

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O objeto da investigação foi o autocuidado de idosos que convivem com doenças crônicas não transmissíveis e que demandam cuidados de enfermagem no domicílio, com enfoque para o processo educativo em saúde e enfermagem no âmbito da temática da educação e promoção da saúde desenvolvida pelo enfermeiro em contexto assistencial multiprofissional de atenção à pessoa idosa. Objetivou-se compreender como as ações educativas e de autocuidado terapêutico contribuem para a autonomia dos idosos com doenças crônicas não transmissíveis, buscando identificar o conhecimento que possuem acerca da doença, seus tratamentos e cuidados de promoção da saúde e prevenção de complicações; identificar as necessidades de educação em saúde para o autocuidado do ponto de vista dos idosos que convivem com doenças crônicas não transmissíveis; compreender como o idoso aplica os conhecimentos de promoção da saúde e prevenção das complicações das doenças crônicas resultantes de práticas educativas; e discutir sobre a contribuição da enfermagem em contexto assistencial multidisciplinar na manutenção e promoção do autocuidado na área da atenção à saúde do idoso. Adotou-se aporte metodológico da Teoria Fundamentada nos Dados. Desenvolveu-se em duas etapas, no período de novembro de 2012 a dezembro de 2013, envolvendo dois cenários distintos: ambulatório de Geriatria e Gerontologia de um hospital público de ensino de Minas Gerais, no qual os participantes foram selecionados, e o ambiente domiciliar, após a seleção e contato prévio com os mesmos. Incluiu-se doze idosos residentes no município sede da pesquisa. Utilizou-se a visita domiciliar com observação participante, registro de notas em diário de campo, entrevista semiestruturada e, para a edição textual dos dados empíricos, o programa OpenLogos®, permitindo-se a codificação e interpretação. Emergiram trinta e cinco códigos que compuseram quatro categorias: “O autocuidado do idoso com doença crônica não transmissível em contexto domiciliar”, “Tornando-se conhecedor de si mesmo”, “Necessidades de educação terapêutica do idoso com doença crônica não transmissível” e “Apoio e suporte ao idoso com doença crônica não transmissível”. As categorias apontaram que à medida que o idoso desenvolve uma doença crônica, surge a necessidade de que aprenda a se autocuidar no âmbito terapêutico, em casa. Diante da vivência deste idoso na prática do seu autocuidado terapêutico, tornou-se evidente o conhecimento desse indivíduo no que permeia aspectos relativos à promoção da saúde e prevenção de agravos. Situações positivas e negativas vivenciadas apontaram para necessidades de educação terapêutica e busca por apoio e capacitação pelos idosos. Nessa dinâmica de movimento, tem-se que as orientações ao idoso quanto ao seu processo saúde e doença contribuem para a realização das ações de autocuidado desenvolvidas no domicílio. A atuação do enfermeiro através das práticas educativas, do planejamento de cuidados individualizados, com vistas ao apoio e educação, contribui para que o idoso se torne reflexivo e ativo no seu autocuidado terapêutico.
The object of research was the self-care of elderly who lives with chronic non-communicable diseases and require nursing care at home, focusing on the educative process in nursing and health under the theme of education and health promotion developed by nurses in the context of multidisciplinary health care to elderly people. This study aimed to comprehend how the educative and therapeutic self-care actions may contribute to the autonomy of elderly people with chronic non-communicable diseases, aiming to identify their knowledge about the disease, its treatments, care for health promotion and complications prevention; identify the needings of health education for self-care from the perspective of elderly people who lives with chronic non-communicable diseases; understand how the elderly applies knowledge of health promotion and complications prevention of chronic diseases resulting from educative practices; and discuss about the contribution of nursing care in a multidisciplinary context in maintenance and self-care promotion in the area of elderly health care. It was adopted the methodological approach of Grounded Theory, which was developed in two stages, from November 2012 to December 2013, involving two different scenarios: outpatient from Geriatrics and Gerontology of a public teaching hospital in Minas Gerais, in which participants were selected, the home environment after selection and prior contact with them. Twelve elderly residents in the county seat of research were included. It was used the home visit with participant observation, recording notes in a field journal, semistructured interview and the OpenLogos ® program for textual editing of empirical data, which allows the encoding and interpretation. Thirty five codes emerged which comprised four categories: "Self-care of elderly patients with chronic non-communicable disease in the family context", "Becoming knowledgeable of yourself", "Therapeutic Education needs of elderly patients with chronic non-communicable disease" and "Support and assistance to the elderly with chronic non-communicable disease". The categories indicated that as the elderly develops a chronic illness, the need arises to learn to take care of themselves in the therapeutic context, at home. Given the experience to the elderly in the practice of their therapeutic self-care, it became evident the knowledge of this individual in which permeates aspects related to health promotion and prevention of disease injuries. Positive and negative situations experienced pointed to the need of therapeutic education and search for support and training for the elderly. In this dynamic movement, the guidelines for the elderly about their health and disease process have contributed for the achievements of self-care actions developed at home. The work of nurses through educative practices, the planning of individualized care, with a view to the support and education, helps elderly to become reflective and active in their therapeutic self-care.
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4

Marquardt, Gesine, and Nadine Glasow. "Braucht der Wohnbereich einen Ausgang?" Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2006. http://nbn-resolving.de/urn:nbn:de:swb:14-1163786055669-11636.

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Der Umgang mit möglicher Selbstgefährdung demenzerkrankter Bewohner durch das selbständige Verlassen des Wohnbereichs wird in Altenpflegeeinrichtungen häufig und kontrovers diskutiert. In dieser Studie wurde untersucht, ob eine milieutherapeutische Intervention in Form eines Vorhangs vor der Ausgangstür die Bewohner am Verlassen des Wohnbereichs hindert. Das wesentliche Untersuchungsziel war es dabei zu erfassen, ob Veränderungen in Verhalten und Wohlbefinden der Bewohner zu verzeichnen sind.
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5

Moran, Shane. "China's aged care crisis : problems, resources, solutions /." View thesis, 2000. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030829.165655/index.html.

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Thesis (Ph.D.)--University of Western Sydney, Hawkesbury, 2000.
"A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy, Faculty of Health, University of Western Sydney."
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6

Preece, Michael. "Knowledge management : a residential aged care perspective." Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/561.

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This research explores perceptions of knowledge management processes held by managers and employees in a service industry. To date, empirical research on knowledge management in the service industry is sparse. This research seeks to examine absorptive capacity its four absorptive capacity capabilities of acquisition, assimilation, transformation and exploitation and their impact on effective knowledge management. All of these capabilities are strategies that enable external knowledge to be recognised, imported and integrated into, and further developed within the organisation effectively.The research tests the relationships between absorptive capacity and effective knowledge management through analysis of quantitative data (n=549) drawn from managers and employees in 35 Residential Aged Care organisations in Western Australia. Responses were analysed using Partial Least Square-based Structural Equation Modelling. Additional analysis was conducted to assess if the job role (of manager or employee) and three industry context variables of profit motive, size of business and length of time the organisation has been in business, impacted on the hypothesised relationships.Structural model analysis examined the relationships between variables as hypothesised in the research framework. Analysis found that absorptive capacity and the four capabilities correlated significantly with effective knowledge management, with absorptive capacity explaining 56% of the total variability for effective xiv knowledge management. Findings from this research also show that absorptive capacity and the four capabilities provide a useful framework for examining knowledge management in the service industry. Additionally, there were no significant differences in the perceptions held between managers and employees, nor between respondents in for-profit and not-for-profit organisations. Furthermore, the size of the organisation and length of time the organisation has been in business did not impact on absorptive capacity, the four capabilities and effective knowledge management.The research considers implications for business in light of these findings. The role of managers in providing leadership across the knowledge management process was confirmed, as well as the importance of guiding routines and knowledge sharing throughout the organisation. Further, the results indicate that within the participating organisations there are discernable differences in the way that some organisations manage their knowledge, compared to others. To achieve effective knowledge management, managers need to provide a supportive workplace culture, facilitate strong employee relationships, encourage employees to seek out new knowledge, continually engage in two-way communication with employees and provide up to date policies and procedures that guide employees in doing their work. The implementation of knowledge management strategies have also been shown in this research to enhance the delivery and quality of residential aged care.
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7

Shohel, Mohammad. "Antibiotic Stewardship in Residential Aged Care Facilities." Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/86378.

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Aged care residents are at increased risk of infections due to their frailty and comorbidities. This study aimed to identify and reduce the risk of antibiotic-related misadventure in this population. Particular medicines were associated with use of antibiotics, suggesting compromised immunity via numerous mechanisms. Potential interactions between antibiotics and residents’ other medicines were also identified, and may increase morbidity in this vulnerable group. Expanded scope of antimicrobial stewardship in aged care facilities is recommended.
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8

Geoghegan, John. "What do RNs working in hospital aged care units identify as the positive and negative aspects of aged care nursing?" View thesis, 2006. http://handle.uws.edu.au:8081/1959.7/19352.

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Thesis (M.Sc.(Hons) Health) -- University of Western Sydney, 2006.
A thesis submitted for examination for the degree of Master of Health Science (Hons) to the University of Western Sydney, College of Health and Science, School of Nursing. Includes bibliography.
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9

DeBeyer, Carrie Jeanette. "Diabetes care : the status of diabetes care in Queensland residential aged facilities." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/2627.

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Diabetes care of the elderly in residential aged care facilities has often been unstructured and non-standardised, with disparities in both the practice and knowledge of health care workers caring for this vulnerable group. Poorly controlled diabetes can contribute to a range of adverse events, including impaired wound health and cardiovascular events. The purpose of this study was to establish if current Australian diabetes management guidelines for the elderly are being met in residential aged care facilities in Queensland and identify areas for clinical practice improvement.A cross-sectional, descriptive design was employed to measure demographic data, perceived and actual diabetes-related knowledge, availability of diabetes management and care guidelines, and facilitators and barriers to meeting diabetes related care. A sample of 109 health care workers from residential aged care facilities completed a postal survey.Diabetes guidelines shown to be available in residential aged care facilities were aimed at care planning, with guidelines for both screening and monitoring of diabetes and diabetes care specific skills more available in private aged care and high care classified facilities. Limited monitoring of outcomes of diabetes care were evident. Overall, participants perceived their diabetes knowledge as “good”, however deficits were found in the level of actual knowledge on diabetes complications and medication management. Ratings for perceived and actual diabetes knowledge was higher with older aged health care workers by those employed in their current position the longest.Furthermore, a positive relationship was shown between perceived and actual diabetes knowledge with years of experience in aged care, employment status (RNs/ENs, AINs and other health care workers) and education status (grade 12 schooling, Technology and Further Education and university award). Diabetes – related knowledge was shown to be the most significant facilitator as well as barrier to diabetes care provision. Factors affecting perceived level of confidence in providing diabetes self-management education included experience in aged care, employment position and level of education.The contribution of this research to the area of study was to provide important data on the availability of diabetes guidelines and protocols and diabetes knowledge base. Data has also been provided for the availability of diabetes guidelines and protocols in different facility types and with different classifications of care as well as data for the perceived level of confidence in providing diabetes care in residential aged care facilities. Study findings indicate a need for an increased focus on diabetes care in residential aged care to improve health outcomes.
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Kaine, Sarah Jane. "Managing labour in the residential aged care sector." University of Sydney, 2010. http://hdl.handle.net/2123/6300.

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Doctor of Philosophy (PhD)
Aged care is a critical public policy issue in Australia. The growing significance of the sector raises important and pressing questions about many aspects of care itself, the size of the labour force and employment relations. Answering these questions is vital, with demand for labour in the sector already outstripping supply and with demand certain to grow substantially. The implications of this labour shortfall for the sector have already been the subject of a number of key government reports. Although these reports have begun to construct a more detailed picture of the issues facing aged care workers and employers, significant gaps remain, most notably any explicit examination of approaches to the management of labour or the importance of labour law in determining these approaches. Despite the obvious importance and critical social and economic significance of the ageing population, we do not sufficiently understand many of the critical labour market features, workplace characteristics or management strategies which are evident in the aged care sector. This study seeks to build knowledge of employment and labour management in this growing and crucial sector at a decisive moment in history. It deepens our understanding of these issues and processes through a study of three residential aged care providers in New South Wales during the period from 2005 to 2009. The thesis specifically examines employer strategy in relation to the management of labour in the three cases. Further, it investigates the impact of the regulatory environment on these approaches. In doing so, the case studies reveal the intricate web of internal and external, direct and indirect, formal and informal regulation which shapes the management of labour within the sector. The complexity of the regulatory web in aged care demands the use of an explanatory framework which recognises that labour-management approaches are influenced by constraints not traditionally associated with the direct, legal regulation of employment relations. Consequently, regulation theory is applied here as an organising framework and as an interpretive prism for the research. This allows for an explicit acknowledgment of the importance of non-legal, informal and indirect regulation ‘at work’ in this sector. The study finds that in the period under review labour law was not the primary determinant of labour-management approaches in aged care. The case studies presented here show that it was, in fact, a second order consideration for aged care providers struggling with what they saw as insufficient funding, onerous ‘paperwork’ and staff recruitment and retention difficulties – in short a range of other regulatory influences. This study also shows that, despite the constraints imposed by these other regulatory modes, employers remained free to exercise their prerogative within the workplace; this, in turn, is revealed as a form of internal regulation in aged care.
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11

Martin, Christine. "The lived experience of the aged care nurse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/959.

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The purpose of this phenomenological study was to describe and interpret the common, shared meanings of the experience of aged care nursing from the perspective of the registered nurse working in a nursing home. There are insufficient registered nurses being attracted into aged care, with resulting difficulties in maintaining regular staffing levels in nursing homes. Previous studies conducted in Australia have predominantly used quantitative research methods to investigate various influences QD the recruitment and retention of aged care nurses. These studies do not take into account the practitioners' perceptions of their experience of aged care nursing. A purposive sample of 15 registered nurses was interviewed and the resulting data were analysed using phenomenology to identify thematic structures of the experience of aged care nursing. The NUD.IST qualitative data analysis software package was used as an analysis tool. Significant statements were coded, patterns and relations between categories were identified and the categories were clustered into conceptual, hierarchical themes. Four major themes emerged as being central to the experience of aged care nursing-Gratification, Rapport, Non-productivity and Conflict. While constraints and obstacles to productivity and personal and political conflict may be seen as the negative aspects of aged care, these experiences were relieved by uplifting events described within the framework of resident care and rapport, and collegial support. The nature of aged care nursing is both complex and ambiguous but nurses have readily identified the interwoven threads of the experience. Findings from this study will increase the depth of understanding of aged care nursing and hence contribute to the development of a nursing home environment which enriches the experience of both nurse and resident.
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12

Tuckett, Anthony Gerrard. "Truth-telling in aged care : a qualitative study." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/15862/1/Anthony_Tuckett_Thesis.pdf.

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This thesis argues that truth-telling in high level (nursing home) aged care is a undamentally important aspect of care that ought to reside equally alongside instrumental care. The health of the resident in a nursing home, as with individuals in other care contexts, is directly linked to care provision that allows the resident to be self determining about their care and thus allows them to make reasonable choices and decisions. This qualitative study explores the meaning of truth-telling in the care providerresident dyad in high level (nursing home) aged care. Grounded within the epistemology of social constructionism and the theoretical stance of symbolic interactionism, this study relied on oral and written text from care providers (personal care assistants and registered nurses) and residents. Thematic analysis of data relied on practices within grounded theory to determine their understanding and the conditions and consequences of their understanding about truth-telling in the nursing home. Through an understanding of the relationship-role-residency trinity, truth-telling in high level (nursing home) care comes to be understood. It has been determined that the link between truth-telling and the nature of the care provider-resident (and residents' families) relationship is that both personal carers and nurses in this study premise their understanding of truth disclosure on knowing a resident's (and resident's family's) capacity for coping with the truth and therefore catering for the resident's or family's best interests. The breadth and depth of this knowing and how the relationship is perceived and described determine what care providers will or will not tell. That is, the perceptions both personal carers and nurses have about the relationship - how they describe themselves as 'family like', 'friend' and 'stranger', has implications for the way disclosure operates and is described. Additionally, how care providers perceive and understand their role determines what care providers will or will not tell. That is, the perceptions both carers and nurses have about their own and each other's role - how they describe themselves for example as 'hands-on' carer and 'happy good nurse' has implications for the way disclosure operates and is described. Furthermore, care providers' meaning and understanding of truth-telling in aged care is not possible in the absence of an appreciation of how the care providers give meaning to and come to understand the care circumstance - residency, the aged care facility, the nursing home. That is, the perceptions both personal carers and nurses have about the aged care facility - how they describe residency as 'Home away from Home' (and what this means), as a place of little time and a plethora of situations have implications for the operation of truth-telling as a whole. Recommendations from the study include the implementation of a telling audit to better serve the truth-telling preferences of residents and the reorientation of care practices to emphasise affective care (talk rather than tasks). Furthermore, it is recommended that changes occur to the care provider roles, that care providers define themselves as facilitators rather than protectors, and education be ongoing to improve communication with and care of residents with dementia and those dying. Finally, the language of residency as 'home' needs to capture an alternate philosophy and attendant practices for improved open communication.
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13

Tuckett, Anthony Gerrard. "Truth-telling in aged care: a qualitative study." Queensland University of Technology, 2003. http://eprints.qut.edu.au/15862/.

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This thesis argues that truth-telling in high level (nursing home) aged care is a undamentally important aspect of care that ought to reside equally alongside instrumental care. The health of the resident in a nursing home, as with individuals in other care contexts, is directly linked to care provision that allows the resident to be self determining about their care and thus allows them to make reasonable choices and decisions. This qualitative study explores the meaning of truth-telling in the care providerresident dyad in high level (nursing home) aged care. Grounded within the epistemology of social constructionism and the theoretical stance of symbolic interactionism, this study relied on oral and written text from care providers (personal care assistants and registered nurses) and residents. Thematic analysis of data relied on practices within grounded theory to determine their understanding and the conditions and consequences of their understanding about truth-telling in the nursing home. Through an understanding of the relationship-role-residency trinity, truth-telling in high level (nursing home) care comes to be understood. It has been determined that the link between truth-telling and the nature of the care provider-resident (and residents' families) relationship is that both personal carers and nurses in this study premise their understanding of truth disclosure on knowing a resident's (and resident's family's) capacity for coping with the truth and therefore catering for the resident's or family's best interests. The breadth and depth of this knowing and how the relationship is perceived and described determine what care providers will or will not tell. That is, the perceptions both personal carers and nurses have about the relationship - how they describe themselves as 'family like', 'friend' and 'stranger', has implications for the way disclosure operates and is described. Additionally, how care providers perceive and understand their role determines what care providers will or will not tell. That is, the perceptions both carers and nurses have about their own and each other's role - how they describe themselves for example as 'hands-on' carer and 'happy good nurse' has implications for the way disclosure operates and is described. Furthermore, care providers' meaning and understanding of truth-telling in aged care is not possible in the absence of an appreciation of how the care providers give meaning to and come to understand the care circumstance - residency, the aged care facility, the nursing home. That is, the perceptions both personal carers and nurses have about the aged care facility - how they describe residency as 'Home away from Home' (and what this means), as a place of little time and a plethora of situations have implications for the operation of truth-telling as a whole. Recommendations from the study include the implementation of a telling audit to better serve the truth-telling preferences of residents and the reorientation of care practices to emphasise affective care (talk rather than tasks). Furthermore, it is recommended that changes occur to the care provider roles, that care providers define themselves as facilitators rather than protectors, and education be ongoing to improve communication with and care of residents with dementia and those dying. Finally, the language of residency as 'home' needs to capture an alternate philosophy and attendant practices for improved open communication.
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14

Bitner, Grace Anne. "The 'home'/'homelessness' continuum in residential aged care." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/128714/2/Grace_Bitner_Thesis.pdf.

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This project drew on the experiences of residents and staff in two different residential aged care facilities in South East Queensland, in order to better understand the factors that affect residents' ability to feel 'at home'. The resulting theoretical model reveals how the factors interconnect over time to contribute in a unique way to the meaning of home for individual residents. Ultimately, the model invites, and supports, a more sensitised and integrated approach to the design and management of Residential Aged Care Facilities.
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15

McCormack, Cynthia Ann. "LONELINESS IN THE INSTITUTIONALIZED AGED." Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275240.

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16

Horner, Barbara Joan. "The impact and influence of change on a residential aged care community: an action research study." Thesis, Curtin University, 2005. http://hdl.handle.net/20.500.11937/1924.

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This study was an investigation of the complexities and challenges of change in a community-based aged care facility in Western Australia, to reveal the impact and influence of change on the community. It explored the impact of change on both the residents and the senior management team, as leaders of the organisation, and explored how change influenced the redevelopment process and future of the organisation. There is considerable literature on organisational change including the impact of change on the structure, function, process, workforce and leaders of the organisation. There is, however, little literature on organisational change within aged care communities, particularly with an emphasis on the complexities and challenges associated with change within an organisation that is both a business and a home for its residents. The study took the form of a participative action research study, occurring predominantly over two years (2002-2003) with some continuation into a third year (2004). The study had three phases and included two action research cycles and a critical reference group (CRG), comprising the senior management team (SMT) and researcher. It adopted a broadly qualitative methodology, using data from participatory observation and semi-structured interview; however, it did include quantitative and qualitative data from two 'quality of service' surveys for independent living residents and a staff satisfaction survey. The finding of this study are presented as a narrative account of the experiences of the participants. The study reveals that change associated with the redevelopment impacted on residents' wellbeing, described by them as quality of life.The redevelopment process and associated change also emphasised the importance of communication and explanation with residents to understand elements of quality of life and to monitor and manage the impact of change. The findings of the study highlight the challenge faced by community-based aged care communities classified by government, the industry and the wider community as primarily not-for-profit, to balance financial accountability and social conscience. The perception of benevolence influenced the attitudes of residents and staff and made business accountability more difficult to explain and realise. The study reveals that change also impacted on the structure and function of the organisation as it built its capacity for change. It reshaped the relationship between the Board and senior management team (SMT), which was reported as an improvement in communication, work relations and leadership effectiveness. The development of the leadership team, being the senior management team, was influenced by change and the change process enabled this team to become a competent, confident, cohesive senior team, with a preferred leadership style. A further finding was the realisation of the value and appropriateness of the action research process. It provided tools and processes that were used to plan, act, analyse and reflect on the many aspects of organisational change and enabled the organisation, principally the SMT, to reflect on the impact and influence of change. The research process supported their development as leaders as well as the development of the team. The process of planning, collecting data, analysing data, reflection and action provided a structure and process that they continued to use in their management practices, as new situations continued to arise with the redevelopment process.
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17

Filipe, Luís Alexandre Coelho. "Estimating demand for primary health care services." Master's thesis, NSBE - UNL, 2012. http://hdl.handle.net/10362/9543.

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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics
Primary health services exist with the purpose of providing basic health care to every person at a cost they can afford. But is it fully available to everyone? The objective of this work project is to estimate the demand for primary health care services having into account that in some regions the citizens are not using as much health care as they would like due to supply side constraints. Using the number of consultations as proxy for demand, and applying an econometric tool called switching regression, the demand for primary health care services will be estimated.
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18

Desai, Mitul S. "Modelling future demand for long-term care." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/341514/.

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This research was jointly funded by the Economic and Social Research Council (ESRC) and the Engineering and Physical Sciences Research Council (EPSRC). As such, its underpinning and innovative aim was to explore the use of Operational Research (OR) techniques, a research area traditionally associated with the EPSRC, to address key societal problems traditionally associated with the ESRC. The ageing population presents many significant challenges for social care services at both a national and local level, one of which is to meet the demand for long-term care. The population of people aged over 65 will continue to grow for some time as the ―baby boom‖ generation ages. The concern for policy planners is whether there will be enough resources in place to handle the expected strain on the system in the future. The research presented in this thesis addresses this key issue, and was carried out in collaboration with the Adult Services Department of Hampshire County Council (HCC). The overarching aim of this thesis was to develop computer models (using data local to Hampshire) which would be of practical use in estimating the future demand and planning the supply of long-term care in Hampshire. A cell-based model was built to forecast the demand for long-term care in Hampshire from people aged 65 and over for the period 2009 to 2026. An important part of this research was to understand the main drivers of future demand for long-term care and to predict the future number of people with a disability. Hampshire County Council has already tried to address these issues of demographic change through a modernisation programme. Part of this has been the establishment of a contact centre called Hantsdirect. A discrete-event simulation model of the contact centre was developed. The two models were combined to explore the short- and long-term performance of the contact centre in the light of demographic change. This hybrid model has enabled HCC to explore the short- and long-term performance of the contact centre. This study combines OR with Gerontology, Demography and Social Policy. This research is novel as it iteratively combines a compartmental population model with a discrete-event simulation model. From an OR perspective, the aim was not only to explore the use of modelling in social care (where, unlike healthcare, there has not hitherto been a lot of research), but also to investigate the potential for combining different modelling approaches in order to obtain additional value from the modelling. This novel approach in a social care setting is one of the main contributions of this thesis.
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19

Piercy, Kathleen Walsh. "Family ties and care for aged parents at home." Diss., This resource online, 1996. http://scholar.lib.vt.edu/theses/available/etd-06062008-154400/.

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20

Nusem, Erez. "A design-led approach to innovation in aged care." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/96318/23/Erez_Nusem_Thesis.pdf.

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This research explores the journey of a non-profit organisation seeking to respond to prominent change drivers in aged care through the strategic integration of design. A longitudinal action research project investigated the business models of aged care providers, the viability and capacity of existing aged care business models, and the ways aged care organisations could utilise design to drive innovation and address emerging challenges in practice. The thesis identified a new aged care business model typology, a framework and methods for integrating design in practice, offering new knowledge and approaches for leveraging design to realise social and economic outcomes.
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21

Pappne, Demecs Ilona. "Woven narratives: Creative participatory art in residential aged care." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/133260/2/Ilona_Pappne%2520Demecs_Thesis%5B1%5D.pdf.

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This thesis presents a participatory art project which involved relocating my tapestry weaving studio into an aged care home for six months and working with residents to co-design and co-create a woven tapestry. The project's concept, materials and processes were designed as an interpretation of two theoretical models: the motivation to meaning and transcendence in ageing focusing on subjective experiences. This thesis contributed to the arts and health literature by presenting craft as a practice and method that connects materials, ideas and people through engagement and facilitates wellbeing. It also highlighted the complexity and the advantages of the research context.
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22

Courtney, Karen Lynne. "Privacy and senior adoption of assistive technology in residential care." Diss., Columbia, Mo. : University of Missouri-Columbia, 2006. http://hdl.handle.net/10355/4399.

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Thesis (Ph. D.)--University of Missouri-Columbia, 2006.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "May 2006" Includes bibliographical references.
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23

Bhandari, Kunwar Sushma. "End-of-life care in residential aged care: The perceptions of bereaved family members." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2022. https://ro.ecu.edu.au/theses/2590.

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Background In recent years, life expectancy has increased causing a higher global percentage of older people living with multiple chronic health problems including dementia. This increase in the aged population with complicated health issues has required governments and health care systems internationally to provide suitable accommodation and health care support such as residential aged care facilities. In residential aged care facilities comprehensive and holistic health care and assessment should ensure good quality of life and a supported death. The Australian Royal Commission into Aged Care Quality and Safety (2021) recognised a need for improvement in the residential aged care sector highlighting end of life care as a core business in aged care. Little research has been completed to explore the family perspective of end of life care provided in the residential aged care setting. Methods This study used an inductive interpretive research method to explore participants’ experiences of their relatives’ end of life care within two residential aged care facilities in Western Australia. Two facilities assisted with the recruitment of participants (n=5) and provided letters of support, and one participant (n=1) was recruited via an advertisement and did not disclose the facility. Fifty one potential participants from two residential aged care facilities were invited to participate in the study, with (n=5) family members agreeing. Qualitative data collection was undertaken using semi-structured face to face individual interviews with six participants utilising predesigned interview questions. The interviews were conducted in the aged care facilities’ meeting rooms (n=5), and Edith Cowan University’s meeting room (n =1) with each interview lasted for approximately 60 to 90 minutes. The eight Principles for Palliative and End of Life Care in Residential Aged Care from Palliative Care Australia were applied as the conceptual framework for the study. Results Through the analysis of data collected from participants, two themes and subthemes were identified about their experiences during the end of life care period of their family member. Family reflecting on care described their experiences of personal care, emotional and spiritual care, symptom management, grief and bereavement, and concerns about care. Providing a supportive environment was related to the palliative care plan, involving families in care, care delivery, staff communication with family, and the physical environment. Families generally observed and expressed satisfaction to the emotional and spiritual care, and to some degree to personal care and pain management. Additionally, most of the families stated that the physical environment of the facility was appropriate, however, key aspects of care highlighted for improvement included bereavement support, and the need for improved communication with families, and in providing timely information. Participants further observed that care staff were attentive, however, two participants mentioned that their expectations of professional behaviour was not met by all staff as they experienced poor communication from a few staff and one participant perceived a personality clash with care staff member. Conclusion This thesis explored the end of life care in Australian residential aged care facilities from the perspective of bereaved family members using a qualitative interpretative methodology. Findings from this study suggest that bereaved families perceived personal, emotional and spiritual care of the residents as satisfactory. Similarly, medication and pain symptoms management were observed to have met most of the families’ expectation. Additionally, emotional, psychological and religious supports was offered to the residents and their family, and they were involved in care discussions and decisions. Issues in communication and post death support and a lack of awareness to the cultural sensitivity were the key aspects identified for improvement.
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24

Price, Marilyn. "Assessing spirituality and spiritual care needs of elderly people living in aged care facilities." Thesis, Price, Marilyn (2016) Assessing spirituality and spiritual care needs of elderly people living in aged care facilities. Masters by Coursework thesis, Murdoch University, 2016. https://researchrepository.murdoch.edu.au/id/eprint/35201/.

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Australians are now able to live longer due to scientific and medical technology advances and improved economic conditions, but, ironically, such benefits do not necessarily guarantee that, as we age, we will all be able to support and maintain ourselves financially, physically, mentally or socially. Residential aged care facilities provide safe accommodation and a range of care services for elderly people for whom remaining in their own homes is not viable. Although some of these facilities provide religious and pastoral care in addition to personal, medical and therapy services, research has indicated that the ‘spiritual care’ dimension of holistic aged care services in Australia is either absent, or given low priority. Spiritual care overarches religious and pastoral care, and is therefore as essential a dimension of holistic care as are its medical, psychological, psychosocial, familial and emotional dimensions. This research project was undertaken with residents of aged care facilities in Perth, Western Australia, as an assessment of the participants’ understanding and presence of spirituality, and to determine whether their spiritual and religious needs are being met. The results showed that the participants are generally representative of their generation in their affiliations with Christian denominations, worship practices and traditions, with their perceptions of the concepts of ‘spirituality’ and ‘religion’ either being confused, or couched in terms of their religious backgrounds and experiences. The majority of participants was found to possess a stoical desire to withstand encroaching debility and loss of independence, while remaining optimistic, keeping occupied, and endeavouring to identify the meaning and purpose within their lives. Most participants expressed contentment with, and acceptance of, the current living arrangements, level of care, and religious and spiritual support provided within their aged care facilities.
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25

Chirico, Willstedt Gabriella. "Demand, Competition and Redistribution in Swedish Dental Care." Doctoral thesis, Uppsala universitet, Nationalekonomiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-267476.

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Essay 1: Individuals with higher socioeconomic status (SES) also tend to enjoy better health. Evidence from the economics literature suggests that a potential mechanism behind this “social health gradient” is that human capabilities, that form SES, also facilitate health-promoting behaviors. This essay empirically investigates the significance of socioeconomic differences in health behaviors, using dental care consumption as an operationalization of health investments. I focus on adults at an age where lifetime trajectories for SES can be taken as given and use lifetime income to capture SES. I estimate the impact of lifetime income on dental care consumption and find robust evidence that the social gradient in dental care consumption steepens dramatically over the life-cycle. Considering that dental care consumption only reflects a small part of individuals' health investments the results suggest that lifetime effects of SES on health behaviors could be substantial in other dimensions. Essay 2: This essay studies the effect of competition on prices on a health care market where prices are market determined, namely the Swedish market for dental care. The empirical strategy exploits that the effect of competition differs across services, depending on the characteristics of the service. Price competition is theoretically more intense for services such as examinations and diagnostics (first-stage services), compared to more complicated and unusual treatments (follow-on services). By exploiting this difference, I identify a relative effect of competition on prices. The results suggest small but statistically significant negative short-term effects on prices for first-stage services relative to follow-on services. The results provide evidence that price-setting among dental care clinics responds to changes in the market environment and substantial effects of competition on prices over time cannot be ruled out. Essay 3: The Swedish dental care insurance subsidizes dental care costs above a threshold and becomes more generous as dental care consumption increases. On average, higher-income individuals consume more dental care and have better oral health than low-income individuals. Therefore, the redistributional effects of the Swedish dental care insurance are ambiguous a priori. I find that the dental care insurance adds to the progressive redistribution taking place through other parts of the Swedish social insurance (SI) for individuals aged 35-59 years whereas it reduces the progressivity in the SI for those aged 60-89 years. While the result for the oldest individuals is problematic from an equity point of view, the insurance seems to strengthen the progressitivy of the Swedish social insurance for the vast majority of patients.
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26

Lukas, Daniel. "Individual decisions and efficiency in health care demand." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-127098.

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Individual decision-making and the generation of medical demand are crucial subjects in healthcare economics. The following scientific discussion can be classified into these threads. The demand for health care services is typically connected to characteristic imperfections reflecting a bias between an objective and a subjective assessment of a specific demand situation or externally caused frictions. For that reason, the realized demand is not necessarily connected to an efficient allocation of resources. Hence, it is a crucial objective to analyze individual decision-making related on the one hand to specific treatment alternatives and on the other hand to the specified decision framework. This framework is characterized by both the attributes of the individual as well as by the external conditions in which the decision takes place. Theirby, the analysis focuses specifically on potential sources of demand inefficiency and their effectiveness. The following discussion broach the issue of two significant objectives within health economics: 1. Trade in medical care and patient migration, 2. Patient autonomy and education. Both fields find their analytical basis in a micro-economic discussion of individual decision behavior. The first field analyzes the decision between medical provision at home or abroad. This subject is specifically related to a potential efficiency gain due to the existence of cross-border price and quality gradients, usually a source of gains in trade. In the focus of the analysis is the impact of the specific characteristics of these gradients as determinants of cross-border medical demand. The second field discusses the investment decision in measures of patient education and prevention in a framework of a common consultation and self-care as imperfect treatment alternatives due to imperfect competences of self-diagnosis and medical self-supply. This subject is related to the commonly acknowledged positive correlation between health and education. Education is able to improve the quality of health production and, therefore, has a specific impact with respect to increasing autonomous behavior of the individual in issues of health production. The specific environment of these decisions significantly influences the mechanism of decision-making and the final outcome; this must be assessed according to the effect on the allocative efficiency of medical demand. The role of price and quality gradients between alternatives, the differentiation of illnesses, as well as subjective factors, are crucial to the results. Moreover, the individual's ability to appraise his or her own health stock and demand decisions is itself risky. Therefore, the form of the insurance coverage is another important element when analyzing individual decisions. The following discussion will clarify the decision-making mechanisms and their impact on efficient resource allocation. Since the focus is on demand behavior, the interaction with, and therefore the behavior of, the supply side is not explicitly formulated.
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27

De, Bellis Anita Marie, and anita debellis@flinders edu au. "Behind Open Doors - A Construct of Nursing Practice in an Australian Residential Aged Care Facility." Flinders University. School of Nursing & Midwifery, 2006. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20061107.122002.

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This thesis explored the relationship between the discourses of nursing care, the nursing care provision, and the perceived nursing care needs of three highly dependent residents in a residential aged care facility in Australia. Residential aged care in this country has undergone major reforms since 1987 and the nursing profession has struggled with these changes because of the documentation, validation, and accreditation requirements; the inadequate determination of dependency on nursing care for funding; the Registered Nurse (RN) being removed from the bedside to a role of scribe and delegator; the increasing acuity and complexity of the residents' needs; an increase in the turnover of residents; a rise in the nursing staff attrition rate; the delivery of care by untrained and unqualified persons; the RN being accountable and responsible for the care given by 'non-nurses' from a distance; and, the inadequate skill mix and staff to resident ratios provided in these institutions. The interest of this thesis was to research gerontological nursing practice in the context of residential aged care. Residential Aged Care Facilities (RACFs) in Australia that care for the highly dependent elderly were identified in the thesis as disciplinary institutions that used 'subjectivation' as a means to control the efficiency and effectiveness of the labour force and the 'docile' bodies of the residents, whilst at the same time the government rhetoric is that of the quality of life standards and the rights of residents in these institutions. As well as the discourse analysis, an historical overview of the aged care reforms in Australia was undertaken for the period from 1975 to 2006 that demonstrated the effects the reforms have had on the voice of nurses and nursing care in these institutions. This analysis highlighted where nurses have been silenced and found the federal government determining what is nursing care and what is not nursing care, and also who is providing this nursing care. Using a case study approach and discourse analysis each of the three residents was studied using data from five sources namely the resident or relative, a RN, a careworker (CW), the current documentation pertaining to the resident's nursing care, and the non-participant observation of the nursing care provided. These discourses on the nursing care and perceived residents' nursing care needs were analysed using the theoretical base developed from the philosophy and research interest of Michel Foucault (1926-1984), who questioned the apparatus and institutions of Western cultures and searched for discontinuities in the practices of what he termed 'disciplines'. The results of the discourse analysis found nursing care practices that were alarming around the residents' perceived nursing care needs, the documentation of the nursing care provision, and the observed 'actual' nursing care provided. A questionable standard of nursing care was evidenced even though this facility had recently been accredited. A custodial level of mechanistic care was provided to residents in an extremely noisy and public environment within a culture of haste and bustle by unknowledgeable CWs, under the distant gaze of a RN, and the direction of the government documentation requirements. This resulted in unsafe, unethical, unprofessional, and negligent practices, as well as fraudulent, illegal, and dangerously out of date documentation practices. This was ultimately affecting each resident's quality of life, nursing care, and wellbeing and was an added burden on the residents' relatives. Many discontinuities, dissonances, conflicts, and contradictions in nursing practice were uncovered for these three highly dependent residents that may be transferable and similar to other highly dependent residents in this and other institutions. Indeed it may mirror other disciplines that provide care services, such as mental health care, acute care, and disability care provision. The concerns for the nursing profession have epistemological, ethical, and political ramifications for the residents and their relatives, the nurses, the non-nurses doing nursing work, the government, and the industry. Epistemologically new nursing 'knowledges' were being developed that were not resident focussed or based on evidence. Ethically, the legislated rights of residents were not being supported, despite the accreditation, funding, and complaint mechanisms in place - and this has the potential to have punitive ramifications for the industry. Professionally and politically, CWs were identified as non-nurses doing nursing work of a poor standard. This care was not based on accepted nursing practice, but developed through the documentation requirements of the federal government department, the applied constraints, and the CWs themselves. Furthermore, the documentation requirements were found to be a pretence in regard to funding through validation and accreditation, as well as a charade in nursing practice. There is presently a substantial third level of nurses who are identified legally and political as non-nurses doing non-nursing work (known as 'personal' care); but these non-nurses are doing nursing work and are identified by the nursing profession and the public as 'nurses' doing nursing work. These non-nurses who provided nursing care are not educated, licensed, or regulated, and are not accountable professionally to nurses or legally to the public. It is proposed that CWs are in need of licensing under nurses' boards requiring at the very least a minimum of training and education. It is further proposed that documentation requirements resort back to professional nursing documentation; funding be dependent on an predetermined minimum skill mix and staff/resident ratio; and the funding of residents be based on a minimum data set and untied from nursing practice. The professional nursing practice of assessment, planning, implementation, and evaluation of nursing care needs resorting to a nursing domain of knowledge, practice, accountability, responsibility, and documentation. If an acceptable quality of life is to be realised for residents in the residential aged care system, given that highly dependent residents are reliant on quality nursing care that is fundamentally imperative to their very quantity and quality of life, then changes in the residential aged care system and the nursing profession will be necessary. This thesis will contribute to opening up such dialogue between the government, the industry, and the nursing profession in Australia, and it also highlights areas of aged care nursing practice in need of further research.
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28

Tse, Yin-loi Susanna. "The housing demand for senior citizens of middle income group in Hong Kong." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21029143.

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29

Shapera, Leah Elizabeth. "Meeting the nursing care needs of the elderly in the community : clients' perspectives on adult day care." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28797.

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A trend toward non-institutionalization of the elderly, in conjunction with the increasing size of the elderly population has resulted in the development of a variety of community programs and services to help meet their complex and diverse health care needs in the community setting. Although there is substantial documentation pertaining to the needs of the elderly in the community and the available services (Lifton, 1989; Padula, 1983; Starrett, 1986; Wallace, 1987), this documentation has been generated primarily by health care professionals and agencies, rather than from the perspectives of the elderly themselves. Adult Day Care [ADC] programs were established in the late 1960s as one means of attempting to meet the needs of the frail elderly in the community (Padula, 1983). On the surface, these programs appear to be effective in meeting the needs of clients through the provision of nursing services and a wide variety of therapeutic programs and social activities. This exploratory descriptive study was based on the premise that there exists a need to gain insight into the clients' perspectives regarding the ways in which ADC services are instrumental in meeting their perceived needs. Data were collected and analyzed to identify the self-perceived needs of ADC clients and their perceptions of how the ADC nursing services were instrumental in assisting them to meet these needs. Two interviews were conducted with each of the 11 ADC participants comprising the sample, using a semi-structured interview guide developed by the researcher. The two needs most commonly identified by participants included the need to cope with a range of concurrent and/or successive losses, and the need to establish new support systems. Participants identified the most significant components of the nursing role as those of the provision of emotional support through counselling, and the provision of health monitoring services. Participants viewed the overall ADC program as important in assisting them to meet their needs by providing access to social outings, individualized care, emotional support, and the opportunity to enhance their self-esteem, confidence, and feelings of belongingness.
Applied Science, Faculty of
Nursing, School of
Graduate
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30

Horner, Barbara Joan. "The impact and influence of change on a residential aged care community: an action research study." Curtin University of Technology, Centre for Research into Aged Care Services, 2005. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=16051.

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This study was an investigation of the complexities and challenges of change in a community-based aged care facility in Western Australia, to reveal the impact and influence of change on the community. It explored the impact of change on both the residents and the senior management team, as leaders of the organisation, and explored how change influenced the redevelopment process and future of the organisation. There is considerable literature on organisational change including the impact of change on the structure, function, process, workforce and leaders of the organisation. There is, however, little literature on organisational change within aged care communities, particularly with an emphasis on the complexities and challenges associated with change within an organisation that is both a business and a home for its residents. The study took the form of a participative action research study, occurring predominantly over two years (2002-2003) with some continuation into a third year (2004). The study had three phases and included two action research cycles and a critical reference group (CRG), comprising the senior management team (SMT) and researcher. It adopted a broadly qualitative methodology, using data from participatory observation and semi-structured interview; however, it did include quantitative and qualitative data from two 'quality of service' surveys for independent living residents and a staff satisfaction survey. The finding of this study are presented as a narrative account of the experiences of the participants. The study reveals that change associated with the redevelopment impacted on residents' wellbeing, described by them as quality of life.
The redevelopment process and associated change also emphasised the importance of communication and explanation with residents to understand elements of quality of life and to monitor and manage the impact of change. The findings of the study highlight the challenge faced by community-based aged care communities classified by government, the industry and the wider community as primarily not-for-profit, to balance financial accountability and social conscience. The perception of benevolence influenced the attitudes of residents and staff and made business accountability more difficult to explain and realise. The study reveals that change also impacted on the structure and function of the organisation as it built its capacity for change. It reshaped the relationship between the Board and senior management team (SMT), which was reported as an improvement in communication, work relations and leadership effectiveness. The development of the leadership team, being the senior management team, was influenced by change and the change process enabled this team to become a competent, confident, cohesive senior team, with a preferred leadership style. A further finding was the realisation of the value and appropriateness of the action research process. It provided tools and processes that were used to plan, act, analyse and reflect on the many aspects of organisational change and enabled the organisation, principally the SMT, to reflect on the impact and influence of change. The research process supported their development as leaders as well as the development of the team. The process of planning, collecting data, analysing data, reflection and action provided a structure and process that they continued to use in their management practices, as new situations continued to arise with the redevelopment process.
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Ohura, Tomoko. "Studies of setting care goals and understanding subjective needs in aged care facilities: care providers' and residents' view." Kyoto University, 2017. http://hdl.handle.net/2433/218011.

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32

Chawewan, Sriburapapirom Veena Sirisook. "Self care practice of the elderly in Bangkok /." Abstract, 2000. http://mulinet3.li.mahidol.ac.th/thesis/2543/43E-Chawewan-S.pdf.

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33

Bush, Sarah 1973. "Forecasting 65+ travel : an integration of cohort analysis and travel demand modeling." Thesis, Massachusetts Institute of Technology, 2003. http://hdl.handle.net/1721.1/29941.

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Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2003.
Includes bibliographical references (leaves 96-104).
Over the next 30 years, the Boomers will double the 65+ population in the United States and comprise a new generation of older Americans. This study forecasts the aging Boomers' travel. Previous efforts to forecast 65+ travel are lacking in key two respects: they have failed to incorporate generation differences and have forecasted only broad travel characteristics (e.g. vehicle miles traveled). Drawing on the theory of generations, this study investigates empirically whether cohort differences in travel exist between the Boomers and the current 65+ population. It incorporates theoretically motivated cohort variables related to the historical processes of motorization, proxied by registered automobiles per person, and gender role evolution, proxied by labor force participation rates of women. The resulting forecast predicts the aging Boomers' travel demand with respect to activities requiring travel, person miles traveled, usage of transit and non-motorized modes, and trip chaining propensity. Data extracted from the 1977, 1983, 1990, and 1995 National Personal Transportation Surveys (NPTS) are used to estimate discrete and joint discrete/continuous demand models. Multiple imputation is used to impute missing survey data. Iterative proportional fitting is used to simulate future populations for forecasting purposes. Although 65+ travel is predicted to increase across all the modeled travel indicators, the results indicate that the current national forecast of 65+ travel prepared for the National Highway Traffic Safety Administration and the U. S. Department of Health and Human Services may overestimate future demand. The forecasts also suggest that investment in transit could increase 65+ transit usage propensities; opportunities for increasing transit viability are identified.
(cont.) Finally, in the estimated models, the cohort variables are significant, and with the exception of forecasted person-miles, cohort variable inclusion increases forecasted travel. The implication for transportation modeling is that historical location and generation membership affects transportation behavior. The implication for planners is that in preparing for future 65+ transportation needs, studying the current 65+ population is not adequate. The Boomers will comprise a new generation of 65+ with different associated travel needs.
by Sara Bush.
Ph.D.
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34

Frean, Isobel. "Modelling communication requirements in aged care using HL7 V3 methods." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20070221.131236/index.html.

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35

McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.

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Grenade, Linda Elise. "Accreditation of residential aged care facilities: experiences of service providers." Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1306.

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The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.
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Grenade, Linda Elise. "Accreditation of residential aged care facilities : experiences of service providers /." Curtin University of Technology, School of Public Health, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15068.

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Abstract:
The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.
Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.
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38

Alizadeh-Khoei, Mahtab. "Assessing factors in utilisation of health services and community aged care services by the Iranian elderly living in the Sydney metropolitan area acculturation aged care /." Connect to full text, 2008. http://hdl.handle.net/2123/3986.

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Thesis (Ph. D.)--University of Sydney, 2008.
Title from title screen (viewed Jan. 19, 2009) Includes tables and questionnaires in English and Farsi. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliography. Also available in print form.
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Wamukuo, Joseph Thairu. "Demand for ante-natal care in Nairobi's slum areas." Master's thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/9699.

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Bibliography: leaves 71-74.
This paper studies the factors influencing the demand for ante-natal care in two of Nairobi's slum areas, namely, Kibera and Mathare. Antenatal care is important as its absence I underprovision means higher incidences of both maternal and infant mortalities. On the other hand proper ante-natal care means improved well-being of both mother and child. These two groups constitute over 70% of Kenya's population. For any economic and social development programmes to succeed, there is need to give mother and child special attention. The factors influencing the demand for ante-natal care could be grouped into three major categories; socio-economic (age, marital status, income etc.), facility (quality of care) as well as policy (user-fee) variables. The data for the analysis was obtained by means of a household survey conducted in Kibera and Mathare. A two stage sampling procedure was used for the data collection. This involved first, listing of all clusters from which a random selection of clusters to be studied was done and secondly, the households were drawn by a random sample within each of the selected clusters.
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40

Suominen-Taipale, Anna Liisa. "Demand for oral health care services in adult Finns." Turku : Turun Yliopisto, 2000. http://catalog.hathitrust.org/api/volumes/oclc/45710669.html.

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41

Palo-Bengtsson, Liisa. "Social dancing as a caregiver intervention in the care of persons with dementia /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4573-x/.

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42

Simms, Mary. "The aged 'in limbo' : accounts of 'community care' in the 1980s." Thesis, Queen Mary, University of London, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295723.

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43

LoMonaco, Marina Lucia. "Investigation of registered nurses' clinical decision-making processes in aged care." Thesis, Australian Catholic University, 2014. https://acuresearchbank.acu.edu.au/download/82226bdbfa1530c6d8ab4af6a353544c82d3bc780769c21c2f7a712a069d908e/2826137/201404_Marina_LoMonaco__PhD_FINAL_28Feb2015pdf.pdf.

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An ageing global population places increasing humanitarian and financial loads on government, health and welfare agencies; necessitating change and innovation to meet and manage clinical and physically complex needs and demands. Australian residential aged care has been influenced by these international and jurisdictional socio-political forces. This thesis aims to inform healthcare professionals and others about Australian aged care registered nurse (RN) decision-making processes, as well as convey understanding of the responsibilities and contextual influences upon RNs working in this sector and scope of practice according to their professional responsibilities...
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McKenzie-Green, Barbara. "Living life in residential aged care: A process of continuous adjustment." Thesis, Australian Catholic University, 2010. https://acuresearchbank.acu.edu.au/download/320774175c89792c3179b6b3583c698b49a8502b130a6659b78c752f33a2bc23/2084272/Barbara_McKenzie_Green_2010_Living_life_in_residential__aged_care.pdf.

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The aim of this study was to examine whether, and how, residents living in residential aged care homes become involved in their care, and what areas of their care and life they work to influence or negotiate.
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Hansen, Annissa Margaret. "Shaping aged care work through technology: A senior manager affordance perspective." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/208914/1/Annissa_Hansen_Thesis.pdf.

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This research identifies the affordances of technology in aged care from the perspectives of senior managers. Interviews with Executives and Directors in a large aged care provider, an aged care industry body, and an aged care technology developer revealed the numerous ways in which technology shapes the aged care work environment. The findings suggest that government, aged care organisations, and technology providers need to balance the efficiencies of technology adoption with the humanistic nature of aged care work.
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46

Walker, Helen M. "The experience of care assistants who care for residents in the final stage of life in residential aged care facilities." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/278.

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This thesis presents the results of a study that explores the experience of care assistants who care for residents in the final stages of life in residential aged care facilities in metropolitan Perth. Care assistants, with little formal training and no regulation, play a pivotal role in the direct care of dying residents in these facilities. Yet little was known about the palliative care role and the impact that caring for residents in the final stage of life has on this health care group. The literature relating to end of life care in residential aged care facilities revealed limited research in this area. In particular, there is a lack of studies that relate specifically to the care assistants' role and their experiences of end of life care. Research to date has focused on the context of palliative care in residential aged care facilities, the workplace environment, how to provide a dignified death, relationships and the central role of the care assistant. This study used a qualitative narrative inquiry research design.
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Sinasac, Patricia A. "Residential aged care health workers' knowledge, attitudes and confidence in providing care to a person with a stoma : a needs analysis for education." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/104436/1/Patricia_Sinasac_Thesis.pdf.

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This study of residential aged care health workers’ knowledge, attitudes and confidence in providing care to an older person with a stoma was conducted to identify characteristics of the learners and educational needs to effectively provide stoma care. The findings will be valuable to inform development of an educational program aimed at aged care health workers’ to give appropriate and confident stoma care to residents.
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Johnson, Lula Juanita. "The effects of home based primary care with chronically ill older adults on visits to the emergency department, hospitalization, and bed days of care." free to MU campus, to others for purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p1422981.

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Glasson, Janet, University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "Improving aspects of quality of nursing care for older acutely ill hospitalised medical patients through an action research process." THESIS_CSHS_NFC_Glasson_J.xml, 2004. http://handle.uws.edu.au:8081/1959.7/481.

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The current literature suggests one of the challenges of nursing today is to meet the health care needs of the growing older population, people over the age of 65. Quality of nursing is important for acutely ill older people who are the largest group of patients in terms of hospital admissions. The ageing population is a major focus for social and economic planners and policy makers. There is an increasing need for health systems to change their focus to more closely assess strategies used to manage the acutely ill older hospital population. The main aim of this study was to improve the quality of nursing care for older, acutely ill, hospitalised medical patients. The study used a mixed method triangulated approach that utilised quantitative and qualitative methods to survey perceived needs of older patients, their family members/carers and the nursing staff, in the process of developing, implementing and evaluating a new model of care using a participatory action research (PAR) process. There were three specific objectives. The first was to evaluate which aspects of nursing care were considered most important for older patients during acute hospitalisation from the perspective of older patients, their family members/carers and their nurses. The second was to develop and implement a model of care that addressed the identified nursing care needs and priorities of older patients through the PAR process. The third was to determine whether employing a PAR process, the chosen model of care addressed the identified nursing care needs and priorities and resulted in increased patient satisfaction and improved health care for older patients. This study demonstrated the implementation of a PAR process to motivate nursing staff, utilising an evidence-based model of care approach, resulted in changes to clinical nursing practice that impacted positively on older patients’ and nursing staff’s satisfaction with care provided, patient knowledge and final health outcomes. It is recommended that the findings of this study be applied to develop guidelines for acutely hospitalised medical patients, particularly for issues relating to educational sessions to increase the patient’s functional activities and knowledge levels of their medication regimes prior to discharge.
Master of Health Science (Hons)
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Moscatel, Sarah J. "End-of-life transition experiences of ICU nurses : mindful realization /." Connect to full text via ProQuest. IP filtered, 2005.

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Thesis (Ph.D. in Nursing) -- University of Colorado at Denver and Health Sciences Center, 2005.
Typescript. Includes bibliographical references (leaves 139-146). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;
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