Journal articles: 'Older people Institutional care Australia'

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Mendes, Philip. "Remembering the ‘forgotten’ Australians: The Care Leavers of Australia Network and the Senate Inquiry into Institutional and Out-of-home Care." Children Australia 30, no. 1 (2005): 4–10. http://dx.doi.org/10.1017/s103507720001052x.

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This study examines the findings of the recent Community Affairs Reference Committee report into institutional and out-of-home care. Attention is drawn to the key role played by the Care Leavers of Australia Network (CLAN) in pushing the concerns of older care leavers onto the public agenda, successfully lobbying for the Senate Inquiry, and providing services and supports to care leavers.The report highlighted the historical failure of state authorities to protect the well-being of children and young people placed in alternative care. Many of those children have subsequently experienced significant emotional and psychological problems, the results of which include psychiatric illness, depression, suicide, substance abuse, illiteracy, impaired relationship skills and marriage breakdown, and incarceration.The report also has contemporary implications. In order to achieve better outcomes for care leavers in the future, we need to ensure that child welfare services are adequately funded, employ properly trained and qualified professional staff, promote a gradual and functional transition from dependence to independence, and ensure accountability to external bodies including consumer groups.

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HOWE, ANNA L., ANDREW E. JONES, and CHERYL TILSE. "What's in a name? Similarities and differences in international terms and meanings for older peoples' housing with services." Ageing and Society 33, no. 4 (May 3, 2012): 547–78. http://dx.doi.org/10.1017/s0144686x12000086.

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ABSTRACTThe diversity of terms and meanings relating to housing with services for older people confounds systematic analysis, especially in international comparative research. This paper presents an analysis of over 90 terms identified in literature from the United Kingdom, the United States of America, Canada, Australia and New Zealand reporting types of housing with services under the umbrella of ‘service integrated housing’ (SIH), defined as all forms of accommodation built specifically for older people in which the housing provider takes responsibility for delivery of one or more types of support and care services. A small number of generic terms covering housing for people in later life, home and community care, and institutional care are reviewed first to define the scope of SIH. Review of the remainder identifies different terms applied to similar types of SIH, similar terms applied to different types, and different terms that distinguish different types. Terms are grouped into those covering SIH focused on lifestyle and recreation, those offering only support services, and those offering care as well as support. Considerable commonality is found in underlying forms of SIH, and common themes emerge in discussion of drivers of growth and diversification, formal policies and programmes, and symbolic meanings. In establishing more commonality than difference, clarification of terminology advances policy debate, programme development, research and knowledge transfer within and between countries.

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Wafer, Mike. "Falls in Older People in Institutional Care." Journal of Tissue Viability 6, no. 3 (July 1996): 82–84. http://dx.doi.org/10.1016/s0965-206x(96)80021-0.

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Juklestad, Olaug. "Institutional care for older people — the dark side." Journal of Adult Protection 3, no. 2 (May 2001): 32–41. http://dx.doi.org/10.1108/14668203200100012.

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MCCORMACK, JOHN. "Acute hospitals and older people in Australia." Ageing and Society 22, no. 5 (September 2002): 637–46. http://dx.doi.org/10.1017/s0144686x02008802.

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The Australian health care system is frequently portrayed as being in crisis, with reference to either large financial burdens in the form of hospital deficits, or declining service levels. Older people, characterised as a homogeneous category, are repeatedly identified as a major contributor to the crisis, by unnecessarily occupying acute beds while they await a vacancy in a residential facility. Several enquiries and hospital taskforce management groups have been set up to tackle the problem. This article reviews their findings and strategic recommendations, particularly as they relate to older people. Short-term policy responses are being developed which specifically target older people for early discharge and alternative levels of care, and which, while claiming positive intentions, may introduce new forms of age discrimination into the health system. Few of the currently favoured proposals promote age-inclusivity and older people's rights to equal access to acute care.

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Kelly, Colette. "Aspects of nutrition for older people in institutional care." Nursing and Residential Care 3, no. 3 (March 2001): 112–13. http://dx.doi.org/10.12968/nrec.2001.3.3.7920.

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McCormack, John, Alun C. Jackson, and Shane A. Thomas. "Gambling and older people in Australia." Australasian Journal on Ageing 22, no. 3 (September 2003): 120–26. http://dx.doi.org/10.1111/j.1741-6612.2003.tb00481.x.

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Routasalo, Pirkko, and Kaisu H. Pitkala. "Loneliness among older people." Reviews in Clinical Gerontology 13, no. 4 (November 2003): 303–11. http://dx.doi.org/10.1017/s095925980400111x.

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Loneliness may be regarded as a ‘geriatric giant’, leading to impaired quality of life, greater need for institutional care and increased mortality. For the past 30 years, a growing number of studies have focused on loneliness. However, the majority of these have been descriptive and cross-sectional. Further longitudinal studies are needed to understand the causal relationship between life-events and loneliness, its prognostic significance and, in particular, whether negative consequences may be alleviated.

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Bužgová, Radka, and Kateřina Ivanová. "Violation of ethical principles in institutional care for older people." Nursing Ethics 18, no. 1 (January 2011): 64–78. http://dx.doi.org/10.1177/0969733010385529.

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This study focuses on issues of elder abuse in residential settings. Violation of ethical principles is shown in the results of this quantitative study aimed at defining the extent, nature and causes of such abuse by employees’ unethical conduct towards clients in senior homes (i.e. residential nursing homes) in the Moravian-Silesian region of the Czech Republic. The research sample comprised 454 employees and 488 clients from 12 residential homes for older people. The data were collected from interviews with clients, who also received a questionnaire concerning their satisfaction with the institution. Two questionnaires were administered to the employees, one based on a pilot qualitative study and a second to investigate burnout. Outcomes were assessed according to the extent and form of elder abuse, the causes of elder abuse and the violation of basic ethical principles. The responses, in particular those of employees, revealed both psychological and physical abuse of older clients, and thus violation of two basic principles: respect for the person and non-maleficence. The group at risk of elder abuse comprised aggressive and dissatisfied clients, as well as those with mental problems and dementia. The employees most at risk of being abusers were those who had been employed in institutional care for more than five years, had inadequate knowledge about social services and suffered from burnout. The prevention of elder abuse is recommended to be through education focused on ethical principles, increasing employees’ satisfaction by promoting a friendly and safe organizational culture, and providing adequate working conditions.

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HUBBARD, GILL, SUSAN TESTER, and MURNA G. DOWNS. "Meaningful social interactions between older people in institutional care settings." Ageing and Society 23, no. 1 (January 2003): 99–114. http://dx.doi.org/10.1017/s0144686x02008991.

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This paper is a contribution to the developing understanding of social relationships in institutional care settings. It focuses on two areas that have been neglected in research: the reasons for and types of social interaction in institutional settings, and the ways in which the context of people's lives shapes social interaction. The paper draws on ethnographic observations conducted in four care settings in Scotland using a symbolic interactionist perspective. It finds that residents communicate and interact, and that the personal, cultural and structural contexts frame social interaction and influence the ways that residents use humour, express sexuality, and show hostility. The paper concludes that residents create social interactions in which action is embedded, but do so within specific structural and cultural contexts. These contexts ‘control’ resident action by establishing frameworks for the interpretation of meaning. At the same time, each facet of context is ‘controlled’ by the ways in which residents actively take on the ‘role’ of others, and project ‘self’ and a ‘label’.

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Healy, Judith. "The Care of Older People: Australia and the United Kingdom." Social Policy and Administration 36, no. 1 (February 2002): 1–19. http://dx.doi.org/10.1111/1467-9515.00266.

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Henderson, Emily J., and Gideon A. Caplan. "Home Sweet Home? Community Care for Older People in Australia." Journal of the American Medical Directors Association 9, no. 2 (February 2008): 88–94. http://dx.doi.org/10.1016/j.jamda.2007.11.010.

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Ames, David. "Depressive Disorders among Elderly People in Long-Term Institutional Care." Australian & New Zealand Journal of Psychiatry 27, no. 3 (September 1993): 379–91. http://dx.doi.org/10.3109/00048679309075793.

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Depressive disorders are common among old people in residential and nursing homes. Outside Australia the prevalence rate for depressive symptoms in homes ranges from 30–75% while that for depressive disorders defined by psychiatric diagnostic criteria is well over 20% in many nursing home studies. These rates are between two and twenty times higher than those found among the elderly living at home. Evidence from Australia indicates that a problem of similar magnitude exists here. While physical disability is strongly associated with depression in these populations, it is not the only factor likely to be responsible for the initiation and maintenance of depression among those in long-term care. There is an urgent need for studies which will better define likely aetiological and maintaining factors for depression in institutional populations, as well as controlled trials of both pharmacological treatments and environmental improvements. In addition, research is needed to establish whether depression is an independent risk factor for mortality among institutional residents.

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Miller, Susan, and Ester Carolina Apesoa-Varano. "Institutional Effects on Early Palliative Care among Mexican-Heritage Elders." Innovation in Aging 5, Supplement_1 (December 1, 2021): 888–89. http://dx.doi.org/10.1093/geroni/igab046.3231.

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Abstract This paper addresses Mexican-heritage older people’s experiences with early palliative care (EPC). EPC is the early provision of medical, social and spiritual reports to relieve suffering. Empirically, Mexican-heritage older people are known to have less access to EPC and, when they access it, to receive care of lower quality. However, little work has explored how Mexican-heritage older people think about and access such care. The paper addresses this gap. Methods are longitudinal: 36 Mexican-heritage people ranging in age from 55 to 90 years completed longitudinal semi-structured qualitative interviews, for a total of 69 interviews. Results explore how respondents’ participation in social institutions may mediate the effects of larger social structural constraints on their health and access to care.

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Brownie, Sonya, and Louise Horstmanshof. "Creating the conditions for self-fulfilment for aged care residents." Nursing Ethics 19, no. 6 (February 20, 2012): 777–86. http://dx.doi.org/10.1177/0969733011423292.

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In 1991 the United Nations General Assembly adopted the Principles for Older Persons as a framework for international policy responses to population ageing. These principles promote independence, participation, care, self-fulfilment and dignity as legitimate entitlements of all older people. Although these principles, or variations of them, are embedded in standards of best-practice in residential aged care facilities, the literature shows that in reality institutional care can deny older people opportunities to exercise some of these entitlements. More specifically, residential aged care facilities can deprive older people of access and support to pursue opportunities for the full development of their potential, i.e. their entitlement to self-fulfilment. This discussion article explores the influence of institutional care on older people’s ability to exercise their entitlement to self-fulfilment. We identify the characteristics of a ‘good life’ in institutional care, according to aged care residents themselves. The Eden Alternative™ is presented as a model of aged care that aims to create the conditions for a ‘good life’ and self-fulfilment for aged care residents.

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Garrett, Mario D. "Critical Age Theory: Institutional Abuse of Older People in Health Care." European Journal of Medical and Health Sciences 4, no. 6 (December 24, 2022): 24–37. http://dx.doi.org/10.24018/ejmed.2022.4.6.1540.

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Theories of elder abuse focus on the characteristics of the victim, the perpetrator, and the context of abuse. Although all three factors play a role, we are biased to notice individual misbehavior as the primary and sole cause of abuse. We see individuals as responsible for abuse. By examining abuses across a spectrum of healthcare services, abuse is more likely to be due to the institutional culture that includes the use of medications, Assisted Living, Skilled Nursing Facilities/nursing homes, hospices, hospitals, and Medicare Advantage programs. This study highlights multiple and consistent institutional abuses that result in harm and death of older adults on a consistent basis. The results show that when profit is increased, standards of care are diminished, and abuse ensues. Assigning responsibility to the management of healthcare becomes a priority in reducing this level of abuse. However, there are biases that stop us from assigning blame to institutions. Individual healthcare workers adhere to work protocol and rationalize the negative outcomes as inevitable or due to the vulnerability and frailness of older people. This culture is socialized for new employees that develop a culture of diminishing the needs of the individual patient in favor of the priorities dictated by the management protocol. In addition, the public is focused on assigning blame to individuals. Once an individual is assigned blame then they do not look beyond that to understand the context of abuse. A context that is generated by healthcare facilities maximizing profit and denigrating patient care. Regulatory agencies such as the U.S. DHHS, CDC, State Public Health Agencies, State/City Elder Abuse units, and Ombudsmen Programs all collude, for multiple reasons, in diminishing institutional responsibility.

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Cotter, AJE, AV Salvage, JE Meyer, and J. Bridges. "Measuring outcomes of long-term care for older people." Reviews in Clinical Gerontology 8, no. 3 (August 1998): 257–68. http://dx.doi.org/10.1017/s0959259898008387.

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There comes a time in the lives of a minority of older people when the extent of their disabilities makes it impossible for them to continue living in their own homes. When this happens, long-term institutional care may be the only option. Given that most residents in long-term care are over 75 years old and that the numbers in this age group will increase into the next century, we can expect an increase in the number of people requiring long-term care.

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Deng, Tongbo, Yafan Fan, Mengdi Wu, and Min Li. "Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions." International Journal of Environmental Research and Public Health 19, no. 19 (September 29, 2022): 12455. http://dx.doi.org/10.3390/ijerph191912455.

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The purpose of this paper was to better understand the long-term care preferences of older people based on intergenerational demonstration effects and social exchange theory, derived from the literature on intergenerational family relationships. The authors relied on the 2014 China Longitudinal Ageing Social Survey database to test the study hypotheses. The results indicated that living with grandchildren was negatively related to the institutional care preferences of older people. Family members’ attitudes and older people’s life satisfaction significantly mediated the relationship between living with grandchildren and their institutional care preferences. Gender and marital status had potentially diverse effects on institutional care preferences. Therefore, in the context of China’s culture of filial piety, social exchange, and intergenerational demonstration, motivation may help foster intergenerational exchange and reciprocity in eldercare arrangements.

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Waling, Andrea, Anthony Lyons, Beatrice Alba, Victor Minichiello, Catherine Barrett, Mark Hughes, Karen Fredriksen-Goldsen, and Samantha Edmonds. "Trans Women’s Perceptions of Residential Aged Care in Australia." British Journal of Social Work 50, no. 5 (October 24, 2019): 1304–23. http://dx.doi.org/10.1093/bjsw/bcz122.

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Abstract Many older people in trans communities in Australia and elsewhere have experienced long histories of violence and discrimination in the health and social care sectors, making some of them fearful of interacting with contemporary health and social care providers. This study explored older trans women’s perceptions of these services. It involved a qualitative, thematic analysis of semi-structured, one-on-one audio-recorded interviews with ten trans women aged sixty years and older in Australia. Participants expressed a number of concerns about using residential facilities for older people in Australia, including potential for abuse and discrimination as a result of being trans, and not having access to appropriate treatments. Participants indicated a range of alternatives in using services, such as renovating the home, relocating to areas with greater access to trans-inclusive services and potential euthanasia. Participants perceived that service providers were not adequately trained for trans and gender diverse needs, and highlighted a number of ways aged care services could better support the trans and gender diverse community. The findings provide important information to assist health and social care professionals, including social workers, as well as residential care service providers, in supporting the health and well-being of older trans women.

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Alderman, Chris. "Special Pharmacy Challenges for Older People in Difficult Times." Senior Care Pharmacist 35, no. 3 (March 1, 2020): 108–9. http://dx.doi.org/10.4140/tcp.n.2020.108.

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Older people are especially vulnerable to the impacts of natural disasters such as the fires in Australia and elsewhere around the world. Health care professionals have a duty of care under these circumstances, and among those who respond are pharmacists who contribute their expertise, energy, and dedication to help where needed.

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Isola, Arja, Kaisa Backman, Päivi Voutilainen, and Tarja Rautsiala. "Quality of institutional care of older people as evaluated by nursing staff." Journal of Clinical Nursing 17, no. 18 (September 2008): 2480–89. http://dx.doi.org/10.1111/j.1365-2702.2007.01951.x.

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González-Gil, Teresa. "Interventions for preventing delirium in older people in institutional long-term care." International Journal of Nursing Studies 55 (March 2016): 133–34. http://dx.doi.org/10.1016/j.ijnurstu.2015.12.009.

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Lambert, Matt A., Jan M. Potter, and Marion ET McMurdo. "Nutritional supplementation for older people." Reviews in Clinical Gerontology 20, no. 4 (August 31, 2010): 317–26. http://dx.doi.org/10.1017/s0959259810000262.

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SummaryMalnutrition is common in older people and is associated with a number of adverse outcomes. We review the evidence for the effectiveness of nutritional supplementation for older people in the community, in institutional care and following discharge from hospital. Studies in these settings are scarce, often include only small numbers of participants and are of variable quality. The interventions used are heterogeneous and difficult to directly compare. Oral nutritional supplements (sip feeds), dietary fortification, educational programmes, exercise, flavour enhancement and meal setting have all been studied. Evidence for use of oral nutritional supplements as sip feeds in undernourished community-dwelling and institutionalized older people and in those discharged from hospital is currently insufficient to recommend routine use. Flavour enhancement and more sociable meal environments may be beneficial. Further, more methodologically robust research is needed to clarify the effect of these interventions.

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BUCHIGNANI, NORMAN, and CHRISTOPHER ARMSTRONG-ESTHER. "Informal care and older Native Canadians." Ageing and Society 19, no. 1 (January 1999): 3–32. http://dx.doi.org/10.1017/s0144686x99007254.

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The number and relative proportion of older Native people in Canada are both increasing rapidly. So also is a social problems discourse asserting that informal care of older Native people by family and kin is traditional, and highly appropriate today. However, neither this discourse nor previous research satisfactorily address the informal care requirements of older Native people nor the gendered implications that high levels of informal care provision may have for Native caregivers. Informal care is provided to Canada's non-Native elderly people primarily by resident wives and non-resident daughters, and secondarily by husbands and sons. Data from the pan-provincial Alberta Native Seniors Study demonstrate that Native people aged 50 or more have comparatively high overall care requirements. Older Native Albertans are poor, and make extensive use of some government income support programmes. They also make moderate use of medical services. Extensive dependence on informal care, institutional barriers and local service unavailability lead Native seniors to under-utilise other formal programmes aimed generically at the older provincial population. Native seniors are much more likely to live with kin than are other Canadians. Informal care appears equally available to older women and men, and is provided chiefly by resident daughters, sons and spouses, and by non-resident daughters, sisters and sons. Extensive elderly caregiving requirements may impose a growing, double burden on many, who are also providing care for dependent children. Without further support, current and future requirements may significantly limit the options of caregiving women and men.

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Parker, D. "KNOWLEDGE INTO PRACTICE: IMPROVING ADVANCE CARE PLANNING FOR OLDER PEOPLE IN AUSTRALIA." Innovation in Aging 1, suppl_1 (June 30, 2017): 1266. http://dx.doi.org/10.1093/geroni/igx004.4611.

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Winblad, Bengt. "Relationship of Behavioral Disturbances in Demented Patients to Institutional Care." International Psychogeriatrics 8, S1 (October 1996): 133–35. http://dx.doi.org/10.1017/s1041610296003262.

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The proportion of institutionalized and noninstitutionalized demented people differs among countries. In the Kungsholmen study in Sweden, in the total population 75 years and older, around 50% of the demented people lived in their own homes and 50% lived in various types of institutions. In the future, it may not be possible, for ideological and financial reasons, to build new institutions to take care of the increasing number of dependent and ill elderly. Home care with support for relatives, day care, and collective living are better alternatives for some demented people.

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Brodaty, Henry, Brian M. Draper, and David C. Lie. "Psychogeriatrics and General Practice in Australia." International Journal of Psychiatry in Medicine 27, no. 3 (September 1997): 205–13. http://dx.doi.org/10.2190/r7yg-7qlj-qjmh-v1cr.

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We describe the interface between general practice and psychogeriatrics in Australia. While aged care services are complex and there are serious deficiencies in the management of the elderly, several initiatives appear set to improve the level of care. Economic considerations, mutual education of general practitioners and psychogeriatricians, and social factors are strong determinants of good primary care of the mental health needs of older people.

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Walker, Alan, Carol Walker, and Tony Ryan. "Older People with Learning Difficulties Leaving Institutional Care—A Case of Double Jeopardy." Ageing and Society 16, no. 2 (March 1996): 125–50. http://dx.doi.org/10.1017/s0144686x00003263.

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AbstractPeople with learning difficulties are now surviving into old age and more and more of them are being resettled from long-stay hospitals. The main purpose of this article is to examine some of the key barriers facing, and dilemmas involved in, the provision of community-based services to this newly emerging user group. The findings of some recent field research on older people with learning difficulties who have been resettled into the community are used to illustrate the challenges facing service providers. Particular reference is made to the impact of age discrimination and traditional differences between service specialisms. The article shows that both official definitions of need in old age and the aspirations of the service responses to those needs have been artificially constructed in very narrow terms, especially when compared with the principled approach to service provision for younger people with learning difficulties. In conclusion, therefore, it is argued that the principles underpinning services for people with learning difficulties, such as normalisation, should be applied to older people as well.

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PETERSEN, MAREE, and JENI WARBURTON. "Residential complexes in Queensland, Australia: a space of segregation and ageism?" Ageing and Society 32, no. 1 (February 7, 2011): 60–84. http://dx.doi.org/10.1017/s0144686x10001534.

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ABSTRACTIn western countries, large residential complexes comprising retirement villages and care facilities have become synonymous with specialised housing for older people, but gerontology has tended to view retirement villages and care facilities as separate and different spaces. By researching these spaces separately, gerontology's examination of the development of residential complexes and older people's housing has been hindered. This paper explores the geographies of residential complexes in south-east Queensland, Australia, by employing data from a larger study that utilised Lefebvre's spatial framework, social space. Its specific focus is Lefebvre's concept of representations of space, part of the triad of social space. The paper outlines how the professional knowledge of designers, planners and policy makers shape and frame the place of older people in contemporary society. The findings indicate that professional knowledge is characterised by contradictions, and that business interests sustain stereotypes of older people as either ageless or dependent. Furthermore, spaces designed for older people reinforce historical legacies of separation from the community. This form of built environment can thus be seen as both a cause and effect of ageism. Generally, the lack of attention by gerontology to these spaces has hampered discussion of alternatives for older people's housing in Australia and, importantly, the development of responsive urban and social planning.

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Mali, Jana. "Social work in the development of institutional care for older people in Slovenia." European Journal of Social Work 13, no. 4 (December 2010): 545–59. http://dx.doi.org/10.1080/13691450903403784.

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Lundberg, Kjetil G. "Care Descriptions at Work." Journal of Comparative Social Work 14, no. 2 (October 17, 2019): 55–75. http://dx.doi.org/10.31265/jcsw.v14i2.248.

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Forms and documents play significant roles in the context of care work for older people. One type of form that care workers use on a daily basis is individual care descriptions (ICDs). An ICD is a text that is written on a piece of paper or on a computer, and specifies the care tasks to be carried out. How do ICDs operate in local settings of care work for older people? Anchored in insights from institutional ethnography, I investigate care work practices from the standpoint of care workers in care settings in Norway. In the empirical analysis, I identify and pay attention to two particular ICDs and how they enter the everyday care work practices. The findings indicate that ICDs contribute to standardizing care work practices that are related to changes in the cultural and institutional foundations of the welfare state. Furthermore, ICDs coordinate practices in different ways, and promote several forms of coordination. Hence, when analysing care descriptions at work, awareness of contextual sensitivity is called for. This paper contributes to research on management and power relationships in home care and nursing care work by illustrating different dimensions of textually based coordination.

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Gibson, Diane. "Reforming Aged Care in Australia: Change and Consequence." Journal of Social Policy 25, no. 2 (April 1996): 157–79. http://dx.doi.org/10.1017/s0047279400000295.

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ABSTRACTFor the last ten years, the Australian system of services for frail elderly people has been undergoing significant reforms. Prior to that time, a series of government reviews and inquiries had repeatedly identified the same problems, including the dominance of institutional care, the inadequate supply of home and community based services, the lack of co-ordination, the inefficiency, and the unequal distribution of services by geographical area. Changes since the implementation of the Aged Care Reform Strategy in 1985 have been considerable, particularly with regard to the residential care sector. This article is concerned with the policy responses which emerged under the Strategy, and their impact on aged care service delivery in Australia.

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Elvidge, Felicity, and Geraldine MacPhail. "The ‘Quality in Care’ model of quality assurance and safeguarding for older people in institutional care." Journal of Adult Protection 11, no. 1 (April 13, 2009): 28–37. http://dx.doi.org/10.1108/14668203200900005.

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Tan, Heather, Robin Digby, Melissa Bloomer, Yixin Wang, and Margaret O'Connor. "End-of-life care in a rehabilitation centre for older people in Australia." Australasian Journal on Ageing 32, no. 3 (January 31, 2013): 184–87. http://dx.doi.org/10.1111/j.1741-6612.2012.00654.x.

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Braithwaite, J. "Regulating nursing homes: The challenge of regulating care for older people in Australia." BMJ 323, no. 7310 (August 25, 2001): 443–46. http://dx.doi.org/10.1136/bmj.323.7310.443.

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Fox, Mary T., Souraya Sidani, Jeffrey I. Butler, and Deborah Tregunno. "Nurses’ Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People’s Care in Ontario Acute Care Hospitals." Canadian Journal of Nursing Research 49, no. 2 (May 17, 2017): 94–100. http://dx.doi.org/10.1177/0844562117707140.

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Background Cultivating hospital environments that support older people’s care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses’ perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people’s care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman’s tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses’ perceptions of older people’s care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

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Challis, David, and Jane Hughes. "Frail old people at the margins of care: some recent research findings." British Journal of Psychiatry 180, no. 2 (February 2002): 126–30. http://dx.doi.org/10.1192/bjp.180.2.126.

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BackgroundCommunity-based care at the margin is a substitute for institutional care. Three factors are considered critical: definitions of eligibility, assessment procedures and balance of care.AimsTo examine determinants of the margin between institutional and home-based care, review current practice, identify the implications and contribute to planning of integrated long-term care services.MethodA selective review was made of findings from research conducted after the community care reforms.ResultsMarked variability and inconsistency in eligibility and assessment processes may contribute to misplacement of frail older people. There remains capacity to shift the balance of care from institutional to home-based care within reasonable cost parameters, particularly with more integrated services.ConclusionsGreater standardisation of approaches to the determination of eligibility for social care and to assessment of need is required. Providing care at home for some of those currently entering care homes is feasible, but will require different service structures and staff roles, including specialist clinicians.

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Duffy, Francis. "A Critical Perspective on Advance Care Planning for Older People." British Journal of Social Work 50, no. 4 (August 8, 2019): 1013–30. http://dx.doi.org/10.1093/bjsw/bcz092.

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Abstract How older people plan ahead for ageing in relation to accommodation, care arrangements, healthcare and medical treatment, and end of life decisions has attracted particular attention in recent years and as a result there has been considerable promotion of the importance of planning ahead and executing planning instruments with the aim of making one’s wishes and preferences known in advance. Planning ahead is promoted as allowing older people to have their voices heard, to advance their autonomy, choice and self-determination and to allow them to decide what treatment they may not want to receive. This article provides a critique of advance care planning, based on a subset of findings from a qualitative intergenerational study on ageing in Australia. The findings suggest that advance care planning is a much more complex and at times problematic endeavour, compared to what is promoted about advance care planning, in particular with regard to the use of planning instruments.

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Zou, Xiang, Ruth Fitzgerald, and Jing-Bao Nie. "“Unworthy of Care and Treatment”: Cultural Devaluation and Structural Constraints to Healthcare-Seeking for Older People in Rural China." International Journal of Environmental Research and Public Health 17, no. 6 (March 23, 2020): 2132. http://dx.doi.org/10.3390/ijerph17062132.

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This paper examines the experiences of seeking healthcare for rural Chinese older people, a population who experiences the multiple threats of socio-economic deprivation, marginalization, and lack of access to medical care, yet have been relatively overlooked within the existing scholarly literature. Based on ethnographical data collected from six-month fieldwork conducted in a rural primary hospital in Southern China, this paper identifies a widespread discouraging, dispiriting attitude regarding healthcare-seeking for rural older members despite the ongoing efforts of institutional reforms with a particular focus on addressing access to health services amongst rural populations. Such an attitude was expressed by older people’s families as well as the public in their narratives by devaluing older members’ health care demands as “unworthy of care and treatment” (“buzhide zhi” in Chinese). It was also internalized by older people, based on which they deployed a family-oriented health-seeking model and strategically downgraded their expectation on receiving medical care. Moreover, underpinning this discouragement and devaluation, as well as making them culturally legitimate, is the social expectation of rural older people to be enduring and restrained with health-seeking. Simultaneously, this paper highlights the sourc2e of institutional and structural impediments, as they intersect with unfavorable socio-cultural values that normalize discouragement and devaluation.

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ZHOU, JUNSHAN, and ALAN WALKER. "The need for community care among older people in China." Ageing and Society 36, no. 06 (June 3, 2015): 1312–32. http://dx.doi.org/10.1017/s0144686x15000343.

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ABSTRACTThe social care system of China has come under close scrutiny from policy makers due to the rapid ageing of China's population. Unfortunately, there is very little Chinese research evidence that might be used to plan future service developments. This article is a contribution to filling that gap and it provides essential new information on the expressed demand among older people in China for various community care services. The data are from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey. According to the characteristics of the dependent variables, we used Binary Logistic Regression Analysis to analyse the need for community care among older people in China. The results show considerable need for such care, but China is still a developing country and there are insufficient resources to fund a Western-style social care system (even if that was desirable). Thus, it is argued that the development of social care in China should emphasise community-based care, in partnership with families, with institutional care as a last resort. In addition, it is argued that China (and other countries) should introduce measures to prevent the demand for social care.

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Mackenzie, Lynette, and Amanda Clifford. "Perceptions of older people in Ireland and Australia about the use of technology to address falls prevention." Ageing and Society 40, no. 2 (August 28, 2018): 369–88. http://dx.doi.org/10.1017/s0144686x18000983.

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AbstractFalls are common events with serious consequences for older people. With an ageing population and increasing health-care costs, information and communication technologies (ICT) will have a potential role in future health-care delivery. However, research on technology acceptance in health care for older people is limited and its application to falls prevention is unknown. The aims of this study were to explore and describe the perceptions of community-dwelling Australian and Irish older people about their current use of technology, and the potential use of technology for falls prevention. Qualitative data were collected from three focus groups conducted in and around Limerick in Ireland, and three in the Sydney area, Australia. A total of 35 older people participated. Data were analysed using thematic analysis. Four themes emerged from the data: (a) perceptions of vulnerability to falls, (b) preferences for exercise interventions, (c) participation in and ownership of technology, and (d) perceptions about applications of technology for falls prevention. As the use of technology is an instrumental activity of daily living, health professionals need to assess the capacity of older people to adopt these technologies, and provide falls prevention interventions to accommodate the technology skills of older people. Some participants were reluctant to embrace technology and barriers to the effective use of technology to assist in preventing falls may conflict with future health service trends.

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Simmons, Daniela. "Implementing Sociometry in a Long-Term Care Institutional Setting for the Elderly: Exploring Social Relationships and Choices." Journal of Psychodrama, Sociometry, and Group Psychotherapy 65, no. 1 (March 1, 2017): 85–98. http://dx.doi.org/10.12926/16-00004.1.

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In this article, I explore the convergence of sociometry and gerontology in order to demonstrate successful practices and to suggest alternative approaches in interacting with elderly people, which would result in stabilizing and improving their mental health and emotional status. As elderly people may experience various psychological conditions, applying sociometry requires innovative approaches and a certain flexibility in the application of some of the techniques. The article specifically deals with older adults residing in long-term care communities and my personal experience in creating and implementing therapeutic modalities for the older population. In this article, “older adults” are those older than 65 years. The “elderly” are those aged 85+ years. The approaches and techniques described in this article are adapted and effective for elderly people at any age.

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Luty-Michalak, Marta, and Aleksandra Syryt. "Long-term care system for dependent people – Austrian experiences." Acta Universitatis Lodziensis. Folia Sociologica, no. 71 (December 30, 2019): 81–98. http://dx.doi.org/10.18778/0208-600x.71.07.

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Austrian society is an ageing society. Old age does not always mean dependence. However, the risk of disability and dependence increases with age. In addition, older people often experience multi-disease. High-quality long-term care services can help frail and dependent elderly on maintaining greater autonomy and participation in society, regardless of their condition. The aim of the article is to analyze legal, institutional and practical solutions in the field of long-term care system functioning in Austria. It should be emphasized that Austria is striving to develop services based on a social model and an independent life paradigm. Analysis of legal solutions indicates that the long-term care system in Austria is very complex. Institutional solutions are divided between the federal level and nine federal states. On the one hand, this results in decentralization and more effective help for the elderly, but on the other hand, it causes the diffusion and heterogeneity of standards.

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Berdajs, Andrej. "Caring For The Elderly and Working With The Aging Population." Revija za elementarno izobraževanje 14, Spec. Iss. (August 2, 2021): 87–101. http://dx.doi.org/10.18690/rei.14.spec.iss.87-101.2021.

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Older people receive care and assistance in both formal and informal ways. About 4% of people aged over 65 are living in institutional care. Most of the help is provided by families and other informal carers. We must arrange assistance for informal carers and direct the care not only to the medical aspect but also to the social component. The social care component helps vulnerable older people to overcome the crisis caused by exclusion from their environment and reduction in their social network. This is an important opportunity for social pedagogical work, either in various institutions or through.

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BOYLE, GERALDINE. "The role of autonomy in explaining mental ill-health and depression among older people in long-term care settings." Ageing and Society 25, no. 5 (August 23, 2005): 731–48. http://dx.doi.org/10.1017/s0144686x05003703.

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This paper examines the extent of mental ill-health and probable depression among older people in long-term care. It presents selected findings from a study in Greater Belfast, Northern Ireland, that compared the quality of life, autonomy and mental health of older people living in nursing and residential homes with those of older people living in private households who were receiving domiciliary care. Structured interviews were conducted with 214 residents in institutions and 44 older people receiving domiciliary care. The study found that those in private households were more severely physically-impaired and had a higher level of mental ill-health than the residents of institutional homes. It is suggested, however, that the mental ill-health effects were associated less with physical impairments than with the restrictions placed on the older person's decisional autonomy, and that long-term care environments that constrain the older person's autonomy contribute to the development of depression. Although the UK National Service Framework for Older People specified that those with depression should be given treatment and support, priority should also be given to preventing the depression associated with living in long-term care settings.

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Gavilan, Hilary. "Care in the community for older housebound people: Institutional living in your own home?" Critical Public Health 3, no. 4 (October 1992): 14–18. http://dx.doi.org/10.1080/09581599208406868.

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Gorsky, Martin. "Creating the Poor Law Legacy: Institutional Care for Older People Before the Welfare State." Contemporary British History 26, no. 4 (December 2012): 441–65. http://dx.doi.org/10.1080/13619462.2012.676910.

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Lloyd-Sherlock, Peter, and Nelida Redondo. "Institutional Care for Older People in Developing Countries: The Case of Buenos Aires, Argentina." Journal of Population Ageing 2, no. 1-2 (June 2009): 41–56. http://dx.doi.org/10.1007/s12062-010-9017-1.

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Day, Jenny, Ann Clare Thorington Taylor, Peter Summons, Pamela Van Der Riet, Sharyn Hunter, Jane Maguire, Sophie Dilworth, et al. "Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia." Australian Journal of Primary Health 23, no. 2 (2017): 162. http://dx.doi.org/10.1071/py16022.

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This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and ‘emotional touchpoints’ relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants’ use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

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Steed, Lyndall, Duncan Boldy, Linda Grenade, and Helena Iredell. "The demographics of loneliness among older people in Perth, Western Australia." Australasian Journal on Ageing 26, no. 2 (June 2007): 81–86. http://dx.doi.org/10.1111/j.1741-6612.2007.00221.x.

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Journal articles on the topic 'Older people Institutional care Australia'

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