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Journal articles on the topic 'Terminal care facilities Australia'

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Published: 10 December 2022

Last updated: 29 January 2023

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1

Reymond, Liz, Fiona J. Israel, and Margaret A. Charles. "A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities." Australian Health Review 35, no. 3 (2011): 350. http://dx.doi.org/10.1071/ah10899.

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The objective of this study was to develop, implement and evaluate an end-of-life (terminal) care pathway and associated infrastructure suitable for Australian residential aged care facilities that improves resident and health system outcomes. The residential aged care end-of-life care pathway was developed by a multidisciplinary collaboration of government and non-government professionals and incorporated best clinical management for dying residents to guide care and increase palliative care capacity of generalist staff. Implementation included identifying and up-skilling Link Nurses to champion the pathway, networking facilities with specialist palliative care services, delivering education to generalists and commencing a Palliative Care Medication Imprest System in each facility. The primary outcome measure for evaluation was transfer to hospital; secondary measures included staff perceived changes in quality of palliative care provided and family satisfaction with care. Results indicated that the pathway, delivered within a care framework that guides provision of palliative care, resulted in improved resident outcomes and decreased inappropriate transfers to acute care settings. What is known about the topic? Residential aged care facilities (RACFs) are the hospices of today. Many RACF staff are not confident in the delivery of high quality palliative care, resulting in inappropriate transfers of dying residents to acute care facilities. Needs-based palliative care pathways are being used increasingly to direct care in a variety of healthcare environments. What does this paper add? Provides the first evidence in Australia that a residential aged care end-of-life care pathway (RAC EoLCP) improves outcomes of care for dying residents and results in fewer residents being inappropriately transferred to acute care facilities. What are the implications for practitioners? Use of the RAC EoLCP will improve resident and health system outcomes by guiding the delivery of high quality palliative care and improving the palliative care capacity of generalist health providers.

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2

Mitchell, Geoffrey, Caroline Nicholson, Keith McDonald, and Anne Bucetti. "Enhancing palliative care in rural Australia: the residential aged care setting." Australian Journal of Primary Health 17, no. 1 (2011): 95. http://dx.doi.org/10.1071/py10054.

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The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

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Tait, Paul, Chris Horwood, Paul Hakendorf, and Timothy To. "Improving community access to terminal phase medicines through the implementation of a ‘Core Medicines List’ in South Australian community pharmacies." BMJ Supportive & Palliative Care 10, no. 1 (February 6, 2017): e4-e4. http://dx.doi.org/10.1136/bmjspcare-2016-001191.

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ObjectivesDifficulties accessing medicines in the terminal phase hamper the ability of patients to die at home. The aim of this study was to identify changes in community access to medicines for managing symptoms in the terminal phase throughout South Australia (SA), following the development of a ‘Core Medicines List’ (the List) while exploring factors predictive of pharmacies carrying a broad range of useful medicines.MethodsIn 2015, SA community pharmacies were invited to participate in a repeat survey exploring the availability of specific medicines. Comparisons were made between 2012 and 2015. A ‘preparedness score’ was calculated for each pharmacy, scoring 1 point for each medicine held from the following 5 classes: opioid, benzodiazepine, antiemetic, anticholinergic and antipsychotic.ResultsThe proportion of pharmacies carrying all items from the List rose from 7% in 2012 to 18% in 2015 (p=0.01). Multiple linear regression demonstrated that a monthly online newsletter subscription (p=0.04) and provision of a clinical service to aged care facilities (p=0.02) were predictors of pharmacies carrying all items on the List. Furthermore, multiple linear regression demonstrated that the provision of an afterhours service (p=0.02) and clinical services to aged care facilities (p=0.04) were predictors of pharmacies with a high ‘preparedness score’. In responding to issues with supply of medicines at end of life, respondents were more likely to contact the prescriber if aware of palliative patients (p=0.03).ConclusionsThese results suggest that there is value in developing and promoting a standardised list of medicines, ensuring that community palliative patients have timely access to medicines in the terminal phase.

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Hughes, Rachel Elizabeth, and Kate Thompson. "Integration of specialist palliative care services into a multidisciplinary adolescent and young adult (AYA) oncology team." Journal of Clinical Oncology 32, no. 31_suppl (November 1, 2014): 64. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.64.

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64 Background: Palliative care is recommended alongside standard oncological care for patients with advanced cancer or high symptom burden (Smith TJ, Temin S, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of Clinical Oncology. 2012;30(8)880-7.). AYA oncology patients are distinguished by several age-specific developmental and biopsychosocial factors, resulting in a unique impact profile (Wein S, Pery S, Zer A. Role of palliative care in adolescent and young adult oncology. J Clin Oncol. 2010;28:4819-4824). Methods: To examine the benefits of multidisciplinary AYA care, a palliative care fellow was incorporated into an existing AYA oncology team in Australia, for a 12 month period. This role facilitated assessment/management of symptoms, general health issues, treatment toxicity, end of life care and bereavement support. Results: Between 2012 and 2013, of 83 new patients were referred to the AYA oncology service, 27 (32.5%) were referred the palliative care fellow. Notably, 37% of patients referred were receiving curative intent treatment. 10 patients (37%) were referred at diagnosis for symptom management. Pain was the most frequent reason for referral (n=17 63%). A total of 7 patients (26%) were referred for advanced disease/terminal care. Conclusions: Evaluation demonstrates that onsite availability of palliative care services is acceptable, facilitates early referral and has encouraged collaborative, AYA multidisciplinary care. A significant additional finding has been recognition of the demand for symptom management of patients early in their cancer experience. Further development and evaluation of AYA specific palliative care is warranted.

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5

Harris, Ross. "Terminal Care in Australia." Hospice Journal, The 3, no. 1 (April 15, 1987): 77–90. http://dx.doi.org/10.1300/j011v03n01_07.

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6

Harris, Ross D., and Lyn M. Finlay-Jones. "Terminal Care in Australia." Hospice Journal 3, no. 1 (March 1987): 77–90. http://dx.doi.org/10.1080/0742-969x.1987.11882583.

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7

Fleming, Richard, Roger Fay, and Andrew Robinson. "Evidence-based facilities design in health care: a study of aged care facilities in Australia." Health Services Management Research 25, no. 3 (August 2012): 121–28. http://dx.doi.org/10.1258/hsmr.2012.012003.

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8

Quigley, Ashley, Haley Stone, Phi Yen Nguyen, Abrar Ahmad Chughtai, and C. Raina MacIntyre. "COVID‐19 outbreaks in aged‐care facilities in Australia." Influenza and Other Respiratory Viruses 16, no. 3 (December 5, 2021): 429–37. http://dx.doi.org/10.1111/irv.12942.

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9

Wakefield, Melanie, and Michael Ashby. "Attitudes of surviving relatives to terminal care in South Australia." Journal of Pain and Symptom Management 8, no. 8 (November 1993): 529–38. http://dx.doi.org/10.1016/0885-3924(93)90082-7.

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10

Roughead, Elizabeth E., Susan J. Semple, and Andrew L. Gilbert. "Quality Use of Medicines in Aged-Care Facilities in Australia." Drugs & Aging 20, no. 9 (2003): 643–53. http://dx.doi.org/10.2165/00002512-200320090-00002.

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Chng, Chwee Lye, and Michael Kirby Ramsey. "Volunteers and the Care of the Terminal Patient." OMEGA - Journal of Death and Dying 15, no. 3 (November 1985): 237–44. http://dx.doi.org/10.2190/j0lw-0ear-jwpx-6pc9.

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In a time of shrinking funds and growing demand for health services, volunteers are indispensable. Civic minded people from all walks of life, when properly trained, can play an important supportive role to health professionals in terminal care facilities. Beside enhancing the quality of life of patients, volunteers may also help educate professionals to cope with death and bereavement. More specifically, the article examines the different roles of the volunteer: companion/friend, advocate, and educator. It also draws a profile of the volunteer, lists qualifications and personal characteristics, offers suggestions on where to work, and discusses special training programs to prepare volunteers for work with the dying.

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12

Smith, Mary, Ann L. Bull, Michael Richards, Pauline Woodburn, and Noleen J. Bennett. "Infection rates in residential aged care facilities, Grampians region, Victoria, Australia." Healthcare infection 16, no. 3 (September 2011): 116–20. http://dx.doi.org/10.1071/hi11017.

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13

Samsudin, Intan Liana, Syed Iskandar Ariffin, Maimunah Sapri, and Jamilia Mohd Marsin. "Reviewing Guidelines on Facilities and Practices of Intergenerational Care in Australia and Malaysia." Environment-Behaviour Proceedings Journal 6, no. 16 (March 21, 2021): 71–77. http://dx.doi.org/10.21834/ebpj.v6i16.2720.

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Developed countries like Australia have guidelines to support intergenerational care development for aged citizen. In Malaysia, the current facilities for aged care are single-user facilities and lack intergenerational interaction conducted with the other generations. The study reviewed the care facilities guidelines to support intergenerational interaction in the Malaysian context based on the Australian intergenerational care practice perspective. The qualitative method is employed through a comparative and content analysis of the guidelines. The finding showed that the childcare visitation model had been identified as a promising alternative intergenerational care to enhance intergenerational interaction in the Malaysian context. Keywords: Intergenerational care facilities; Aged Care; Childcare; Guidelines eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i16.2720

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14

ABE, Koji. "Effects of a terminal care experience on working stress among care-workers in long-term care facilities." Proceedings of the Annual Convention of the Japanese Psychological Association 74 (September 20, 2010): 3AM121. http://dx.doi.org/10.4992/pacjpa.74.0_3am121.

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15

Snowdon, John, and Tom Arie. "Old age psychiatry services: long-stay care facilities in Australia and the UK." Psychiatric Bulletin 26, no. 1 (January 2002): 24–26. http://dx.doi.org/10.1192/pb.26.1.24.

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We are old age psychiatrists; T.A. based in Britain, J.S. in Australia. A return visit by T.A. to Australia allowed us to focus attention on differences between the two countries in their provision of long-term care for old people with mental disabilities. What works well? What constrains development?

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Robinson, Andrew, Catherine See, Emma Lea, Marguerite Bramble, Sharon Andrews, Annette Marlow, Jan Radford, et al. "Wicking teaching aged care facilities program: Innovative Practice." Dementia 16, no. 5 (September 8, 2015): 673–81. http://dx.doi.org/10.1177/1471301215603846.

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This paper reports on the design of a program that aims to prototype teaching aged care facilities in Australia. Beginning in two Tasmanian residential aged care facilities, the intent of the program is to support large-scale inter-professional student clinical placements, positively influence students’ attitudes toward working in aged care and drive development of a high-performance culture capable of supporting evidence-based aged care practice. This is important in the context of aged care being perceived as an unattractive career choice for health professionals, reinforced by negative clinical placement experiences. The Teaching Aged Care Facilities Program features six stages configured around an action research/action learning method, with dementia being a key clinical focus.

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Silvester, William, Rachael S. Fullam, Ruth A. Parslow, Virginia J. Lewis, Rebekah Sjanta, Lynne Jackson, Vanessa White, and Jane Gilchrist. "Quality of advance care planning policy and practice in residential aged care facilities in Australia." BMJ Supportive & Palliative Care 3, no. 3 (November 14, 2012): 349–57. http://dx.doi.org/10.1136/bmjspcare-2012-000262.

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Hunt, R., A. Bonett, and David Roder. "Trends in the terminal care of cancer patients: South Australia, 1981-1990." Australian and New Zealand Journal of Medicine 23, no. 3 (June 1993): 245–51. http://dx.doi.org/10.1111/j.1445-5994.1993.tb01725.x.

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19

Courtney, Mary, Maria T. O'Reilly, Helen Edwards, and Stacey Hassall. "Benchmarking clinical indicators of quality for Australian residential aged care facilities." Australian Health Review 34, no. 1 (2010): 93. http://dx.doi.org/10.1071/ah09663.

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To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase. What is known about the topic?The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes. What does this paper add?The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation. What are the implications for practitioners?Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.

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Kirk, M. D., C. R. M. Moffatt, G. V. Hall, N. Becker, R. Booy, L. Heron, R. MacIntyre, D. E. Dwyer, and R. Lindley. "The Burden of Infectious Gastroenteritis in Elderly Residents and Staff of Long-Term Care Facilities, Australia." Infection Control & Hospital Epidemiology 31, no. 8 (August 2010): 860–63. http://dx.doi.org/10.1086/654000.

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We estimated the incidence of gastroenteritis in 16 Australian long-term care facilities. During 12 months' surveillance, 245 (96%) of 254 episodes of gastroenteritis among long-term care residents were associated with 17 outbreaks in 11 facilities. Incidence in long-term care residents was 0.64 episodes per 1,000 bed-days (95% confidence interval, 0.29-1.42).

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21

Grbich, Carol, Ian Maddocks, Deborah Parker, Margaret Brown, Eileen Willis, Anne Hofmeyer, and Neil Piller. "Palliative care in aged care facilities for residents with a non-cancer disease: results of a survey of aged care facilities in South Australia." Australasian Journal on Ageing 24, no. 2 (June 2005): 108–13. http://dx.doi.org/10.1111/j.1741-6612.2005.00085.x.

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22

IKUTA, Kyoko, Yukiko INOUE, Sachiko ONO, and Keiko TSUBOI. "A STUDY ON THE TERMINAL CARE ENVIRONMENT IN NEW TYPE LONG-TERM CARE FACILITIES WITH SMALL CARE UNIT." Journal of Architecture and Planning (Transactions of AIJ) 72, no. 622 (2007): 49–56. http://dx.doi.org/10.3130/aija.72.49_6.

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23

Cusack, L., L. Siegloff, P. Arbon, A. Hutton, and L. Mayner. "(A227) Tension between Emergency Management Policy Decisions and Aged Care Facilities in Australia: A Case Study." Prehospital and Disaster Medicine 26, S1 (May 2011): s61—s62. http://dx.doi.org/10.1017/s1049023x11002135.

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This paper considers the impact that a number of Australian emergency management policy and operational decisions are having on residential aged care facilities located in the community. For example, all residential aged care facilities applying for new federal government funded aged care places are required to demonstrate a plan for environmental disaster threats such as bushfires and floods. Another example is the adoption of new fire danger rating scale, with the inclusion of an extreme level called “catastrophic”-code red. This inclusion requires all services and community members, living in bushfire-prone areas to decide whether or not to evacuate the day before or morning of a Bureau of Meteorology fire danger index indicating a code red. There is evidence that these policy and operational decisions have been made without fully examining the practical implications, particularly for aged care facilities. While many of the facilities on which these decisions impact see the rational for such decisions, they argue that these decisions have serious implications for their services and patients. Many residential aged care facilities, which are privately operated, historically have not been involved in any state or local government emergency management planning. Therefore, the whole concept of risk assessment, preparation, and planning to increase the absorbing, buffering, and response capacity of their facilities against extreme weather events has become quite overwhelming for some. This paper presents a case study that demonstrates the tension between emergency management policy decisions on an aged care facility, and outlines their issues and response.

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Martins, Jo M., and Godfrey Isouard. "Managers of Aged Care Residential Services: 2006-2016." Asia Pacific Journal of Health Management 14, no. 1 (April 15, 2019): 68. http://dx.doi.org/10.24083/apjhm.v14i1.213.

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Purpose : Aged care Australia is going through a transformation reform to respond to the growing number of aged people in need of support in daily living. In this context, this article provides analyses of the number and characteristics of managers of aged care residential services in relation to number of aged people, residents of aged care facilities and people employed in them. Methodology/Design: Design of the analyses follows specifications provided by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2016. Analysis : Analysis of changes of the number of managers of aged care residential facilities against the number of aged people, residents of aged care facilities, and people employed in them. Further, the analyses examine changes in the age and sex of managers, their category, field and level of education, weekly income, hours worked, marital status, country of birth and indigenous status. Findings: There was a large increase in the number of employees and managers per resident, and a stable ratio of managers per employees. While the proportion of female managers declined, the average age of managers increased slightly. Both the fields and level of education remained similar in the decade. The average income of managers was similar as that in all industries in 2016, with a larger increase during the decade than in all industries. Average hours worked remained about the same. The same applied to marital status. The proportion of Australia-born managers declined while that of managers born in Asia rose substantially. The proportion of indigenous managers about doubled during the decade. Implications: Relevance to those concerned with the evolving transformation of aged care in Australia and those interested with management training of the growing number of managers of aged care residential services.

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Paley, Glenys Anna, Linda Slack-Smith, and Martin O’Grady. "Oral health care issues in aged care facilities in Western Australia: resident and family caregiver views." Gerodontology 26, no. 2 (June 2009): 97–104. http://dx.doi.org/10.1111/j.1741-2358.2008.00230.x.

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Moore, Kirsten J., Keith D. Hill, Andrew L. Robinson, Terry P. Haines, Betty Haralambous, and Jennifer C. Nitz. "The state of physical environments in Australian residential aged care facilities." Australian Health Review 35, no. 4 (2011): 412. http://dx.doi.org/10.1071/ah10932.

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Objective. This paper examines the quality and safety of the physical environment in Australian residential aged care facilities (RACFs). Design. Cross-sectional study. One assessor completed environmental audits to identify areas of the physical environment that needed to be addressed to improve the wellbeing and safety of residents. Setting. Nine RACFs participating in a broader falls prevention project were audited. RACFs were located in Queensland, Tasmania or Victoria and were chosen by convenience to represent high level, low level, dementia and psychogeriatric care, regional and metropolitan facilities, small and large facilities and a culturally specific facility. Main outcome measure. An environmental audit tool was adapted from a tool designed to foster older person friendly hospital environments. The tool consisted of 147 items. Results. Across all sites 450 items (34%) required action. This ranged from 21 to 44% across sites. The audit domains most commonly requiring action included signage, visual perception and lighting, and outdoor areas. Conclusions. Although not representative of all residential facilities in Australia, this audit process has identified common environmental problems across a diverse mix of residential care facilities. Results highlight the need for further investigation into the quality of physical environments, and interventions to improve physical environments in Australian RACFs. What is known about the topic? Despite the importance of the physical environment on the health, wellbeing and safety of older people in residential aged care facilities, few studies have comprehensively evaluated the physical environment in facilities in Australia. What does this paper add? This paper provides findings from comprehensive audits of nine residential aged care facilities representing a broad range of facility settings in terms of location, level and type of care and target population. Findings indicate that each facility had at least 21% of items requiring action with an average of 34% of items requiring action across all facilities. What are the implications for practitioners? There is a need to undertake intermittent, thorough assessments of the physical environments in which residents live and, if applicable, implement strategies or modifications to improve the environment. Areas requiring particular consideration may be lighting, colour contrasts, signage and outdoor areas.

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Harvey, Peter W. "The Australian Royal Commission into the Aged Care Industry 2019." Journal of Aging Research and Healthcare 2, no. 4 (January 30, 2019): 1–6. http://dx.doi.org/10.14302/issn.2474-7785.jarh-19-2608.

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In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.

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Liyanage, Thilini, Geoffrey Mitchell, and Hugh Senior. "Identifying palliative care needs in residential care." Australian Journal of Primary Health 24, no. 6 (2018): 524. http://dx.doi.org/10.1071/py17168.

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The aim of this study is to determine the accuracy, feasibility and acceptability of the surprise question (SQ) in combination with a clinical prediction tool (Supportive and Palliative Care Indicator Tool (SPICT)) in identifying residents who have palliative care needs in residential aged care facilities (RACFs) in Australia. A prospective cohort study in two RACFs containing both high-level care (including dementia) and low-level care beds. Directors of Nursing screened 187 residents at risk of dying by 12 months using first the SQ, and if positive, then the SPICT. At 12-months follow-up, deaths, hospitalisations, use of palliative care services, end-of-life care and clinical indicators were recorded. The SQ had a sensitivity of 70%, a specificity of 69.6%, a positive predictive value of 40.6% and a negative predictive value of 88.7% for death. All residents identified by the SQ had at least two general indicators of deterioration, while 98.8% had at least one disease-specific indicator on the SPICT. The SPICT marginally increased the ability to identify residents in need of proactive end-of-life planning. A combination of the SQ and the SPICT is effective in predicting palliative care needs in residents of aged care facilities, and may trigger timely care planning.

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Gadzhanova, Svetla, and Richard Reed. "Medical services provided by general practitioners in residential aged‐care facilities in Australia." Medical Journal of Australia 187, no. 2 (July 2007): 92–94. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01148.x.

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Brown, Margaret, Carol Grbich, Ian Maddocks, Deborah Parker, Penny Roe Connellan, and Eileen Willis. "Documenting end of life decisions in residential aged care facilities in South Australia." Australian and New Zealand Journal of Public Health 29, no. 1 (February 2005): 85–90. http://dx.doi.org/10.1111/j.1467-842x.2005.tb00754.x.

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Kirk, Martyn D., Kathleen E. Fullerton, Gillian V. Hall, Joy Gregory, Russell Stafford, Mark G. Veitch, and Niels Becker. "Surveillance for Outbreaks of Gastroenteritis in Long‐Term Care Facilities, Australia, 2002–2008." Clinical Infectious Diseases 51, no. 8 (October 15, 2010): 907–14. http://dx.doi.org/10.1086/656406.

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32

Hills, Neville. "Old age psychiatry services: long-stay care facilities in Australia and the UK." Psychiatric Bulletin 26, no. 6 (June 2002): 235–36. http://dx.doi.org/10.1192/pb.26.6.235-b.

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33

BOWLES, E., P. CHERAS, J. STEVENS, and S. MYERS. "A survey of aromatherapy practices in aged care facilities in northern NSW, Australia." International Journal of Aromatherapy 15, no. 1 (2005): 42–50. http://dx.doi.org/10.1016/j.ijat.2004.09.012.

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34

Webb, Bettine C., Terry Whittle, and Eli Schwarz. "Provision of dental care in aged care facilities NSW Australia- Part 2 as perceived by the carers (care providers)." Gerodontology 32, no. 4 (December 12, 2013): 254–59. http://dx.doi.org/10.1111/ger.12103.

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35

Dawes, John. "Dying with Dignity: Prisoners and Terminal Illness." Illness, Crisis & Loss 10, no. 3 (July 2002): 188–203. http://dx.doi.org/10.1177/1054137302010003002.

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During the past twenty years in Australia, there has been a developing concern about deaths in police and correctional custody. This article discusses a small but important component of deaths in correctional custody: the care of those prisoners in the terminal phase of a terminal illness. Hospice care in prison as well as in the community (achieved through compassionate release provisions) is discussed, and some of the problems with both strategies are identified. Two briefcase histories are discussed. The background to concern about dying prisoners is the aging of Australians in the community as well as those imprisoned, greater community awareness of issues dealing with loss and grief for the survivors of such deaths (through the work of state and territory coroners and support groups), and correctional agencies' becoming increasingly aware of their duty of care responsibilities.

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McVey, Peta, Heather McKenzie, and Kate White. "A community-of-care: the integration of a palliative approach within residential aged care facilities in Australia." Health & Social Care in the Community 22, no. 2 (November 6, 2013): 197–209. http://dx.doi.org/10.1111/hsc.12077.

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Garrido, Sandra, Laura Dunne, Janette Perz, Esther Chang, and Catherine J. Stevens. "The use of music in aged care facilities: A mixed-methods study." Journal of Health Psychology 25, no. 10-11 (February 22, 2018): 1425–38. http://dx.doi.org/10.1177/1359105318758861.

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Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings.

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Lesage, Alain, David Groden, Elliot M. Goldner, Daniel Gelinas, and Leslie M. Arnold. "Regionalised Tertiary Psychiatric Residential Facilities." Epidemiologia e Psichiatria Sociale 17, no. 1 (March 2008): 38–46. http://dx.doi.org/10.1017/s1121189x00002670.

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SummaryAims– Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely – with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call.Methods– This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing.Results– In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments withhostel wardssince the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia,Community Care Units(CCUs) have been applying this concept. In the Canadian province of British Columbia (BC),Tertiary Psychiatric Residential Facilities (TPRFs)have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital.Conclusions– This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary Psychiatric Care Facilities have the potential to act as hubs of expertise not only for treatment, rehabilitation, community integration and ser-vice co-ordination for the severely mentally ill, but also for research and training.Declaration of Interest: None.

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Tuckett, Anthony G. "The experience of lying in dementia care." Nursing Ethics 19, no. 1 (December 2, 2011): 7–20. http://dx.doi.org/10.1177/0969733011412104.

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This analysis examines the practice of care providers in residential aged care lying to residents with dementia. Qualitative data were collected through multiple methods. Data here represents perceptions from registered and enrolled nurses, personal care assistants, and allied health professionals from five residential aged care facilities located in Queensland, Australia. Care providers in residential aged care facilities (RACFs) lie to residents with dementia. Lying is conceptualized as therapeutic whereby the care provider’s intent is to eliminate harm and also control behaviour. Care providers of residents with dementia in RACFs need guidance around lying. An ethical framework cognisant of an ethical theory of good and ethical theory of right supplemented by a theory of virtue is proposed. A complimentary four stage communication strategy that promotes truth telling as a first option while also recommending the lie as a suitable strategy is also promoted.

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Lion, Katarzyna M., Clarissa Giebel, Ilaria Chirico, Monica Cations, Rabih Chattat, Mark Gabbay, Wendy Moyle, Giovanni Ottoboni, and Marco Valente. "A cross-country comparison of family carers experiences with residential aged care facilities during the COVID-19 pandemic." International Psychogeriatrics 33, S1 (October 2021): 26. http://dx.doi.org/10.1017/s1041610221001575.

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Background:The number of research projects into residential aged care (RAC) during the COVID-19 pandemic is increasing, however there are limited data on the cross-country comparison of experiences residents living with dementia and their families. Our study aimed to 1) give an overview of the RAC restrictions and changes (visiting policy, governmental & health authorities’ advice, service delivery) implemented during the pandemic in Australia, Italy and the UK and 2) and their impact on people with dementia in RAC facilities and their families.Methods:A total of 56 informal family carers of people with dementia residing in RAC took part in semi- structured interviews over the telephone or via Skype in Australia (n=6), Italy (n=25) and the UK (n=26) between July 2020 and March 2021. The interviews were recorded and translated verbatim. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.Results:Inductive thematic analysis identified four overarching themes: 1) Adaptations implemented in RAC facilities due to the COVID-19 pandemic in Australia, Italy and the UK; 2) means of communication between RAC facility personnel, people with dementia living in RAC and family members; 3) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on people with dementia in RAC facilities and 4) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on families of people with dementia in RAC facilities. While differences between countries and facilities were identified, the restrictions and changes within the residential care system impacted families’ well-being, increased their worries about care quality and safety of people with dementia. The consequences of a lack or modified services for people with dementia included noticeable physical and mental health changes. Although the majority of the facilities implemented some form of video-communication between families and residents, those solutions were unable to replace face-to-face contact.Conclusions:These findings demonstrate the need for implementing safe solutions which might facilitate more frequent in-person contact between families and residents with dementia preventing consequences in mental and physical health in both groups.

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Boonwaat, Leng, Stephanie Fletcher-Lartey, and Stephen Conaty. "Underreporting of influenza outbreaks in aged care facilities in South Western Sydney, Australia, 2014." Western Pacific Surveillance and Response 7, no. 1 (March 18, 2016): 32–34. http://dx.doi.org/10.5365/wpsar.2015.6.3.001.

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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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Xiong, Beibei, Shannon Freeman, Davina Banner, and Lina Spirgiene. "Hospice Utilization Among Residents in Long-Term Care Facilities." Journal of Palliative Care 36, no. 1 (February 24, 2020): 50–60. http://dx.doi.org/10.1177/0825859720907415.

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Background: Hospice care can improve quality of life for persons nearing end of life, yet little is known about utilization of hospice care among persons residing in long-term care facilities (LTCFs). Given the increasing number of deaths that occur in LTCFs, it is important to examine hospice care practices in LTCFs. Aim: The aim of the cross-sectional study was to describe residents who received hospice care in LTCFs and explore factors that can predict hospice use in LTCFs across Canada. This study included 185 715 residents aged 19 years or older in LTCFs in Canada in 2015. Results: Of all residents, 2.7% (n = 4973) received hospice care and 6.8% (n = 12 684) were profiled as having an end-stage disease. Among those who received hospice care, most were noted as end stage (89.5%) and had severe physical impairment (Activities of Daily Living Hierarchy Scale ≥ 5, 74.3%), mild-to-severe pain (Pain Scale ≥ 1, 76.0%), and moderate-to-severe health instability (Changes in Health, End-Stage Disease, Signs, and Symptoms Scale ≥3, 82.9%). Residents who received hospice care were in more severe and complex clinical conditions than those who did not receive hospice care. Conclusion: Only a small proportion of residents in LTCFs received hospice care. Further investigation of standardized assessment of terminal status is needed as accuracy of end-stage diagnosis continues to be challenging and criteria for hospice eligibility are narrow. Special attention should be paid to improve access to hospice care among residents with dementia or other progressive chronic diseases with severe and complex clinical needs.

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BIRCH, C. J., H. J. CLOTHIER, A. SECCULL, T. TRAN, M. C. CATTON, S. B. LAMBERT, and J. D. DRUCE. "Human coronavirus OC43 causes influenza-like illness in residents and staff of aged-care facilities in Melbourne, Australia." Epidemiology and Infection 133, no. 2 (December 22, 2004): 273–77. http://dx.doi.org/10.1017/s0950268804003346.

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Three outbreaks of respiratory illness associated with human coronavirus HCoV-OC43 infection occurred in geographically unrelated aged-care facilities in Melbourne, Australia during August and September 2002. On clinical and epidemiological grounds the outbreaks were first thought to be caused by influenza virus. HCoV-OC43 was detected by RT–PCR in 16 out of 27 (59%) specimens and was the only virus detected at the time of sampling. Common clinical manifestations were cough (74%), rhinorrhoea (59%) and sore throat (53%). Attack rates and symptoms were similar in residents and staff across the facilities. HCoV-OC43 was also detected in surveillance and diagnostic respiratory samples in the same months. These outbreaks establish this virus as a cause of morbidity in aged-care facilities and add to increasing evidence of the significance of coronavirus infections.

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Webb, Bettine C., Terry Whittle, and Eli Schwarz. "Provision of dental care in aged care facilities, NSW, Australia - Part 1 as perceived by the Directors of Nursing (care providers)." Gerodontology 30, no. 3 (May 21, 2012): 226–31. http://dx.doi.org/10.1111/j.1741-2358.2012.00670.x.

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Conway, Jane, Sophie Dilworth, Carolyn Hullick, Jacqueline Hewitt, Catherine Turner, and Isabel Higgins. "A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities." Australian Health Review 39, no. 5 (2015): 514. http://dx.doi.org/10.1071/ah15049.

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This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person.

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Courtney, Mary, Maria T. O'Reilly, Helen Edwards, and Stacey Hassall. "Development of a systematic approach to assessing quality within Australian residential aged care facilities: the Clinical Care Indicators Tool." Australian Health Review 31, no. 4 (2007): 582. http://dx.doi.org/10.1071/ah070582.

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Recent years have seen the introduction of formalised accreditation processes in both community and residential aged care, but these only partially address quality assessment within this sector. Residential aged care in Australia does not yet have a standardised system of resident assessment related to clinical, rather than administrative, outcomes. This paper describes the development of a quality assessment tool aimed at addressing this gap. Utilising previous research and the results of nominal groups with experts in the field, the 21-item Clinical Care Indicators (CCI) Tool for residential aged care was developed and trialled nationally. The CCI Tool was found to be simple to use and an effective means of collecting data on the state of resident health and care, with potential benefits for resident care planning and continuous quality improvement within facilities and organisations. The CCI Tool was further refined through a small intervention study to assess its utility as a quality improvement instrument and to investigate its relationship with resident quality of life. The current version covers 23 clinical indicators, takes about 30 minutes to complete and is viewed favourably by nursing staff who use it. Current work focuses on psychometric analysis and benchmarking, which should enable the CCI Tool to make a positive contribution to the measurement of quality in aged care in Australia.

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Baines, D., and J. H. Overton. "Parental Presence at Induction of Anaesthesia: A Survey of N.S.W. Hospitals and Tertiary Paediatric Hospitals in Australia." Anaesthesia and Intensive Care 23, no. 2 (April 1995): 191–95. http://dx.doi.org/10.1177/0310057x9502300212.

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We undertook a survey of N.S.W. hospitals and tertiary paediatric hospitals in other States to determine their practice in relation to parental presence at induction of anaesthesia of children. There were 135 responses to 174 questionnaires. Twenty-one indicated that no children were anaesthetized at their institution and one was inadequately filled out. One hundred and thirteen questionnaires were assessed. Only 44% of departments had an official policy on parental attendance. A quarter of all hospitals described their facilities as entirely suitable, and a half compromised to allow parents to be present. The remaining quarter described their facilities as unsuitable. Overall, two-thirds of hospitals never or only sometimes had parents present at induction, and this applied equally to daystay patients and inpatients. Tertiary hospitals were more likely to have parents present, however they were more likely to have suitable facilities. The most common reason cited for parental attendance was parental expectation of being present, closely followed by the individual anaesthetist's philosophy. The most common reason for parents not attending was the individual anaesthetist's philosophy, followed by inadequate staffing.

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Borotkanics, Robert, Cassandra Rowe, Andrew Georgiou, Heather Douglas, Meredith Makeham, and Johanna Westbrook. "Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory." Australian Health Review 41, no. 6 (2017): 613. http://dx.doi.org/10.1071/ah16125.

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Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period. Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables. Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents. Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services. What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods. What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia. What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.

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Gray, Rhys, Joseph Magdy, Joan Li, Samantha Helais, Rose Lougheed, Gary Nicholls, Scott West, Patrick Bolton, and Sze-Yuan Ooi. "CREATION OF A VIRTUAL SPECIALIST OUTPATIENT CARDIOLOGY CLINIC FOR CORRECTIONAL FACILITIES IN AUSTRALIA." Cardiovascular Digital Health Journal 3, no. 4 (August 2022): S25—S26. http://dx.doi.org/10.1016/j.cvdhj.2022.07.059.

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