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ABSTRACT: The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.
Journal of Aging and Physical Activity 04/2013; 21(2):140-54.
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ABSTRACT: A randomised controlled trial was conducted to test the effectiveness of the Home Independence Program (HIP), a restorative home-care programme for older adults, in reducing the need for ongoing services. Between June 2005 and August 2007, 750 older adults referred to a home-care service for assistance with their personal care participated in the study and received HIP or 'usual' home-care services. Service outcomes were compared at 3 and 12 months. Subgroups of 150 from each group were also compared on functional and quality of life measures. Data were analysed by 'intention-to-treat' and 'as-treated'. The intention-to-treat analysis showed at 3 and 12 months that the HIP group was significantly less likely to need ongoing personal care [Odds ratio (OR) = 0.18, 95% CI = 0.13-0.26, P < 0.001; OR = 0.22, 95% CI = 0.15-0.32, P < 0.001]. Both subgroups showed improvements on the individual outcome measures over time with the only significant differences being found at 12 months for Instrumental Activities of Daily Living (IADL) in the as-treated analysis. Contamination of the control group by an increased emphasis on independence across the home-care agency involved, together with other methodological problems encountered, is thought to account for the few differences between groups in individual outcomes. Despite no difference between the groups over time in their overall ADL scores, a significantly smaller proportion of the HIP group required assistance with bathing/showering, the most common reason for referral, at 3 and 12 months. The results support earlier findings that participating in a short-term restorative programme appears to reduce the need for ongoing home care. The implementation of such programmes more broadly throughout Australia could substantially offset the projected increase in demand for home care associated with the five-fold projected increase in numbers of the oldest old expected over the next 40 years.
Health & Social Care in the Community 09/2012; · 0.86 Impact Factor
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ABSTRACT: The three study objectives were to: compare the activity levels of older people who had received a restorative home care service with those who had received "usual" home care; explore the predictors of physical activity in these two groups; and, determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1490 clients who had been referred for a home care service between 2006-2009. Older people who had received a restorative care service were more active than those who had received "usual" care (p=.049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.
Journal of Aging and Physical Activity 07/2012;
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Australian and New Zealand Journal of Public Health 12/2011; 35(6):583. · 1.20 Impact Factor
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ABSTRACT: To investigate 'ageing in place' in terms of house, locality and support, related to the Western Australia members of National Seniors Australia.
A postal survey of 6859 members, followed by structured interviews with a subsample of respondents.
A similar proportion of respondents (nearly 30%) had either moved house recently or not for at least 20 years. Almost half were intending to stay in their current residence as they aged, this proportion increasing with age. A key reason for staying was having a 'comfortable' home. Related to moving, lifestyle change was particularly important for younger respondents and upkeep/maintenance difficulties for older respondents.
For varied and complex reasons, many adults choose to move between the ages of 55 and 75. Government policy can further support older Australians to have choices of 'places' to live in that maximise their ability to retain independence.
Australasian Journal on Ageing 09/2011; 30(3):136-42. · 0.90 Impact Factor
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ABSTRACT: This article presents the results of a study on the barriers and facilitators to bus use for people aged 60 or older. Two complementary methodologies, nominal group technique and focussed ethnography, were used to identify barriers and facilitators and rank their importance. Two sample sites from Queensland, Australia, were selected, with 227 people participating in the nominal group technique and 40 people participating in the focussed ethnography component. Seven priorities for age-friendly bus systems emerged from the data: vehicle entrance/exit; bus driver friendliness and helpfulness; timetables and scheduling of buses; bus stop locations; pedestrian infrastructure; information and training for older people; and bus routes and destinations. These findings will assist researchers, policy makers, and transport providers to set evidence-based strategic directions for creating age-friendly bus systems. Both methods provide complementary perspectives on bus usability, which could not be gained from either method alone.
Canadian journal on aging = La revue canadienne du vieillissement 09/2010; 29(3):435-44. · 0.92 Impact Factor
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ABSTRACT: Aim: To determine whether older people reported and prioritised different barriers and facilitators to bus use than younger people. Method: The Nominal Group Technique was used with 301 participants (231 older, 70 younger) to elicit reported barriers and facilitators to bus use. Categories were developed using qualitative content analysis and comparisons of categories and priorities were made. Results: Driver friendliness, ease of entry/exit and information useability were prioritised barriers and facilitators for older people. In contrast, younger participants prioritised bus punctuality, signage clarity, information provision at bus stops, bus service availability and parking facilities at the bus stop. Some similarities between older and younger adults were noted relating to convenience and bus scheduling. Conclusions: Older and younger adults have specific requirements for public transport systems which should be addressed in order to promote useable transport for all.
Australasian Journal on Ageing 03/2010; 29(1):33-8. · 0.90 Impact Factor
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ABSTRACT: The aim of this study was to pilot test the vision self-management programme (VSM) a newly developed, 8-week self-management intervention. The programme is a structured, repeatable and theoretically derived programme for older adults with age-related vision loss (ARVL).
A pre-and post-test design was used, and involved 12 older adults with ARVL. The activity card sort, a measure of participation in life situations, was the primary outcome measure. Secondary outcome measures examining general health and vision specific domains were also used.
Participants reported a statistically significant increase in participation in life situations immediately following the VSM programme. However, whilst an increase in such participation was still present at 12-week follow-up, this was no longer statistically significant. In addition, the participants demonstrated statistically significant gains in both general health and vision specific domains. Although these findings are exploratory they suggest that the VSM may have both short and longer term benefits for older adults living with ARVL.
Overall findings indicate that the participation in the self-management programme resulted in improved participation and health outcomes and support the need for further study using more rigorous designs.
Disability and Rehabilitation 04/2009; 31(16):1353-61. · 1.50 Impact Factor
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ABSTRACT: Although often associated with older age, loneliness and social isolation are not well understood in terms of their prevalence, risk and protective factors. Evidence suggests that only a minority of community-dwelling older people are "severely" lonely or isolated, however a number of factors need to be considered to fully understand the extent and significance of the problem. Community-based studies have identified a variety of risk factors for loneliness/isolation including widowhood, no (surviving) children, living alone, deteriorating health, and life events (eg, loss and bereavement). Having a confidant has been identified as a protective factor for loneliness. However, evidence is often unclear or inconclusive, especially within residential settings. We identified the need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated.
Australian health review: a publication of the Australian Hospital Association 09/2008; 32(3):468-78. · 0.55 Impact Factor
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ABSTRACT: Objectives: To determine the prevalence and demographic correlates of loneliness in a sample of older people in Perth, Western Australia.Methods: People aged 65 years and over living in private dwellings were recruited randomly, stratified by socioeconomic area, sex and 5-year age groups to 85 years. A total of 353 people with mean age of 77.5 years responded to a mailed questionnaire comprising demographic questions and three measures of loneliness.Results: Severe loneliness was reported by 7.0% of the sample and feeling lonely sometimes by 31.5%. Higher levels of loneliness were reported by single participants, those who lived alone and those with worse self-rated health. The protective value against loneliness of social networks appears to be, in order of importance: friends, relatives, neighbours and children.Conclusions: Although loneliness is not universally reported by older Perth residents, its prevalence is still considerable and worthy of attention from mental health practitioners and policy-makers.
Australasian Journal on Ageing 05/2007; 26(2):81 - 86. · 0.90 Impact Factor
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ABSTRACT: To estimate the likelihood and costs of in-patient care in the last three years of life.
A population-based retrospective cohort study using linked hospital and death records to evaluate in-patient use by Western Australians who died in 2002.
Age was unrelated to the likelihood of in-patient admission and inversely related to in-patient costs, after adjustment for sex, cause of death and proximity to death. In-patient costs increased in the final three quarters before death. In the last quarter before death, the predicted average quarterly in-patient cost increased 2.8 fold from quarter two and 3.8 fold from quarter three.
Older decedents were not more likely to be hospitalised than younger decedents in the final three years of life. Moreover, once hospitalised, their in-patient costs were lower. In-patient costs were heavily concentrated in the three last quarters of life.
Remaining lifetime is a significant predictor of in-patient costs. Failure to account for proximity to death will overemphasise the impact of population ageing on health care expenditure, because older people have a higher probability of dying.
Australian and New Zealand Journal of Public Health 05/2006; 30(2):143-6. · 1.20 Impact Factor
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ABSTRACT: Clinical pathways are widely regarded as providing valuable knowledge about specific types of patients and their care, as well as providing direct guidance in clinical practice. In Australia, the use of care pathways has occurred with seemingly minimal professional nursing debate as to their benefits in practice. Comments supporting the introduction of pathways into clinical practice have focused on assistance to decision making, facilitation of clinical judgements about care, assistance in improving practice and utility as educational tools, particularly for new staff, new graduates and casual employees. A survey of 259 nurses working in an acute paediatric setting sought to gain their views about pathways of care with regard to satisfaction with use, content of pathway, ability to use in practice, effect on practice and commitment to use. While the most positive findings to emerge from the research indicated that nurses liked clinical pathways because they saved time and reduced documentation requirements, issues were also raised about the need for a broader, more inclusive development process for pathways, and an improved education program for staff use. The implications to arise from these findings are important for senior staff and educators who are responsible for staff orientation programs and ongoing staff development as well as for those responsible for the development and implementation of clinical pathways into practice.
Collegian Journal of the Royal College of Nursing Australia 11/2005; 12(4):22-8. · 0.90 Impact Factor
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ABSTRACT: Objective: To describe the characteristics of the Host Family Respite Program and its value within the community, and to discuss some of the issues associated with the use of respite care services.Method: The study includes a retrospective analysis of the characteristics of 97 families and 33 host family carers taking part in the program between 1998 and 2002. Benefits associated with the program were assessed through information provided by 31 primary carers.Results: Most care recipients suffered from some form of dementia (93%). Host family carers were primarily women aged 50–59 years. Primary carers described feeling worried, stressed and exhausted prior to using the service, but reported a high degree of satisfaction after their break.Conclusion: The Host Family Respite Program represents an alternative service that can make a significant impact on and improvement in the quality of life of older people with dementia living in the community, and their carers.
Australasian Journal on Ageing 06/2005; 24(2):94 - 97. · 0.90 Impact Factor
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ABSTRACT: Objective: To explore the extent of elder abuse in Western Australia and associated aspects, such as the relationship of the abuser to the victim, risk factors and desirable interventions, and current knowledge and use of relevant protocols.Methods: A mail-out questionnaire was sent to over 1000 organisations and 129 general practitioners (GPs). Recipients were asked to identify any known or suspected cases of elder abuse encountered during the previous 6 months.Results: The estimated prevalence of elder abuse was 0.58% (in individuals 60+ years). Females and those 75 years and older were more at risk than males or those younger. Financial abuse was the most common, and frequently more than one type of abuse was suffered by the same person. The main abusers were adult children or other relatives.Conclusion: The importance of education targeted at professionals, the general public and older people themselves was evident. Important direct interventions identified included respite care, advocacy and counselling.
Australasian Journal on Ageing 02/2005; 24(1):3 - 8. · 0.90 Impact Factor
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Reviews in Clinical Gerontology 01/2005; 15(01):63 - 70.
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ABSTRACT: Relatively little emphasis has been placed on identifying health promotion research and program priorities for the older age group. A one-day conference culminating in an interactive session was organised to engage health service professionals in a process to identify such priorities in Western Australia. Physical activity social isolation, mental health and medications were deemed issues warranting more attention by both health promotion research and health promotion intervention programs. Additional consultation with representatives of the target population is recommended to further refine the priorities.
Australian health review: a publication of the Australian Hospital Association 02/2004; 27(1):49-55. · 0.55 Impact Factor
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ABSTRACT: The Health Department of WA currently operates as a single integrated funder and purchaser of health services for the State. Health Service Agreements defining the level of health provision are negotiated with the various health services in WA. During the latter part of the 1990s, the funding of public hospitals for acute inpatient care moved away from a historical basis to output-based funding using a casemix approach based on Diagnosis Related Groups (DRGs). Other hospital services are still mainly purchased using historical funding levels, negotiated block funding or bedday payments, with output-based funding mechanisms under investigation. WA has developed its own approach to classifying admitted patients that recognises differences in complexity of care among episodes grouped to the same DRG. WA also has a unique cost estimation model for calculating DRG cost weights, which is based on a linear estimate of the relationship between nights of stay in hospital and the cost of hospital care for each DRG. Another emerging trend in the provision of public hospital services in WA has been the greater involvement of the private sector through the contracting of private providers to operate public hospitals. While no close examination has been undertaken of the outcomes of these changes in terms of their effect on efficiency or other relevant indicators of hospital performance, current purchasing arrangements are being reviewed following recommendations made in a report by the Health Administrative Review Committee. No decision has yet been made as to future changes to the funding policy of WA public hospitals.
Australian health review: a publication of the Australian Hospital Association 02/2002; 25(1):173-88. · 0.55 Impact Factor
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ECU Publications.
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ABSTRACT: Previous consultation with, and observation of, older people identified seven (7) priorities for an age-friendly bus system. The aim of this study is to identify whether implementation of age-friendly changes improves bus use, useability and social activity outcomes for older people. A number of age-friendly changes were introduced to the bus system in Hervey Bay, Australia over a three year intervention period. Concurrently, the bus system in Brisbane, Australia underwent few age-friendly changes as a result of usual practice. Pre/ post measures with a volunteer sample of community-dwelling older people (aged 60 and over) were used to measure the impact of age-friendly changes on bus use, useability and social activity. One hundred (100) older people took part in the survey both before and after the intervention period. The majority of Hervey Bay participants reported an improvement in the bus system, whilst the majority of the Brisbane sample reported no improvement. Self-rated ease of bus use remained the same for Hervey Bay participants, whilst Brisbane participants experienced a significant decrease in self-rated ease of bus use. Neither Hervey Bay nor Brisbane participants reported a significant change in frequency of bus use. There was no significant difference in Hervey Bay participants’ social activity participation, whilst Brisbane participants reported decreased participation in 7 out of 20 activities. In Brisbane, participants experienced a decline in ease of bus use and social activity participation over a three year period. This is consistent with a natural decline in function associated with ageing. Age-friendly changes in Hervey Bay may have allowed older users to maintain ease of bus use and social activity participation. Sensitivity to changes in frequency of bus use may have been restricted by use of a three point scale. Future research will compare the outcomes of on-board surveys across the intervention period.
Social Research in Transport (SORT) Clearinghouse.
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ABSTRACT: Age-friendly guidelines offer principles for overcoming environmental, attitudinal, physical and social barriers to the optimal participation of older people in society. The aim of this project is to develop age-friendly guidelines as a method of promoting social inclusion for older people. Because of the pivotal role that transport plays in enhancing the mobility and in turn the quality of life of older people, public buses will be used as a case study for developing and evaluating age-friendly guidelines. Data from the first phase of the project will be presented. The data stems from two sites (a coastal town and a large metropolitan city) in Queensland, Australia. Nominal Group Technique (NGT) data from 231 people 60 years and over across both sites will be presented. Barriers and facilitators to using buses were explored in these groups and participants were subsequently observed using the bus system using ethnographic methodology. Core environmental factors identified include information, prior experience, pedestrian crossings and safety, bus stop location and shelters, signage, entry / exit, drivers, ticketing, scheduling, seats and others on the bus. These, and other, factors will be described and discussed.
Social Research in Transport (SORT) Clearinghouse.
