Craig Whitehead

Craig Whitehead
Flinders Medical Centre · Department of rehabilitaion aged and pallaitive care

About

80
Publications
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Introduction

Publications

Publications (80)
Article
Background and Objectives Multidisciplinary rehabilitation is not incorporated into the usual care pathway for dementia despite increasing demand from key advocates. Clinician views regarding the relevance of rehabilitation in dementia care are not well known. This qualitative study explored the perspectives of health professionals regarding barrie...
Article
Background Current information on the patterns of medication use in nursing home residents living with dementia is conflicting. Aim The aim of this study was to investigate medication use and its associations with dementia diagnosis in Australian nursing home residents. Methods A cross‐sectional study of 541 residents from 17 Australian nursing h...
Article
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Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens’ jury to elicit views of members of the public regarding c...
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Objectives This analysis estimates the whole‐of‐system direct costs for people living with dementia in residential care by using a broad health and social care provision perspective and compares it to people without dementia living in residential care. Methods Data were collected from 541 individuals living permanently in 17 care facilities across...
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Background This systematic overview reports findings from systematic reviews of randomized controlled trials of pharmacological and non-pharmacological interventions for behavioural and psychological symptoms of dementia (BPSD). Methods The Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE, and PsycINFO were searched to September 2015...
Conference Paper
People with dementia are increasingly vocal about their right to make decisions regarding their own care. Enabling informed choice is a challenge in long term care where many residents are in the later stages of dementia. Care facilities are bound by both financial and legal responsibilities and task-centred care can be rooted in staff culture. A C...
Article
Behavioural and psychological symptoms of dementia (BPSD) are common amongst people with dementia and can have a large impact on public health by potentially reducing quality of life, increasing caregiver impact and increasing costs associated with dementia care. The objective of this study was to synthesise the findings of systematic reviews of ra...
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Objective To examine associations between cardiovascular system medication use with cognition function and diagnosis of dementia in older adults living in nursing homes in Australia. Methods As part of a cross-sectional study of 17 Australian nursing homes examining quality of life and resource use, we examined the association between cognitive im...
Conference Paper
Full-text available
Listening to the views of members of the public is increasingly recognised as a way to improve healthcare decision making. A citizen’s jury is a deliberative process that convenes a small group of general public (jurors) to consider a complex aspect of healthcare. A citizen’s jury was convened to consider how increased personal decision making can...
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Objectives: The objective of this study was to conduct a systematic review of evidence for the accuracy of the Kimberley Indigenous Cognitive Assessment (KICA) tool in supporting the diagnosis of dementia in Indigenous Australian populations. Methods: Cross-sectional diagnostic accuracy studies of the KICA with an appropriate reference standard...
Article
Background: Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 years, have a number of comorbidities and experience a trajectory of functional decline. General practitioners (GPs) have an important role in the diagnosis and management of people with dementia. The Cognitive Decline Partnership Cent...
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Background The discrepancy between the number of admissions and the allocation of hospital beds means that many patients admitted to hospital can be placed in units or wards other than that which specialise in the patient’s primary health issue (home-ward). These patients are called ‘outlier’ patients. Risk factors and health system outcomes of hos...
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Objective To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. MethodsA battery of instruments to measure health-related qual...
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Background/aim : The first evidence-based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence-based recommendations for occupational therapists. The aim of this paper is (1) to provide an overview of Guideline development, and (2) to descr...
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Objective To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia. Design Overview of systematic reviews. Methods A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE an...
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About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in communit...
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Objective: To undertake a cost-utility analysis of the Individual Nutrition Therapy and Exercise Regime: A Controlled Trial of Injured, Vulnerable Elderly (INTERACTIVE) trial. Design: Cost-utility analysis of a randomized controlled trial. Subjects: A total of 175 patients following a hip fracture were allocated to receive either alternate wee...
Article
Introduction: Stroke unit care is an established intervention for all stroke patients where the benefits derive from having a system which integrates acute reperfusion with secondary prevention and rehabilitation as needed. While most stroke units are staffed by dedicated stroke neurologists, in many parts of the world non-neurologist stroke physic...
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Background Total costs associated with care for older people nearing the end of life and the cost variations related with end of life care decisions are not well documented in the literature. Healthcare utilisation and associated health care costs for a group of older Australians who entered Transition Care following an acute hospital admission wer...
Article
Background Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared-decision-making (SDM) approach is...
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Background Geriatric cachexia is distinct from other age-related muscle wasting syndromes; however, detection and therefore treatment is challenging without the availability of valid instruments suitable for application in the clinical setting. This study assessed the sensitivity and specificity of a newly developed screening instrument utilising p...
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Objective: To investigate the preferences of frail older people for individualised multidisciplinary rehabilitation to promote recovery from a hip fracture. Design: Discrete Choice Experiment. Setting: Acute and Rehabilitation Hospitals in Adelaide, South Australia. Subjects: Eighty-seven patients with recent hip fracture (16 living in residential...
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Frail older people who are considering movement into residential aged care or returning home following a hospital admission often face complex and difficult decisions.Despite research interest in this area, a recent Cochrane review was unable to identify any studies of interventions to support decision-making in this group that met the experimental...
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Ageing is associated with weight loss and subsequently poor health outcomes. The present study assessed agreement between two field methods, bioelectrical impedance spectroscopy (BIS) and corrected arm muscle area (CAMA) for assessment of body composition against dual-energy X-ray absorptiometry (DXA), the reference technique. Agreement between two...
Article
To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. A single blind, multicenter, randomized controlled trial with 12-month follow-up. Participants were recruited after discha...
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To assess the feasibility of a physiotherapy intervention using an interactive gaming program compared with conventional physiotherapy for hospitalised older people. Randomised controlled pilot study in a geriatric rehabilitation unit within an acute public hospital. Participants were randomly allocated to physiotherapy using an interactive gaming...
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Background Frail older people who are considering movement into residential aged care or returning home following a hospital admission often face complex and difficult decisions. Despite research interest in this area, a recent Cochrane review was unable to identify any studies of interventions to support decision-making in this group that met the...
Article
While there has been wide uptake of the Nintendo Wii Fit as a therapy tool in hospital and aged care settings there is a lack of evidence regarding the effectiveness and safety of this approach when used with older people. This pilot study compared the effect of a physiotherapist providing activities from the Wii Fit with conventional therapy on mo...
Article
What walking aid prescription occurs at discharge after hip fracture? What changes in walking aid use occur in the following six months? Who initiates changes in walking aids and why? Prospective longitudinal observational study. 95 community-dwelling older adults who had undergone surgical treatment of a hip fracture. Range of walking aids prescri...
Poster
Aims: Older adults undergoing transitions from acute care, and their carers, are often unprepared for what will happen next and their respective roles and responsibilities in the process. A lack of understanding of self-care activities, a sense of abandonment, disregard for patient and caregiver preferences and lack of input into care planning have...
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The ageing of the Australian population is placing increasing demand on the nation's healthcare system. This study set out to describe the level of need for multidisciplinary care in an Australian tertiary hospital setting. A cross-sectional audit by case note review of all patients on acute medical and surgical wards in an Australian tertiary hosp...
Article
Currently the operational model of a Falls Clinic is not clearly defined making it difficult to assess outcomes. Predominantly referrals are for older, frail adults and while there is merit in current interventions prescribed the effect on falls and other outcomes over time are unclear. The aim of this pilot study is to describe 12 month health out...
Conference Paper
Full-text available
Aims Almost half of women and a third of men aged 65 years will enter residential aged care (RAC) at some time in their remaining life [1]. Consumer-directed care (CDC) is being discussed at policy and provider levels in Australia but this is the first attempt to canvass community preferences for aged care funding and expectations of entry to RAC i...
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Falls are common in stroke survivors returning home after rehabilitation, however there is currently a lack of evidence about preventing falls in this population. This paper describes the study protocol for the FLASSH (FaLls prevention After Stroke Survivors return Home) project. This randomised controlled trial aims to evaluate the effectiveness o...
Article
Objectives: bL To determine which combination of available measures of nutritional status can adequately describe the nutritional status of a large sample of older patients. bL To describe the prevalence of malnutrition in this large sample of older community dwelling Australians and provide a set of values that could be used as reference data for...
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Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25-35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcom...
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While hip fractures are an important cause of disability, dependency and death in older adults, the benefit of multi-disciplinary rehabilitation for people who have sustained hip fracture has not been demonstrated. Systematic review of randomized controlled trials which compare co-ordinated multi-disciplinary rehabilitation with usual orthopaedic c...
Article
To ascertain the reasons for not taking up a fall or injury prevention strategy among older people who have sustained a fall and attended an emergency department. As part of another trial, we identified 60 people who attended the emergency department of a public hospital with a fall. Participants were interviewed to ascertain the reasons for not ta...
Article
To describe the independent and combined effects of oral nutrition supplementation and resistance training on health outcomes in nutritionally at risk older adults following lower limb fracture. Randomized controlled trial with 12-week masked outcome assessment. Teaching hospital. One hundred nutritionally at risk older adults hospitalized followin...
Article
Falls among inpatients are the most frequently reported critical incidents in hospitals and can have tragic consequences that affect morbidity and mortality. The present study aimed to determine whether certain nursing units of care identified on patient care plans can be used to predict falls among hospitalized inpatients. A retrospective analysis...
Article
Providing geriatric assessments to older people residing in rural or remote areas is a challenge due to the complexities of distance and a declining medical workforce. This study aimed to develop a feasible model of service delivery in a rural area, delivering specialised falls and memory clinics similar to those available in the metropolitan area....
Article
Objectives: To determine the validity of the Resident Classification Scale (RCS) in measuring functional dependence. Methods: Participants newly assessed in hospital as requiring residential care were randomised to receive either transitional care or traditional inpatient hospital care. At the 4 month follow-up, the RCS and modified Barthel Index w...
Article
The authors describe carers' experiences of the traditional process of moving a relative into residential care from an acute hospital admission and how a transitional care unit affected this experience. Telephone interviews (total 31) confirmed that looking for permanent care was a stressful, time-consuming, and confusing process for all carers. Th...
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Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide we...
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To assess the effectiveness of moving patients who are waiting in hospital for a long term care bed to an off-site transitional care facility. Randomised controlled trial. Three public hospitals in Southern Adelaide. 320 elderly patients (mean age 83 years) in acute hospital beds (212 randomised to intervention, 108 to control). A transitional care...
Article
To produce safer and more integrated hospital discharge planning practices for older people living in rural and remote settings. Plan-Do-Study-Act framework using case-note audit and focus groups. Central Yorke Peninsula Hospital in South Australia. All patients aged 65 years or older admitted between October 2001 and June 2002. Interventions: Rang...
Article
To describe the first 2 years of operation of a specialist Falls Clinic providing assessment of falls risk and individual preventive interventions in a public hospital setting. Drawing from the available falls prevention evidence, a multidisciplinary Falls Clinic involving specialist medical assessment, physiotherapy assessment and treatment was es...
Article
Objective: To report on the validity of the Nursing Home Behaviour Problem Scale (NHBPS) in an Australian residential care setting. Method: Cluster randomised controlled trial. As part of this, questionnaires were administered to residential care staff concerning participating residents. The study was carried out in 20 residential care facilities (...
Article
To determine whether individualized advice on non-pharmacological strategies for hospitalized older patients with confusion and behavioral problems can improve levels of agitation and reduce the use of psychotropic medication. Pragmatic randomized controlled trial in two metropolitan teaching hospitals in South Australia. Seventy-one older patients...
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The aim of this project was to assess whether outreach visits would improve the implementation of evidence based clinical practice in the area of falls reduction and stroke prevention in a residential care setting. Twenty facilities took part in a randomized controlled trial with a seven month follow-up period. Two outreach visits were delivered by...
Article
To compare the four-month outcomes of fallers and nonfallers as well as those with slow gait speed in patients with hip fracture successfully discharged back to the community. Prospective study with four-month follow-up data. Community sample of survivors of hip fracture who have completed their rehabilitation programme. A consecutive sample of 73...
Article
To compare the effect of early discharge and home-based therapy with conventional hospital rehabilitation on patient and caregiver outcomes at 12 months after hip fracture. Randomized controlled trial. Acute and subacute care with follow-up in a community setting in Australia. Sixty-six older adults admitted to acute care after hip fracture who wer...
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Full-text available
Evidence-based guidelines recommend a range of treatments for falls and injury prevention. We undertook a randomised trial of a falls prevention service to screen for falls risk factors and recommend to GPs an evidenced base prescription for falls prevention. All patients who presented with a fall to the Emergency Department at Flinders Medical Cen...
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To evaluate, in terms of function and mobility, the predictive value of commonly adopted anthropometric 'definitions' used in the nutritional assessment of older adults, in a cohort of older Australians. Prospective cohort study - Australian Longitudinal Study of Ageing (ALSA). Adelaide, South Australia (1992-1994). Data were analysed from 1272 non...
Article
OBJECTIVES: Older people are at risk of undernutrition because of a number of physiological conditions and lifestyle factors. The purpose of this study was to explore the predictive relationship of corrected arm muscle area (CAMA) with 8-year mortality in a representative sample of older Australians. DESIGN: Prospective cohort study: The Australian...
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Full-text available
To compare hospital and home settings for the rehabilitation of patients following hip fracture. Randomized controlled trial comparing accelerated discharge and home-based rehabilitation (n = 34) with conventional hospital care (n = 32) for patients admitted to hospital with hip fracture. Three metropolitan hospitals in Adelaide, Australia. Sixty-s...
Article
The Australian Longitudinal Study of Ageing (ALSA) aims to identify factors that contribute to & predict the health & social well-being of older Australians. Analyses were performed to determine the predictive value of anthropometric measurements in older Australians for four-year mortality. Weight, height, skinfolds (triceps, abdominal, supra-spin...
Article
Hospitalized patients who require admission to residential care are often thought to make prolonged and inappropriate use of hospital resources. There are no Australian data on the factors that contribute to length of hospital stay for such patients. The aim of this study was to determine the timing of critical steps in discharge planning for hospi...
Article
Abstract Hospitalized patients who require admission to residential care are often thought to make prolonged and inappropriate use of hospital resources. There are no Australian data on the factors that contribute to length of hospital stay for such patients. The aim of this study was to determine the timing of critical steps in discharge planning...