Lynn Chenoweth

University of Technology Sydney | UTS · Discipline of Sport and Exercise Management

Background: While Australian guidelines promote person-centered healthcare (PCC) for persons with dementia, healthcare systems, routines, rules, and workplace cultures can pose challenges in the provision of PCC. Objective: To present a knowledge translation protocol of the PCC model in a sub-acute rehabilitation hospital. Methods: The two-yea...

Objectives This study investigated the views of people living with dementia and their families/care partners on (i) what they find helpful or unhelpful regarding behavioral changes, i.e. which coping strategies they used for themselves and/or which responses from others, and (ii) what they consider to be appropriate terminology to describe behavior...

Background: Behavioral and psychological symptoms of dementia (BPSD, also known as neuropsychiatric symptoms (NPS), changed behaviors and responsive behaviors), occur in up to 90 percent of people living with dementia (PLWD). These symptoms and behaviors strongly correlate with functional and cognitive impairment and contribute to ~30% of overall d...

Background The World Health Organization has proposed a model of healthy aging built around the concept of functional ability, comprising an individual’s intrinsic capacity, the physical and social environment they occupy, and interactions between the two. However, these constructs have been poorly defined. We examined the structure of intrinsic ca...

Objectives This pilot study assessed clinical outcomes and quality care for persons with dementia in an acute hospital with PCC, compared with usual care. Methods Forty-seven consented persons 60 years and over with dementia were assigned to PCC (n = 26) or usual care (control) (n = 21). Hospital nurses and allied health staff received 3 h of face...

Background During hospitalisation, older people can quickly become disoriented and agitated. In these instances, ‘specialling’, involving close monitoring and observation of the person to prevent accidents, injuries and clinical deterioration is often required. Despite the widespread practice of older patient specialling, there is no evidence of th...

Objectives: Agitation is common and problematic in care home residents with dementia. This study investigated the (cost)effectiveness of Dementia Care Mapping™ (DCM) for reducing agitation in this population. Method: Pragmatic, cluster randomised controlled trial with cost-effectiveness analysis in 50 care homes, follow-up at 6 and 16 months and st...

Background The quality of care for people with dementia in care homes is of concern. Interventions that can improve care outcomes are required. Objective To investigate the clinical effectiveness and cost-effectiveness of Dementia Care Mapping™ (DCM) for reducing agitation and improving care outcomes for people living with dementia in care homes,...

Objectives Use of antipsychotic drugs in long-term aged care (LTC) is prevalent and commonly exceeds the recommended duration, but contributors to this problem are not well understood. The objective of this study is to provide a snapshot of the features of and contributors to prolonged use of antipsychotic medications (>12 weeks) among a sample of...

This paper is not yet published and so the authors are unable to provide a copy. It will be available open access once published. Sorry for any inconvenience - we are unable to take this down as we are unsure who/how it was uploaded here before published

This study explored intervention implementation within a pragmatic, cluster randomised controlled trial of Dementia Care MappingTM (DCM) in UK care homes. DCM is a practice development tool comprised of a five component cycle (staff briefing, mapping observations, data analysis and reporting, staff feedback, action planning) that supports delivery...

Background Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed decision-making. Proxy measurement of this construct is difficult and is often rated lower than self-report. Accurate proxy rating of quality of life in dementia is related to identification of concepts important to...

Antipsychotic and other tranquilising medicines are prescribed to help care staff manages behaviour in one-quarter of older people living in Australian long-term care homes. While these medicines pose significant health risks, particularly for people with dementia, reliance on their use occurs when staff are not educated to respond to resident beha...

The HALT emergency behaviour response protocol was used by the study's nurses and champions when investigating, interpreting, and responding to resident behaviour that staff found extremely challenging, including person-centred approaches.

Objectives: Despite limited efficacy and significant safety concerns, antipsychotic medications are frequently used to treat behavioral and psychological symptoms of dementia (BPSD) in long-term residential care. This study evaluates the sustained reduction of antipsychotic use for BPSD through a deprescribing intervention and education of health...

Policy and practice guidelines recommend person-centred care to support people to live well with dementia in long-term care. Therefore, staff working in long-term care settings need to be trained in dementia awareness and person-centred care. However, the access to, content of and reach of training across long-term care settings can be varied. Data...

Objective: To describe how an Australian age care provider, BaptistCare NSW & ACT, has embraced the National Guidelines for Spiritual Care in Aged Care for people with dementia. Method: A 12-month study was conducted in 19 Baptistcare residential homes, including 14 dementia units. Data were obtained from selected items of the Person-Centred Enviro...

Objective The primary objective of the study was to measure the impact of an observational pain assessment dementia tool on time from ED arrival to first dose of analgesic medicine. Methods A multisite cluster randomised controlled trial was conducted to test the Pain Assessment in Advanced Dementia (PAINAD) tool. Patients aged 65 years or older s...

Background Antipsychotic medications continue to be used in the management of Behavioral and Psychological Symptoms of Dementia (BPSD) despite adverse effects and revised guidelines. The Halting Antipsychotic use in Long Term care (HALT) project aimed to deprescribe these medications and improve non-pharmacological behavior management. Method We re...

Background Inappropriate use of antipsychotic medications to manage Behavioral and Psychological Symptoms of Dementia (BPSD) continues despite revised guidelines and evidence for the associated risks and side effects. The aim of the Halting Antipsychotic Use in Long-Term care (HALT) project is to identify residents of long-term care (LTC) facilitie...

Aims and objectives: To explore emergency nurses' perceptions of the feasibility and utility of Pain Assessment in Advanced Dementia tool in people over 65 with cognitive impairment. The Pain Assessment in Advanced Dementia tool was then compared with The Abbey Pain Scale, Doloplus-2 and PACSLAC. The objective was to determine which observational...

While there is considerable evidence on the impact of specific design features on problems associated with dementia, the link between the quality of the built environment and quality of life of people with dementia is largely unexplored. This study explored the environmental and personal characteristics that are associated with quality of life in p...

Background: Up to 90 % of people living with dementia in care homes experience one or more behaviours that staff may describe as challenging to support (BSC). Of these agitation is the most common and difficult to manage. The presence of agitation is associated with fewer visits from relatives, poorer quality of life and social isolation. It is re...

Background Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-directed behaviour, by partici...

Objectives: To develop and validate a short version of the Cornell Scale for Depression in Dementia (CSDD-19) for routine detection of depression in nursing homes. Setting: Australian nursing homes. Methods: A series of cross-sectional studies were conducted involving: 1) descriptive analysis of pooled data from five nursing home studies that...

While person-centred principles provide an ideal foundation for developing service standards in residential aged and dementia care, there has been limited attention to developing tools which can measure service structures, processes and outcomes according to these principles. The Person-Centred Environment and Care Assessment Tool (PCECAT) was deve...

This is the protocol for a review and there is no abstract. The objectives are as follows: Primary objective: To determine the effectiveness of organisation-wide interventions to implement person-centred care for people with dementia, in relation to reduction of behavioural symptoms such as agitation and depression, improvement in quality of life a...

Aim: To answer questions on the essential components (services, operations and resources) of a person-centered aged care home (iHome) using computer simulation. Materials & methods: iHome was developed with AnyLogic software using extant study data obtained from 60 Australian aged care homes, 900+ clients and 700+ aged care staff. Bayesian analy...

Background: Well-being and various forms of agitation in people with dementia can be improved in a person-centered long-term care setting. Data obtained during the Person-Centered Dementia Care and Environment (PerCEN) randomized controlled trial shed light on the factors that influenced the adoption and outcomes of person-centered interventions in...

Older Australians experience health disparities in pain management compared to other groups. This article is focused on understanding the emergency nurses' perceptions of pain and pain management for older persons with cognitive impairment and presenting with a long bone fracture. This article is part of a larger study focusing on emergency nurses'...

Although older people frequently present to the emergency department (ED), little is known about their experiences in this setting, despite increasing attendance rates reported in this population internationally. This study explores the experiences of older people and their carers leading to and during ED care in a metropolitan university hospital...

Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting. Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and t...

To evaluate the effectiveness of a leadership and management program in aged care. Double-blind cluster randomized controlled trial. Twelve residential and community-aged care sites in Australia. All care staff employed for 6 months or longer at the aged care sites were invited to participate in the surveys at 3 time points: baseline (time 1), 9 mo...

On arrival to the emergency department many older persons are accompanied by family/carers. Yet the role of family/carers in the emergency department is unclear. We know very little about how emergency department nurses balance care practices to accommodate family/carers while specifically meeting the needs of cognitively impaired older persons exp...

Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed...

SUMMARY Political, economic and organizational factors shape requirements for long-term aged care (LTC) serving people with chronic conditions, including dementia. Organization size, ownership and human resources need to be considered when examining the use and effectiveness of nonpharmacological modalities for people with dementia in LTC. Since LT...

AimTo examine the literature on the impact of the discharge experience of patients with dementia and their continuity of care.Methods Peer-reviewed and grey literature published in the English language between 1995 and 2014 were systematically searched using Medline, CINAHL, PubMed, PsycINFO and Cochrane library databases, using a combination of th...

The study aimed to explore the practice of care among emergency nurses caring for older persons with cognitive impairment and who presented in pain from a long bone fracture, to highlight nurse confidence and self-efficacy in practice. Cognitive impairment is an issue increasingly facing emergency departments. Older persons with cognitive impairmen...

The residential aged care industry in Australia will expand rapidly over the next 10 years leading to substantial increases in government expenditure. Recent and future reforms are likely leading to changes in the structure of the industry with a potential impact on quality of care. The purpose of this paper is to stimulate broader public debate, b...

Objective To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. Setting Fourteen nursing homes in Sydney and Brisbane, Australia. Participants Ninety-two residents with a mean age of 85 years. Measure ments: Consenting residents were assessed by care staff for depression using the CSDD as part o...

Aims and objectivesTo establish validity of a clinical leadership framework for aged care middle managers (The Aged care Clinical Leadership Qualities Framework). Background Middle managers in aged care have responsibility not only for organisational governance also and operational management but also quality service delivery. There is a need to be...

Background Older people who present to the emergency department (ED) often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture. Methods The aim of the study was to determine if cognitive impairment is associated with...

Aim: To examine the relationship between structural factors and the imposition of sanctions on residential aged care services across Australia for regulatory compliance failure. Methods: Poisson Regression analysis was used to examine the association between the number of sanctions imposed and the structural characteristics of residential aged c...

To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. Single-blind cluster randomized controlled trial. A total of 35 Sydney nursing homes. All eligible residents within geographically defined areas within each nursing home were invited to participate. Pr...

Background: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. Methods: 38 Australian reside...

A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leade...

Life in residential care can be challenging for residents and staff. Bringing humor into this setting may benefit residents, creating a more productive, enjoyable work environment for staff. The potential effect of exposure to humor therapy on staff, both as active and incidental participants, as part of a randomized controlled trial of the effect...

To test the hypothesis that individual and institutional-level factors influence the effects of a humor therapy intervention on aged care residents. Data were from the humor therapy group of the Sydney Multisite Intervention of LaughterBosses and ElderClowns, or SMILE, study, a single-blind cluster randomized controlled trial of humor therapy condu...

Aim: To assess the feasibility and the effects of a multi-component education toolkit that used the Aged Care Funding Instrument behaviour (ACFI-BEH) scores to trigger care planning for older people experiencing behavioural and psychological symptoms of dementia (BPSD). Method: Forty-six older people and 209 staff and managers from five Sydney m...

AimTo identify key issues and factors affecting retention of qualified nurses who care for older people and persons with dementia in Australian acute, subacute, community and residential health-care settings. Background As the number of older people with chronic conditions needing health care continues to increase research is needed to optimize nur...

Abstract Aim: To assess the feasibility and the effects of a multi-componenteducation toolkit that used the Aged Care Funding Instrument behaviour (ACFI-BEH) scores to trigger care planning for older people experiencing behavioural and psychological symptoms of dementia (BPSD). Method: Forty-six older peopleand 209 staff and managers from five Sydn...

To determine whether humour therapy reduces depression (primary outcome), agitation and behavioural disturbances and improves social engagement and quality-of-life in nursing home residents. The Sydney Multisite Intervention of LaughterBosses and ElderClowns study was a single-blind cluster randomised controlled trial of humour therapy. 35 Sydney n...

In press

Person-centered care (PCC) for people with dementia is a system of care that is based on the belief that personhood can be maintained despite cognitive impairment. A recently conducted cluster randomized trial (Chenoweth et al., 200910. Chenoweth , L. , King , M. , Jeon , Y. , Brodaty , H. , Stein-Parbury , J. , Norman , R. … and Luscombe ,...

Aim: To provide further validation of the Environmental Audit Tool (EAT) by describing data on scores from 56 facilities and comparing the scores of facilities with a purpose-built dementia environment with those with non-purpose-built designs. Methods: Fifty-six facilities were assessed with the EAT. EAT scores for 24 purpose-built environments...

Background: Humor therapy is a non-pharmacological intervention with potential to improve mood and quality of life for institutionalized older persons, including those with dementia. The primary aims of the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) are to examine the effects of humor therapy on residents’ mood, quality...

Dementia care mapping and person centred care are well-accepted as processes for improving care and well-being for persons with dementia living in the residential setting. However, the impact of dementia care mapping and person centred care on staff has not been well researched. The impact of person centred care and dementia care mapping compared t...

The number of older people living with a schizophrenic disorder (SD) is increasing yet little attention paid has been paid to the needs of this population relative to people with other chronic illnesses. In order to achieve optimal functioning people with a SD need to manage their illness and its impact; therefore, this study set out to determine t...

The study reviewed all the published instruments used for the assessment, diagnosis, screening, and outcomes monitoring/evaluation of behavioral disturbances associated with dementia (BDAD) to recommend a set of psychometrically valid measures for clinicians and researchers to use, across a range of different practice settings. The study involved a...

gallagher r, warwick m, chenoweth l, stein-parbury j & milton-wildey k (2011) Journal of Nursing and Healthcare of Chronic Illness 3, 30–40 Medication knowledge, adherence and predictors among people with heart failure and chronic obstructive pulmonary disease Background. Although medicines are a key component in the self-management of chronic illn...

Literature suggests that quality of life (QOL), quality of care (QOC) and Behavioural and Psychological Symptoms of Dementia (BPSD) can be improved by relatively simple and inexpensive person-centred approaches to nursing care practices (PCC) and modifications to physical environment (PCE). Most research on this topic is observational and few rando...

The aim of this study is to examine the issues and the progress being made in leadership and management with relevance for the residential aged care workforce. A systematic review was conducted using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts. After a seven-tiered culling pr...

To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. A prospective, descriptive survey design was use...

To present evidence-based factors for the recruitment and retention of licensed nurses caring for older people and persons with dementia. The international nurse shortage crisis is intensified in the aged and dementia care sector. Strategies to address this crisis rely on qualitative, quasi-experimental, anecdotal and unsubstantiated literature. Sy...

Evidence for improved outcomes for people with dementia through provision of person-centred care and dementia-care mapping is largely observational. We aimed to do a large, randomised comparison of person-centred care, dementia-care mapping, and usual care. In a cluster randomised controlled trial, urban residential sites were randomly assigned to...

This paper reports on an exploratory two-group, pre- and posttest design study, which employed data triangulation with a convenience sample (n = 120) of women over 45 years aged between 45 and 83 years, living and/or working within the South East Sydney and Illawarra areas of New South Wales. Sixty-nine women recorded the Health Check Log (HCL) (33...

Objectives.  To determine effectiveness of the health check log (HCL) in promoting health-related quality of life and health awareness, health monitoring skills and timely consultation with health professionals for a cohort of community-dwelling people over 45 years, compared with a similar cohort not recording the HCL. Design.  An exploratory long...

Chronic illness causes the majority of disease burden and health costs in developed countries; however, this could be substantially reduced by optimal patient self-management. This study examined the levels of self-management in patients (n = 300) with chronic illness (chronic heart failure, chronic respiratory disease, Parkinson's disease and chro...

Aim. To identify the factors associated with better self-management in people with moderate to high levels of Parkinson’s disease following an acute illness event. Design and methods. A prospective, descriptive study conducted with 75 persons with Parkinson’s disease over the age of 55, collected twice: within a week of an acute event and 1 month l...