Luke Schmidt, Daniel Broszczak, Margaret MacAndrew, Christina Parker
Objective
The Modified Barthel Index (MBI) is the sole reporting metric required by the Australian Government for the Short-Term Restorative Care program (STRC). This study investigated the suitability of the MBI as an outcome measure of functioning/self-care ability in the older Australian reablement context.
Methods
This was a retrospective cohort study where historical data from 921 participants involved in the STRC between January 2018 to March 2023 were collected from an aged care provider located in Australia. This study compared STRC program responders and non-responders based on MBI across a range of demographic variables. Additionally, Generalised Linear Modelling was performed to investigate the utility of the MBI to inform changes to the delivery of the intervention.
Results
Although the MBI was able to show significant differences between responders and non-responders at baseline (p ≤ 0.05), this is likely due to the sample size used. It was identified that the MBI suffers from a ceiling effect in the studied population. Therefore, the ability of the MBI to inform evidence-based changes relating to program delivery is limited.
Conclusions
This study provides a solid evidence base to guide the implementation of assessments in future programs and studies. This is due to the identification of limitations of the sole reporting metric used in the program. Based on findings throughout this manuscript, a range of standardised assessments dependent on the participant's goals should be implemented in future programs, such as the Restorative Care Pathway in the Support at Home program.
{"title":"Evaluating the Modified Barthel Index for Policy and Practice in Reablement: Lessons From Australia's Short-Term Restorative Care Program","authors":"Luke Schmidt, Daniel Broszczak, Margaret MacAndrew, Christina Parker","doi":"10.1111/ajag.70136","DOIUrl":"10.1111/ajag.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Modified Barthel Index (MBI) is the sole reporting metric required by the Australian Government for the Short-Term Restorative Care program (STRC). This study investigated the suitability of the MBI as an outcome measure of functioning/self-care ability in the older Australian reablement context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cohort study where historical data from 921 participants involved in the STRC between January 2018 to March 2023 were collected from an aged care provider located in Australia. This study compared STRC program responders and non-responders based on MBI across a range of demographic variables. Additionally, Generalised Linear Modelling was performed to investigate the utility of the MBI to inform changes to the delivery of the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although the MBI was able to show significant differences between responders and non-responders at baseline (<i>p</i> ≤ 0.05), this is likely due to the sample size used. It was identified that the MBI suffers from a ceiling effect in the studied population. Therefore, the ability of the MBI to inform evidence-based changes relating to program delivery is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides a solid evidence base to guide the implementation of assessments in future programs and studies. This is due to the identification of limitations of the sole reporting metric used in the program. Based on findings throughout this manuscript, a range of standardised assessments dependent on the participant's goals should be implemented in future programs, such as the Restorative Care Pathway in the Support at Home program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ending the abuse of older people in Australia is a national policy priority. Harmonisation of financial enduring power of attorney (FEPOA) legislation is regularly called for to protect against financial elder abuse. A FEPOA is a legal instrument by which an adult appoints one or more people to manage their legal obligations, money and property, particularly during periods of incapacity. Although older Australians are urged to make FEPOAs, and a majority of those over age 65 report having one, these instruments are implicated in an estimated 50%–85% of cases of financial elder abuse. This commentary offers a critical perspective on legislative harmonisation as a policy intervention to prevent financial abuse committed via FEPOA arrangements. We address three main issues. First, we explain several approaches to harmonisation, illustrated with examples from different areas of law-making, noting that harmonisation is often a slow process that does not achieve uniformity. Second, we argue that deficiencies in knowledge and practices that create risks of financial abuse via FEPOAs will not be cured by harmonisation alone. Third, we highlight that the legislative variation across states and territories provides opportunities for innovation in research. Further investment in high-quality research is essential to guide effective legislative and compliance strategies to prevent the financial abuse of older people.
{"title":"Preventing Financial Elder Abuse: A Critical Commentary on Harmonisation of Enduring Power of Attorney Laws","authors":"Nola Ries, Eugenia Tsihlis, Teresa Somes","doi":"10.1111/ajag.70122","DOIUrl":"10.1111/ajag.70122","url":null,"abstract":"<p>Ending the abuse of older people in Australia is a national policy priority. Harmonisation of financial enduring power of attorney (FEPOA) legislation is regularly called for to protect against financial elder abuse. A FEPOA is a legal instrument by which an adult appoints one or more people to manage their legal obligations, money and property, particularly during periods of incapacity. Although older Australians are urged to make FEPOAs, and a majority of those over age 65 report having one, these instruments are implicated in an estimated 50%–85% of cases of financial elder abuse. This commentary offers a critical perspective on legislative harmonisation as a policy intervention to prevent financial abuse committed via FEPOA arrangements. We address three main issues. First, we explain several approaches to harmonisation, illustrated with examples from different areas of law-making, noting that harmonisation is often a slow process that does not achieve uniformity. Second, we argue that deficiencies in knowledge and practices that create risks of financial abuse via FEPOAs will not be cured by harmonisation alone. Third, we highlight that the legislative variation across states and territories provides opportunities for innovation in research. Further investment in high-quality research is essential to guide effective legislative and compliance strategies to prevent the financial abuse of older people.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Dark, G. Ritchie, R. Reedman, et al., ‘Translation, Cultural Adaptation and Validation of the British Sign Language Cognitive Screening Tool Into Australian Sign Language’, Australasian Journal on Ageing 44, no. 4 (2025): e70120, https://doi.org/10.1111/ajag.70120.
There is an error in an author's first name. The name Patricia J McLean is incorrect. It should read Tricia J McLean.
We apologise for this error.
F. Dark， G. Ritchie， R. Reedman, et al.，“英国手语认知筛选工具在澳大利亚手语中的翻译、文化适应和验证”，《澳大利亚老龄化杂志》，第44期。4 (2025): e70120, https://doi.org/10.1111/ajag.70120.There是作者名字中的错误。帕特里夏·J·麦克莱恩这个名字是不正确的。应该是崔西娅·J·麦克莱恩。我们为这个错误道歉。
{"title":"Correction to ‘Translation, Cultural Adaptation and Validation of the British Sign Language Cognitive Screening Tool Into Australian Sign Language’","authors":"","doi":"10.1111/ajag.70135","DOIUrl":"10.1111/ajag.70135","url":null,"abstract":"<p>F. Dark, G. Ritchie, R. Reedman, et al., ‘Translation, Cultural Adaptation and Validation of the British Sign Language Cognitive Screening Tool Into Australian Sign Language’, <i>Australasian Journal on Ageing</i> 44, no. 4 (2025): e70120, https://doi.org/10.1111/ajag.70120.</p><p>There is an error in an author's first name. The name Patricia J McLean is incorrect. It should read Tricia J McLean.</p><p>We apologise for this error.</p>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Completed Life By Rodney Syme, Helga Kuhse, Cathy Henkel, and Dying With Dignity Victoria, 2023. 286 pp. A$28 (soft cover). ISBN: 978-0-64-688535-3","authors":"Jesse Zanker, Jarrah Fitzgerald","doi":"10.1111/ajag.70137","DOIUrl":"https://doi.org/10.1111/ajag.70137","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Wisdom of Age: Lessons on Living From Our Wise Elder Women. By Parsons, J, Australia: HarperCollins Publishers, 2025. 288 pp. $35.99 (soft cover). 9780733343513","authors":"Luella Monson","doi":"10.1111/ajag.70138","DOIUrl":"https://doi.org/10.1111/ajag.70138","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. D. Sharavanashree, Raveendra Niharika, M. K. Niharika
Objective(s)
The present study aimed to explore the preparedness of speech-language pathologists (SLPs) enrolled in a graduate programme in South India on serving the ageing population, including their preparedness, practice patterns, challenges faced and prospects.
Methods
A total of 122 SLPs enrolled in a graduate programme in South India voluntarily participated in a cross-sectional online survey. The survey questionnaire gathered information on the following aspects in the context of serving the ageing population: caseload characteristics, assessment and diagnosis, management, challenges faced and future perspectives.
Results
The survey results revealed that approximately 50% of the participants' caseloads included older adults. However, the participants reported being moderately prepared for the assessment and management of communication and swallowing disorders in the ageing population. Further, the survey reports the perceived barriers to their preparedness and practice, including physical health issues, cognitive decline and lack of support from caregivers among significant others.
Conclusions
Overall, the survey findings indicate growing recognition of the increasing demand for speech-language pathology services for older adults in India in the coming years, particularly for cognitive-communication and swallowing disorders. The survey highlights the need for the inclusion of courses related to the communication and swallowing needs of older adults in the graduate curriculum, specialised training in the use of evidence-based practices for addressing age-related conditions and greater use of technology to improve service delivery.
{"title":"Evaluating the Preparedness of Speech-Language Pathologists Enrolled in a Graduate Programme in South India to Serve the Ageing Population: A Survey Study","authors":"H. D. Sharavanashree, Raveendra Niharika, M. K. Niharika","doi":"10.1111/ajag.70133","DOIUrl":"10.1111/ajag.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>The present study aimed to explore the preparedness of speech-language pathologists (SLPs) enrolled in a graduate programme in South India on serving the ageing population, including their preparedness, practice patterns, challenges faced and prospects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 122 SLPs enrolled in a graduate programme in South India voluntarily participated in a cross-sectional online survey. The survey questionnaire gathered information on the following aspects in the context of serving the ageing population: caseload characteristics, assessment and diagnosis, management, challenges faced and future perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey results revealed that approximately 50% of the participants' caseloads included older adults. However, the participants reported being moderately prepared for the assessment and management of communication and swallowing disorders in the ageing population. Further, the survey reports the perceived barriers to their preparedness and practice, including physical health issues, cognitive decline and lack of support from caregivers among significant others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, the survey findings indicate growing recognition of the increasing demand for speech-language pathology services for older adults in India in the coming years, particularly for cognitive-communication and swallowing disorders. The survey highlights the need for the inclusion of courses related to the communication and swallowing needs of older adults in the graduate curriculum, specialised training in the use of evidence-based practices for addressing age-related conditions and greater use of technology to improve service delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bernadette Brady, Danielle Ní Chróinín, Carlos El-Haddad, Isabella Kang, Cindy Setiawan, Audrey Chrysilla, Daraveasna Daing, Lynette McEvoy, Seema Radhakrishnan, David Lieu, Clarice Tang, Steve Frost, Balwinder Sidhu, Elshaddai Leema, Rebecca Ivers, Friedbert Kohler, Justine Naylor
Objectives
To evaluate the implementation of the Australian Hip Fracture Clinical Care Standard for patients with low-trauma hip fracture. This study aimed to (1) document facility-level adoption, (2) explore healthcare providers' perspectives on Standard delivery and (3) describe patient engagement with post-acute discharge care recommendations, including outcomes for culturally and linguistically diverse (CALD) and limited English proficiency subgroups.
Methods
A mixed-methods approach was undertaken. Community-dwelling adults who underwent surgical treatment for low-trauma hip fractures at a tertiary hospital over 1 year were included. Facility-level adoption was determined by auditing medical records against the Clinical Care Standard. Patient engagement with post-discharge recommendations was assessed by structured telephone follow-up at 16 weeks and English proficiency. An electronic survey explored healthcare providers' perspectives of Standard implementation.
Results
Of 189 patients admitted, 136 (72%) were eligible; 127 completed follow-up assessment. The cohort was predominantly female (66%), with a mean age of 79 years and 80% migrants. Most components of the Care Standard were implemented with high fidelity (> 90% for four of seven indicators). Acute care data indicated effective implementation of most components of the Care Standard, supported by responses from 28 healthcare providers (28% response rate). However, healthcare providers highlighted the need for enhanced interprofessional training and resourcing for refracture prevention. Patient engagement with refracture prevention recommendations was low (44% participated in strength exercises, 26% in balance, 11% sought dietary advice and 44% consumed calcium supplementation), with no significant differences by CALD status or English proficiency.
Conclusions
Despite high facility-level implementation of the Care Standard, patient adoption of post-discharge refracture prevention strategies remains suboptimal. Bridging this gap requires multi-faceted, consumer-centred solutions and improved interdisciplinary training to enhance outcomes and reduce refracture risk, particularly in diverse and multicultural populations.
{"title":"Adoption of Hip Fracture Care Standards: A Mixed-Methods Analysis of Patient and Healthcare Provider Perspectives","authors":"Bernadette Brady, Danielle Ní Chróinín, Carlos El-Haddad, Isabella Kang, Cindy Setiawan, Audrey Chrysilla, Daraveasna Daing, Lynette McEvoy, Seema Radhakrishnan, David Lieu, Clarice Tang, Steve Frost, Balwinder Sidhu, Elshaddai Leema, Rebecca Ivers, Friedbert Kohler, Justine Naylor","doi":"10.1111/ajag.70124","DOIUrl":"10.1111/ajag.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the implementation of the Australian Hip Fracture Clinical Care Standard for patients with low-trauma hip fracture. This study aimed to (1) document facility-level adoption, (2) explore healthcare providers' perspectives on Standard delivery and (3) describe patient engagement with post-acute discharge care recommendations, including outcomes for culturally and linguistically diverse (CALD) and limited English proficiency subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods approach was undertaken. Community-dwelling adults who underwent surgical treatment for low-trauma hip fractures at a tertiary hospital over 1 year were included. Facility-level adoption was determined by auditing medical records against the Clinical Care Standard. Patient engagement with post-discharge recommendations was assessed by structured telephone follow-up at 16 weeks and English proficiency. An electronic survey explored healthcare providers' perspectives of Standard implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 189 patients admitted, 136 (72%) were eligible; 127 completed follow-up assessment. The cohort was predominantly female (66%), with a mean age of 79 years and 80% migrants. Most components of the Care Standard were implemented with high fidelity (> 90% for four of seven indicators). Acute care data indicated effective implementation of most components of the Care Standard, supported by responses from 28 healthcare providers (28% response rate). However, healthcare providers highlighted the need for enhanced interprofessional training and resourcing for refracture prevention. Patient engagement with refracture prevention recommendations was low (44% participated in strength exercises, 26% in balance, 11% sought dietary advice and 44% consumed calcium supplementation), with no significant differences by CALD status or English proficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite high facility-level implementation of the Care Standard, patient adoption of post-discharge refracture prevention strategies remains suboptimal. Bridging this gap requires multi-faceted, consumer-centred solutions and improved interdisciplinary training to enhance outcomes and reduce refracture risk, particularly in diverse and multicultural populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tesfahun C. Eshetie, Alana R. Cuthbert, Janet K. Sluggett, Solomon Yu, Carolyn Dawkins, Marjorie Schulze, Gillian E. Caughey, Maria C. Inacio
Objective
To examine the prevalence, trends and geographic variation of informal care reported by individuals accessing long-term home care support between 2012 and 2019 in Australia.
Methods
Population-based national cross-sectional study using the Registry of Senior Australians (ROSA) National Historical cohort. Non-Indigenous individuals 65–105 years old who accessed long-term home care through a Home Care Package between 01 January 2012 and 31 December 2019 in Australia were included. Informal carer availability was ascertained from individuals' aged care eligibility assessments. Informal carers are individuals who provide unpaid care and support to others. Socio-demographic and clinical characteristics of those with and without informal carers were examined. Yearly trends and geographic variation in the proportion of individuals reporting a carer were examined. The effect of a 1-year increase in receiving initial long-term home care on the probability of having a carer over time was described using an odds ratio (OR) and 95% confidence interval (95% CI) from a logistic regression model, adjusted for age, sex and dementia status.
Results
Overall, 233,567 long-term home care recipients with known carer status were studied. The proportion of care recipients with an informal carer decreased from 86% in 2012 to 78% in 2019 (adjusted OR: 0.95, 95% CI 0.95–0.95). The decrease in informal care reported over time was more pronounced in females (OR: 0.96, 95% CI 0.95–0.97) than in males and in individuals without dementia (OR: 0.95, 95% CI 0.94–0.95). Visualisations of informal care prevalence showed substantial geographical (range: 60%–98%) variation nationally.
Conclusions
There was a decline in reported informal care availability for older Australians entering long-term home care between 2012 and 2019, with substantial national variation. Lower informal carer availability likely translates in greater formal care needs.
目的：研究2012年至2019年澳大利亚获得长期家庭护理支持的个人报告的非正式护理的患病率、趋势和地理差异。方法：以人口为基础的全国横断面研究，使用澳大利亚老年人登记处（ROSA）国家历史队列。包括2012年1月1日至2019年12月31日期间通过家庭护理一揽子计划获得长期家庭护理的65-105岁非土著个人。非正式照顾者的可用性从个人的老年护理资格评估中确定。非正式照顾者是为他人提供无偿照顾和支持的个人。检查了有和没有非正式照顾者的人的社会人口学和临床特征。每年的趋势和地域差异的个人报告一个照顾者的比例进行了检查。采用logistic回归模型的比值比（OR）和95%置信区间（95% CI），对年龄、性别和痴呆状态进行了调整，描述了接受初始长期家庭护理的1年增加对有护理人员的概率的影响。结果：总体而言，研究了233,567名已知照顾者身份的长期家庭护理接受者。由非正式护理人员照料的护理对象比例从2012年的86%下降到2019年的78%（调整后的OR: 0.95, 95% CI 0.95-0.95）。随着时间的推移，报告的非正式护理减少在女性（OR: 0.96, 95% CI 0.95-0.97）中比在男性和无痴呆个体（OR: 0.95, 95% CI 0.94-0.95）中更为明显。非正式护理流行率的可视化显示了全国范围内显著的地理差异（范围：60%-98%）。结论：据报道，2012年至2019年期间，进入长期家庭护理的澳大利亚老年人的非正式护理可用性有所下降，且全国差异很大。较低的非正规护理人员可用性可能转化为更大的正规护理需求。
{"title":"Characterising Informal Care in Older Individuals Receiving Long-Term Home Care Support: A National Epidemiological Study","authors":"Tesfahun C. Eshetie, Alana R. Cuthbert, Janet K. Sluggett, Solomon Yu, Carolyn Dawkins, Marjorie Schulze, Gillian E. Caughey, Maria C. Inacio","doi":"10.1111/ajag.70128","DOIUrl":"10.1111/ajag.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the prevalence, trends and geographic variation of informal care reported by individuals accessing long-term home care support between 2012 and 2019 in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based national cross-sectional study using the Registry of Senior Australians (ROSA) National Historical cohort. Non-Indigenous individuals 65–105 years old who accessed long-term home care through a Home Care Package between 01 January 2012 and 31 December 2019 in Australia were included. Informal carer availability was ascertained from individuals' aged care eligibility assessments. Informal carers are individuals who provide unpaid care and support to others. Socio-demographic and clinical characteristics of those with and without informal carers were examined. Yearly trends and geographic variation in the proportion of individuals reporting a carer were examined. The effect of a 1-year increase in receiving initial long-term home care on the probability of having a carer over time was described using an odds ratio (OR) and 95% confidence interval (95% CI) from a logistic regression model, adjusted for age, sex and dementia status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 233,567 long-term home care recipients with known carer status were studied. The proportion of care recipients with an informal carer decreased from 86% in 2012 to 78% in 2019 (adjusted OR: 0.95, 95% CI 0.95–0.95). The decrease in informal care reported over time was more pronounced in females (OR: 0.96, 95% CI 0.95–0.97) than in males and in individuals without dementia (OR: 0.95, 95% CI 0.94–0.95). Visualisations of informal care prevalence showed substantial geographical (range: 60%–98%) variation nationally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was a decline in reported informal care availability for older Australians entering long-term home care between 2012 and 2019, with substantial national variation. Lower informal carer availability likely translates in greater formal care needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Tissot, Sara Karacsony, Sharon Andrews, Russell James
Objectives
Experiences across aged care services for older LGBTIQA+ individuals vary, with some receiving affirming care and others having unmet needs. Given the growing demand from this population, it is essential to examine both effective care aspects and ongoing challenges. This study aimed to explore the perspectives of aged care providers, carers and community stakeholders on opportunities and barriers to the consistent implementation of culturally safe care for older LGBTIQA+ Australians.
Methods
Adopting an interpretive descriptive methodology, a thematic analysis using Braun and Clarke's six-step framework was conducted on LGBTIQA+-specific transcripts from the Royal Commission into Aged Care Quality and Safety Diversity Hearing (October 2019) in Melbourne, Australia.
Results
Thematic analysis identified two main themes: Inclusive and Culturally Safe Care and Robust Governance for Inclusive Care. Findings revealed that engagement with aged care is severely undermined by historical trauma and a profound mistrust of formal services by some LGBTQIA+ older people. Systemic barriers persisted due to inconsistencies in governance and a lack of accountability for diversity standards. Stakeholders highlighted the critical necessity of mandatory, identity-affirming LGBTIQA+ workforce training and the vital role of advocacy and community connections in bridging access gaps and ensuring cultural safety.
Conclusions
While policy frameworks and ‘special needs’ recognition exist, genuine inclusion for older LGBTIQA+ Australians hinges on operationalising cultural safety through consistent governance, stronger compliance mechanisms and a mandatory, well-resourced training regimen for the aged care workforce. These findings provide critical implications for policy reform and practice improvement under Australia's evolving aged care standards.
{"title":"LGBTIQA+ Inclusion in Aged Care: Perspectives From Providers and Community Stakeholders","authors":"Daniel Tissot, Sara Karacsony, Sharon Andrews, Russell James","doi":"10.1111/ajag.70129","DOIUrl":"10.1111/ajag.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Experiences across aged care services for older LGBTIQA+ individuals vary, with some receiving affirming care and others having unmet needs. Given the growing demand from this population, it is essential to examine both effective care aspects and ongoing challenges. This study aimed to explore the perspectives of aged care providers, carers and community stakeholders on opportunities and barriers to the consistent implementation of culturally safe care for older LGBTIQA+ Australians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adopting an interpretive descriptive methodology, a thematic analysis using Braun and Clarke's six-step framework was conducted on LGBTIQA+-specific transcripts from the Royal Commission into Aged Care Quality and Safety Diversity Hearing (October 2019) in Melbourne, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thematic analysis identified two main themes: Inclusive and Culturally Safe Care and Robust Governance for Inclusive Care. Findings revealed that engagement with aged care is severely undermined by historical trauma and a profound mistrust of formal services by some LGBTQIA+ older people. Systemic barriers persisted due to inconsistencies in governance and a lack of accountability for diversity standards. Stakeholders highlighted the critical necessity of mandatory, identity-affirming LGBTIQA+ workforce training and the vital role of advocacy and community connections in bridging access gaps and ensuring cultural safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While policy frameworks and ‘special needs’ recognition exist, genuine inclusion for older LGBTIQA+ Australians hinges on operationalising cultural safety through consistent governance, stronger compliance mechanisms and a mandatory, well-resourced training regimen for the aged care workforce. These findings provide critical implications for policy reform and practice improvement under Australia's evolving aged care standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12814923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather Block, Michael Lawless, Alexandra Stevens, Helen Exley, Stacey George
Objective
As the population ages more people are experiencing chronic conditions, placing substantial burden on the healthcare system. General practice plays a crucial role in managing chronic health conditions and early interventions to support healthy ageing. This study explored patients' perceptions of early intervention initiatives to support healthy ageing in Australian general practice settings.
Methods
Using a qualitative descriptive design, semi-structured interviews were conducted with general practice patients aged 40 years and older living with chronic conditions, in Adelaide, South Australia. Interview data were analysed using inductive content analysis.
Results
Twenty participants from eight general practices were interviewed. Three themes were developed: (1) General practice consultations enable management planning but show gaps in ageing-related support; (2) Management plans promote early problem identification, reinforce self-management and foster positive healthcare relationships; and (3) Addressing gaps in management plans requires improved access, affordability and more comprehensive support.
Conclusions
Patients perceive their general practice enables care and management of chronic conditions for healthy ageing. There is a need for proactive healthy ageing interventions including increased uptake of chronic disease management Medicare Benefit Schedule (MBS) items into routine general practice care. Primary care policies should address multidisciplinary team-based care to facilitate optimal comprehensive care for healthy ageing. Further exploration and strategies to address barriers to proactive, comprehensive care for chronic conditions earlier in the ageing trajectory are needed.
{"title":"Patient Perspectives of Early Interventions for Healthy Ageing in General Practice: A Qualitative Study","authors":"Heather Block, Michael Lawless, Alexandra Stevens, Helen Exley, Stacey George","doi":"10.1111/ajag.70132","DOIUrl":"10.1111/ajag.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>As the population ages more people are experiencing chronic conditions, placing substantial burden on the healthcare system. General practice plays a crucial role in managing chronic health conditions and early interventions to support healthy ageing. This study explored patients' perceptions of early intervention initiatives to support healthy ageing in Australian general practice settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative descriptive design, semi-structured interviews were conducted with general practice patients aged 40 years and older living with chronic conditions, in Adelaide, South Australia. Interview data were analysed using inductive content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty participants from eight general practices were interviewed. Three themes were developed: (1) General practice consultations enable management planning but show gaps in ageing-related support; (2) Management plans promote early problem identification, reinforce self-management and foster positive healthcare relationships; and (3) Addressing gaps in management plans requires improved access, affordability and more comprehensive support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients perceive their general practice enables care and management of chronic conditions for healthy ageing. There is a need for proactive healthy ageing interventions including increased uptake of chronic disease management Medicare Benefit Schedule (MBS) items into routine general practice care. Primary care policies should address multidisciplinary team-based care to facilitate optimal comprehensive care for healthy ageing. Further exploration and strategies to address barriers to proactive, comprehensive care for chronic conditions earlier in the ageing trajectory are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"45 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号