Mustafa Atee, Srivalli Vilapakkam Nagarajan, Rebecca Lloyd, Stephen Macfarlane, Angela Raguz, Thomas Morris
Objectives
Behaviours and psychological symptoms of dementia (BPSD) have a serious impact on care and health outcomes, such as inappropriate pharmacotherapy and impaired quality of life. These symptoms are common across care settings but are more prevalent in residential aged care homes (RACHs). BPSD such as aggression and psychosis may pose a high risk of harm to residents, co-residents, caregivers and families, and the severe forms of these BPSD are linked to RACH premature admission. When people with very severe BPSD in Australia cannot be cared for in mainstream RACHs, the Specialist Dementia Care Program (SDCP) is offered. This article describes the SDCP model of care and examines the available evidence on SDCP outcomes.
Methods
The SDCP model of care delivers person-centred care via multidisciplinary staff in small, ‘cottage-like’, domestic units with a familiar, dementia-friendly care environment for an anticipated duration of 12 months. SDCP units are designed to stabilise or reduce BPSD, facilitate transition to mainstream RACHs, prevent unnecessary hospitalisations and minimise health-care costs.
Results
Preliminary evidence suggests that SDCP units may enhance resident outcomes, decrease the severity of BPSD and improve quality of life.
Conclusion
This article highlights the importance of prioritising the type of care this program provides to people with very severe BPSD.
{"title":"The Specialist Dementia Care Program in Australia: Evidence to date on a home-like model of care for people with very severe behaviours and psychological symptoms of dementia","authors":"Mustafa Atee, Srivalli Vilapakkam Nagarajan, Rebecca Lloyd, Stephen Macfarlane, Angela Raguz, Thomas Morris","doi":"10.1111/ajag.70046","DOIUrl":"https://doi.org/10.1111/ajag.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Behaviours and psychological symptoms of dementia (BPSD) have a serious impact on care and health outcomes, such as inappropriate pharmacotherapy and impaired quality of life. These symptoms are common across care settings but are more prevalent in residential aged care homes (RACHs). BPSD such as aggression and psychosis may pose a high risk of harm to residents, co-residents, caregivers and families, and the severe forms of these BPSD are linked to RACH premature admission. When people with very severe BPSD in Australia cannot be cared for in mainstream RACHs, the Specialist Dementia Care Program (SDCP) is offered. This article describes the SDCP model of care and examines the available evidence on SDCP outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SDCP model of care delivers person-centred care via multidisciplinary staff in small, ‘cottage-like’, domestic units with a familiar, dementia-friendly care environment for an anticipated duration of 12 months. SDCP units are designed to stabilise or reduce BPSD, facilitate transition to mainstream RACHs, prevent unnecessary hospitalisations and minimise health-care costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preliminary evidence suggests that SDCP units may enhance resident outcomes, decrease the severity of BPSD and improve quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This article highlights the importance of prioritising the type of care this program provides to people with very severe BPSD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118182","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}
Xuan Mai Tran, Sonia Chan, Genevieve Z. Steiner-Lim, Lyn Phillipson, Kim-Huong Nguyen, Déborah Oliveira, Tiet-Hanh Dao-Tran, Joyce Siette, Diana Karamacoska
Objectives
Validated scales assessing dementia attitudes in Chinese populations are needed to understand the extent and nature of stigma in communities, design appropriate sociocultural interventions and assess their impact. This study was aimed at translating and validating an Australian version of the 12-item dementia diagnosis attitude scale in simplified Chinese.
Methods
Following a forward and backward translation process, including pretesting with community members, the final version was administered to Mandarin speaking adults aged 18 years or older in Australia (n = 325). We conducted exploratory and confirmatory factor analyses, and internal consistency reliability testing.
Results
The final version had 10 items covering a two-factor structure of five items each (‘fear of labelling’ and ‘fear of losing face’) with high reliability (α = .90).
Conclusions
The simplified Chinese dementia diagnosis attitude scale (SC-DDAS) is robust for use with Chinese populations in Australia. Future studies can extend on this work to determine further psychometric properties of the 10-item scale and assess its utility in informing and evaluating community interventions.
{"title":"Validation of a dementia diagnosis attitude scale in simplified Chinese with Mandarin-speaking adults in Australia","authors":"Xuan Mai Tran, Sonia Chan, Genevieve Z. Steiner-Lim, Lyn Phillipson, Kim-Huong Nguyen, Déborah Oliveira, Tiet-Hanh Dao-Tran, Joyce Siette, Diana Karamacoska","doi":"10.1111/ajag.70049","DOIUrl":"https://doi.org/10.1111/ajag.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Validated scales assessing dementia attitudes in Chinese populations are needed to understand the extent and nature of stigma in communities, design appropriate sociocultural interventions and assess their impact. This study was aimed at translating and validating an Australian version of the 12-item dementia diagnosis attitude scale in simplified Chinese.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following a forward and backward translation process, including pretesting with community members, the final version was administered to Mandarin speaking adults aged 18 years or older in Australia (<i>n</i> = 325). We conducted exploratory and confirmatory factor analyses, and internal consistency reliability testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final version had 10 items covering a two-factor structure of five items each (‘fear of labelling’ and ‘fear of losing face’) with high reliability (<i>α</i> = .90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The simplified Chinese dementia diagnosis attitude scale (SC-DDAS) is robust for use with Chinese populations in Australia. Future studies can extend on this work to determine further psychometric properties of the 10-item scale and assess its utility in informing and evaluating community interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117948","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}
Amanda J. Cross, Brooke Blakeley, Helen V. Dowling, Kate Laver, Terry P. Haines, Sarah N. Hilmer, Atish Manek, Alexandra Bennett, Angelita Martini, Lyntara Quirke, Mary Ann Kulh, J. Simon Bell
Objective
All Australian residential care facilities are recommended to have access to a medication advisory committee (MAC) to provide governance of medication management. The objective was to explore the structure and function of Australian MACs.
Methods
A national 43-item survey of MACs was conducted from November 2023 to January 2024. The survey was adapted from the Australian Government Department of Health and Aged Care Audit Tool and Checklist for a Medication Advisory Committee (Audit Tool). All MAC representatives were recruited using a comprehensive and purposive strategy including the Department of Health and Aged Care newsletter, professional organisations, social media and professional contacts. Outcomes included self-reported MAC structure and function across four key roles as per the Audit Tool, including policy development, risk management, education and quality improvement.
Results
Responses were received from 120 MACs covering 642 residential care facilities (24% of Australian residential care facilities) in all Australian states and mainland territories. The MACs provided oversight to a median (IQR) 116 (61–196) beds/residents and a median (IQR) 1 (1–4) facilities. Over half (58%) of MACs were multidisciplinary (nursing, pharmacist and prescriber representation). More than half of MACs reported performing all functions listed in the Audit Tool relating to policy development (59%) and risk management (53%). Only 41% and 28% of MACs reported they performed all functions in the Audit Tool related to education and quality improvement, respectively.
Conclusion
There is extensive heterogeneity in the structure and function of MACs with scope for MACs to become more multidisciplinary, identify staff training needs and proactively lead quality improvement.
{"title":"National audit of the structure and function of Australian residential care medication advisory committees","authors":"Amanda J. Cross, Brooke Blakeley, Helen V. Dowling, Kate Laver, Terry P. Haines, Sarah N. Hilmer, Atish Manek, Alexandra Bennett, Angelita Martini, Lyntara Quirke, Mary Ann Kulh, J. Simon Bell","doi":"10.1111/ajag.70048","DOIUrl":"https://doi.org/10.1111/ajag.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>All Australian residential care facilities are recommended to have access to a medication advisory committee (MAC) to provide governance of medication management. The objective was to explore the structure and function of Australian MACs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A national 43-item survey of MACs was conducted from November 2023 to January 2024. The survey was adapted from the Australian Government Department of Health and Aged Care Audit Tool and Checklist for a Medication Advisory Committee (Audit Tool). All MAC representatives were recruited using a comprehensive and purposive strategy including the Department of Health and Aged Care newsletter, professional organisations, social media and professional contacts. Outcomes included self-reported MAC structure and function across four key roles as per the Audit Tool, including policy development, risk management, education and quality improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses were received from 120 MACs covering 642 residential care facilities (24% of Australian residential care facilities) in all Australian states and mainland territories. The MACs provided oversight to a median (IQR) 116 (61–196) beds/residents and a median (IQR) 1 (1–4) facilities. Over half (58%) of MACs were multidisciplinary (nursing, pharmacist and prescriber representation). More than half of MACs reported performing all functions listed in the Audit Tool relating to policy development (59%) and risk management (53%). Only 41% and 28% of MACs reported they performed all functions in the Audit Tool related to education and quality improvement, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is extensive heterogeneity in the structure and function of MACs with scope for MACs to become more multidisciplinary, identify staff training needs and proactively lead quality improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117950","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}
Wei Jin Wong, Tan Van Nguyen, Irum Farooq, Ying Zhang, Christopher Harrison, Kit Mun Tan, Katie Harris, Mark Woodward, Tu Nguyen
Objectives
This study sought to quantify the prevalence of frailty among type 2 diabetes (T2D) patients with coronary heart disease (CHD) and examine the relationship between frailty and the prescription of secondary prevention medications.
Methods
A prospective observational study was conducted at a tertiary hospital in Vietnam from November 2022 to June 2023. Patients aged 60 years or above with T2D and CHD were included for analysis. Multivariable logistic regression was applied to examine the association between frailty and the prescription of secondary prevention medications: antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEIs/ARBs). Frailty was measured using the Clinical Frailty Scale (CFS) version 2.0.
Results
There were 274 participants included in this analysis. Participants had a median age of 72.0 years, 28% were female and 59% were frail. The prescription rates of cardiovascular medicines for frail versus non-frail participants were as follows: antiplatelets (66% vs. 94%, p < .001), statins (96% vs. 92%, p = .21), beta-blockers (81% vs. 88%, p = .13), ACEIs/ARBs (75% vs. 81%, p = .22) and for all four types (42% vs. 64%, p < .001). In the multiple adjusted regression models, increased CFS score was associated with reduced prescriptions of beta-blockers, ACEIs/ARBs and all four types of medications.
Conclusions
Frailty was common among older Vietnamese patients with CHD and diabetes, and significantly affected the prescription of secondary prevention medicines. Future research should explore the link between frailty and secondary prevention medicines in a larger, more diverse population.
{"title":"Frailty and prescriptions of secondary prevention medications in older people with diabetes and coronary heart disease—An observational study in Vietnam","authors":"Wei Jin Wong, Tan Van Nguyen, Irum Farooq, Ying Zhang, Christopher Harrison, Kit Mun Tan, Katie Harris, Mark Woodward, Tu Nguyen","doi":"10.1111/ajag.70045","DOIUrl":"https://doi.org/10.1111/ajag.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study sought to quantify the prevalence of frailty among type 2 diabetes (T2D) patients with coronary heart disease (CHD) and examine the relationship between frailty and the prescription of secondary prevention medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective observational study was conducted at a tertiary hospital in Vietnam from November 2022 to June 2023. Patients aged 60 years or above with T2D and CHD were included for analysis. Multivariable logistic regression was applied to examine the association between frailty and the prescription of secondary prevention medications: antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEIs/ARBs). Frailty was measured using the Clinical Frailty Scale (CFS) version 2.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 274 participants included in this analysis. Participants had a median age of 72.0 years, 28% were female and 59% were frail. The prescription rates of cardiovascular medicines for frail versus non-frail participants were as follows: antiplatelets (66% vs. 94%, <i>p</i> < .001), statins (96% vs. 92%, <i>p</i> = .21), beta-blockers (81% vs. 88%, <i>p</i> = .13), ACEIs/ARBs (75% vs. 81%, <i>p</i> = .22) and for all four types (42% vs. 64%, <i>p</i> < .001). In the multiple adjusted regression models, increased CFS score was associated with reduced prescriptions of beta-blockers, ACEIs/ARBs and all four types of medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frailty was common among older Vietnamese patients with CHD and diabetes, and significantly affected the prescription of secondary prevention medicines. Future research should explore the link between frailty and secondary prevention medicines in a larger, more diverse population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085052","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}
This study evaluated the impact of precision nursing on blood sugar levels, psychological health and quality of life in ageing type 2 diabetes patients.
Methods
A prospective cohort study involving 100 older patients was carried out at a tertiary hospital located in Sichuan Province, China. The patients were categorised into two groups: a control group that received standard nursing care and an observation group that received tailored nursing interventions.
Results
The outcomes for the observation group were considerably more favourable, featuring decreased levels of fasting blood glucose (FPG), 2-h postprandial blood glucose (2hPG) and glycosylated haemoglobin (HbA1c). Additionally, this group reported lower levels of anxiety and depression, along with a better quality of life relative to the control group. Furthermore, the occurrence of hypoglycaemia was notably less in the observation group.
Conclusions
Precision nursing significantly improves glucose management, mental health and overall quality of life, while also lowering the risk of hypoglycaemia in older patients with type 2 diabetes. This research highlighted the efficacy of precision nursing in the care of ageing adults, promoting its integration as a common approach for managing chronic illnesses.
{"title":"The intervention effect of comprehensive precision nursing in elderly patients with type 2 diabetes","authors":"Hongmei Gao, Yan Han, Dan Deng, Liqiong Liu","doi":"10.1111/ajag.70047","DOIUrl":"https://doi.org/10.1111/ajag.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated the impact of precision nursing on blood sugar levels, psychological health and quality of life in ageing type 2 diabetes patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort study involving 100 older patients was carried out at a tertiary hospital located in Sichuan Province, China. The patients were categorised into two groups: a control group that received standard nursing care and an observation group that received tailored nursing interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The outcomes for the observation group were considerably more favourable, featuring decreased levels of fasting blood glucose (FPG), 2-h postprandial blood glucose (2hPG) and glycosylated haemoglobin (HbA1c). Additionally, this group reported lower levels of anxiety and depression, along with a better quality of life relative to the control group. Furthermore, the occurrence of hypoglycaemia was notably less in the observation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Precision nursing significantly improves glucose management, mental health and overall quality of life, while also lowering the risk of hypoglycaemia in older patients with type 2 diabetes. This research highlighted the efficacy of precision nursing in the care of ageing adults, promoting its integration as a common approach for managing chronic illnesses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949957","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}
Neve Davison, Karin Hammarberg, Thach Tran, Taya A. Collyer, Judy Lowthian, Maggie Kirkman, Jane Fisher, Rosamond Dwyer, Natasha Layton
Objective
Little is known about the psychosocial care of older people presenting to the emergency department (ED), or whether their psychosocial well-being during and after an ED admission can be enhanced. People over the age of 65 years experiencing psychosocial distress and mental health concerns have higher rates of ED admission than those without. As part of a larger mixed-methods study investigating the relationships between older people's psychosocial well-being and emergency care, this study aimed to explore the experiences of older people in ED and their influence on patient psychosocial well-being.
Methods
Participants aged 65 years or older receiving care in a large Australian public hospital ED were invited to participate in a telephone interview soon after discharge. Interviews were audio recorded and transcribed. Transcripts were analysed thematically.
Results
Eleven people (five women) aged 68–87 years participated in semi-structured interviews. Analyses revealed three overarching themes: ‘interpersonal interactions’, ‘quality of care’ and ‘physical environment’. The theme ‘interpersonal interactions’ had two subthemes: ‘communication’ and ‘human contact’. The three subthemes of ‘quality of care’ were ‘appropriate care’, ‘psychological care’ and ‘unmet needs’. Physical environment referred to participant impressions of the ED setting.
Conclusions
We found that staff sensitivity in their interactions with patients and their efforts to promote patients' physical comfort and protect their privacy influenced the psychosocial well-being of older adults in the ED. Based on the findings, we present a set of recommendations for enhancing the psychosocial care of older adults during ED admission.
{"title":"Understanding the psychosocial well-being of people older than 65 years during emergency department admissions: A qualitative analysis of patients' accounts of their experiences","authors":"Neve Davison, Karin Hammarberg, Thach Tran, Taya A. Collyer, Judy Lowthian, Maggie Kirkman, Jane Fisher, Rosamond Dwyer, Natasha Layton","doi":"10.1111/ajag.70033","DOIUrl":"https://doi.org/10.1111/ajag.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Little is known about the psychosocial care of older people presenting to the emergency department (ED), or whether their psychosocial well-being during and after an ED admission can be enhanced. People over the age of 65 years experiencing psychosocial distress and mental health concerns have higher rates of ED admission than those without. As part of a larger mixed-methods study investigating the relationships between older people's psychosocial well-being and emergency care, this study aimed to explore the experiences of older people in ED and their influence on patient psychosocial well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants aged 65 years or older receiving care in a large Australian public hospital ED were invited to participate in a telephone interview soon after discharge. Interviews were audio recorded and transcribed. Transcripts were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven people (five women) aged 68–87 years participated in semi-structured interviews. Analyses revealed three overarching themes: ‘interpersonal interactions’, ‘quality of care’ and ‘physical environment’. The theme ‘interpersonal interactions’ had two subthemes: ‘communication’ and ‘human contact’. The three subthemes of ‘quality of care’ were ‘appropriate care’, ‘psychological care’ and ‘unmet needs’. Physical environment referred to participant impressions of the ED setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that staff sensitivity in their interactions with patients and their efforts to promote patients' physical comfort and protect their privacy influenced the psychosocial well-being of older adults in the ED. Based on the findings, we present a set of recommendations for enhancing the psychosocial care of older adults during ED admission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949956","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}
Michelle DiGiacomo, Sara-Jane Roberts, Tim Luckett, David Symons, Georgia Ellis, Slavica Kochovska, Tony Warner, David C. Currow, Deborah Parker, Karey Payne, Meera R. Agar
Objectives
This study aimed to describe the techniques that Laughter Care Specialists (LCSs) use to promote engagement of people living with dementia in long-term care.
Methods
Semi-structured interviews were conducted with LCSs (n = 8) and analysed inductively using thematic analysis.
Results
The overarching theme was that techniques used to promote engagement reflected ways of valuing personhood. Sub-themes reflect the distillation of techniques according to ways LCSs approach and connect with people and ways that they then engage. When willingness to interact is indicated, LCSs assess environments to individualise their approach. Ways of engaging include creating opportunities to contribute, identity appreciation, reminiscence, enacting generational norms, presence and play. Engagement techniques were described as supporting identity and personhood through techniques that are individualised, supportive, empathetic and gentle.
Conclusions
Techniques reflect person-centred, strengths-based approaches that attempt to meet psychosocial needs of persons living with dementia and highlight ways of valuing people living in long-term care.
{"title":"‘Our role is to listen more than entertain’: A qualitative study of techniques used by Laughter Care Specialists with people who have dementia in long-term care","authors":"Michelle DiGiacomo, Sara-Jane Roberts, Tim Luckett, David Symons, Georgia Ellis, Slavica Kochovska, Tony Warner, David C. Currow, Deborah Parker, Karey Payne, Meera R. Agar","doi":"10.1111/ajag.70002","DOIUrl":"https://doi.org/10.1111/ajag.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to describe the techniques that Laughter Care Specialists (LCSs) use to promote engagement of people living with dementia in long-term care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with LCSs (<i>n</i> = 8) and analysed inductively using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overarching theme was that techniques used to promote engagement reflected ways of valuing personhood. Sub-themes reflect the distillation of techniques according to ways LCSs approach and connect with people and ways that they then engage. When willingness to interact is indicated, LCSs assess environments to individualise their approach. Ways of engaging include creating opportunities to contribute, identity appreciation, reminiscence, enacting generational norms, presence and play. Engagement techniques were described as supporting identity and personhood through techniques that are individualised, supportive, empathetic and gentle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Techniques reflect person-centred, strengths-based approaches that attempt to meet psychosocial needs of persons living with dementia and highlight ways of valuing people living in long-term care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944890","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}
This study explored the forms and motivations of older migrants' creative engagement in the host country in their daily context, and how the engagement influences older migrants in their postmigration life.
Methods
A qualitative approach was used by conducting in-depth interviews and photo elicitation with 18 older Chinese migrants in New Zealand. Data were coded using a hybrid approach of deductive content analysis and inductive thematic analysis.
Results
Four types of creative engagement were identified: nature (gardening), art-making (e.g. making vlogs and painting), handcrafts (knitting and carpentry) and creative writing (journaling). Gardening, as the most popular activity, helped link participants' past to their current life. Some participants used digital tools (e.g. mobile phones) to develop their creative skills. Respondents reported that migration-related stress (e.g. language barriers and a limited social network) contributed to their having constrained lives, which meant that they had more spare time for creative pursuits. Participants' life histories influenced their choice of pursuits. Finally, participants indicated that creative activities helped alleviate stress and contributed to their adjustment to life in the host country and to sustaining their well-being. Those who did not engage in creative pursuits attributed it to their personal life histories (e.g. deprivation of education) and postmigration commitments (e.g. caregiving responsibilities).
Conclusions
Postmigration challenges do not necessarily discourage older migrants from creative pursuits, but instead they may shape the type of pursuit chosen and the form of engagement. Previous life experiences also affected the choice of creative pursuits in later life. These creative engagements appear to help sustain older migrants' postmigration well-being.
{"title":"Creative engagement and well-being: Older Chinese migrants in New Zealand","authors":"Yingqiu Chen, Louisa Buckingham","doi":"10.1111/ajag.70043","DOIUrl":"https://doi.org/10.1111/ajag.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study explored the forms and motivations of older migrants' creative engagement in the host country in their daily context, and how the engagement influences older migrants in their postmigration life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative approach was used by conducting in-depth interviews and photo elicitation with 18 older Chinese migrants in New Zealand. Data were coded using a hybrid approach of deductive content analysis and inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four types of creative engagement were identified: nature (gardening), art-making (e.g. making vlogs and painting), handcrafts (knitting and carpentry) and creative writing (journaling). Gardening, as the most popular activity, helped link participants' past to their current life. Some participants used digital tools (e.g. mobile phones) to develop their creative skills. Respondents reported that migration-related stress (e.g. language barriers and a limited social network) contributed to their having constrained lives, which meant that they had more spare time for creative pursuits. Participants' life histories influenced their choice of pursuits. Finally, participants indicated that creative activities helped alleviate stress and contributed to their adjustment to life in the host country and to sustaining their well-being. Those who did not engage in creative pursuits attributed it to their personal life histories (e.g. deprivation of education) and postmigration commitments (e.g. caregiving responsibilities).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Postmigration challenges do not necessarily discourage older migrants from creative pursuits, but instead they may shape the type of pursuit chosen and the form of engagement. Previous life experiences also affected the choice of creative pursuits in later life. These creative engagements appear to help sustain older migrants' postmigration well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919363","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}
Shay Farbotko, Alice Owen, Suzanne G. Orchard, Robyn L. Woods, Mark Nelson, Nigel P. Stocks, Andrew Tonkin, Rory Wolfe, John McNeil, Peter Gibbs, John Zalcberg, Joanne Ryan
Objective
To examine the prevalence of health risk factors by rurality status and the association of rurality and incidence of disability-free survival (DFS), its components (death, dementia and physical disability), cardiovascular disease (CVD), cancer and underlying cause of death.
Methods
Data came from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and observational extension, ASPREE-XT. Community-dwelling Australians aged 70 years or older, with no prior CVD events, dementia or independence-limiting physical disability, were recruited through General Practitioners between 2010 and 2014. Area of residence was classified as major cities, inner regional or outer regional/remote. Major incident health events were adjudicated by expert panels.
Results
Participants (n = 16,697, median age 74 years; 55% female) were followed over a median 8.3 years. A small, but statistically significant higher prevalence of many health risk factors was found for individuals living outside metropolitan areas. Rurality was not associated with the incidence of DFS, dementia, physical disability or CVD events in adjusted Cox proportional hazards regression models. Compared to major cities, individuals in outer regions/remote areas had an increased risk of all-cause death (HR: 1.17; 95% CI 1.02, 1.34) which appeared to be driven by fatal CVD (HR: 1.40; 95% CI 1.02, 1.83), while those in inner regions had a lower cancer incidence (HR: .89; 95% CI .82, .98).
Conclusions
Incidence of DFS, dementia and physical disability did not differ according to rurality. Heightened risk of mortality was evident outside urban areas, possibly reflecting inequitable health service and access. Lower cancer incidence in inner regions requires further investigation.
目的了解农村状况下健康危险因素的流行情况，以及农村状况与无残疾生存（DFS）及其组成部分（死亡、痴呆和身体残疾）、心血管疾病（CVD）、癌症和潜在死亡原因的关系。方法数据来自阿司匹林降低老年人事件（ASPREE）试验和观察扩展（ASPREE - xt）。2010年至2014年间，通过全科医生招募了年龄在70岁或以上的澳大利亚社区居民，既往无心血管疾病事件、痴呆或限制独立性的身体残疾。居住区域被划分为主要城市、内陆地区或外围地区/偏远地区。重大事故卫生事件由专家小组裁决。参与者(n = 16,697，中位年龄74岁；其中55%为女性)，随访时间中位数为8.3年。研究发现，居住在大都市地区以外的人，许多健康风险因素的患病率虽小，但在统计上具有显著意义。在调整后的Cox比例风险回归模型中，乡村性与DFS、痴呆、身体残疾或CVD事件的发生率无关。与主要城市相比，外围地区/偏远地区的个人全因死亡风险增加(HR: 1.17；95% CI 1.02, 1.34)，似乎是由致死性心血管疾病驱动的(HR: 1.40；95% CI 1.02, 1.83)，而内陆地区的癌症发病率较低(HR: 0.89；95% ci = 0.82, 0.98)。结论DFS、痴呆和肢体残疾的发生率无农村差异。在城市以外地区，死亡风险明显增加，这可能反映出保健服务和获得机会不公平。内陆地区较低的癌症发病率需要进一步调查。
{"title":"Incidence of major health events across metropolitan and regional areas: A 10+ year prospective study of 16,697 older Australians","authors":"Shay Farbotko, Alice Owen, Suzanne G. Orchard, Robyn L. Woods, Mark Nelson, Nigel P. Stocks, Andrew Tonkin, Rory Wolfe, John McNeil, Peter Gibbs, John Zalcberg, Joanne Ryan","doi":"10.1111/ajag.70036","DOIUrl":"https://doi.org/10.1111/ajag.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the prevalence of health risk factors by rurality status and the association of rurality and incidence of disability-free survival (DFS), its components (death, dementia and physical disability), cardiovascular disease (CVD), cancer and underlying cause of death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data came from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and observational extension, ASPREE-XT. Community-dwelling Australians aged 70 years or older, with no prior CVD events, dementia or independence-limiting physical disability, were recruited through General Practitioners between 2010 and 2014. Area of residence was classified as major cities, inner regional or outer regional/remote. Major incident health events were adjudicated by expert panels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 16,697, median age 74 years; 55% female) were followed over a median 8.3 years. A small, but statistically significant higher prevalence of many health risk factors was found for individuals living outside metropolitan areas. Rurality was not associated with the incidence of DFS, dementia, physical disability or CVD events in adjusted Cox proportional hazards regression models. Compared to major cities, individuals in outer regions/remote areas had an increased risk of all-cause death (HR: 1.17; 95% CI 1.02, 1.34) which appeared to be driven by fatal CVD (HR: 1.40; 95% CI 1.02, 1.83), while those in inner regions had a lower cancer incidence (HR: .89; 95% CI .82, .98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Incidence of DFS, dementia and physical disability did not differ according to rurality. Heightened risk of mortality was evident outside urban areas, possibly reflecting inequitable health service and access. Lower cancer incidence in inner regions requires further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"44 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919458","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}
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