Specialist palliative care, within hospices in particular, has historically led and set the standard for caring for patients at end of life. The focus of this care has been mostly for patients with cancer. More recently, health and social care services have been developing equality of care for all patients approaching end of life. This has mostly been done in the context of a service delivery approach to care whereby services have become increasingly expert in identifying health and social care need and meeting this need with professional services. This model of patient centred care, with the impeccable assessment and treatment of physical, social, psychological and spiritual need, predominantly worked very well for the latter part of the 20th century. Over the last 13 years, however, there have been several international examples of community development approaches to end of life care. The patient centred model of care has limitations when there is a fundamental lack of integrated community policy, development and resourcing. Within this article, we propose a model of care which identifies a person with an illness at the centre of a network which includes inner and outer networks, communities and service delivery organisations. All of these are underpinned by policy development, supporting the overall structure. Adoption of this model would allow individuals, communities, service delivery organisations and policy makers to work together to provide end of life care that enhances value and meaning for people at end of life, both patients and communities alike.
Large scale centralised water, wastewater and stormwater systems have been implemented for over 100 years. These systems have provided a safe drinking water supply, efficient collection and disposal of wastewater to protect human health, and the mitigation of urban flood risk. The sustainability of current urban water systems is under pressure from a range of challenges which include: rapid population growth and resulting urbanisation, climate change impacts, and infrastructure that is ageing and reaching capacity constraints. To address these issues, urban water services are now being implemented with Integrated Urban Water Management (IUWM) and Water Sensitive Urban Design (WSUD) approaches. WSUD systems can deliver multiple benefits including water conservation, stormwater quality improvement, flood control, landscape amenity and a healthy living environment. These systems can be provided as stand-alone systems or in combination with centralised systems. These systems are still novel and thus face knowledge gaps that are impeding their mainstream uptake. Knowledge gaps cover technical, economic, social, and institutional aspects of their implementation. This paper is based on the outcomes of a comprehensive study conducted in South Australia which investigated impediments for mainstream uptake of WSUD, community perceptions of WSUD and potential of WSUD to achieve water conservation through the application of alternative resources, and in flood management. The outcomes are discussed in this paper for the benefit of water professionals engaged with WSUD planning, implementation, community consultation and regulation. Although the paper is based on a study conducted in South Australia, the comprehensive framework developed to conduct this detailed study and investigation can be adopted in any part of the world.
This article explores a relatively new and little understood phenomenon, that of the Australian Grey Nomads. Every year increasing numbers of older Australians take to the road. This article explores the phenomenon both empirically and theoretically. A grounded approach is used by which the experience is explored from an ethnographic account involving interviews with some 400 travelers, including in-depth taped interviews with 26 traveling groups. The data is analyzed and discussed in terms of "Ulyssean" aging. The Ulyssean lifestyle requires the freedom to pursue personal choice and new, personally risky experience. Issues of health, personal development, and social networks are discussed in relation to the literature on aging. In particular, it is argued that the Grey Nomad phenomenon fundamentally challenges the dominant decline model of aging. It presents a picture instead of these older Australians taking active and very positive control of their lives, regardless of financial and health conditions. In doing so, they are rewriting the dominant social script for aging.
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