The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim: The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method: The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011–2016. Results: Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions: Findings indicate that adult day services use a range of approaches to support attendees and their carers. In spite of these efforts, there appears to be a lack of interest in utilizing these services while a person is in the early stages of dementia. This suggests that policies in aged care, such as aging-in-place, need to consider the pressure and stress they exert on carer’s quality of life. Another consideration is to better promote the benefits of participating in adult day services in the early stages of dementia for both the attendees and their carers, thereby delaying the tendency towards early institutionalization.

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This paper examines the experiences of family members who have previously been primary carers of residents of residential aged care services to identify factors, which have encouraged them to remain involved in a caring role. The context for this study was a residential aged care facility in Western Australia that was selected on the basis of its reputation of being highly sought after by relatives requiring formal care for older family members and also having a high level of ongoing involvement of relatives. Findings from the study provide evidence of the importance of staff developing relationships with relatives, supporting relatives through the change process and developing care partnerships where relatives could define new caring roles in providing social and emotional support for residents. This study is part of a larger study investigating relational quality in aged care environment.

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Introduction The proportion of older adults throughout the world has increased significantly over the last decade and continues to rise. Such substantial growth highlights the importance of facilitating older people\u27s wellbeing. This research aimed to identify enablers and barriers to participation in community-based activities experienced by active older adults. Method This qualitative study employed the evidence-based paradigm of occupation and Model of Human Occupation to underpin protocol and discussion. Ten participants (females = 9, males = 1) who were aged 64-83 years and actively engaged in their community took part in semi-structured interviews. Participants reported mixed health levels including chronic/terminal illnesses and normal degenerative changes. Interview transcripts were analysed using thematic analysis. Findings Analysis identified four themes of enablers and barriers to community participation. These were: relationships; interests; personal knowledge and awareness towards health and wellbeing; and resources and the environment. Conclusion Intrinsic factors such as developing or maintaining strong relationships and developing interests were identified as enabling community participation. Barriers identified within this study included unappealing group cultures or structures, such as having limited opportunity to develop friendships or explicitly targeting \u27seniors aged 60+ years\u27 and accessibility limitations. Recommendations were established to inform the development of programmes to increase community participation among this group. © The College of Occupational Therapists Ltd

In Australia, children removed from the parental home because substance use–related child maltreatment issues are commonly placed in grandparent custodial care; however, the longer term relational costs of this approach have yet to be determined. Conventional, summative, and directive content analyses were conducted on data extracted from 88 Australian custodial grandparent completed Grandcarer Needs, Wellbeing and Health Surveys. Conventional analysis revealed the most common reason grandparents gave for their assumption of custodial care was drug use–related acts of parental child maltreatment. Summative analysis revealed antidepressants, marijuana, Valium, ice, and amphetamines were the most commonly used parental drugs and that these drugs were frequently used in combination with dexamphetamine, antipsychotics, heroin, ecstasy, and cocaine. Directed analysis contextualized the strain that drug use–related custodial caregiving places on grandparents’ financial resources, and how this strain is burdensome when the grandparents’ annual income is less than Aus$80,000. It also contextualizes the need for future research to explore family reunification desires/barriers.

Rapid ageing in western societies is placing increasing strain on health and social care services. In response, governments and health agencies have sought to promote healthy ageing through a range of interventions, many of which aim to enhance social engagement and participation among older people. Such interventions are based on evidence that being socially engaged through participation in various activities leads to better physical, mental and psychosocial health outcomes. The research reported here employed focus groups and individual interviews to address research aims: (a) identify enablers and barriers to participation in community-based group activities among a sample of older people (n = 35, median age 71 years) living in a local government area in the northern suburbs of Perth, Western Australia, and (b) examine how these factors differ between those who regularly participate and those who do not. Our research highlighted four themes: Friendship and Function; Availability and Accessibility; Competing Responsibilities and Priorities; and Changing of the Guard. In particular, this research highlighted the importance of group activities in offering social support as a platform to develop friendships. The findings also indicated that opportunities for social interaction should be embedded in the structure of the group, beyond that which may occur incidentally during activities. This is important, given that while interest may motivate older people to join a group, a sense of belonging and connectedness generated through the group is more likely to maintain their attendance. Barriers included limited availability of local programmes, limited accessibility related to programme scheduling, and lack of programmes relevant to those who do not find traditional seniors' centres appealing. Recommendations include incorporating social engagement as an outcome measure when evaluating the efficacy of programmes targeting older people, and encouraging local governments to work with seniors' centres in developing activities attractive to a broader cohort of older people.

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