What do older <scp>A</scp>ustralians want?

Dow, Briony; Sparrow, Patricia; Moore, Kirsten; Gaffy, Ellen; Yates, Ian

doi:10.1111/ajag.12040

Cited by 18 publications

(16 citation statements)

References 11 publications

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“…Since the early 1980’s, the Australian Government’s aged care policy has consistently sought to assist older people to remain in their own homes (private dwellings) in preference to residential care. Fortunately, this is consistent with the preferences of older people [ 1 ]. The government has also long recognised the importance of informal carers in supporting older people at home, with family caregivers being considered a client of the home and community care service since its inception in 1986 and their needs assessed accordingly.…”

Section: Introductionsupporting

confidence: 82%

Informal care relationships and residential aged care recommendations: evidence from administrative data

2017

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BackgroundThe Australian government recognises the importance of informal care to enable ageing in place. Yet, few multivariable studies have examined aspects of informal care that alter the probability of entry to residential care in Australia. Existing Australian and international studies show differing effects of informal care on entry to residential care.MethodsWe utilise unique administrative data on aged care assessments collected from 2010 to 2013, consisting of 280,000 persons aged 65 and over. Logistic regression models were fitted to measure the propensity to be recommended care in a residential care setting, disaggregated by characteristics of informal care provision.ResultsProviding some explanation for the divergent findings in the literature, we show that close familial carer relationships (partner or child) and coresidence are associated with recommendations to live in the community. Weaker non-coresidential friend or neighbour carer relationships are associated with recommendations to live in residential care for women, as are non-coresidential other relatives (not a child, partner or in-law) for both males and females. Non-coresident carers who are in-laws (for females) or parents have no impact on assessor recommendations. Despite these significant differences, health conditions and assistance needs play a strong role in assessor recommendations about entry to residential care.ConclusionCo-resident care clearly plays an important protective role in residential care admission. Government policy should consider the need for differential supports for co-resident carers as part of future aged care reform.

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Section: Introductionsupporting

confidence: 82%

Informal care relationships and residential aged care recommendations: evidence from administrative data

2017

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“…An undercurrent of bias may manifest as disrespect, ageism, lack of responsiveness and a de-valuing of their personal strengths and life experience. Older people want to be seen as valuable and active citizens and to be independent [9]. Older people want to feel respected, listened to (and heard) which can be achieved through respectful professional conduct, effective communication and advocacy on behalf of older people [35].…”

Section: Diversity Principles Underpin Care Participation Of Older Pementioning

confidence: 99%

“…However, current systems are unable to support optimal wellbeing of older people and ageing in place. This is a result of a number of reasons: most health services were designed around acute care models, poorly aligning with the complexity and chronicity of issues associated with older age and the supports needed for older people to age in place [6]; there is endemic age-based discrimination [7,8]; and limited understanding of the priorities and needs of older people [9].…”

Section: Introductionmentioning

confidence: 99%

The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study

Ogrin

Meyer

Appannah

et al. 2020

Int J Equity Health

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Background: The health and aged care workforce must understand and support the diverse needs of older people to enhance their care experience. We previously identified five principles of diversity training for this workforce: awareness of unconscious bias and prejudice; promotion of inclusion; access and equity; appropriate engagement; and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians. Methods: Older people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, diversity. Interviews were thematically analysed using a priori categories based on our previous work on principles of diversity training, and themes were interpreted and expanded upon based on the participants' experiences and understanding of diversity concepts and their care needs.Results: Fifteen older people (seven female, eight male), mean age 76 years (range 71-85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1) trust and rapport was highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2) intersectionality, that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3) unconscious bias and prejudice by health professionals and its impact on their care. Participants also noted that (4) promotion of inclusion through language was important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5) access and equity of the system. A model articulating these relationships was developed. Conclusion: Health and aged care training should incorporate the five diversity principles to support older people to participate in their own care.

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“…Underpinning the interconnected themes was a clear preference for autonomy; to choose and control how they want to live and the services they wanted to access, whilst being treated with dignity and respect. These preferences have been identified previously as important to older people (Dow et al 2013). Further, this was linked with women's keen awareness and reluctance to becoming a "burden" on those around them.…”

Section: Discussionmentioning

confidence: 77%

Interventions to improve the health and wellbeing of older people living alone: a mixed-methods systematic review of effectiveness and accessibility

Johnstone¹,

Dickins

Lowthian

et al. 2020

Ageing and Society

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The global population is ageing and the likelihood of living alone increases with age. Services are necessary to help older people living alone to optimise health and wellbeing. This systematic review aimed to summarise the effectiveness and accessibility of interventions to improve the health and wellbeing of older people living alone. Relevant electronic databases (CINAHL, MEDLINE, PsycINFO and Scopus) were searched for all years up to August 2018. Studies were included if they involved older people (aged ⩾55 years) living alone, and an intervention with measured health and wellbeing outcomes. All study types were included. The Theory of Access was used to assess interventions across dimensions of accessibility, availability, acceptability, affordability, adequacy and awareness. Twenty-eight studies met the eligibility criteria; 17 studies focused on ageing safely in place and 11 on psychological and social wellbeing. Studies comprised quantitative (N = 19), qualitative (N = 4) and mixed-methods (N = 5) approaches. Dimensions from the Theory of Access were poorly addressed in the studies, particularly those of higher-quality methodology. Studies were heterogeneous, preliminary in scope and lacked consistent study design, methodology or measurement. Services that do not address user accessibility in design or evaluation may be limited in their uptake and impact. It is recommended that dimensions of access and co-creation principles be integrated into service design processes and be evaluated alongside clinical effectiveness.

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What do older Australians want?

Abstract: This paper provides consumer perspectives to inform aged care policy, practice and research in Australia.

Cited by 18 publications

References 11 publications

Informal care relationships and residential aged care recommendations: evidence from administrative data

Informal care relationships and residential aged care recommendations: evidence from administrative data

The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study

Interventions to improve the health and wellbeing of older people living alone: a mixed-methods systematic review of effectiveness and accessibility

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