bluuebunny/crossref_metadata_2025 huggingface dataset:
COMMUNITY OPTIONS: A NEW APPROACH IN ASSESSMENT AND THE DELIVERY OF SERVICES IN THE AGED CARE FIELD.
Authors: Abbey Robert , Hall Jeane , Rungie Michael
Published: December 2008

This paper draws attention to a pilot programme sponsored by Aged Cottage Homes Inc. in South Australia with the aim of reducing the movement into residential care of elderly people assessed as urgently needing and eligible to enter such forms of care. The programme focuses directly on those factors precipitating movement into residential care. By negotiating with existing service providers, advocating on behalf of users of the programme, establishing new services which are specific to user needs, the Community Options programme has demonstrated that many users of aged accommodation services can be supported to live in their own homes. The benefits of the programme include enhanced lifestyles for elderly people, individuality of specific programs for users, close and continuing contact with users, and the process is cost effective in terms of government outlays.
SURVEY OF KNOWLEDGE OF STAFF ABOUT URINARY INCONTINENCE
Authors: Fonda David , Nickless Ruth
Published: December 2008

Urinary incontinence is a common, distressing and costly condition afflicting up to 25% of hospitalized patients and 60% of nursing home patients most of whom are elderly. It is important for nurses and doctors to have a good knowledge base and positive attitudes in order for them to deal optimally with this condition.

A survey of 106 nurses and doctors was conducted in a large general acute teaching hospital. The survey assessed both attitudes and knowledge to various aspects of the causes, investigation and management of incontinence.

It was found that (1) most staff had little teaching on this subject, (2) most staff had a poor knowledge base as to causes, investigation and management, (3) about 40% of nurses felt urinary incontinence was an attention seeking act, (4) State enrolled nurses who had the greatest contact with such patients had the poorest knowledge base.

The results of this survey support the need for more undergraduate and inservice training, and particularly for the appointment of hospital based Clinical Nurse Specialists, with expertise in continence management.
SOME ISSUES IN LIBRARY SERVICES FOR THE AGED
Authors: Herr Twila A. J.
Published: December 2008

Australia's elderly do not use library services as frequently as other age groups. There are a variety of explanations for this under‐utilisation ranging from the attitudes of the elderly through the library materials available to physical demands on aged users. This article examines some recent literature and survey data to review these impediments to more effective use of library services by aged Australians. It argues that the “disengagement theory” is not an adequate explanation. Greater library sensitivity to the needs of the elderly and modifications of library services to minimise the effects of physical circumstances of the elderly appear likely to have impact on aged user rates. Thus libraries can redress the problem of low aged participation by catering for the special needs of this growing (potential) user group.
UNITS FOR THE CONFUSED AND DISTURBED ELDERLY: DEVELOPMENT, DESIGN, PROGRAMMING AND EVALUATION
Authors: Fleming Richard , Bowless John
Published: December 2008

In New South Wales, the implementation of the ‘new’ Mental Health Act and the deinstitutionalisation of Mental Hospital patients following the Richmond Report, have lent urgency to the need to develop specialised units and services for the confused and disturbed elderly.

Experience gained working with this population in a traditional Mental Hospital has led to both an appreciation of the limitations of therapeutic programmes implemented within this setting and the designing of purpose built units appropriate to the needs of these patients.

Units which will facilitate a Reality Orientation/Behavioural approach within a simple, domestic scale environment are now being built.

This paper presents the developmental stages of this concept, describes the units' design and programmes and outlines the assessment and selection procedures.
PROMOTION OF CONTINENCE IN MOBILITY GROUPS FOR ELDERLY PEOPLE
Authors: Harrison Sheila M.
Published: December 2008

This study involves elderly women who attend mobility groups conducted weekly by physiotherapists employed by the Health Department of Western Australia.

It aims to assess the prevalence and severity of micturition disorders in women attending the groups. The effect of adding a specific routine for re‐education of the pelvic floor muscles to the general exercise programme will be evaluated.

Analysis of the data shows that micturition disorders are prevalent in elderly women. Regular practise of pelvic floor exercises is shown to decrease nocturia, frequency and stress incontinence of urine and thus reduce some of the morbidity associated with childbearing and the menopause.
RECREATION PATTERNS AMONG OLDER AUSTRALIAN ADULTS
Authors: Earle L.
Published: December 2008

The paper is based on a Department of Sport, Recreation and Tourism Participation survey and focuses on the recreation participation trends of older adults (55 + years). It is divided into three main parts. These include (1) a brief introductory section focusing on the aged in Australian society, (2) a section analysing the survey data and their implications and (3) a conclusion section.
COMMUNITY SERVICES AND MIGRANTS
Authors: Mykyta L. J.
Published: December 2008

The recent experience of the Western Domiciliary Care and Rehabilitation Service with clients of Italian, Greek and Polish origin is analysed. It is argued that our Service is accessible to and utilised by non‐English‐speaking clients to an extent that is proportional to the needs of their “at risk” population.
THE GERIATRIC ASSESSMENT PROJECT IN TASMANIA
Authors: Atkinson R. , Curran J.T.
Published: December 2008

A stale‐wide assessment service for elderly persons at risk of long term residential care was established in Tasmania under the geriatric assessment project. The general goal of the project was to achieve a better match between the needs of the elderly and the allocation of services particularly with regard to nursing home admission. The operation of the assessment teams between 1984 and 1987 is described. Decline in demand for nursing home beds during the second and third year of the teams' operation was attributed to a reduction in inappropriate admissions following assessment.
HOME CARE BEFORE HACC: INTER‐STATE COMPARISONS
Authors: Healy J.
Published: December 2008

Despite different delivery systems for home care, similar services were delivered to similar proportions of elderly people in Sydney, Melbourne and Adelaide in 1981. Per capita government expenditure on home care in the three States varied, as did the cost of service delivery. Client characteristics also differed, in that the health‐oriented regional services in Adelaide had more disabled and more poor clients, while local government in Melbourne and local voluntary groups in Sydney served a more mainstream clientele. Substantially more funds have gone to home care through the HACC Program, warranting an analysis of current service patterns, client characteristics and client outcomes.
THE ELDERLY SPEAK TO POLICY: PERSPECTIVES ON CONSUMER INVOLVEMENT IN POLICY AND PROVISION OF SOCIAL CARE SERVICES IN QUEENSLAND
Authors: Brown C. , Halladay A.
Published: December 2008

Despite the rehetoric in commerce that the ‘customer’ is always right and similar claims that in a democracy the policies and services reflect the wishes of the ‘citizen’, little attention seems to have been given to finding out the preferences of elderly people, nor to involving them in defining their needs or the planning of services. This small Queensland study seeks to document the views of elderly recipients and planners and providers concerning consumer involvement in planning social care services. Six potential consumer roles are identified and an analysis presented of some of the factors inhibiting greater consumer participation.
PROVISION OF RESPITE CARE IN A GERIATRIC UNIT — AN EVALUATION
Authors: Munro‐Ashman J.
Published: December 2008

Respite care has been defined as a temporary relief service for families or primary care givers and has emerged as a vital requirement for those caring for the disabled, and the elderly in the community.

Although respite care has been suggested in the United States “as an element in the after care of recently discharged patients or to acquaint patients with the range of services available in a nursing home it remains in Australia as primarily a service which enables care givers to continue to maintain frail elderly people in their own homes. This review was undertaken to examine whether there might also be a measureable benefit for disabled and elderly individuals themselves, an issue which appears to have been neglected by researchers and service providers alike.

Four beds in a geriatric unit in a general hospital were set aside for respite care for one year. Of the 96 patients referred for such care 43% benefited from additional diagnosis, 40% required medication alteration and 37.5% additional community services. At discharge although 4 patients stayed beyond their allotted time for other reasons no relatives refused to care again for their relative. At review in Jan 1985 38 were still alive and in the community, 23 had died and 13 were in nursing homes, It is argued that there are benefits in providing respite care in geriatric units.

Four beds in a geriatric unit in a general hospital were set aside for respite care for one year. Of the 96 patients referred for such care 43% benefitted from additional diagnosis, 40% required medication alteration and 37.5% additional community services. At discharge although 4 patients stayed beyond their allotted time for other reasons no relatives refused to care again for their relative. At review in Jan 1985, 38 were still alive and in the community, 23 had died and 13 were in nursing homes. It is argued that there are benefits in providing respite care in geriatric units.
THE ESTABLISHMENT OF A GERIATRIC PAIN CLINIC — A PRELIMINARY REPORT OF THE FIRST 100 PATIENTS.
Authors: Helme R.D. , Katz B. , Neufeld M. , Lachal S. , Herbert J. , Corran T.
Published: December 2008

A multidisciplinary pain management clinic specifically catering for the geriatric population, has been established in Melbourne and an analysis of the first 100 patients is presented. The major pathological problems referred to the clinic have been musculoskeletal disease (45) and post‐herpetic neuralgia (18). A third major category of patients had no identifiable pathological process to account for their pain. Using a variety of measurement scales at least 50% of patients were considered to benefit from attendance at the clinic. It is considered that a pain clinic for the elderly is of value for a patient group often considered difficult to manage; it combines expertise in treatment of age specific pain syndromes with the holistic approach to the care of the elderly.
‘AGEING’: A MULTIDISCIPLINARY SOCIAL SCIENCES UNDERGRADUATE TOPIC AT FLINDERS UNIVERSITY
Authors: Healy J.
Published: December 2008

‘Ageing’ is a popular multidisciplinary semester‐length option, taken by undergraduate students in the School of Social Sciences. The discipline contributions come mainly from Geography, Psychology and Social Administration. The emphasis is upon a social sciences education about ageing rather than the provision of vocational training. The topic particularly attracts women and older students who generally achieve good results.
AGEING IN THE SOCIAL WORK CURRICULUM AT MELBOURNE UNIVERSITY
Authors: Ozanne E.
Published: December 2008

This article briefly reviews the eight year development of content on ageing in the social work curriculum at Melbourne University across three programme areas highlighting a number of educational issues arising from these course developments.
AGEISM: INTEGRATING RESEARCH WITH EDUCATION AND PROFESSIONAL PRACTICE
Authors: Russell C.
Published: December 2008

This paper argues that Australian research in gerontology is dominated by a focus on ‘problems’ and ‘care issues’ which exactly parallel and thereby actively reinforce prevailing myths and stereotypes about old people. Illustration is drawn from recently completed research on the cultural construction of ageing and gender in popular Australian media, and the implications for education and professional practice are explored.
THE ANU AGEING AND THE FAMILY PROJECT
Authors: Kendig H.
Published: December 2008

This article provides an overview of the Ageing and the Family Project conducted from 1980 to 1986 at the Australian National University. The development of the Project is reviewed in the context of Australian gerontology over this period. The research agenda is outlined and key findings are summarised on family relationships, population ageing, and related policy issues. Emphasis is placed on the potential and challenges of carrying out applied, policy‐relevant research by a multidisciplinary team. The article concludes by assessing strengths and weaknesses of the ANU Ageing Project and directions for the future development of Australian gerontology.
AGE, EXERCISE AND THE MUSCULO‐SKELETAL SYSTEM
Authors: Twomey L.
Published: December 2008

A striking cultural feature of most of Western society is the expectation that the elderly will become progressively more sedentary, increasingly indolent and gradually more febrile until they are eventually unable to cope for themselves. There is the perception that old people do not need to exercise to any great extent, that exercise may be harmful to the elderly and that older people in exercise are most unattractive. Advertising emphasises that exercise is for the young and encourages a belief that the elderly should take life easily as reward for a lifetime's work.

Research into musculo‐skeletal structure and performance has clearly shown the necessity for high levels of exercise activity through the whole life span. Inactivity is associated with a decline in muscle bulk, strength and endurance; an increase in joint stiffness and a decline in the individual's ability to respond to rapid environment change.

All of the above changes are markedly improved by exercise, even in the very elderly. This paper discusses current research into the effect of ageing and exercise on the musculo‐skeletal system of the body, and demonstrates the necessity for continued high levels of physical activity into old age.
The Integration of Research, Education and Practice in Gerontology: SOCIAL WORK EDUCATION AT THE UNIVERSITY OF QUEENSLAND
Authors: Rosenman L. , Wilson J. , Setterlund D.
Published: December 2008

A brief outline of features of the aged population and services for the aged in Queensland, one Australian state, is given as a background to describing one approach to gerontology education within the University of Queensland Social Work Faculty. The challenges and tasks of curriculum development in relation to gerontology in a generic undergraduate course are described. Specific training in gerontology at a theoretical and practical level is provided through field practicums in an institution for the aged and proposals to extend this to a community based practice‐research program for the aged are outlined. Current research programs that will relate to this program to give a combined approach to social work, social policy and ageing are described.
COMMUNITY CARE FOR DEMENTIA SUFFERERS
Authors: Mykyta L.J. , Lovell G.
Published: December 2008

A programme of intensive domiciliary support for dementia sufferers operating as part of a regional geriatric service is described in detail and illustrated with a case study.

It is argued that domiciliary support for people with advanced dementia and limited social support is feasible and cost‐effective.
KID'S PALS: AN INTERGENERATIONAL COMMUNITY PROJECT
Authors: Austin A.
Published: December 2008

“Kids Pals” is an intergenerational project which has been running in the Eastern Suburbs of Sydney since 1985. It was designed to link children who are behind in their reading with an understanding and caring elderly person. The project addresses the myth of aged persons as dependent and a drain on the community and provides benefits for both the children and the elderly volunteers.
COOKING FOR ELDERLY PEOPLE
Authors: Thomson Donald
Published: December 2008

A guide to good nutrition, including 120 recipes for day centres, hospitals and residential homes: by Alan Steward pp. 182. Winslow Press ISBN 0 86388 0673, S50.00
PROVISIONS MADE FOR ETHNIC PATIENTS IN NURSING HOMES
Authors: Legge V. , Westbrook M.T.
Published: December 2008

Australia's aged population is rapidly expanding, and people from non‐English speaking backgrounds are the most rapidly increasing sector of that population. Although many expressions of concern and disquiet are voiced, very little detailed knowledge exists about the institutional response to this changing clientele of nursing homes. A questionnaire survey of nursing home matrons in Sydney resulted in 163 responses. These provided information regarding the special provisions made for ethnic patients, the difficulties encountered in making provisions, the strategies used to deal with such problems and matrons' general attitudes regarding these issues. Catering for food preferences was the provision most frequently made but also the custom most difficult to accommodate. Family involvement was seen as the most useful strategy in coping with problems. Matrons expressed a strong desire for more interpreters and more information on ethnic needs. Significant differences were found in the provisions made by private and charitable homes but not in their matrons' attitudes.
METHODOLOGICAL ISSUES IN RESEARCH OF THE AGED IN INSTITUIONAL CARE
Authors: Thomas T.
Published: December 2008

Although studies of institutionalization of the aged are numerous, in many cases inadequate research designs have been employed and methodological problems have created serious obstacles to understanding. Many findings are unreliable and not generalizable due to sampling problems. The reliability and validity of measures for predictors and outcome variables were often not established. Serious confounding among measures has not been investigated, and few studies selected their variables on sound theoretical bases. Cross‐sectional and retrospective designs were frequently employed and data analyses have been predominantly qualitative and descriptive. These methodological issues created considerable uncertainty about the effects of institutionalization in gerontological literature.
THE JACK YOUNG CENTRE, SALISBURY, SOUTH AUSTRALIA — A CENTRE FOR ALL OVER 50's
Authors: Porter B.
Published: December 2008

I am writing about the Jack Young Centre because I have been actively involved in its creation and progress. I have been a member of the Centre's Advisory Committee since January 1987 and before that I was a member of the Steering Committee which helped push the idea forward, designed the plans for the extensions and got the Centre off the ground. I write as a Centre volunteer and as such I speak on behalf of all its many users.
THE FUTURE OF THE WELFARE STATE IN AGEING: QUESTIONS FROM AN AMERICAN OBSERVER
Authors: Bass S.A.
Published: December 2008

Five different policy questions are raised for Australian welfare planners in ageing based on observations of an American policy analyst. The questions reflect recent trends and directions in public policy both in the United States and Australia. Through these questions and through discussion, the author identifies concepts that may lead to programs which are more effective and responsive to the diversity of elders in these two nations.
ACCEPTABILITY AND EFFICACY OF ANTI‐ARTHRITIC DRUGS IN OLD AGE
Authors: Warne R.W. , Prinsley D.M. , Bryant L.
Published: December 2008

The aim of the study was to study the acceptability and effectiveness of two commonly used nonsteroidal anti‐inflammatory drugs (Naproxen and Sulindac) specifically in an elderly population with symptomatic osteo‐arthritis of the hip and/or knee.

39 patients aged 70 years and over with degenerative arthritis of hip or knee were randomly allocated to Sulindac or Naproxen treatment groups for a treatment period of twelve weeks.

There were no pretrial differences between the two randomly allocated groups. Both Naproxen and Sulindac produced improvement in patient symptoms and there was no difference in the efficacy or acceptability of the two drugs. Both drugs were well tolerated in the study population. Side effects from Naproxen tended to occur later during the trial resulting in withdrawal of three patients after a period of six weeks. Side effects from Sulindac resulted in early withdrawal of two patients only. Patients in the Naproxen group had a minor but significant (p= <.01) increase in the platelet count during the trial period while patients in the Sulindac group had significant (p □ <.001) elevation in serum alkaline phosphatase. No patient developed hepatotoxicity. The appropriateness of a primary health care setting for evaluating the efficiency and acceptability of drugs meant to alleviate symptoms in an elderly population functioning in the community is stressed.
AGEING, CAREGIVING, AND SUPPORT SYSTEMS: AN OVERVIEW
Authors: Schultz C.L. , Schultz N.C. , Ward E.F.
Published: December 2008

The implications of ageing and associated caregiving for Australian family life are examined within the framework of a discussion about available support systems and the utilisation. A brief overview of the literature demonstrates how support systems, resource usage, and caregiving interact with one another. It is argued that educational group programmes represent a viable form of support, which warrants close attention. Issues raised include caregiver coping resources and strategies, prediction levels and effects of resource usage, the role of individual and cultural differences, and the impact of caregiving responsibilities on levels on anxiety, depression, and general health.
THE PSYCHOGERIATRIC RATING SCALE: A PRACTICAL TOOL FOR ASSESSMENT, MONITORING AND PROGRAMME DEVELOPMENT.
Authors: Fleming R.
Published: December 2008

The development of the 50 item Psychogeriatric Rating Scale is described. Data is provided which show exceptionally high inter‐rater reliability between trained raters, ranging between 0.9 and 0.98 for the seven sub‐scales of Physical, Self Help, Confusion, Behaviour, Social, Psychiatric Observations and Nursing Dependency.

Internal consistency of the scales is good, ranging from 0.68 to 0.93.

Validity was assessed by comparing the Confusion scale with the Mini‐Mental Status Questionnaire (correlation = 0.84) and the Nursing Dependency scale with the Farr Dependency Scale (correlation = 0.74).

All of the sub‐scales were foundto beableto discriminate between self care, hostel and nursing home groups in a large retirement village.
THE MARGINALIZATION OF THE ELDERLY: AN AUSTRALIAN CASE STUDY
Authors: Dempsey K.
Published: December 2008

In this paper I report on the social marginalization of the elderly members of an Australian rural community. The community, which is given the pseudonym of Smalltown, has a population of about 4000 and is situated in north west Victoria. The elderly comprise approximately 16% of the combined population of the township and the surrounding farming district the town services.
STAFF PERCEPTIONS OF CARING FOR ITALIAN GREEK AND CHINESE NURSING HOME RESIDENTS
Authors: Westbrook M.T. , Legge V.
Published: December 2008

Despite the fact that Australia is a multicultural society there has been little research into health practitioners' experiences of providing care for patients from various ethnic backgrounds. A survey of Sydney nursing homes obtained staff ratings of the tensions involved in 14 aspects of caring for the ethnic groups with whom they had most experience. These were Italians, Greeks and Chinese. Patterns of tension associated with their care differed significantly and can be related to differences in group characteristics (time in Australia, English speaking skills) and to the degree of similarity of group illness behaviours to Anglo‐Australian norms. The implications of the findings for the education of health practitioners are discussed.
ELDER ABUSE: THE RESPONSE AND ROLE OF THE POLICE
Authors: Gately B.C. , Whalley W.F.
Published: December 2008

In Australia, the continuing user rights debate concerning care and protection of older people has concentrated on care of elderly people in the context of the provision of institutional residential care facilities. There has been little discussion of elder abuse in other contexts, particularly the domestic context, or of the role of the police force. This paper discusses the establishment and operation of The Aged Services Unit within the NSW Police Service. It comments on the role of the police force in detecting and preventing elder abuse and on this aspect of police force in detecting and preventing elder abuse and on this aspect of police deployment as a developing aspect of community‐based policing. By recording these NSW initiatives, and speculating on future developments, this paper endeavoures to stimulate discussion on particular aspects of elder abuse and a consideration of the role that the police may or should adopt in relation to the protection of the physical, financial, emotional and personal rights of the elderly.
THE CARE OF PEOPLE WITH DEMENTIA IS THERE A NEED FOR A SPECIAL HOSTEL?
Authors: Lefroy R.B. , Hobbs M.S.T. , Parsons R.
Published: December 2008

One hundred and ninety two people with an altered mental state, who had been referred to several geriatric services, were studied with regard to their need for future care. The services were asked to include consideration of the special hostel, even though this facility was not freely available.

Immediate admission to a special hostel was regarded as desirable for 47 percent and a further thirteen percent fitted this category.

The study supports the concept of making this facility available as an alternative to nursing home or standard hostel when institutional care becomes necessary for people with dementia.
A COMPARISON OF RESIDENTS IN A SPECIAL HOSTEL WITH THOSE AT HOME AND IN OTHER INSTITUTIONS
Authors: Lefroy R. , Hobbs M.S.T. , Parsons R.
Published: December 2008

Sixty percent of 192 people with an altered mental state were considered to be suitable for admission to a special hostel. One in four of the subgroup had severe cognitive impairment and were incontinent. Two in five were likely to wander away. About half showed evidence of agitation.

A comparison was made between the behavioral characteristics of this group, those in nursing institutions and those being cared for at home. Comparison was also made between people living alone, with their spouse and with other relatives.

People with advanced behavioral changes can be cared for in a special hostel.
PREVENTING FALLS AT HOME IN OLD AGE: A BROAD APPROACH
Authors: Walker C. , Boldy D. , Spickett J. , Stevenson M.
Published: December 2008

This paper addresses the problem of falls in the home by older people within a health promotion framework. It brings together current knowledge of risk factors and elements of injury control theory to formulate some broad strategies for falls prevention. These strategies have the potential to significantly reduce this costly and distressing problem and can be implemented in a variety of ways by individuals working in diverse roles with older people.
ALZHEIMER'S DISEASE: IMPROVING THE QUALITY OF LIFE‐ A CASE STUDY
Authors: Binkley A. L.
Published: December 2008

Recreation Professionals Building a Caregiving Partnership

To try to stem the tide of increasing age is an impossible task. It seems that in working with the very aged one is always losing ground to the incoming waves of chronic illness. But the task of a recreation worker is not to try to hold back the water but merely to place barriers of sand in front of it to keep the breakers from crashing in and diminishing the life experience of the people they work with. Less metaphorically, that is to say those who provide activity programmes for the infirm aged need to provide a range of activity programmes which will help stimulate the quality of a patient's present life situation by encouraging independence and assisting with the adjustment to increased physical decline. Daniel Ferguson (1978, p.10, 11)
Training and Education in Industry: The Role of Government from an Industry Perspective
Authors: Pittman B.
Published: December 2008

Education and training in gerontology have entered a new era in which a new coalition between government, industry and tertiary education is possible. Major changes on the industrial front have created an expanded focus upon education and training for aged care. New and creative possibilities have been opened up: there is a better opportunity than ever before for a co‐operative alliance between government, industry and tertiary education bodies provided these parties are able to accept and meet the challenges presented.
SOCIAL CHANGE AND ITS INCORPORATION INTO TERTIARY COURSES
Authors: Green D.
Published: December 2008

The impacts of longevity and societal ageing and their relationship to morbidity are significant areas of social change. However this paper does not address such weighty issues, but would ask the reader to accept the general trends well outlined elsewhere. The matters identified here focus on the contemporary dilemmas of professional practice, deriving from such changes as ageing‐in‐place, the decline of resources and the relevance of individual consumer rights in service delivery.
DIRECTIONS AND PRIORITIES IN TERTIARY GERONTOLOGICAL EDUCATION
Authors: Jones D. , Minichiello V.
Published: December 2008

The increasing demand for education and training programmes for a skilled aged care workforce signals the need for establishing a comprehensive gerontological education data base for future planning. The rationale and aims of a national data collection project are described. The authors have identified issues in gerontological education which will form the basis for questions included in the survey. Implications for future directions and priorities in education programmes in tertiary institutions will be discussed.
PROFESSIONAL PRACTICE WHICH INFORMS EDUCATION
Authors: Garratt S.
Published: December 2008

This paper discusses the current practice issues that inform education and promote the need for constant revision and change within gerontological programmes. Current issues that are emerging from the practice area can be identified under the broad headings of service provision, management, emerging technology, ethical decision‐making, community involvement and collaborative practice. Each of these issues has generated needs that require a response from education. An examination of the practice issues and possible educational responses is offered.
A SURVEY OF PERSONAL EMERGENCY ALARMS FOR THE FRAIL ELDERLY
Authors: Farquhar D.L. , Fonda D. , Danek C.L. , Ryan A.M.
Published: December 2008

Elderly individuals living alone in the community are at risk of falls or medical emergencies. Portable emergency alarm systems are now available for this group. This study reports on 125 persons consecutively assessed as requiring such an alarm and follows them up by telephone interview over a 19 month period. Information obtained from these people was corroborated by their carers. The study group was in general very elderly, required major family and/or community support and had multiple medical problems.

At follow up, 38% had given up their alarms. Of those still receiving an alarm, only 38% had used it in the last year ‐ but nearly half of these required hospitalisation. Satisfaction with the alarms was high in both subjects and their carers with over 80% feeling that continued alarm usage was required. When alarms were activated, carers responded to the emergency.

It should be possible with proper screening and review to keep to a minimum the financial costs of issuing alarms while at the same time providing a major resource for the ‘at risk’ elderly.
EDITORIAL
Authors: Graham S. , Fine M.
Published: December 2008

The Social Policy Research Centre and the Australian Association of Gerontology (New South Wales Division) Conference: The Allocation of Funding of Long‐Term Support in the Community: Australian and International Perspectives. University of NSW, 29 October 1991.
THE EFFECTS OF CAREGIVING FOR THE DEMENTED ELDERLY
Authors: Flicker L.
Published: December 2008

The number of demented elderly within the Australian population is increasing rapidly. The financial and societal aspects of their care represent a major public health problem. The subjective effects of caregiving, that is burden, have been well described but the physical and mental health effects of caregiving have not been adequately determined except for selected populations. Interventions to improve the well‐being of caregivers have not been comprehensively evaluated. Future research should focus on establishing the efficacy of interventions in either unselected populations or in individuals who have a clearly described selection process.
RECREATIONAL ACTIVITIES OF ELDERLY AUSTRALIANS CATEGORISED BY CARDIOVASCULAR STATUS
Authors: Mitchell R.A. , Imperial E.S. , Kelleher P.W. , Brunker P. , Cross J. , Cue R.
Published: December 2008

This study examines the participation in active and passive recreational activities among elderly Australians classified by cardiovascular status. The findings suggest that when an elderly person has a treated cardiovascular condition his/her participation in such activities does not differ from those who have no cardiovascular condition. It is also suggested, independent of cardiovascular status, that males belong to more clubs than females.
TELELINK AND THE VISUALLY‐IMPAIRED ELDERLY: A GROUP DYNAMIC ANALYSIS
Authors: Thomas T. , Urbano J.
Published: December 2008

Telelink is a special telephone group support program designed to bring small groups of elderly people with visual impairment together each week for stimulation, social interaction or therapy. This study aims to investigate factors which contribute to the effectiveness of Telelink. Group dynamic analyses were obtained by direct ‘observation’ (listening in) of the group meetings. The analyses revealed extensive use of humour and exchange of coping strategies, with little evidence of conflict or domination among group members. The paper concludes with a discussion of the value of group telephone support programs for the elderly, the limitations of their use, and the possible application of Yalom's Group Model for future research.
NON‐STEROIDAL ANTI‐INFLAMMATORY DRUG (NSAID) USAGE AND HYPERTENSION IN THE ELDERLY
Authors: Johnson A.G. , Imperial E.S. , Kelleher P. , Burnett B. , Holmes M. , Glodoveza M. , Mitchell R.
Published: December 2008

Aims: To determine the prevalence of usage of NSAIDs and whether these drugs contribute to the high prevalence of hypertension in this age group. Method: Data obtained from participants in a cardiac screening program for the non‐institutionalised elderly were submitted to a cross‐sectional analysis. Results: 529 elderly ambulatory subjects were screened. Twenty eight percent of all participants (females > males) were consuming NSAIDs. A significantly higher prevalence of usage of NSAIDs was found in hypertensive females (60–64 years) and in hypertensive males (65–69 years) compared to those with a normal cardiovascular state in the same sex and age groups. Conclusions: NSAID usage may be excessive in the elderly and an association between NSAID usage and hypertension in some elderly patients is postulated although further studies are required to adequately evaluate this potential interaction.
INNOVATIVE SERVICE DELIVERY MODELS: LESSONS LEARNED IN PROVIDING CARE FOR OLDER PEOPLE AND PEOPLE WITH DISABILITIES
Authors: Barnett K. , Schultz R.
Published: December 2008

An evaluation is reported of six projects funded under the HACC (Home and Community Care) Program from Commonwealth Unmatched Monies. Each project provided an innovative service delivery model and two of the key purposes of the evaluation were to determine whether or not these models had been effective in meeting individual needs and to determine the factors most critical to supporting people at home. The evaluation found that the projects had been effective from both a service and a cost perspective and identified as the key factors a sense of security based on a belief in one's ability to manage care in the home setting, access to available services, flexibility in the provision of services and supports, effective case management and the presence of a caregiver. An analysis of costs was also undertaken and the projects were found to be cost‐effective and considerably less expensive than equivalent care in a residential setting.
RESOLUTION THROUGH CONFRONTATION: WORKING WITH THE PERPETRATORS OF ELDER ABUSE
Authors: Kingsley B. , Johnson S.
Published: December 2008

This paper outlines an intervention program for confronting the abuser. It was developed by the authors and is currently practised by them. The program format includes sessions about fact‐finding to confront abuse, contracting and setting the ground rules, skills and strategies to prevent re‐occurrence, confronting abusive behaviours, confronting feelings regarding abuse, confronting emotional reality, closure of the program and evaluation of outcomes. While a number of interventions directed at victims are readily available, this program for abusers will be a useful addition to the battery of interventions available to practitioners.
PROTECTION OF THE ELDERLY: SOME LEGAL AND ETHICAL ISSUES
Authors: Collingridge M.
Published: December 2008

In this paper the author argues that policy makers are overlooking important questions about the legal bases for intervention in cases of elder abuse. Further, they are side‐stepping more fundamental ethical questions about general societal and individual obligations concerning care of the vulnerable, the limits of intervention and the balance between autonomy and protection. The author concludes that it is doubtful if we have either adequate laws to protect the vulnerable, nor adequate safeguards against unwarranted or uninvited intervention.
CLAIM MAKING ABOUT ELDER ABUSE IN AUSTRALIA
Authors: Dunn P.F. , Sadler P.M.
Published: December 2008

The abuse of older people, commonly known as elder abuse, has recently been claimed to be a significant social problem in Australia. This paper examines the activity of claim making about elder abuse from an historical and sociological perspective. A framework for understanding the processes by which phenomena become social problems is presented. The effect of the social environment on a twenty‐year history of Australian claims about elder abuse is analysed. Like many other social problems, elder abuse has been defined in individualistic terms and proposals for person‐centred interventions predominate. The authors advocate that Australia employ a comprehensive approach, attending to both individual and structural factors. We support the arguments that a person‐centred approach is limited and put forward some suggestions for future policy and practice.
The Continued Success Of Conservative Management For Established Urinary Incontinence In Older People
Authors: Fonda D. , Woodward M. , D'Astoli M. , Chin W.F.
Published: December 2008

Seventy‐eight community residing patients (63% women) aged 60 years or older attending an outpatient continence clinic were randomised to receive immediate conservative (non‐surgical, non‐pharmacological) management or to a control group in which treatment was deferred for two months. All patients were followed up for 12 months. Outcome was assessed by three day bladder charts (objectively) and by patient questionnaires (subjectively). The average age was 74.8 yean and mean duration of incontinence was 7.3 years with 60% not having had any previous treatment. After four months of active treatment incontinence was cured or improved subjectively in 88% of patients and objectively in 58% of patients. This was sustained through to the 12 month follow‐up. Severity of incontinence was significantly reduced on a range of variables.

Conservative management of elderly community‐based patients can be very effective, taking up to four months to see peak benefit which can be sustained over a 12 month period with little additional input. The improvement seen in the control group perhaps reflects the importance of support and destigmatisation of this condition.
Relocation Of The Aged‐A Literature Review
Authors: Stein I. , Morse C.
Published: December 2008

This paper reviews both national and international literature concerning aged relocation. Various types of relocation and the motivations for relocation are identified. The outcomes for the seniors who relocate and the target relocation areas are discussed. The stress that moving creates for the aged person is acknowledged.
Dependence and Independence in the Hostel
Authors: Groves M. , Strong J. , Camamile C. , White A.
Published: December 2008

This study examined the level of independence/dependence of 233 elderly persons domiciled in Brisbane. Subjects were drawn from both elderly persons living in their own homes (n=75) and elderly persons residing in hostels (n=158). The study investigated the relationship between the environments of elderly persons and their level of independence. As anticipated, significant differences were found on the Iowa Self‐Assessment Inventory (ISAI) scores between the own home group and the hostel group. On the basis of a survey of Queensland hostels using the Institutional Regimes Questionnaire (IRQ), eleven hostels were classified as having positive regimes or restrictive regimes. The ISAI scores of 85 ‘positive regimes’ hostel residents and the 73 ‘restrictive regimes’ hostel residents were then examined. A significant difference was found between residents living in their own home and hostel residents. However, the results indicated that regimes, as measured by the IRQ, could not be used to differentiate the independence level of hostel residents. The level of dependence of residents in hostels with restrictive management regimes was no different from the level of independence of residents in hostels with positive management regimes.
Impact of a Medication Card on Compliance in Older People
Authors: Lourens H. , Woodward M.C.
Published: December 2008

Medication compliance is often poor amongst older people, and this can contribute to adverse drug reactions, therapeutic inefficiency and associated increase in morbidity. This study was conducted among outpatients to assess the impact of a medication card as a counselling aid to increase knowledge about medications and increase drug compliance. Patients were randomly assigned to Group A, which received counselling only, from a pharmacist, or to Group B, which received both counselling and a medication card from the pharmacist. Knowledge improvement for patients in Group B was significant, compared with patients in Group A, t = 9.82, p < 0.001. The compliance of patients in Group A and in Group B, were respectively, (mean ± S.D) 87.5 ± 15.1 v 92.5 ± 11.9, t = 1.76, p = 0.082. The results of this study show that a medication card can increase medication knowledge and may aid compliance.
Health Professional Attitudes Towards Ageing and Older People: Preliminary report of the Reactions to Ageing Questionnaire
Authors: Gething L.
Published: December 2008

The rationale, development and preliminary findings are outlined for the Reactions to Ageing Questionnaire (RAQ). The first version of the instrument was developed following a content analysis of open ended responses. Subsequent administrations to nurses and members of the general population resulted in revisions, producing a 30‐item questionnaire. Results are reported of psychometric analyses following administration of the final version to 531 health professionals. Assessments of item homogeneity, use of factor analysis and assessment of associations with other measures of attitudes support the instrument's reliability and validity.
Reports of Health Workers from Six Australian Communities on Aged People's Evaluation of Health Services
Authors: Legge V. , Westbrook M.T.
Published: December 2008

In response to a questionnaire survey, health workers (N=371) from the Chinese, German, Greek, Italian, Arabic speaking and Anglo Australian communities reported the reactions to health services of aged people in their communities. Significant community differences were found in the evaluation of IS of the 18 aspects of health services examined. In all ethnic communities mainstream services received higher ratings than did services specifically for non‐English speaking patients. Communities with a shorter history in Australia tended to value services more highly.
THE WORTH OF A HUMAN LIFE: A FOCUS ON THE FRAIL AGED
Authors: Seedsman T.A.
Published: December 2008

This paper aims to challenge the thinking and perspectives of health care personnel who claim to have a genuine interest in the well‐being of the frail aged. The point is made that nursing home management must have a philosophy about its purpose and meaning if it is to offer total care for older residents. A rationale for the provision of recreation services for the frail aged is discussed along with a useful mnemonic for establishing effective relationships with older residents. The paper concludes with the thought that quality care for the frail aged is to be found in the belief that the vital element in any life equates with the dimension of aliveness.
Australian Research on Ageing and Families: Developments and Directions
Authors: Kendig H.
Published: December 2008

This paper draws on primary publications in Australian gerontology to review Australian knowledge on ageinig and families. Government funding has played a large part in increasing psychological research on caregiver stress and applied studies of the needs and supports of older clients of community services. Priorities for further research are: better appreciating diversity among different social groups, revealing older people's own experiences of families, and developing better theoretical frameworks of how individuals fit within broader social structures. Research can play a major part in confronting public misperceptions of ageing and suggest how practitioners can work most effectively with frail older people according to their particular family situations.
Family Change and Marital Status in Later Life
Authors: Rowland D.T.
Published: December 2008

This paper discusses the marital status of the aged in the context of changes in the family, especially trends in marriage and divorce. Marital status is an indicator of family resources for care and support; decreases in the proportions married particularly denote diminished access to such resources. Although the decline in the prevalence of marriage has been most marked among younger generations, the composition of the older population is changing as birth cohorts with disrupted marital histories advance into later life. The paper discusses the past and future marital status of cohorts of the aged using observed data and information from a new method of projecting marital status. The analysis shows that although past changes have mainly indicated an improvement in family resources, Australia is on the threshold of a decline in such resources as higher proportions experience family breakdown and live their later years without spouses, the main carers and supporters of the aged.
Long Term Marriage and Long Term Care “We Thought We'd be Together till we Died”
Authors: Tilse C.
Published: December 2008

Within the Australian context, few studies have explored how aged care facilities provide for and treat families. Using qualitative methods, this study sought to link an understanding of the experience of placing a long term partner, with an exploration of how residential facilities treat such family members. Results show that facilities had a variable capacity to recognise and respond to the needs of older spouses. Although family input is valued, families need to be provided for, supported and included more directly as part of long term care