bluuebunny/crossref_metadata_2025 huggingface dataset:
“Population Invasion” versus Urban Exclusion in the Tibetan Areas of Western China
Authors: Fischer Andrew Martin
Published: December 2008

This article examines the confluence of local population transitions (demographic transition and urbanization) with non‐local in‐migration in the Tibetan areas of western China. The objective is to assess the validity of Tibetan perceptions of “population invasion” by Han Chinese and Chinese Muslims. The article argues that migration to Tibet from other regions in China has been concentrated in urban areas and has been counterbalanced by more rapid rates of natural increase in the Tibetan rural areas—among the highest rates in China. Overall, it is not clear whether there is any risk of population invasion in the Tibetan areas. However, given that non‐Tibetan migration to Tibet has been concentrated in urban areas, Tibetans have probably become a minority in many of their strategic cities and towns, and non‐Tibetan migrants definitely dominate urban employment. Therefore, while the Tibetan notion of population invasion may be a misperception, it reflects a legitimate concern that in‐migration may be exacerbating the economic exclusion of Tibetan locals in the context of rapid urban‐centered development.
Comparison between complete denture and implant‐retained overdenture: effect of different mucosa thickness and resiliency on stress distribution
Authors: Assunçāo Wirley Gonçalves , Barāo Valentim Adelino Ricardo , Tabata Lucas Fernando , De Sousa Edson Antonio Capello , Gomes Erica Alves , Delben Juliana Aparecida
Published: December 2008

Background:  The effect of different mucosa characteristics on stress distribution of complete dentures and overdentures remains unknown.

Objective:  The aim of this study was to evaluate the effect of different mucosa thickness and resiliency on the stress distribution of complete dentures and implant‐retained overdentures using a two‐dimensional finite element analysis.

Material and methods:  Representative models of the edentulous mandible were constructed on AutoCAD software according to the groups’ characteristics. In group CD, a model of the edentulous mandible supporting a complete denture was obtained while in group IO, a model of edentulous mandible supporting an overdenture over two unsplinted implants with an o’ ring system was constructed. In each group, mucosa assumed three characteristics of thickness (1, 3 and 5 mm) corresponding to the resiliencies hard, resilient and soft respectively. Evaluation was performed on Ansys software with 100N vertical load applied on central incisor teeth. The principal stress was used as analysis criteria.

Results:  Group IO showed higher stress values than group CD regardless of mucosal thickness and resiliency. Stress decreased at the supporting tissues in both groups as the thickness and resiliency of mucosa increased. In relation to the supporting tissues, cortical bone showed the highest stress values.

Conclusion:  It was concluded that the use of an attachment system increases stress values and the thickness and resiliency of mucosa influence more on these values.
INTERVIEWING VERY OLD PEOPLE
Authors: Job E. , Johansen C. , Jones J. , Spenceley E.
Published: December 2008

Interviewing is an interactional situation par excellence. Nevertheless situational, respondent, and interviewer effect can be distinguished, all of which introduce biases. These biases are best dealt with by bringing them out into the open at all stages of the research, so that their effects can be recognised and allowed for. Finally, some suggestions have been made for the interviewing of very old people. They include the reminder that such respondents are highly individual, and cannot be adequately described by stereotypes; but consideration should be shown for common disabilities such as hearing loss. Respondents should be allowed to set their own pace, however slow that may seem to the interviewer, and as far as possible, their own choice of emphasis on topics. And like respondents of all ages, they must be interviewed only with their full consent and understanding, and accorded the respect due to one human being by another.
THE AGEING ADULT PLAYING SIMULATION GAMES
Authors: Feingold Olga
Published: December 2008

In 1975, the writer carried out a pilot study on the change of attitudes, the perception of self and of others, interactional behaviour and learning outcomes among the ageing adults participating in simulation games. The average age of the participants was 64. All of them (N= 33) have been the students of her tutorial class “Human Relations”, at the Sydney School for Seniors (the Wesley Centre). The simulation games included “Survival”, “Bafa–Bafa”, “Star Power”, and some games organised for the study purposes.
A CARE CENTRE FOR HUNTINGTON'S DISEASE: CONFRONTING ATTITUDES TO CHRONIC TERMINAL ILLNESS.
Authors: Ball Alison
Published: December 2008

This paper first describes the Arthur Preston Centre at Mary's Mount in Balwyn, Victoria and what Huntington's Disease is. It then discusses the old attitudes to this chronic, terminal illness and the confrontation with these attitudes presented to sufferers and families. The type of care offered at the Centre is described and the ways in which the experience at the centre calls into question the old professional attitudes and assumptions relating to the sufferers of this disease. Finally a challenge is made for the adoption of a new viewpoint.
CLASS, AGEING & RETIREMENT1
Authors: Douglas‐Smith Lucinda
Published: December 2008

Most discussion and research about retirement has centred upon characteristics which map the circumstances of people before and after their retirement. This paper reports the findings of part of a study on ageing and social stratification which examined the retirement experience of a sample of people against the underlying system of social relations. The respondents' perceptions and experiences of the retirement process emerge as being closely related to their position with respect to class, status and power although this relationship was cross cut by sex role differences.
ATTITUDE TO LIVING IN A RETIREMENT VILLAGE
Authors: Legge Varoe
Published: December 2008

Professional and public opinion about the appropriate housing of the aged varies over time. At the present the emphasis is upon keeping the aged in their own homes. This study examines the experiences of a group of Retirement Village residents and how that experience has affected their well being. The findings suggest that the more options that can be kept open, by the provision of alternate lifestyles, the more likely are the aged to retain the capacity for decision making in their own lives thus facilitating their physical and mental health.
THE CUMULATION OF INEQUALITY: HOUSING COSTS AND INCOME SUPPORT IN OLD AGE
Authors: Kendig Hal. L.
Published: December 2008

Housing inequalities accumulate over the life course and take on their greatest force in old age. Among the 95 per cent of older people who continue to live in the community, there is a polarisation between the majority of outright home owners and the minority of permanent private tenants. This article identifies the effect of housing tenure and related public policies on standards of living in retirement. Most importantly, it, concludes that increases of Supplementary Assistance are an immediate priority. A major restructuring of taxation, pension, and housing policy is recommended to resolve the more fundamental problems.
HOW QUEENSLAND PUBLIC SERVANTS SPEND THEIR LUMP SUMS
Authors: McCallum Dr John
Published: December 2008

Current debates about income security in later years have questioned the legitimacy of lump sum retirement benefits. The debates have been conducted with a paucity of information about these benefits and the uses to which they are put. A 68 percent response to a mail questionnaire sent to en‐contributors to the Queensland State Service Superannuation Fund who retired between 1/1/78 and 30/6/80 is used here to provide evidence for the debate. Attitudinal responses, along with self reported evidence on the allocation of lump sums to some twenty‐two investment and consumption items, yield a consistent picture about the financial behaviour of retirees. As we would expect from psychological studies of retirees, they are typically cautious and anxious and seek to shelter from any added stress arising from managing personal finances. Their orientation is revealed as risk avoiding rather than risk aversive. Four patterns, namely an effect of the amount, of membership of occupation, of interest rate (at the time of retirement) and marital breakdown, were found in this investment behaviour. Finally whilst recipients of large lump sums report higher levels of life satisfaction now than recipients of lower amounts, this difference disappears when they are asked about the expectations of life satisfaction into the future. The uncertainties of older age seem to outweigh the securities provided by a large lump sum.
HOUSING TENURE AND COSTS OF OLDER AUSTRALIANS: GENDER ISSUES
Authors: Rossiter Chris
Published: December 2008

This paper investigates some aspects of housing amongst people aged 65 and over, using previously unpublished data. It aims to explore further the generally optimistic view of elderly people's housing and to illuminate the variety of circumstances within this population. The analysis concentrates on gender‐based inequalities.

Although elderly people generally have adequate and affordable housing compared with the population as a whole, in terms of housing tenure and costs, elderly women lend 10 fare less well than their male counterparts. Gender inequalities in housing circumstances are discussed in relation to differences in marital status and income levels.
POVERTY AND PENSIONS
Authors: Bradbury Bruce , Vipond Joan
Published: December 2008

It has been argued that it is impossible to measure poverty among elderly people because pension levels and poverty lines are so similar. Whether poverty among them appears to be high or low may depend upon an arbitrary decision as to whether the poverty line should be a dollar a week above or below the age pension. This paper analyses poverty among elderly people suggesting that it can be measured by the number who live below an after‐housing cost poverty line. That is, their poverty should be measured after they have paid for their housing. This procedure not only avoids some of the measurement problems, it also provides a more realistic test of the level of poverty in Australia than other techniques. It takes into account not only the incomes of families but also their ownership of the main form of household wealth — the family home.

In general when poverty is measured in this way its incidence is much lower among elderly people than others. An important reason is the widespread ownership of homes among the elderly which reduces their housing outlays. Among a minority of the elderly, the private‐sector renters, the incidence of after‐housing poverty is however very high.
AGED WOMEN FROM NON ENGLISH SPEAKING BACKGROUNDS
Authors: Legge Varoe
Published: December 2008

Aged women from all groups in Australia experience common problems. Financially they are less well off than are men, they are more likely to be widowed and to be living alone. In addition to these experiences aged women from non‐English speaking backgrounds can also experience difficulties through their inability to communicate, especially in formal and semi‐formal situations. Inter‐family value shifts also threaten self image and the quality of life. Ethnically segregated retirement villages can be instrumental in enabling people to retain control of their lives, in enhancing social networks and in preserving family relationships.
PEPPERTREE LODGE SOME OBSERVATIONS ON THE FIRST FIFTEEN MONTHS OF THE FIRST C.A.D.E. UNIT
Authors: Fleming R. , Bowles J. , Mellor S.
Published: December 2008

The development, design and programming involved in establishing Peppertree Lodge, a unit specifically designed for the care of the confused and distrubed elderly (C.A.D.E.), have been described earlier (Fleming and Bowles, 1987). This paper outlines the characteristics of the residents admitted in the first 15 months and charts their progress with special reference to a group of ten who have been followed throughout the fifteen month period.

The information presented supports the hypothesis that a purpose built unit staffed at the same level as a psychiatric hospital can bring about significant improvements in self‐help skills, behavioural problems and social skills while reducing dependency on staff. While the reduction in the level of confusion in the residents did not reach significance the trend to a lower level is clearly demonstrated.

Some observations on the probable causes of the low staff turnover are presented.
FAMILY CAREGIVERS‘: EXPERIENCES AND CONSEQUENCES ASSOCIATED WITH CARING FOR FAMILY MEMBERS WITH DEMENTIA
Authors: Brown P.J. , Holmes A.B. , Mitchell R.A.
Published: December 2008

The aim of this research was to study family cnregiv‐ers' experiences and consequences associated with caring for a family member with dementia with the purpose of identifying major difficulties, service needs and appropriate interventions. A further aim was to assess carers' support group experiences. Caregivers were identified as those attending 16 Sydney metropolitan A.D.A.R.D.S. groups. Fifty‐three carers returned the self‐report quesionnaire.

Sufferers were both males and females who were cared for, in the main, by their spouses. A small group of carers had little or no personal physical and emotional support from others. Almost half of the carers are providing care 21 to 24 hours a day. Eighty‐three per cent of carers reported changes in health status related to this role.

Clearly, there is a need to provide physical and emotional support for carers generally, and for those with little or no support (for example, those who do not attend a support group) in particular.
Essay Review
Authors: Thomas Trang
Published: December 2008

Research and the Ageing Population, Ciba Foundation. Published by John Wiley & Sons, Chichester, U.K. 1988, pp. 264.
‘THERE MUST BE BETTER SONGS TO SING’ INSERVICE TRAINING FOR RESIDENTIAL AGED CARE
Authors: Embelton G. E. , Paul V. E. , Gow K. M.
Published: December 2008

Adult learners are frequently anxious when faced with the learning process but are also committed to innovative learning methods. This paper relates to inservice training for nursing and personal care staff in a residential aged care nursing home. Negative attitudes towards the elderly and the ability of training programmes to overcome these are explored. The DO, LOOK, THINK, ACT and GROW model for inservice training is presented Four levels of mastery are described as they relate to various educational levels and abilities of participants. The overall programme of the Training and Resource Centre for Residential Aged Care (TARCRAC) is outlined.
EVALUATING QUALITY OF CARE IN AUSTRALIAN NURSING HOMES
Authors: Gibson D. , Braithwaite J. , Braithwaite V. , Makkai T.
Published: December 2008

This paper reviews some results from a large scale longitudinal and cross national study of nursing home regulation. The Australian system of standards monitoring was designed to be heavily outcome oriented and resident focused. The outcome orientation of the approach is critically appraised, with particular attention to the broadly defined nature of the standards, their subjectivity, and the validity and reliability of the regulation process.
RATING SCALES IN RESIDENTIAL CARE FOR ELDERLY PEOPLE: THE CRICHTON ROYAL BEHAVIOURAL RATING SCALE
Authors: Lefroy R.B. , Hobbs M.S.T. , Hyndman J.
Published: December 2008

The Purpose of the study was to consider the merits of the Crichton Royal Behavioural Rating Scale (CRBRS) with respect to its use in selection, monitoring progress and predicting the outcome of residents in institutions.

Participants were residents in a special dementia unit (SDU) in the form of a hostel, a standard hostel and a nursing home for sufferers with severe dementia.

Method: scores were recorded over a period of five years in the SDU and intermittently in the other two institutions.

Results demonstrated the range of scores of residents on admission to the SDU and their changes in behavioural function over five years. The probability of retention in the SDU was greater for residents admitted with scores in the lower ranges. Differences in the three institutions were demonstrated in both range and level of behavioural function. Comparison with the Resident Classification Index (RCI) suggested that the CRBRS has superior discrimination concerning behavioural function.

Conclusions: the regular use of rating scales in institutions for elderly people should be mandatory. The CRBRS is useful in the selection of residents and in monitoring outcome but it cannot substitute for conventional methods of diagnosis and assessment.
THE PREVALENCE OF DEPRESSIVE SYMPTOMS AND COGNITIVE IMPAIRMENT IN SUPPORTED RESIDENTIAL SERVICES IN VICTORIA—A PILOT STUDY
Authors: Flicker L. , Keppich‐Arnold S. , Chiu E. , Calder R. , Theisinger J.
Published: December 2008

Supported Residential Services (SRS), also known as Special Accommodation Houses, house large numbers of disabled Victorians, the majority of which are elderly. However there is currently no information available concerning the prevalence of the common psychiatric syndromes of depression and dementia, or the general levels of disability, displayed by these individuals. To address this need five SRS were randomly selected, and one SRS catering for clients of Italian background was chosen for study. Information was obtained on 108 of the 116 residents. Using the Abbreviated Mental Test Score and Geriatric Depression Score 44% demonstrated some cognitive impairment and 28% were found to exhibit significant depressive symptoms. High rates of functional and behavioural disability were detected. Neuroleptic medication was used by 37% of residents and antidepressants by 31%. There was marked discordance between supervisors' impressions and estimates of morbidity using standard scales. We conclude that there are high rates of prevalence of depressive symptoms and cognitive impairment within SRS and that policy changes to promote better recognition and care of residents with these syndromes are justified.
OLDER PEOPLE: THE EFFECT OF ACTIVITIES ON THEIR SOCIAL INTERACTIONS
Authors: Riggs A. , Mott S.
Published: December 2008

This exploratory study, funded by the Australian Rotary Health Research Fund, investigated the factors affecting the social interactions of older people.

The study was based on interviews with one hundred people aged 65 years and over to determine their past activities, present pursuits and the activities, if any, in which they would like to be involved.

This article, the second of two, examines the results relating to the activities and social interactions of older people.
PERSONAL POSSESSIONS AND SELF‐IDENTITY: THE EXPERIENCES OF ELDERLY WOMEN IN THREE RESIDENTIAL SETTINGS
Authors: Cram F. , Paton H.
Published: December 2008

Possessions allow us to understand and to express our self‐identity. For the elderly, possessions are also important repositories of memories of one's self‐identity in the past, especially when opportunities for the external validation of self are limited, for example, as a result of institutionalisation. The present study explored the relationship between possessions and self‐identity for elderly women in (a) their own homes, (b) a residential unit, and (c) a nursing home. Ten women in each residential setting were interviewed about the meaning and value of their possessions. Qualitative analysis revealed five themes relating to self‐identity (memories of people, memories from gifted possessions, memories of creator, memories of time or place, possessions as part of self)‐The responses of the three groups of women for each of these themes are discussed.
Workers with Family Responsibilities Adopting a Wider Family Outlook
Authors: Russell G.
Published: December 2008

ILO Convention 156, signed by the Australian Government, seeks to enable workers with family responsibilities to work without discrimination. Family responsibilities for care of elders were investigated in a study of 8662 employees from 5 organisations. Between 15 and 33% of employees had elderly parents dependent on them and between 50 and 66% expected eldercare to be a problem for them in the next 15 years. There was little difference in proportions with eldercare responsibilities and those caring for pre‐school aged children. Gender of the employee was not a significant factor in taking leave for eldercare. Policies and practices to deal with eldercare are discussed.
Cancer Screening and Early Detection Among Ageing Women: Should Practice or Policy Change?
Authors: Ward J.
Published: December 2008

Australian health authorities recommend cessation of Pap smear screening at the age of 70 years for women who have had two normal Pap smears within the last five years. Pap smear screening should be initiated for women over 70 years of age who never have been screened. Mammographic screening is recommended for women 50–70 years. All adults over 40 years of age are advised to check for rectal blood after every bowel motion. This study was conducted to determine current compliance with these guidelines in an ageing female population, using a self‐administered questionnaire. A 94% response rate resulted in 414 completed questionnaires from women aged 60 to 99 years (median 81). Of women over 70 years with intact uteri, 40% never had had a Pap smear. Twelve percent of women over 70 had had a recent screening mammogram. In total, 21% of respondents checked the toilet bowl every time they passed a bowel motion and 27% checked the toilet paper every time. These results demonstrate that cancer screening and early detection practices among ageing women are varied. In contrast to current policies, cervical cancer screening is not always initiated for women over 70 years who never have been screened. Further, mammographic screening continues beyond 70 years of age although there is no evidence of benefit for these older women. Too few studies have been conducted to ascertain the benefits, acceptability and unintended negative sequelae of cancer screening activities in ageing women. Research is required to inform and, if necessary, revise screening policies and clarify the preventive messages promulgated to the elderly and their health care providers.
Charity, Goodwill and Community Spirit: Day Care Provisions for Older Adults in a Suburban Community
Authors: Thomson C. , Fine M.
Published: December 2008

This paper examines the provision of day care for frail aged people and people with disabilities in a suburban community of approximately 200,000 people in New South Wales. Using defined criteria, sixteen different day care centres providing approximately 680 day places per week for people remaining at home were identified. These centres are categorised according to differences in their source of funding and their affiliation with existing services. It is argued that although these differences explain variations in the operation of each of the centres, there were also marked similarities in the way each of the services operates which reflect the reliance on an often ad hoc series of local initiatives for the development of community support services. The study also highlights a number of issues for further research.
A Specialised Advisory Service for Older People and Those Caring for Them
Authors: Fox A. , Sims N. , Farish S. , Sullivan M. , Gray L.
Published: December 2008

An Information Office for older persons and their carers was established at Bundoora Extended Care Centre in 1990. The Office accepts enquiries by telephone or in person, both by appointment and on an ‘off‐the‐street’ basis. To determine the effectiveness of the project, a study of 798 consecutive enquiries made between October 1990 and March 1991 was conducted. People making enquiries participated in an interview at the time of their initial enquiry and a follow‐up telephone interview 3–4 weeks later. This second interview ascertained the relevance and usefulness of the information provided to the user. The study identified two major groups of enquirers‐professional health workers (40%) and children of elderly people (28%). The main areas of enquiry related to residential care (23%), Aged Care Assessment Teams (20%) and information on specific diseases or disabilities, e.g. Alzheimer's disease (10%).
Determinants of the Need for Respite Among Carers of People with Dementia
Authors: Clark M.S. , Bond M.J. , Nankivell A. , Jarrad S.
Published: December 2008

Respite is effective in alleviating the stress caused by caring for a person with dementia. A questionnaire survey examined the factors associated with the use of, and unmet need for, respite. In the past year, one third of carers had used respite monthly or more; 20% indicated an unmet need for respite at least monthly. Frequent users were likely to be female, providing care for a more elderly person, and obtaining respite from family and friends rather than from formal sources, Unmet need was associated with depression, restricted social activities, family illness, and negative perceptions of formal respite services. Flexibility may be the key element in enabling formal respite services to reduce unmet need.
Health Services and the Elderly: an Evaluation of Utilisation Data
Authors: Haas M. , Rushworth R.L. , Rob M.I.
Published: December 2008

Medical and diagnostic services for people aged 65 and over comprise a substantial proportion of all services provided by the Health Insurance Commission under the Medicare Benefits Schedule. To examine the utilisation of these services by people in this age group, we analysed de‐identified data on a cohort of people who claimed for at least one such service in NSW in 1991. The total number of services claimed for by this cohort of 7,724 people was 144,658. The median number of services received by individuals during the year was 13.5 per person for the cohort (or 9.9 for the total group). Of the total services reimbursed, 64.7% were for doctors' consultations, 24.8% were for diagnostic services and 10.6% were for other services, predominantly operations. The most common claims were for visits to a general practitioner for a standard consultation. Service utilisation differed between the age and sex categories of the patients in the study sample. Utilisation tended to increase with age and was more common among women than men for several of the service groups considered. We report the results of these analyses and discuss the potential benefits and disadvantages of using claims data to evaluate utilisation of medical and diagnostic services, and current clinical practices.
Care‐receivers' and Care‐givers' Experience and Perceptions of Respite Care: Implications for Service Provision
Authors: Clarke R.M. , Finucane P.
Published: December 2008

A random sample of elderly people living in a defined geographic area who were receiving care, together with those providing care, were interviewed about their need for, and their experience of, respite care. For comparative purposes, a sample of elderly clients of service providers was also interviewed. A total of 67 care‐receivers and 71 care‐givers were interviewed. Less than half the respondents reported having had a respite break. Care‐givers reported more benefit from respite than care‐receivers, and were less enthusiastic about the return to normal care arrangements. Respondents identified a number of problems with, and barriers to, respite care. We conclude that alternatives to residential respite care should be further explored.
Home Away From Home: a Study of Out of Area‘; Nursing Home Placement
Authors: Grace N. , Death J.
Published: December 2008

Disabled people waiting in public hospitals for nursing home admission restrict the available acute medical and surgical beds and therefore the ability of hospitals to provide acute and elective services. In areas where nursing home vacancies are scarce, people awaiting placement are often sent to distant areas where vacancies are frequent. We retrospectively studied 217 persons placed out of area from the Central Coast of NSW in 1994. We report their disabilities, their circumstances, factors leading to their transfer and their location at the end of the twelve month study period. Some of the reasons for their situation are discussed and plans for the future explored.
Use of the Short‐Form‐36 Health Sun to Assess Quality of Life Among Australian Elderly
Authors: Pit S.W. , Schurink J. , Nair B.R. , Byles J. , Heller R.F.
Published: December 2008

The aim of this cross‐sectional study was to assess the quality of life of elderly non‐demented hostel residents. Quality of life was measured by face to face administration of the SF‐36 questionnaire. The very old had better self‐reported quality of life than the 75 – 84 age group. We report some problems with the administration of the questionnaire and suggest some modifications.
Some Pleasures and Pitfalis of Working with Older Research Assistants
Authors: Mayhew C. , Swindell R.
Published: December 2008

This paper reports on the pleasures and pitfalls experienced by two academic researchers who recruited senior Australians as Research Assistants (RAs) to work on two different projects. The focus of this paper is on the activities carried out by the RAs, not on the projects. All RAs were able to establish excellent rapport with older study participants, they obtained high quality data, and were reliable and enthusiastic workers. It is argued that the older population represents a valuable source of expertise which could be used effectively by researchers.
The Meaning of Home for Older Women in Rural Australia
Authors: Gattuso S.
Published: December 2008

Policies targeting community care of older people in Australia are predicated partly on the belief that home is a place of particular meaning to them. This research examines the meaning of home for older women living in the community in rural Australia. A life historical perspective is taken on the assumption that the significance of home is located in a network of meanings constructed over the lifetime of women interviewed. It is claimed that home and identity for these women are integrally linked. Home is a locus for experiencing power over the environment and connection with others in real and symbolic ways. The experience and expression of power and connectedness is modulated by marital status, living arrangement and physical location.
A Special Dementia Unit (Hostel): Review of the First Eleven Years Operation
Authors: Lefroy R.B. , Hyndman J. , Hobbs M.S.T.
Published: December 2008

The aim of this review was to study the outcome of residents in a Special Dementia Unit (SDU) in the form of a hostel for 36 people during the first eleven years of operation. The participants were one hundred and seventy one residents admitted for permanent care during that period. The median length of stay in the hostel was 2.3 years. By the end of the period 113 residents (83 percent of those who had completed their time in the hostel) had been transferred to nursing homes. The average survival time after admission to the hostel was 4.7 years. In order to accommodate those who had been transferred from the SDU about the same number of hostel places were needed in nursing homes. We concluded that admission to an SDU hostel for selected people with dementia is more appropriate and less costly than direct admission to a nursing home, notwithstanding the need for subsequent nursing care for the majority. Adequate subsidy should be provided by the Commonwealth Government so that voluntary associations are encouraged to set up SDU hostels for this purpose. Nursing homes should be run in association with these hostels.
Relatives' Experiences of Nursing Home Life: Characterised by Tension
Authors: Nay R.
Published: December 2008

Indepth interviews were conducted with nineteen relatives of nursing home residents regarding their experience of nursing home entry. The study is interpretative and themes were identified from the data which assist understanding of this experience. In a previous paper I reported on the experiences from decision making to entry. This paper reports on the experiences after entry.
Age differences in the identification of psychosocial problems among hospitalised patients in Israel: social worker and client perceptions
Authors: Auslander G.K. , Schneidman G.
Published: December 2008

The type of services and the way they are provided by the helping professions may be affected by the helpers' biases in relation to socioeconomic characteristics of groups of clients. Some studies have shown that when clients are older adults, social workers have characteristically focused on procedural matters, often neglecting emotional dimensions of client need and care provision, as well as the role of patients in decision making. This paper examines these issues in the context of research conducted in a large medical centre in Israel Findings about the ways in which services were offered in 120 social work cases included worker and client perceptions of the types of psychosocial problems dealt with. These cases were categorised in 2 groups, one including patients under 65 and the other including patients aged 65 and over. Differences in the findings were analysed with reference to this age‐related case classification. Implications for the provision of care in the acute care setting are discussed.
Who Would You Choose? Appointing an Agent with a Medical Power of Attorney
Authors: Brown M.
Published: December 2008

Appointing an agent with a medical power of attorney in the event of future incompetency is a relatively new concept in Australia. This qualitative study explores some of the associated issues raised in focus groups and interviews with 62 well elderly people in South Australia. Findings reveal some confusion about current rights and responsibilities and concerns about selecting the most suitable person, the burden this would impose and the degree of trust implicit in such an arrangement. The majority favoured a written form of advance directive, with or without an agent. Clarification and further discussion are required to ensure that the wishes of individuals are respected when dying.
Risky Discharges: Are We Too Cautious?
Authors: Hanger H.C. , Sainsbury R.
Published: December 2008

Some elderly individuals choose to remain at home, despite considerable risks of injury or even death. We followed 19 patients who returned home despite all of the multidisciplinary team considering that they were extremely unsafe and at considerable risk. At six months, 10(53%) were still at home, 5(26%) were in rest homes, 1(5%) was in long stay hospital care and 3(16%) had died. The three patients who “failed to manage” at home, did so early (within one day), emphasising the importance of a “trial leave” period Patients who lived with a carer were more likely to remain at home than those who lived alone (p = 0.006), These findings suggest that very frail, “at risk”, elderly patients can often manage at home despite considerable dangers.
Use of Physical Restraints in South Australia's Nursing Homes
Authors: Retsas A.P.
Published: December 2008

A postal survey seeking information about the use of physical restraints was completed by 93 out of 130 Directors of Nursing (DONs) of nursing homes in South Australia. Of a total of 3419 nursing home residents, 28.4% (970) were physically restrained, of which 74.2% (720) were female and 25.8% (250) were male. The commonest forms of physical restraint were bedrails (34.4%) and vests (23.7%), The commonest patient‐oriented reason for using physical restraints was to “prevent falls” (84.9%) and the commonest nurse‐oriented reason was “because no alternative exists” (39.8%), The use of physical restraints did not appear to be influenced by nursing home size or staff numbers. The extent to which physical restraints are used is cause for concern. Further efforts, particularly through education programs which fully apprise all staff of the deleterious effects of physical restraints, and which also provide alternatives, are needed.
Literature in the Teaching of Gerontology
Authors: Gattuso S.
Published: December 2008

The educational experience of students in gerontology and related professional areas of education, such as gerontological social work, is enriched by exposure to creative works that deal with topics in ageing. Such works are a way of engaging students in an empathic understanding of ageing. Two recent Australian novels, Thea Astiey's Coda and Dorothy Hewett's The Toucher, are discussed in relation to the ways they confront stereotypical thinking about older women.
Demographic Decomposition of Household Arrangements Among the Ethnic Aged
Authors: Neupert R.F.
Published: December 2008

In Australia, as in other countries of immigration, relatively high proportions of the ethnic aged minority live with their adult sons and daughters and, consequently, low proportions live alone or in institutions. The usual interpretation is that these differences indicate cultural preferences for extended‐family lifestyles and greater family cohesion within ethnic minority groups. It has also been argued, however, that differences in living arrangements between groups may arise from differences in compositional features and not only from underlying propensities. The purpose of this paper is to decompose differences in household arrangements between the ethnic minority and the mainstream elderly populations in Australia. The demographic components or compositional factors analysed here are marital status, gender and age. The most important finding in this paper is that differences in marital status, gender and age composition between the mainstream and ethnic aged populations do not contribute to explaining the existing differences in household extendedness. Household arrangements among the ethnic elderly are essentially the result of propensities, that is, cultural, economic or social factors that predispose them to tend toward more complex living arrangements than the mainstream population.
Mainstream Service Providers can Deliver Culturally Appropriate Residential Care for Ethnic Diversity
Authors: Petrov L.
Published: December 2008

With the implementation of the multicultural model of care outlined in the paper, St George's Nursing Home and Hostel, Altona Meadows, Victoria (a facility of Anglican Homes for the Elderly) has successfully challenged the preconception our society has about the needs of the NESB aged and found that NESB communities and individuals will access a mainstream service that offers culturally appropriate care.
The Sociology of the Postmodern Self: Intimacy, Identity and Emotions in Adult Life
Authors: Riggs A. , Turne B.S.
Published: December 2008

This paper reports findings from a research project on intimacy and emotional satisfaction in the ageing process. The principal theoretical guidelines are taken from Anthony Giddens's recent work on the transformation of intimacy in modern society. The data from interviews do not in general support the notion that people experience ‘ontological insecurity’ in the life course with respect to significant changes in identity. In everyday life, there is little evidence of widespread self reflexivity, which in Giddens's recent theory is the hallmark of high modernity. There is generally an attitude of pragmatic accommodation to the vicissitudes of ordinary life events.
Australian Research on Ageing and Social Support
Authors: Kendig H. , Brooke L. , Kendig Hal
Published: December 2008

This paper draws on primary publications in Austalian gerontology to review knowledge on ageing and support While there is a well‐established literature on family care, social networks studies of the 1980s provided more comprehensive views of expressive and instrumental support across a range of relationships. Notwithstanding stereotypes to the contrary, older people contribute as well as receive support. A new generation of qualitive, interpretative shudies are reporting on the meanings and processes of social support as experienced by older people themselves. Policy‐related studies examine social support as a cornerstone for community services, and epidemiological investigations examine social influence on health and well‐being. The field could be advanced considerably by longiturdinal surveys and qualitative enquiris exploring the diversity of older people in a variety of social settings.
The Use of Nursing Homes and Hostels for Respite Care
Authors: Choi C.Y. , Liu Z.
Published: December 2008

Objective: To examine the use of respite care in nursing homes and hostels and the destinations of respite residents on completion of their respite stay.

Method: Administrative by‐product data on admissions and separations from nursing homes and hostels are analysed to show the length and pattern of stay of respite residents.

Results: The data show that utilisation rate of approved respite beds is relatively low: 69% for hostels in 1994–95 and 50% for nursing homes. This is in spite of government subsidies available for respite care. Many respite residents become permanent residents. Thirty percent of hostel residents in 1992–93 and 42% of nursing home residents in 1993–94 became permanent residents after their first respite admission.

Conclusion: The transfer from respite to permanency may be caused by changes in personal circumstances of respite residents and their carers after respite admission. But it may also indicate an inappropriate use of respite beds. The reasons behind the considerable proportion of residents moving to permanent care and the low level of use of respite beds are worth further study.
A Preliminary Survey of Patients Seen by the Kimberley Aged Care Assessment Team
Authors: Bruce David G. , Baird Maxine , Saddler A. Howard , Goldswain Peter
Published: December 2008

Objectives: To assess whether cognitive or physical impairments are common in indigenous Australians living in the Kimberley.

Methods: A retrospective review of the first 119 cases assessed by members of the Kimberley Aged Care Assessment Team.

Results: Chronic dementia (40%), at least moderate degrees of physical impairment (55%) and longstanding urinary incontinence (43%) were common in the Aboriginal patients in this series. The Aborigines were on average a decade younger than patients referred to a metropolitan geriatric service. Potentially preventable conditions accounted for impairments in many of these patients.

Conclusions: Cognitive and physical impairments are common in elderly aborigines. These problems are seen at an earlier age than in non‐indigenous Australians suggesting that risk factors for excess early mortality are also risk factors for chronic disabilities. Health programs aimed at prevention and support of these profoundly disabled people are required.
Thyroxine Replacement and Ischaemic Heart Disease in the Elderly
Authors: Trescoli‐Serrano Carlos , Tulloch James
Published: December 2008

Abstract. Elderly patients with coronary artery disease and hypothyroidism should be treated cautiously with thyroid hormone replacement to avoid precipitating or exacerbating angina pectoris, precipitating acute myocardial infarction, and precipitating or aggravating ventricular arrhythmias or congestive cardiac failure. However, despite this, 7% will develop angina at the time of starting thyroxine replacement therapy and nearly half of these will not respond to standard antianginal therapy. We present a case of thyroxine replacement induced angina and its management as well as a review of the medical literature concerning the potential therapeutic options in the management of unmasked ischaemic heart disease, hypothyroidism and thyroxine replacement therapy.
Rising IQ Scores: Implications for the Elderly
Authors: Flynn James R.
Published: December 2008

Data from twenty nations show not a single exception to massive IQ gains over time. The escalation of whatever skills are involved probably began no later than the onset of the industrial revolution. There are national differences, of course. However, over the last 60 years, the most interesting differences are in terms of the kind of IQ test.
The Role of Gerontological Associations in Korea
Authors: Choi Sung‐Jae
Published: December 2008

Abstract. It was in the late 1960s to the early 1970s, when ageing began to be recognised as a social problem, that gerontological studies began to attract attention in Korea, and a beginning was made in geriatrics at that time. Over the next quarter of a century, gerontological studies developed to become a multi‐disciplinary and applied science which involves a variety of disciplines, and is also making contributions to policy formulation in Korea. This paper has three purposes: it canvasses the emergence of social awareness of the problems of ageing in Korea, it reviews the historical development of gerontology associations and their roles and activities, and it considers issues that will shape the future development of the field.
Family Caregiving of Older People with Dementing Illnesses in Nursing Homes: a Lifeline of Special Care
Authors: Fleming A. Andrew
Published: December 2008

Objective: Explore the meaning of the care given by family caregivers to family members with a dementing illness after their placement in a nursing home.

Method: A constructivist approach, informed by symbolic interactionism, and using grounded theory methods, served as the theoretical and analytical underpinnings of this study. In all, 14 family caregivers (predominantly daughters caring for mothers) were interviewed.

Results: There is a dual meaning inherent in family caregiving activities in this context. It is perceived as a lifeline of special care for the family member in the nursing home, and is meaningful and constructive for the caregivers themselves.

Conclusion: Understanding this ‘;dual’ meaning of family caregiving activities is highly relevant for health care workers and others who interact with family members in the nursing home situation.
Discriminating Factors Between Hip and Other Fractures in Older Women
Authors: Zivanovic Ekaterina , Lord Stephen R. , Ward John A.
Published: December 2008

Objective: To elucidate discriminating factors between femoral neck and other fractures in older women.

Method: A case‐control study of 110 women aged 60 to 91 years.

Results: Both cases and controls had reduced bone density, with no significant difference evident between the groups. Hip fracture subjects were older, had lower BMI scores and were more likely to have fallen sideways or backward. The controls were more likely to be taking prednisone.

Conclusions: The prevention of hip fractures may depend on strategies such as excessive weight loss prevention, enhancement of strength and provision of local hip protection, in addition to strategies aimed at maintaining bone density.
Clinical Use of Preserved Learning Capacity in Dementia
Authors: Bird Michael
Published: December 2008

Abstract. Many health professionals continue to believe that people with dementia are incapable of new learning. There are conceptual and observational grounds for arguing that this belief is false, a view supported by experimental evidence summarised in this paper. Clinical cases are also presented showing that impaired but still extant learning can be used to ameliorate some behavioural problems. Patients were taught, using spaced retrieval and the method of fading cues, to associate a cue with more adaptive behavior. Uses and limitations of this clinical technique are discussed.