bluuebunny/crossref_metadata_2025 huggingface dataset:
“I JUST ACCEPT IT!” RESEARCH REMINISCENCES ON AGED INCOME SECURITY
Authors: Wiles D.
Published: December 2008

From its inception in 1909 the Australian Age Pension became well established as a social ‘right’ of citizenship over the following eight decades. Since 1988 and the Social Security Review, though, retirement incomes policy has become subject to political debate and policy turbulence. Ideally, abstract and applied policy should draw upon the lessons of history. So the perceptions of pensioner beneficiaries about the effects of pension provision on life chances are pertinent to present discussion. Such social policy story‐telling suggests that for working class seniors of the present cohort, memories of the Great Depression ameliorate any sense of present hardship, creating appreciation and acceptance of extant pension provisions. In view of the contemporary exhortations that individuals should now take full financial responsibility for their own retirement income security, the lesson that ordinary working folk cannot save an adequate retirement nest egg seems salient Furthermore, politicians' past behaviour of ‘super swindle’ seems likely to be repeated. The baby boom generation, having funded aged care in its day, can itself only anticipate a bleak future in terms of the retreat of the State from the provision of aged income security.
CONFLICT AND CAREGIVING: TESTING A SOCIAL‐PSYCHOLOGICAL MODEL
Authors: Rahman N.
Published: December 2008

Interpersonal conflict in the caring relationship and coping with conflict were explored in a survey of 151 informal caregivers of the elderly. Burden, maladaptive coping strategies and the functional limitation of the elderly person were found to be significant predictors of conflict. A two way relationship between conflict and maladaptive coping was indicated. Caregivers experiencing severe amounts of conflict dealt with the situation by using maladaptive coping strategies. Maladaptive coping strategies often lead to abusive behaviour which in turn aggravates the degree of conflict.
Prevalence of Psychiatric Disorders Among Inpatients of an Acute Geriatric Hospital
Authors: Ames D. , Flynn E. , Harrigan S.
Published: December 2008

In order to determine the approximate point‐prevalence of psychiatric disorder in an acute geriatric hospital, a cross‐sectional sample of 81 inpatients was approached for interview with the Geriatric Mental Status schedule (GMS). Psychiatric diagnoses were generated using the AGECAT computer program. Nine of the 81 patients could not be interviewed. Organic psychosis (dementia or delirium) affected 44% of 72 patients, 18% were cases of depression and there was one case each of schizophrenia and phobic disorder. A further 31% of patients had some psychiatric symptoms (usually anxiety), which were not of sufficient severity to warrant classification as cases of disorder. Sixty‐seven of the 72 interviewed patients had an abbreviated mental test score (AMTS) recorded in their notes, and these scores correctly predicted the presence of organic psychosis in 92% of these patients. Age, sex, AGECAT diagnosis and AMTS were not related to length of stay in hospital or discharge destination.
Differences between Elderly Persons Entering For‐Profit and Nonprofit Long‐Term‐Care Residences
Authors: Thomas T. , Over R.
Published: December 2008

Ninety‐eight elderly people (mean age 83 years) were assessed soon after admission to long‐term‐care residences in Melbourne. Those entering facilities (‘far‐profit’) operating in the private sector had overall been less involved in pre‐entry planning and preparation than the elderly people who entered residences (‘nonprofit’) operated by religious, charitable or local government organisations. The elderly admitted to far‐profit residences also were less active, they demonstrated higher levels of homesickness and they experienced greater stress associated with institutional living. These results are consistent with other evidence that far‐profit and nonprofit long‐term‐care residences have different clientele. Allowance needs to be made for these differences when assessing the extent to which long‐term outcomes such as life satisfaction, level of function, and survival are associated with the residential setting in which the elderly live.
Residential Aged Care Workers In Rural Settings: A Study Of Their Roles And Training Needs
Authors: Harris R. , Simons M. , Bone J.
Published: December 2008

The role of the rural care worker is being affected by a number of significant social changes. This paper focuses on the competencies required by these workers and the most appropriate way of providing training in these changing times. A competency profile was developed and verified with 80 rural and 58 city care workers in South Australia, and a training needs analysis was completed with the rural care workers. The results of this research indicate that a number of care workers do not have formal training in aged care. Further, while most workers have experienced difficulties in gaining access to training, they firmly believe that on‐going development is important for them in their role as carers. The study also identified a number of areas where training was considered to be a priority and obtained opinions from care workers on the best ways to provide this training. A number of implications and ideas for further research are explored.
The Family and Women in an Ageing Society: the Philippine Situation
Authors: Domingo L.J.
Published: December 2008

In the Philippines, ageing is a low priority issue for government. This increases the need for the elderly to rely on female family members for support. Children incur a debt of gratitude (utang na loob) to their parents which is expected to be fulfilled in old age. The patterns of support are explored in detail using evidence from 18 focus groups conducted by the author throughout the Philippines. Families in the Philippines are changing with women marrying later and having lower fertility. Coupled with increasing work opportunities, these changes create new challenges for family support for the aged.
Well‐being of Elderly Australians: the Role of Parent‐Adult Child Contacts
Authors: Ranzijn E. , Luszcz M.A.
Published: December 2008

It has been reported that the psychological well‐being of elderly people is influenced by their relationships with their adult children. In this study, data from the Australian Longitudinal Study of Ageing (ALSA) (N=2087, age range 65–103, M = 78.16 yrs) were analysed to assess the importance of parent‐adult child contact. Respondents were asked questions relating to the frequency of contact with their children and their satisfaction with that contact. Well‐being was measured by scales of depression and morale. For respondents with children, satisfaction with contact predicted both morale and depression once self‐assessed health and adequacy of income had been entered into the regression equation, while frequency of contact predicted morale but not depression. For those who lived alone, the same pattern was found but the effect of the predictors was greater. However, in both cases the extra variance accounted for by contact predictors was small. The impact of child contact and possible reasons for the small effect size were discussed.
The Queen Elizabeth Graphical Assessment System for Urinary Incontinence
Authors: Hargrove M. , Hiley B. , Hurley J. , Giles M.
Published: December 2008

Until now, no single recording system for urinary incontinence has found widespread acceptance. The Queen Elizabeth Graphical Assessment for Urinary Incontinence has been developed to display the pattern of voiding on an hourly basis over a four day period. Colour coding of the chart indicates clearly whether the patient is incontinent, continent or able to remain continent with the help of staff or carers. The system can be used in the initial assessment of urinary incontinence and also in monitoring progress in any subsequent treatment interventions. In established urinary incontinence in the nursing home setting, the chart has been used in the documentation for Resident Classification Instrument ratings. The format is simple to use and can be applied to hospital, residential care and home settings.
Dementia and Elder Abuse
Authors: Sadler P. , Kurrle S. , Cameron I.
Published: December 2008

Cognitive impairment, especially dementia, has been found to be a major risk factor for elder abuse. This paper reports a study of 54 cases of abuse and 100 non‐abused people with dementia seen by the Hornsby Rehabilitation & Aged Care Service in 1990–91. The aim of the study was to investigate the relationship between dementia and elder abuse considering the person with dementia as either the victim or abuser. The findings confirmed that when dementia was combined with factors such as psychiatric illness or substance abuse on the part of the carer, or pre‐existing family conflict (including domestic violence), there was a significant risk of abuse occurring. However, dementia did not place the sufferer at greater risk of physical and psychological abuse, even when there was disturbed behaviour such as aggression and paranoia. Carers appeared to be at particular risk of physical abuse and psychological abuse. When abuse did occur, extra services of some types were required to maintain the person with dementia in the community, although victims were not at greater risk of institutionalisation than non‐abused dementia sufferers.
Resolving Elder Abuse: Issues Arising from a Perpetrator Program
Authors: Kingsley B. , Johnson S.
Published: December 2008

The majority of programs to address elder abuse centre on the plight of the victim. In contrast, the Elder Abuse Perpetrator Program deals directly with the abuser. Based on the principle of confrontation and utilising cognitive‐behavioural techniques, the program applies to those cases which have not been resolved through supportive educative measures or by abuser self‐resolution. This paper briefly outlines the program and describes some of the valuable lessons learned since its introduction. It also offers suggestions to agencies and practitioners who may wish to implement such a program.
“That Triggers Me Right Off”: Factors Influencing Abuse and Violence in Older People's Care‐giving Relationships
Authors: Hughesy M.
Published: December 2008

While the role of family members and spouses as informal care‐givers of older people is increasingly valued in Australia, few studies have investigated the impact of pre‐care‐giving abuse or violence on these relationships. This paper presents results of semi‐structured interviews conducted with 43 primary care‐givers in 47 care‐giving relationships. Two risk factors for abuse and violence in older people's care‐giving relationships were examined: the mental health status of the care‐receiver and the pre‐care‐giving history of abuse or violence. Care‐receivers with mental health problems (including dementia) appeared no more likely than others to have initiated abuse or violence, although their care‐givers were more likely to have directed violence towards them. A series of associations indicated that pre‐care‐giving experiences of abuse and violence were key risk factors for similar experiences during care‐giving. This was even the case in those relationships involving a care‐receiver with mental health problems. Implications for research, social policy and service delivery are considered.
Violence and Staffing on a Psychogeriatric Ward
Authors: Shah A.
Published: December 2008

A study of the relationship between violent behaviour and nursing staffing levels on a psychogeriatric ward is described. An association between violent behaviour and nursing staffing levels, over a 24 month period, was not demonstrated. These findings cast doubt on previous studies which used similar methodology to demonstrate associations between violence and staffing levels. Further prospective studies using well validated and reliable instruments to measure violence are required, particularly because the present climate of cost‐efficiency and cut‐backs induces pressure to reduce staffing levels.
Interdependence and the Aged Stereotype
Authors: White A.M. , Groves M.A.
Published: December 2008

If being dependent is a stigmatised state in western society, then older members of the society will attempt to define their situation as independent However, most people act out their daily lives involved in social networks in which they exchange money, goods, services, emotional support, etc., with kin, friends, neighbours, etc. From the qualitative analysis of 78 interviews with older persons living independently in the community, the concept ‘independence’ was found to include interdependence. When asked to define and describe their independence, participants illustrated how they were not dependent and they were not powerless. The key concepts in the maintenance of their independent lifestyle are control, mediation and reciprocation of assistance. It is concluded that the assessment of independence, and the development of programs aimed at promoting independence, should be expanded to include participation within unique interdependent networks.
The Health, Psychological and Social Consequences of Caring for a Person with Dementia
Authors: Lorensini S. , Bates G.W.
Published: December 2008

Most elderly persons with dementia (EDPs) are cared for at home, usually by their spouse or child. The present study examined the health, psychological, and social consequences of caregiving for an EDP and the impact of having the EDP attend a day care centre. Data were obtained from subjects comprising three groups: (a) caregivers with an EDP attending a day care centre (n = 45); (b) caregivers undertaking full‐time care (n = 40); and (c) a comparison group of non‐caregivers (n = 47), Overall, results indicate that caregivers suffer more negative consequences when compared with non‐caregivers, and caregivers undertaking full‐time care suffer more negative consequences than those with their EDP attending a day care centre. Negative consequences were related to symptoms, life satisfaction and social interaction, but not physical health. The study also established that access to day care reduced the negative consequences of caregiving.
What Does Community Care Research Tell Us About Community Care in Australia?
Authors: Howe A.
Published: December 2008

A critical appraisal of 21 studies of community care conducted in Australia between 1990 and 1995 provides the basis for assessing the account of community care that is presented in recent research. Several aspects of the policy and program context in which the Home and Community Care (HACC) Program operates give rise to great diversity in community care, and the design and methods of community care research are also diverse. Review of the coverage of the HACC client population in research, the range of services studied and outcomes investigated shows however, that findings fall short of giving a representative account of community care. The focus on outcomes relating to admission to residential care is especially seen to prescribe too narrow a view of the range of outcomes achieved by communnity care. The need to recognise a wider range of outcomes is identified as findamental to strengthening the contribution that research can make to the development of community care in Australia and in other countries.
Dementia Care Staff and Family Carers: Their Relationships in the Context of Care
Authors: Setterlund Deborah S.
Published: December 2008

Objectives: This research examines relationships between care staff specifically employed to care for residents with dementia and family carers.

Method: The study employed a qualitative approach involving multiple methods of data collection (in‐depth interviews, participant observation, assessment of the physical and mental function of residents). A non‐random sample consisting of fifteen care staff from seven residential care settings was used.

Results: Care staff perceive that family carers are generally grateful and undemanding and that a significant number lack sufficient involvement in residents' care. Policy and organisational factors may produce positive understanding between care staff and family carers, while at a less visible level, may prevent both groups from voicing more difficult concerns related to care.

Conclusions: Policy and organisational change is needed to enable staff and family carers to voice the tensions inherent in their relationship. Funding arrangements for residential care need to include time for staff to develop relationships with family carers.
Regulation and Quality in Aged Care: a Cross‐National Perspective
Authors: Braithwaite John
Published: December 2008

Abstract. The objective of this article is to assess critically the regulatory foundations required for continuous improvement in the quality of nursing home care. Data from observation of nursing home inspections in Australia and other nations (particularly the US) are used to illuminate this assessment. Conclusions are:

The quality of regulatory dialogue affects care outcomes: disrespectful dialogue and tolerance of law‐breaking make things worse.

Trustful dialogue, praise, reintegrative shaming and building the self‐efficacy of managers improves compliance.

A useful policy framework is a regulatory pyramid that tries dialogue first and then escalates to more sanction‐based strategies when dialogue fails.

Attempts to pursue consistency in regulatory decisions by rendering rules more specific and disciplining them with scientific protocols is counterproductive because of the operation of a ‘;reliability paradox’.
Advances in Longitudinal Research Methodology
Authors: Schaie K. Warner
Published: December 2008

Abstract. Issues in longitudinal research in geropsychology are identified. Advances in longitudinal research methodology are illustrated by summarising three symposium contributions. Tjörborn Svensson discussed whether biographical retrospective data can be conceptualised as a longitudinal inquiry, and what the kind of design would be that one would want to apply given a positive answer to the question. Scott Hofer treated the topic of subject attrition in longitudinal studies within the more general framework of contemporary missing data analysis. Christoph Rott addressed the issue of variability within and across individuals. Using the example of the Bonn Longitudinal Study (BOLSA), he showed how model misspecifications can circumvent limitations of the designs using an age‐cohort‐period model. He also incorporated adjustments for attrition and substitution of an event definition for calendar time.
Age and Employment
Authors: Walker Alan
Published: December 2008

Abstract. This thematic plenary paper reviews the changing relationship between age and employment. The important role of the labour market in defining the onset of ‘;old age’ in both developed and underdeveloped societies is emphasised at the start and taken for granted in the subsequent analysis. The first and main section of the paper examines the changing relationship between age and employment and three distinct phases are identified in the post‐second world war period. The decline in the age of exit from gainful employment is of great importance in all advanced industrial societies. The second section of the paper focuses on the role of employers in determining the inclusion and exclusion of ageing workers ‐ an issue that has only recently begun to interest researchers in social gerontology. Age discrimination is high on this new research agenda. Brief reference is made to two recent research projects, in Europe and Canada, which have undertaken case studies of employer practices. Despite the development of greater age awareness on the part of employers, the continuation of disadvantage among older workers is emphasised and the ‘;gendered ageism’ experienced by older women is also highlighted. The final key section of the paper argues for a deconstruction of age at the workplace ‐ the replacement of remedial action to combat age barriers with a preventive strategy aimed at avoiding their occurrence.
Hip Protectors: Results of a User Survey
Authors: Birks Carol , Lockwood Keri , Cameron Ian , Kurrle Susan , Burnside Wendy , Easter Sandra , Venman Jennifer , Cumming Robert , Quine Susan , Salkeld Glenn , Finnegan Terence
Published: December 2008

Introduction: Hip fracture has the greatest personal and economic impact of all fall‐related injuries in the elderly population. External hip protectors have been developed and have been effective in reducing the incidence of hip fracture in one study. Their level of effectiveness, however, is influenced significantly by whether people will wear them.

Objectives: To ascertain, from the users of hip protectors, their experiences with the garments and their attitudes towards them.

Method: A postal self‐report questionnaire was sent to all purchasers (n=82) of hip protectors from the Hip Protector Project Office at Hornsby Ku‐ ring‐gai Hospital from June 1996 to March 1997.

Results: The response rate was 55%. The majority (71%) of users wore the hip protectors at all times during the day. Eleven per cent of all users had fallen while wearing the protectors. Most responders found hip protectors comfortable and acceptable to wear and believed that they were effective. Problems identified included difficulty in wearing the garment if suffering from incontinence or from a weakness in the upper limbs. The cost of the hip protectors was also identified as an important issue.

Conclusions: A positive attitude overall towards the garment was demonstrated. However, more formal user testing needs to be conducted in order to clarify recommendations for people with incontinence, and for those who have difficulty pulling the garment down for toileting.
Ageing in Hong Kong
Authors: Chi Iris , Chui Ernest
Published: December 2008

Abstract. Hong Kong has experienced a steady and significant growth in its elderly population. Being essentially a Chinese community, the traditional virtue of filial piety has been upheld and the family is expected to be the prime source of care for its members. However, there has been a gradual increase in the number of nuclear families and a gradual dwindling of the positive image of the elderly person, which threatens the basis for community care for the elderly. About half of the elderly population are living in government rental housing and are receiving public primary medical care. Community support services are not in‐home support in nature and are of low levels of care. The professional and social organisations unanimously urge the government to take a more proactive stance in providing services to the elderly and encourage the community to revitalise its traditional Chinese cultural heritage in caring for the elderly.
Australian Innovations in Home‐based Care: a Comparison of Community Aged Care Packages, Community Options Projects and Hostel Care
Authors: Gibson Diane , Mathur Sushma
Published: December 2008

Objective: To compare Australian client dependency levels in Community Aged Care Packages, Community Options projects and hostels, and to explore the interplay between client dependency, carer availability and levels of service use in community care services.

Method: The data analysed were derived from the first national Community Aged Care Packages Survey conducted by the then Department of Health and Family Services in 1996.

Results: Community Aged Care Package clients in Australia were found to be less dependent than both Community Options clients and hostel residents. For both sets of community care clients, service use increased with dependency levels. The presence of co‐resident carers was associated with lower levels of service use for given levels of dependency.

Conclusions: Community Aged Care Packages, while intended to provide an alternative to admission to a hostel at the personal care level, were found to be serving a somewhat less dependent sector of the frail and disabled aged population. Most recipients had an informal carer in addition to being in receipt of formal services. The evidence suggests that, among the clients of both Community Options and Community Aged Care Packages, available resources were targeted on those in greater need.
Client Outcomes in Case Managed Care: Who Benefits Most?
Authors: Wells Yvonne , Swerissen Hal , Kendig Hal
Published: December 2008

Objective: To determine how well outcomes could be predicted by initial circumstances and subsequent deterioration in clients and carers.

Method: Longitudinal data from the Victorian Linkages projects, collected in 1992 and 1994, were examined.

Results: Institutionalisation was highly likely in cases where carers experienced reduced motivation to care. Placement in nursing homes rather than in hostels was best predicted by incontinence. Death was associated with changes in health status. Those clients most successful in avoiding long‐term institutional care were in stable situations with a spouse carer.

Conclusion: The study provides supportive evidence of the capacity of intensive community services to provide alternatives to entry to residential care.
Cognitive Screening of Older Hospital Patients: a Quality Assurance Study
Authors: Katz Benny , Helme Robert D.
Published: December 2008

Objective: To evaluate the impact of two educational techniques on the rate of cognitive screening of patients referred to a hospital aged care service.

Method: Audit of documentation of cognitive status in the medical record of patients aged 65 years or older referred for aged care consultation in an acute teaching hospital following two interventions: a general education program, and a general education program complemented with a pocket‐sized laminated Abbreviated Mental Test card.

Results: Cognitive impairment, defined as Abbreviated Mental Test (AMT) score of 7 or less was present in 49.9% of patients referred for geriatric consultation over a four year period. Documentation of cognitive state by the referring unit, within forty‐eight hours of admission, using a recognised mental status screening instrument was initially 9.4%. Following an education program, documentation of cognitive screening increased to 18.1%, with a further improvement to 28.2% occurring when the education program was supported with a memory aid, a laminated pocket‐sized AMT card. In the following year when the card was provided without an education program, the rate of cognitive screening fell to 13.4%. (p<.0001). The average frequency of a written description of cognition was 50.2% over the four years, and did not increase with the educational programs.

Conclusions: Cognitive screening is infrequently performed on older hospital inpatients referred for geriatric consultation, despite a high prevalence of cognitive impairment in this patient group. The rate of cognitive screening can be influenced by the use of an educational program, and further improved with a memory aid. A memory aid without an educational program is less effective.
Adverse Drug Reactions Mimicking Disease
Authors: Callaghan J.D. , Katz B.
Published: December 2008

Abstract. Advancing age is associated with an increased prevalence of illness, often resulting in the requirement for multiple medications, placing the older person at increased risk of adverse drug reactions (ADRs). Rather than simply attributing new signs and symptoms to progression of an old disease or the development of a new illness, the possibility that they are consequences of existing drug therapy should be considered. We present a case where symptoms associated with ADRs mimicked age‐related diseases. Nursing home admission was avoided through recognition of the problem, and withdrawal of the offending medications.
The Coming Crisis of Australian Aged Care: Fact or Fiction?
Authors: Gibson Diane , Goss John
Published: December 2008

Abstract. The last decade has seen a proliferation of concern that the ageing of the population will lead to a crisis in levels of public expenditure for health and aged care. This paper employs conceptual, technical and methodological arguments to examine the debates in this area in Australia, and concludes that an ageing population has not created insuperable difficulties for public or private expenditure in the last fifteen years, nor is it likely to create significant problems in the future.
South Australia's Ageing Population and its Increasingly Multicultural Nature
Authors: Hugo Graeme
Published: December 2008

Introduction: In South Australia there has been a massive change in the background of the older population.

Objective: The paper analyses recent changes in the growth and distribution of the ethnic aged population in South Australia.

Method: The paper utilises the results of the 1996 Australian Census of Population and Housing.

Results:Whereas in 1971, 19.7 percent of the State's population aged 65 years and over were overseas‐born, this applied to 34 percent in 1996. Moreover, this share will continue to increase over the next decade. The proportion who were born in non‐English‐speaking countries has increased from 5.1 to 22.1 percent. Each of the major birthplace groups among the ethnic aged has a distinctive spatial distribution.

Conclusion: This presents a major challenge to policy makers and service providers since the overseas‐born groups have some characteristics which mean that their needs for services are somewhat different to those of the Anglo‐Celtic majority.
Using the Internet to Build Bridges to Isolated Older People
Authors: Swindell Rick
Published: December 2008

Objective: To evaluate isolated older persons' perceptions of cognitively challenging courses delivered through the Internet.

Method: Characteristics, aspirations and perceptions of the impact of the courses were obtained from 29 of 34 participants who completed pre‐and post‐course written surveys and telephone interviews.

Results: Nearly three‐quarters of the participants were women and most of these were aged over 65. Few were experienced Internet users. More than half lived in large cities but regarded themselves as isolated by circumstances such as poor health or care‐giving. Most wanted to continue using the Internet for personal development and to communicate with others.

Conclusions: The Internet may be able to enrich the lives of isolated older adults.
Information and Communication Practices: the Joint Concerns of Age and Gender in the Information Age
Authors: Barnett Karen R. , Buys Laurie R. , Adkins Barbara A.
Published: December 2008

Objectives: To explore the extent to which gender differences appear in the choices of information and communication sources used by older men and women.

Method: Data were analysed from a survey utilising questions related to older people's use of a variety of traditional and computer‐based information and communication categories.

Results: Older adults are making use of a wide variety of traditional and computer‐based communication technologies. Involvement with traditional categories, such as books, newspapers, television, radio and the telephone continue. When older men and women have access to the new computer mediated activities, they make equal use of them, however men appear to be more likely to own a computer.

Conclusion: In view of the late life health and social scenarios for older women, the implications of gendered life experience should be considered when encouraging older adults' involvement with computers and the Internet.
Footwear and Hip Fracture‐related Fails in Older People
Authors: Hourihan Fleur , Cumming Robert G. , Taverner‐Smith Karen M. , Davidson Ian
Published: December 2008

Objective: To describe features of footwear worn at the time of hip fracture‐related falls.

Method: Subjects were 107 persons (mean age 77 years) admitted with a hip fracture‐related fall to a hospital in the Illawarra region of New South Wales, Australia, between February 1995 and February 1996. All subjects resided in private homes or hostels at the time of their fall. An interviewer‐administered questionnaire was used to collect data from participants on foot problems, falls history, and age and use of footwear worn at the time of hip fracture. A standardised approach was used to physically examine features of footwear worn at the time of fracture.

Results: Most subjects wore slippers (33 %} or were not wearing any footwear (24%) when they fell and fractured their hip. Among the 79 subjects in footwear, most (70%) fell in footwear they wore every day and 43% of their footwear was less then six moths old. Participants chose to wear their footwear for comfort, not safety.

Conclusion: Enthusiasm for developing a ‘;safe shoe’ should be tempered somewhat by the fact that many people who suffer a hip fracture are not wearing shoes at the time they fall.
Rent Assistance Policy for Residents of Retirement Villages
Authors: Eardley Tony
Published: December 2008

Objectives: To assess whether policies on rent assistance for retirement village residents are targeting help towards those who need it, and to provide an information base for future policy decisions on eligibility for assistance.

Method: A telephone survey of managers of a national sample of 52 retirement villages and a postal survey of residents in 49 of these villages. Results: The findings did not support the policy rationale that higher entry contributions were correlated with lower ongoing charges. Just over 40 per cent of residents of self‐care housing and two‐thirds of those in serviced apartments had paid entry contributions low enough for eligibility for rent assistance with their ongoing housing charges. Many of these were not, however, receiving assistance, mainly because their charges were below the minimum rent threshold. The distribution of reported levels of non‐housing assets tended overall to match the varying levels of entry contributions, but half of those paying relatively high entry contributions still had low levels of both assets and income.

Conclusions: It appears that targeting remains reasonably accurate for the majority of residents, but there is a potential boundary problem created by the eligibility and minimum rent thresholds. Thus a minority of residents may be disadvantaged compared with others in similar financial circumstances.
Care and Support Assistance Provided in Retirement Villages: Expectations vs Reality
Authors: Buys Laurie R.
Published: December 2008

Objective: To investigate reasons older people move to a retirement village that does not offer on‐site care and support services.

Method: 323 participants living in independent living units were interviewed.

Results: Almost all participants cited care and support as one reason for moving to the retirement village.

Conclusion: Provisions for in‐home care and support services to assist older residents with on‐going independent living should be addressed by retirement village management.
Age Discrimination in Hiring Practices Against Older Adults in Western Australia: the Case of Accounting Assistants
Authors: Gringart Eyal , Helmes Edward
Published: December 2008

Objectives: To investigate the willingness of employers to hire older adults. Method: Measures of actual age discrimination were obtained through the use of correspondence testing. Unsolicited fictitious resumes were simultaneously mailed to 452 companies across industries in Western Australia. Resumes were similar in all job relevant information except the applicant's age that was either 32 or 57 and gender. Measures of discrimination were obtained through comparisons of the time for receipt, and the number of positive and negative responses across age and gender.

Results: Responses for 202 resumes were received from 154 companies. A significant three‐way interaction between age, gender, and mailing condition was found for time for receipt of negative responses. The interaction showed that both younger males and older females were significantly faster to receive negative responses compared with either older males or younger females. Overall, younger applicants received a greater number of positive and a smaller number of negative responses compared with the older applicants.

Conclusions: The current study found evidence of actual age discrimination in hiring practices against older adults in Western Australia, with older women the most discriminated against. These trends of discrimination were different and of lower magnitude to those found in the US. Correspondence testing with unsolicited applications was shown to be a valid and sensitive tool for measuring actual discrimination in Western Australia.
Management of Age Related Hearing Loss
Authors: Welsh Jan F. , Purdy Suzanne C.
Published: December 2008

Abstract. This paper presents some current issues relating to the management of age‐related hearing loss to reduce the effects of auditory deprivation and maximise the potential for acclimatisation during the hearing rehabilitation process. Early intervention in age‐related hearing loss affords the best chance for successful aural rehabilitation, promotes healthy communication and may reduce the effects of other serious health issues for older people. In both Australia and New Zealand the older person may be eligible for subsidised hearing aids under the Governments' Hearing Services Programmes. However, hearing aids are just the beginning of a hearing rehabilitation programme. Best practice audiological management depends on a combination of strategies.
Research with older people: Comparison of a General Practice and Electoral Roll Sample with the Australian National Health Survey
Authors: Kerse Ngaire , Osborne Deborah , Browning Colette , Flicker Leon , Young Doris
Published: December 2008

Objectives. To establish the utility of general practice and electoral roll sampling frames in research involving older age groups.

Methods. Demographic characteristics, medication use, self‐rated health and walking behaviour of research based samples derived from general practice patients, and members of the electoral roll, were compared with participants in the National Health Survey (NHS) residing in Melbourne, Victoria, Australia.

Participants. The GP sample comprised 267 older patients, (64% patient participation rate), randomly selected from 42 general practices, (52% GP participation rate). The electoral roll sample comprised 1000 older people sampled from electoral roll data (70% participation rate). These two samples were compared with data on those over age 6Syears from the 1995 NHS sample, a multi‐stage area sample (93.5% completion rate).

Results. The distribution of demographic characteristics in the GP group was similar to that of the NHS group whereas the sample based on the electoral roll contained more men. The GP sample rated their health in the middle of the range and the electoral roll sample rated their health more positively compared with the NHS group. Medication use differed in both groups compared with the NHS sample. Conclusion. Health related characteristics of both the general practice and the electoral roll samples differed from the “gold standard” NHS sample. Interpretation of research findings from similar samples would benefit from consideration of potential effects of selection and response bias. General practice sampling frames may provide a useful alternative for population based research.
Advance Care Planning: Should we be Discussing it with our Patients?
Authors: Mador Julie
Published: December 2008

Introduction: Advance care planning (ACP) is a term used for a variety of legal and informal options available to ensure that our wishes will be respected in the future, should we lose competence in decision making.

Objectives: This research aimed to establish whether older people being treated at a regional rehabilitation service were aware of ACP options and whether discussion with a physician supplemented with written information increased their uptake of ACP options. Method: Forty people aged over 60 years and participating in inpatient or outpatient rehabilitation programs in Lismore, New South Wales (NSW) were interviewed and provided with verbal and written information about ACP options. They were then interviewed by telephone one month later to determine whether they had taken further action concerning ACP. Results: Overall 30 (78%) demonstrated a good level of knowledge of enduring power of attorney at baseline interview. Only 1 (2.5%) knew about enduring guardianship and 1 (2.5%) knew about advance directives. All those interviewed felt that ACP was an important issue, grading its' importance as 6 or greater on a 10 point scale. Thirty four (85%) patients were successfully followed up one month later. Of these 27 (77%) had taken further action in relation to their ACP‐ 13 (33%) had had discussions with family and important others and 14 (35%) had completed further documentation (10 enduring power of attorney, 3 enduring guardianship and 1 an advance directive).

Conclusions: ACP is considered an important issue by older people undergoing rehabilitation. A short discussion with a physician along with written information increases the uptake of ACP. However the options of advance directives and enduring guardian are not readily taken up, with most people in this study preferring informal discussions with family and friends when considering advance care planning.
The Oldest Patient with Bronchial Asthma
Authors: Kurishima Koichi , Satoh Hiroaki , Yamashita Yuko T. , Ohtsuka Morio , Sekizawa Kiyohisa
Published: December 2008

Abstract: Asthma is not uncommon in old age and carries significant morbidity and mortality. This case report purports to describe the oldest asthma patient ever reported, a 96‐year old male with a 46‐year asthma history. We emphasize not only his age, but also the fact that he continues to have significant reversibility, at least he did at age more than 90‐year old.
The caring computer: The role of information & telecommunications technologies in aged care
Authors: Wilson Laurie
Published: December 2008

The challenges to the health system posed by increasing health costs and ageing populations are well documented. An inevitable consequence seems likely to be a substantial increase in services provided directly to individuals in their homes, rather than through institutions such as hospitals, nursing homes and the like. Information and telecommunications technologies are already playing a rapidly increasing role in health care through the introduction of telemedicine techniques and electronic health records. Australia is already a significant player in both of these areas, through, for example, the use of telemedicine in rural areas and the Federal Government's recently‐announced HealthConnect Initiative. The impact on health consumers has so far been minimal, particularly in aged care. However, some “smart” systems are already finding their way into aged care, a recently‐introduced fall detector [1] being a prime example.
Working in later life
Authors: Encel Emeritus Prof Sol
Published: December 2008

The issue of work in later life has assumed increasing salience as the population (and consequently the work force) continues to age. Within 10 years, the average age of the work force will be over 40, and employers will have to face up to the fact that the pool of young school leavers is steadily shrinking.
A health surveillance program for the community dwelling elderly
Authors: Greenway‐Crombie Angela M. , Conners Ann‐Maree , Snell Anthony P. , Jamieson Robert D.
Published: December 2008

Objectives: The objective of the study was to develop and evaluate a health surveillance program for the community‐dwelling elderly.

Method: Participants were community‐dwelling people, aged between 70 and 75 years, registered with a local general practice. A health surveillance screening instrument (HSSI) was developed and trialed. The nurse project worker administered the HSSI and sent a health summary to the participant and to their general practitioner.

Results: Seventy one participants were assessed and twenty five participants (35.2%) were referred for further evaluation by their doctor. The majority of referrals were for hearing impairment (28%), home maintenance (16%) and podiatry (16%). Validation studies were supportive.

Conclusion: A large number of potential health problems requiring referral were detected in the study population.
Cessation of driving in later life may not result in dependence
Authors: Buys Laurie R. , Carpenter Lorelei
Published: December 2008

Introduction: The relationship between driving and independence appears to strengthen as we age, so that retaining our licence is vital. The purpose of this paper is to investigate whether dependency necessarily follows the cessation of driving or whether it could represent a later life rite of passage.

Method: The respondents were 26 individuals over the age of 70 years living in the Brisbane area. Half of the participants were current drivers with the remainder having surrendered their licence within two years. Semi‐structured, qualitative, telephone interviews were used to gather data. Results and Discussion: Older drivers expressed that the cessation of driving would result in the loss of their independence. However, the stories of ex‐drivers directly challenged this strongly held belief and raised the possibility that the struggle of relinquishing a drivers licence may represent another of life's rites of passage that does not necessarily lead to a loss of independence.
The mismanagement of the assets of older people: the concerns and actions of aged care practitioners in Queensland
Authors: Tilse Cheryl , Wilson Jill , Setterlund Deborah
Published: December 2008

Objective: To explore the types of financial abuse coming to their attention of aged care workers, the practice responses and the barriers to effective responses.

Method: A mailed survey of 159 ACAT members, allied health professionals and other aged care workers across metropolitan, regional and remote Queensland.

Results: Financial abuse is coming to the attention of a broad range of aged care workers. It takes a variety of forms with a consistent pattern reported across urbanlregionallrural locations and differing ethnic groups. Although a range of resources exists, one third of respondents reported limitations in their capacity to intervene appropriately.

Conclusions: This complex area requires a greater understanding of the dimensions of financial abuse, further evaluation of the effectiveness of current mechanisms, professional and community education and additional support for workers seeking to intervene.
Older patients request more information: a survey of use of written patient education materials in general practice
Authors: McKenna Kryss T. , Tooth Leigh R. , King David B. , Clark Michele J. , O'Rourke Peter K. , Steinberg Margaret A. , de Looze Ferdinandus J.
Published: December 2008

Objectives: To determine GPs' reported use of written education materials with older patients and older patients' reported receipt of these materials. To determine GPs' and older patients' perceptions of written materials.

Method: Using self‐report questionnaires, two populations were surveyed; a randomised sample of SO GPs (29 males and 21 females) practising in Brisbane's southern suburbs and a convenience sample of 188 older community‐dwelling people (aged over 64 years).

Results: All GPs reported using written materials with patients, although 28% had not given any to the last 10 patients. This increased to 46% when patients were older. Twenty percent of patients wanted more written information from their GP, while some GPs believed that older patients preferred verbal information and gave out written information only when they perceived patient interest. All GPs reported giving written materials at the time of consultation and over two‐thirds discussed the content with patients. Just over 50% of patients reported receiving written information from GPs in the last six months and only half of these again discussed it directly with their GP. Overall, patients were more positive than GPs about the value of written education materials.

Conclusions: Older patients' desire for written information may be better met if they are more assertive in requesting this of GPs and GPs may better serve their patients' needs if they make written information more readily available to them. Better access to materials and more financial incentives to give them out might also increase GPs' use of written materials.