bluuebunny/crossref_metadata_2025 huggingface dataset:
Women, Ageing and the Family in Korea
Authors: Suh Mee Kyung
Published: December 2008

It is expected that in another 30 years, people aged 60 years and over will account for one out of five Koreans. This change will increase the burden on women, the dominant caregivers. In 1990, among people 60 years and over, 3 per cent of men compared with 13 per cent of women lived alone. In rural areas 17 per cent of elderly women lived alone. While sons and daughters are both responsible for care of elderly family members, daughters‐in‐law usually carry out the duties of sons. Population ageing in Korea poses a grave challenge to the task of improving the status of women
Elderly Women in Thailand: Their Role, Status and Family Supports
Authors: Chayovan N.
Published: December 2008

The Thai population aged 60 and over is expected to increase by 296 per cent, and 75 and over, by 321 per cent between the years 1980 and 2020. Rapid ageing will pose urgent challenges to the system of family (care of older people) and it will have particularly severe impacts on women. Fertility reductions have already led to declining family size. There are greater concerns that socio‐economic changes will undermine the existing family support system. This issue is discussed in detail Continued monitoring of family support resources for the elderly is recommended.
Caregiving For Ageing Parents: an Exploratory Study of Attitudes and Opinions
Authors: Hohaus L. , Caird D.
Published: December 2008

The purpose of this study was to elicit attitudes and opinions about caregiving to elderly parents. Three focus groups were conducted. Each group consisted of 6 or 7 middle‐aged adults. The discussions were recorded and content analysed. Several major themes emerged in each group, with considerable conceptual overlap in themes across groups. All groups showed an understanding of potential difficulties in providing care. Lack of information about services available, the impact on the family providing accommodation and care, and the need to maintain independence were common themes. Daughters were perceived as more appropriate caregivers than sons. This preliminary information will be useful in the development of measures of attitudes to caregiving of elderly parents.
Caring for Family Caregivers of Dependent Ageing Persons: Process and Outcome Evaluation
Authors: Schultz C.L. , Schultz N.C. , Smymios K.X.
Published: December 2008

Two research issues are examined with a view to establishing the viability of a model for disseminating support for family caregivers of dependent elderly persons through psychoeducation in small group settings. Continuing program effectiveness through multiple leadership is described. Secondly, the improved psychological well‐being of 432 caregiver participants is demonstrated in terms of their altered affect balance and levels of state anxiety. The relevance of the model to community‐based age care is discussed. A coordinated and collaborative approach to research and practice is advocated.
The Effects of Functional Health Status on the Everyday Life of Older People in Japan
Authors: Koyano W. , Okamura K. , Ando T. , Hasegawa M. , Asakawa T.
Published: December 2008

The effects of functional health status on socio‐psychological aspects of everyday life were analysed with data from 2,255 Japanese persons aged 55 years and over. The sample was randomly selected from the residents' registration (response rate was 75.2%). The socio‐psychological variables were self‐rated health, working status, frequency of going out, leisure activities, social networks, social supports, and subjective well‐being. Health status had significant and positive effects on these variables when the effects of age, gender and educational attainment were controlled. The results seem to confirm the notion that health status is the pivotal condition of quality of life in old age and ageing.
Aged Care Assessment Teams in Australia: a General Practice Perspective
Authors: Hebblewhite J. , Finucane P.
Published: December 2008

To explore the interaction between general practitioners (GPs) and Aged Care Assessment Teams (ACATs) from the GP's perspective, structured telephone interviews were held with the GPs of 77 people consecutively admitted to nursing homes in the Hunter region of New South Wales. Overall, GPs expressed satisfaction with the assessment process. However, on 37 (48%) occasions, GPs claimed not to have been asked for information prior to assessment, on 36 (47%) occasions no feedback was received, and on 58 (75%) occasions, GPs claimed they were not informed of their patient's admission to a nursing home. Some solutions to these perceived deficiencies were offered by the GPs interviewed. These indicate practical ways in which cooperation between GPs and ACATs can be enhanced.
The Scale of Conflict: A Psychometric Instrument for Measuring Interpersonal Conflict in Caregivers
Authors: Rahman N.
Published: December 2008

The Scale of Conflict is a psychometric instrument that identifies and measures the degree of interpersonal conflict in elder‐caregiver relationships. The scale was tested on 283 informal caregivers in Canberra and Sydney. Factor analysis identified 12 items that measure conflict. The 12 items had excellent internal reliability with a reliability coefficient alpha of 0.92. Although this study does not report formal testing of validity, the high internal reliability of items indicates that it may be a useful instrument for research purposes and for screening family caregivers of community‐based elderly people.
Retest Reliability of Centre of Pressure Measures of Standing Balance in Healthy Older Women
Authors: Hill K.D. , Carroll S.G. , Kalogeropoulos A. , Schwarz J.A.
Published: December 2008

Centre of pressure (COP) measurements have been frequently used in the evaluation of postural control, especially in the elderly. Despite this, the retest reliability of these measures has not been well investigated in this age group. This study investigated the retest reliability of COP measures using a force platform in 17 women with a mean age of 69.5 years. Results indicated low correlations between test occasions for static stance postures with Intra class Correlation Coefficients (ICCs) ranging between 0.27 and 0.55. In contrast, ICCs were high (between 0.81 and 0.92) for test conditions involving angular perturbation of the support surface. Investigation of test durations of 10 and 25 second length did not indicate any significant difference between these two test durations (p>0.05). The study also revealed no series effects using twelve consecutive 25 second tests on the force platform. These results support further investigation of dynamic standing balance in older women using the test protocol described in this study, including whether these tests are able to discriminate between fallers and non fallen, and their predictive validity.
Communicative Needs and Bilingualism in Elderly Australians of Six Ethnic Backgrounds
Authors: Baker R.
Published: December 2008

The communicative needs and bilingual language use of elderly members of six ethnic communities in Brisbane were investigated, to provide a basis for the development of linguistically and culturally appropriate measures of communication impairment. Data were collected using group and individual interview methods. The results highlighted the importance of communication in the family and social domains for all groups. This is not adequately reflected in some existing measures of functional communication. Degrees of bilingualism were found not to be consistently related with length of residence in Australia. For subjects reporting difficulty in speaking English, communication in the public domain was restricted.
The Relationship Between Communication Skills, Social Networks and Decision‐making Strategies: an Exploratory Study
Authors: Hickson L.M.H. , Worrall L.E. , Barnett H.M. , Yiu E.M‐L.
Published: December 2008

This exploratory study investigated the impact of communication impairments on the lives of older people. The communication abilities, social networks and decision‐making experiences of 50 community‐based people over 60 years of age were examined using screening communication tests, social network analysis and the critical incident technique. The majority of subjects (82%) failed on at least one of the hearing, memory and naming tests. A significant relationship was found between a forward digit span task and number of social contacts. Communication was used in 88% of all decision‐making incidents described by the subjects. Communication was used in 92% of incidents with a successful outcome as opposed to 81% of unsuccessful incidents. The methodologies of social network analysis and the critical incident technique provided valuable quantitative and qualitative information about communication function in everyday life.
Veterans Helping Veterans: a NSW Example
Authors: Baxter A.C.
Published: December 2008

World War II veterans are now in their seventies and eighties. Health problems that were experienced during the years of conflict have a lasting effect on this unique section of the community. Through VWAWC, a nucleus of veterans and the widows of veterans on the Central Coast of New South Wales have developed successful strategies of support for the wider veteran community, to help them accomplish healthier, happier ageing.
Resident Improvement in a Dementia Specific Nursing Home
Authors: Kramer T.
Published: December 2008

A reduction in disability is not the normal expectation for a resident of a nursing home. In fact, it is usual to expect a decline in ability as the resident's disease progresses. This paper will outline a program that restructured care practices and is now demonstrating improvements in levels of confusion and disability.
Understanding the Behaviour of People in Special Dementia Units: the Contribution of Rating Scales
Authors: Lefroy R.B. , McHale P. , Hyndman J. , Hobbs M.S.T.
Published: December 2008

The aim of this study was to investigate the contribution that rating scales can make to the understanding of the behaviour of people with dementia in a residential unit The participants were thirty eight residents in a Special Dementia Unit (SDU) organised as a hostel. Scores were recorded at staff meetings for the following scales: Crichton Royal Behavioural Rating Scale (CRBRS), Confusion Rating (CR), Barthel Index (BI), Cohen‐Mansfield Agitation Inventory (CMAI) and the Mini Mental State Examination (MMSE). It was found that the CRBRS and the CR provide a useful reference to mental and physical disabilities. Scores from the CMAI recorded the type, the frequency and the number of agitated behaviours displayed by individual residents. The majority of agitated behaviours belonged to the physically non‐aggressive category. Information from these scores was combined to construct residents' profiles. We concluded that the CRBRS, the CR and the CMAI can provide information about residents, both as individuals and as a group, which can assist in the understanding of behaviour and in the evaluation of the function of an SDU.
Burden and Stress on Relatives (Informal Carers) of Dementia Sufferers in Psychogeriatric Nursing Homes
Authors: Waltrowicz W. , Ames D. , McKenzie S. , Flicker L.
Published: December 2008

The Zarit Burden Scale (ZBS), the 30‐item General Health Questionnaire (GHQ) and a General Knowledge Test of Dementia (GKT) were administered to the primary family carers (usually a spouse or daughter) of 51 patients with dementia who had been admitted to two psychogeriatric nursing homes for mobile disturbed dementia sufferers. Informal carers for these patients demonstrated significant levels of burden and psychological morbidity up to two years after their demented relatives' admission to the nursing home. Spouse carers and carers from non‐English speaking backgrounds demonstrated significantly more burden than other carers.
The Validity of Elderly Patients' Self Reports of Daily Functioning
Authors: Bentur N.
Published: December 2008

The plethora of measures and tools for evaluating functional status raises questions as to their validity and reliability, and that of the data collected with them. The goal of this study was to examine the validity of the self‐reports on functional status of elderly patients hospitalised in rehabilitative geriatric settings, relative to patient observations. The functional status of 367 inpatients (half of whom suffered stroke and half of whom suffered fracture of the neck of femur), whose average age was 76, was examined through their performance of three tasks: putting on a shirt, putting on socks, and walking a short distance. First, patients were interviewed regarding each task, and then a direct observation made. High correlation was found between the interview and the observation for putting on a shirt and walking a short distance. A lower correlation was found for putting on socks. The possible reasons for this difference, and its implications, are discussed.
Preventive Programs for Older People: How Effective are They?
Authors: Harris M. , Byles J. , Higginbotham N. , Nair B.R.
Published: December 2008

The purpose of the study is to critically review the empirical evidence for the effectiveness of preventive health programs for older people living in the community. A literature review of randomised controlled trials, involving subjects aged predominantly over 65 years, published in the English language, was conducted. The data base MEDLINE produced the majority of references. The search yielded 20 randomised controlled trials. A potential for cost savings and improved health outcomes has been demonstrated. However, given the heterogeneity of studies and methodological weaknesses, the overall benefit is unclear. It is recommended a randomised controlled trial be conducted to test the effectiveness of comprehensive preventive programs for the Australian elderly.

Margaret Harris is a Senior Research Assistant and Julie Byles and Nick Higginbotham are Senior Lecturers in the Faculty of Medicine and Health Sciences at the University of Newcastle, New South Wales. Balakrishnan R. Nair is Director of Geriatric Medicine at the Hunter Area Health Department, New South Wales.
Attitudes of Employees and Employers Towards Older Workers in a Climate of Anti‐discrimination
Authors: Steinberg M. , Donald K. , Najman J. , Skerman H.
Published: December 2008

Attitudes and practices towards older workers were surveyed in Brisbane with 525 employees randomly sampled from the electoral roll and executives of 104 companies obtained by stratified random sampling from the Register of Workplaces (response rates, 60% and 80% respectively). The results indicated that “older workers” are young in terms of contemporary life expectancy, and younger for employers than employees; they have some desirable personal qualities (eg. loyalty), but are not perceived as adaptable; workers aged 25–39 were preferred on qualities held to be important in the workplace and there was minimal interest in recruiting anyone over 45 years.
Older Adults: the Labour Market, Employers and the Role of the Employment Specialist
Authors: Buys L.R. , Buys N.J.
Published: December 2008

Trends in the Australian labour market indicate that the nature and extent of work will continue to change into the next century, creating obstacles and opportunities for the employment of older workers. Current labour market programs are viewed as inadequate to meet the employment needs of older adults. The impact of the labour market upon the employment of older adults is discussed. It is argued that employers need to change their employment practices in order to employ and retain older workers in the work place and the importance of the employment specialist in this process is outlined. Recommendations are made regarding the role of employment specialists in terms of promoting the employment and retention of older adults.
The Older Worker ‐ Value for Money?
Authors: Seedsman T.
Published: December 2008

The race towards downsizing, high performance and the pursuit of excellence has led to workplace policies and practices that tend to discourage the older worker from staying on the job.

It is recognised that failing health or decreasing attachment to achievement may result in the decision by an older worker to retire from mainstream employment. It must be appreciated, however, that retirement is often perceived as a better alternative to working in an overly authoritative, routinised, robotic and unstimulating environment.

On the other hand, it is well known that better health and the opportunity to engage in stimulating and creative work will prevent many age related deficits in ability and productivity.
Preferences for Voluntary Euthanasia During Major Depression and Following Improvement in an Elderly Population
Authors: Hooper S.C. , Vaughan K.J. , Tennant C.C. , Perz J.M.
Published: December 2008

The purpose of the present study is to evaluate the effects of improvement or recovery from major depression on the preferences for voluntary euthanasia (VE) of elderly patients. Twenty five consecutive patients diagnosed with major depression (DSM‐IV) were examined for their preferences regarding VE in their present state, as well as in two hypothetical scenarios. They were then treated for depression, and their preferences re‐examined. Twenty two subjects completed both stages of the study. Of these, 18 improved in levels of depression. Before treatment, eight (44%) indicated a desire for VE, but after treatment only two (11%) desired VE. A similar trend in preference was found for the good prognosis scenario; but for the uncertain prognosis illness, preferences for VE remained high. Major depression in elderly patients may be associated with very high levels of preference for VE which is reversible with treatment in the majority of cases. However, there was a suggestion that high levels of acceptance of VE occurring in situations involving serious medical illnesses may not reverse following treatment for depression.
Family Advocacy Roles and Highly Dependent Residents in Nursing Homes
Authors: Tilse C.
Published: December 2008

A developing critique has questioned the practical utility of user rights policy initiatives for highly dependent residents of nursing homes. This paper seeks to extend this critique to the advocacy roles that families have been accorded within the policy initiatives. The discussion is based on a qualitative research study of family participation in six aged care units. The paper argues that the capacity of families to act as advocates for highly dependent nursing home residents is limited by the their weak position within the organisations and the complexity of their relations with staff. It questions both the applicability and the appropriateness of rights models which do not take sufficient account of the structure and meaning of care.
Health and Cognitive Ageing: the Emerging Role of Sensorimotor Abilities
Authors: Stankov L. , Anstey K.
Published: December 2008

Recent research on the role of health in cognitive ageing is reviewed to show that the relationship between health and cognitive function is still not entirely clear, possibly due to methodological limitations in health measurement When the relationship has been reported, its effect appears to be small Recent research suggests that sensorimotor abilities may have a stronger association with cognitive function in old age than health. This study aimed to evaluate the relationships between health, sensorimotor function and cognition by evaluating two alternative models using structural equation modelling. These analyses suggested that while health may have a negligible direct effect on cognition in old age it may have a significant direct effect via sensorimotor processes.
Admission and Discharge Policies and the Elderly: a Survey of Queensland Public Hospitals
Authors: Clark M.J. , Steinberg M.A. , Bischoff N.G.
Published: December 2008

Consumer groups and health professionals have expressed concerns about the impact of casemix funding on the elderly. Hospital admission and discharge policies have been advanced as a mechanism for ensuring quality of care for the aged. A questionnaire survey of Queensland public hospitals with a bed size of 15 or more (N = 98) was undertaken to determine the extent to which admission and discharge policies have been formulated and examine whether or not these policies take into account the special needs of the aged. Descriptive statistics revealed a relative policy void in that many hospitals do not have formal admission or discharge policies for the general population let alone formal policies which specifically address the needs of the aged. Moreover, a large number of hospitals do not employ discharge planning nurses or routinely inform the patients' carers about discharge matters. It would appear that despite prolonged calls for hospitals to address the special needs of the aged, many are yet to do so, at least as measured by their formal admission and discharge policies.
A Prospective Evaluation of Discharge Efficiency in a University General Medical Unit
Authors: Johnson A.G. , Couteur D.G. Le , Martin P. , Taylor A.
Published: December 2008

To determine whether a significant delay existed between the date when patients admitted to the University General Medical Unit (UGMU) at Princess Alexandra Hospital were considered to be medically fit for discharge, and the date of actual discharge from the ward, we undertook a prospective evaluation of all general medical patients admitted under the care of the UGMU physicians during the period 1 August to 31 October 1995 inclusive. A delay in discharge from the ward of more than one day occurred in 31.1% of patients, with the total number of days attributed to discharge delays representing 17% of all bed days. The two major causes of delays in discharge identified were insufficient institutional care beds and failure to plan patient discharges. Strategies proposed to improve discharge efficiency include early discharge planning, the provision of interim care wards and in the longer term, the provision of increased nursing home and hostel beds.
Caring for Someone with Dementia in a Rural Town Part 1: Family and Friends
Authors: O'Reilly M.T. , Strong J.
Published: December 2008

Caring for someone with dementia at home is a difficult task. Support services can do much to assist carers. However, in rural areas these may not be readily available or accessible. This paper reports on a qualitative study in which a group of carers living in a rural community participated in a focus group and interviews. Issues explored included the carers' experiences of caring, and the effects of rural life on this. Through content analysis of the data, it was found that these carers faced many challenges but were also able to access a number of supports, particularly in terms of family and the local community.
Caring for Someone with Dementia in a Rural Town Part 2: Services
Authors: O'Reilly M.T. , Strong J.
Published: December 2008

Dementia care in rural areas is in need of attention from researchers, planners and policy makers. Family carers in these areas face some significant challenges, in terms of managing the care where support services are often unavailable or inaccessible. This paper reports on a qualitative study in which a group of rural based carers participated in a focus group and interviews. Through this process, the carers' perceptions of support services were explored. Content analysis of the data revealed that, despite a number of supportive aspects of rural life, these carers felt in need of more services, a finding supported by current literature.
Evaluation of Physical Environments in Dementia Care Units
Authors: Coulson I.
Published: December 2008

The aim of this paper is to present an overview of the development of the physical Environment Rating Scale and its use in evaluating dementia care physical environments. The main objective in developing the scale was to evaluate how the physical environment prohibited or promoted staff in the provision of dementia care. The scale was tested using five trained registered nurses who had at least one year dementia care experience. Using Kendall Tau B, the inter‐reliability coefficients for five raters ranged between .65 and .96 indicating an acceptable level of reliability. Test re‐test reliability was assessed using two raters who showed perfect reliability. It was concluded that the rating scale was a valuable tool in understanding the impact of the physical environment in care provision and assisted in the development of strategies to improve the physical environment.
A Snapshot of Psychogeriatric Research in Australia
Authors: Brodaty H.
Published: December 2008

A survey of academic departments specialising in psychogeriatrics was undertaken in order to provide a picture of current research in this area. Reports from departments in seven universities demonstrate strong performance in dementia, depression and care research, and burgeoning interest in nursing home and biological areas.
Aged Care in Japan and Australia: a Comparative Overview
Authors: Nishimura J.
Published: December 2008

There are surprising paralles between aged care developments in Japan and Australia This paper outlines the Japanese system and contrasts it with the situation in Australia. It also describes recent reforms and current policy issues in Japanese aged care.
Will the Hostel Survive?
Authors: Lefroy R.B.
Published: December 2008

Specialisation has been a consistent trend since the custodial institution was abandoned in favour of nursing homes and hostels. Recent proposals, however, no longer support the hostel as a separate entity; nor is there support for the special feature of segregation necessary for the care of people with dementia. The process of specialisation is thereby being reversed.

Townsend supported his proposal by arguing that “we belong to a society that has the means and a greater inclination to act more tolerantly towards victims of adversity?”[4]. Can we make a similar claim 30 years later?
Management of Late‐life Depression
Authors: Snowdon John
Published: December 2008

Abstract. Assessment is the vital first step in management of late‐life depression. Somatic treatments are more likely than psychological approaches to be effective in relieving melancholia, psychotic depression and bipolar depressive swings. However, if severe depressions are associated with brain changes (eg. white matter lesions), recovery is less likely. A complex interplay of psychological and organic factors may account for depressions associated with medical conditions. Physical handicap has a strong association with depression. Psychological and psychosocial interventions may be appropriate in managing non‐melancholic, loss‐related or situational depressions, though antidepressants are also effective in many cases. Research is needed to compare the effectiveness of antidepressants and non‐pharmacological treatments in non‐melancholic and ‘;understandable’ depressions. An optimistic and persistent approach will lead to a good and maintained outcome in most cases of depression, in spite of the losses of old age.
Screening for Depression by the Nursing Staff in an Acute Psychogeriatric Unit
Authors: Akoo Shiraz , Shah Ajit
Published: December 2008

Objective: The early identification of depression in the elderly.

Method: The performance of the Depressive Signs Scale (DSS), completed by the nursing staff, in detecting depression among acutely ill psychogeriatric inpatients was prospectively examined.

Results: A cut‐off score of 4/5 gave the best sensitivity and specificity in detecting depression.

Conclusion: The performance of this scale should be evaluated in other settings such as geriatric wards and nursing homes.
Management of Residents' Pain in Extended Care Settings: Resource Issues for Nurses
Authors: Parish Karen , Willis Eileen
Published: December 2008

Objectives: To discuss the issues of poor management and inadequate allocation of resources in the management of chronic pain for residents in an extended care setting.

Method: Drew on critical social science and entailed the first author acting as a consultant in the research setting, assisting nurses to identify practices which enhanced pain management and to overcome barriers to adequate pain control with a selected number of clients.

Results: Identified a lack of resource allocation. Resourcing difficulties occurred at two levels. Documentation provided minimal opportunity to record nursing time spent dealing with residents in pain or to have pain identified as an area needing resources. Secondly, when pain was identified during the research process it became evident that staffing levels and expectations put upon nurses were an issue.

Conclusion: Each case study was a success story in terms of increased knowledge for those individual nurses and allied health care workers involved, and respite for those residents suffering pain. However, the adequate and effective recording of needed resources, and allocation of these resources remains a fundamental issue for the organisation to grapple with.
Recently Retired Non‐professional Men and Their Perceptions of Retirement
Authors: Fudge Elizabeth
Published: December 2008

Objective: To provide insights for primary health workers into the nature of retirement for non‐professional men, to assist the promotion of healthy ageing for men.

Method: The qualitative methodology of phenomenology was utilised to explore the recent retirement experience of ten men that were salutogenic (health creating) in nature, especially in relation to their social health. Information was gained via self‐reflective journals and in‐depth interviews.

Findings: Four major themes were revealed which positively impacted on the men's social health. Retirement was perceived as (a) an anticipated life stage; (b) a time of freedom; (c) a time of activity, especially as a practical support to others; and (d) a time to consolidate primary relationships.

Conclusions: The study supports other Australian literature on retirement and gives insights from the perspective of recently retired non‐professional men. It provides further information for those wishing to promote the social health of older men in the Australian context at both an individual and policy level.
Educating Medical Students in Geriatric Medicine: the Christchurch Experience
Authors: Wilkinson T.J. , Sainsbury R
Published: December 2008

Abstract. A five week program in geriatric medicine for fourth (first clinical) year medical students is described which is not only regarded as valuable by the students but has been shown to result in lasting beneficial effects on attitudes to the elderly. The program structure differs from some other courses in geriatric medicine. Possible reasons for its value and effectiveness include (1) teaching by committed and specialised staff, (2) seeing the elderly within a therapeutic environment which includes sufficient time for students to see the benefits of intervention, (3) the involvement of allied health professionals, (4) small group and patient based teaching and (5) a community focus which includes seeing people in their own homes and which emphasises the importance of the social context in a person's illness.
Training in Aged Care Advocacy for Primary Health Care Workers in Central Australia: an evaluation
Authors: Tsey Komla , Morrish Sue , Lucas Alison , Boffa John
Published: December 2008

Abstract. Concern felt by advocates for frail aged Aboriginal people in central Australia that residents are in nursing homes against their wishes led to a project to promote the process of obtaining informed consent. A Trainer's Manual was developed for workshops to help health care providers ‐ especially remote area nurses ‐ learn about this process and about respecting the rights of the elderly. This paper reports the findings of an evaluation of the Trainer's Manual. Although the manual challenged the basis of decision‐making of health professionals looking after the aged care needs of remote area Aboriginal people, it was not entirely sucessful with all the target audience partly because of a perceived lack of Aboriginal input at many levels of the project and partly, too, because of a lack of input to the process by remote area nurses. The workshops raise, among other things, important issues relating to the rights of the frail aged to make informed choices about their care versus the health professionals' sense of duty to their clients, reflecting both a need for ongoing examination and definition of what constitutes care, as well as challenging governments to address and resource the rights of Aboriginal people with regards to their service needs. The issues also reflect a need for greater attention to be paid to cross‐cultural training in the education of health professionals.
The Importance of Adopting a Client Focus in Assessing Outcomes Following Inpatient Rehabilitation Treatment of Older People
Authors: Gething Lindsay , Fethney Judith , Blazely Angela
Published: December 2008

Objectives: To explore quality of life for older people at hospital discharge and in the three months following discharge and to assess the impact of independence measured in terms of function, ability and perceived confidence in carrying out daily tasks.

Method: A questionnaire battery was administered through interview on three occasions. Thirty seven people participated in Interview 1, twenty‐three in Interview 2 and twenty in Interview 3. Eighteen people completed all three interviews.

Results: Respondents initially reported an objective quality of life comparable with other samples of older Australians, but this decreased significantly within the study group over the interview period. Subjective quality of life also was initially reported as similar to that found for a comparably‐aged group, but decreased significantly one month following hospital discharge. The only functional measure found to be related to quality of life was confidence in carrying out daily activities.

Conclusion: These findings highlight the importance of an holistic approach to assessing treatment outcomes which incorporates the views of clients as well as those of professionals. The article closes with recommendations designed to maximise health management outcomes.
Gender Differences in Depressive Symptoms Among Older People Living in the Community
Authors: Wells Yvonne , Stacey Barrie
Published: December 2008

Objective: To study gender differences in depressive symptoms among older people.

Method: Data obtained from a study of 533 women and 467 men aged 65 and over living independently in Melbourne were analysed to explore any gender differences in depressive symptoms.

Results: There is a low prevalence of depressive symptoms among both older men and women living in the community, with a slightly higher prevalence among women. However, women were twice as likely as men to report sufficient symptoms to be classified as depressed. This gender difference was not explained by age, but was fully accounted for by either IADL dependency or marital status. In turn, widows were more likely to be classified as depressed because they were more often lonely.

Conclusions: Women are more likely than men to be classified as depressed in community surveys of older people because they are more likely to experience an IADL dependency and because they are more likely as widows to experience loneliness.
Supporting Caregivers of Older People: an Overview of Problems and Priorities
Authors: Askham Janet
Published: December 2008

Abstract. This paper uses a broad definition of ‘;support’ to caregivers and considers how, given the need for support, this can be provided in a variety of ways. It emphasises issues such as the need for more research on the relative merits of different types of support, for consideration of the social context within which support is given and received, the way in which it is provided, and caregivers' own perceptions of what helps them in their caring activities.
Biology of Ageing: a Review
Authors: Hayflick Leonard
Published: December 2008

Abstract.We interpreted our findings that normal human and animal cells have a finite proliferative capacity to be the expression of ageing and longevity determination at the cell level. This finding implied the existence of a counting mechanism which, after a 35 year search, has now been found to be governed by diminished telomere length at each round of DNA replication. I suggest the name ‘;replicometer’ for this mechanism because replications are metered and not time, thus precluding calling this a clock or chronometer. Immortal abnormal cells, like cancer cells, can express the reverse transcriptase ‘;telomerase’ which maintains telomere length constant, thus providing immortality to this class of cells.
Emerging Demographic Changes in an Ageing World: an Overview
Authors: Myers George C.
Published: December 2008

Abstract. This overview reviews the presentations on demographic trends that were given at the IAG Congress in Adelaide and the pre‐Congress satellite in Singapore. It provides a framework for the field of the demography of ageing, and suggests some promising future research directions. The presentations provided the main features of trends in the demography of population ageing occurring in the main regions of the world. Highlights include the diversity that is found between and within regions, which stem mainly from variations in the pace of the demographic transitions towards lower levels of fertility and mortality. Notable changes also are occurring in the demography of the aged population. These include the growth of the oldest‐old, increasing proportions of females at the older ages, and important emergent cohort differences in those reaching the older ages. One thrust of future demographic activity will be to provide more realistic population projections of future trends, especially for countries that are showing super‐ageing. A second direction will be more concerted attention to cohort developments, which are particularly crucial in determining social, economic and political responses to changing population structures. A third will be greater attention to changing family structures and behaviours. Finally, there is growing interest in the field of biodemography that draws social scientists, demographers and biologists to focus on interdisciplinary aspects of morbidity, disability and mortality dynamics.
Filial Piety in Modern Times: Timely Adaptation and Practice Patterns
Authors: Sung Kyu‐taik
Published: December 2008

Abstract. In recent years industrialisation and urbanisation have weakened the willingness of adult children to care for their elderly parents. The results of the author's studies reveal that the majority of Korean adult children still value and practice filial piety in their day‐to‐day living. However, the way they express this cultural value has changed in the process of adapting to rapid and massive social changes. For instance many of them, due to job situation, schooling and needs to explore better opportunities, live separately from their elderly parents. In spite of this physical separation, most Korean adult children strive to practice filial piety in terms of affection, responsibility, family harmony, repayment, sacrifice and so forth. By expressing and practising these basic values using the telephone, letters, visitation and other tools for communication, they maintain close relationships with their elderly parents. The relationship between parents and adult children in Korea is transforming into a new type in which mutual respect and reciprocal care and support are considered more important than submission to the authority of the elderly.
Advocacy: Bringing Science to Policy and Practice
Authors: Sykes James T.
Published: December 2008

Abstract. During the 1997 Congress on Gerontology the issue of advocacy was prominently raised in numerous sessions. The delegates affirmed the Declaration of Adelaide, an important statement which called attention to the policy implications of scientific findings. The Declaration set research, practice and education agendas and urged increased resources for gerontological research and programs affecting the well‐being of older persons and their families. The wisdom of “linking what we know and can do with what we hope for and desire,” as the theologian Jurgen Moltman has written, requires a systematic effort on the part of gerontologists to influence public policy, standards and professional practice. In short, gerontologists must become advocates. To be effective advocates they must raise awareness of critical issues, form coalitions with those who share the goal of a better world, and exchange information and best practices if the elders of society today ‐ and those who will be the elders of tomorrow ‐ are to benefit from science translated into sound policies and effective practices. Gerontologists must take their scientific findings ‐ and questions ‐ to the forums where policies are discussed and standards and practices developed.
Intergovernmental Policy Lessons from Canada: Paying the Piper and Calling the Tune
Authors: Clark Michele J.
Published: December 2008

Abstract. In 1996 the Council of Australian Governments proposed transferring aged care community and residential programs to the States. This transfer of responsibility would have involved a reduced role for the Commonwealth Government. The Canadian Federal Government recently made unprecedented changes to the nature of intergovernmental arrangements with Provinces and Territories in respect to the policy domains of health, welfare and post‐secondary education. This study examines recent intergovernmental reforms in Canada and highlights trends and concerns which may be of relevance to the provision of aged care policies and programs in Australia.
Money Talks: Ascribing a Dollar Value to Voluntarism in Australian and New Zealand U3As
Authors: Swindell Richard , Vassella Ken
Published: December 2008

Objective: To ascribe a dollar value to voluntarism in Australian and New Zealand Universities of the Third Age (U3A).

Method: Questionnaires were sent to administrators of all U3As in Australia and NZ asking them to itemise and quantify every activity carried out by volunteers in their organisations. Hours were totalled by country and, using a notional value of $10 per hour, an overall dollar worth was calculated.

Results: The value of U3A voluntarism in Australia is more than $4 million annually. For NZ, the value is more than $300,000.

Conclusion: The value of voluntarism by older people tends to be taken for granted or overlooked entirely by many in society. In today's cost‐benefit focused climate a monetary equivalent should be calculated for voluntarism and the real value included with other measures of national productivity.
Risk Factors Associated with Falls in the Elderly Rehabilitation Client
Authors: Barr Jeanne , Brown Peter , Perry Greg
Published: December 2008

Objective: The purpose of the study was to determine risk factors associated with falls in an elderly rehabilitation client group.

Method: The study involved retrospective analysis of incident reports/medical files over four years of 87 clients who had fallen in the aged care rehabilitation unit under study. A comparison group was chosen of 87 randomly selected clients who did not fall during their rehabilitation program. Factors involved were analysed using a logistic regression equation to develop a model of those at risk of falling.

Results: The factors that were associated with falls in the elderly include confusion, primary diagnosis of stroke, lower limb amputation and sleep disturbances.

Conclusion: The elderly client who was confused, had a primary diagnosis of stroke, a recent lower limb amputation or experienced sleep disturbances was at increased risk of falling while undergoing in‐patient rehabilitation.
When Should We Measure Functioning? A Comparison of Serial Measurement of the MOS SF‐36 in an Australian Hospital Sample with Australian Norms
Authors: Snow Lucy , O'Brien Elizabeth , Saltman Deborah C. , Ahern Maureen
Published: December 2008

Objective: To compare the functional status at admission, discharge and three months post‐discharge of a group of elderly hospitalised people with a range of general hospital medical and surgical conditions with Australian Bureau of Statistics (ABS) community data.

Method: 400 randomly selected patients aged 65 and over completed the SF‐36 survey within 48 hours of admission to Manly Hospital and within 24 hours of discharge. These patients were followed up three months post‐discharge.

Results: Functional status of the hospital sample differed from the ABS data. Approximately half of the 8 hospital SF‐36 mean scores were significantly lower than the Australian norms for women and men on admission and discharge. However, by the three month follow‐up, the majority of these differences disappeared, except for women aged 75 and over.

Conclusions: This study describes differences in the SF‐36 data at three points in time surrounding an acute hospital episode. The apparent differences in SF‐36 scores at admission, discharge and 3 months post‐discharge, with the lowest scores occurring at discharge has implications for planning post‐hospital services for the elderly.
Drug Treatments for Alzheimer's Disease
Authors: Woodward Michael
Published: December 2008

Abstract. Alzheimer's disease (AD), the commonest cause of dementia, presents many challenges in pharmacological management. Newer cholinergic agents are modestly effective in improving or delaying decline in cognitive function, and should be considered for all with mild to moderate AD unless contra‐indicated. Other cognitive agents with possible, but more modest, efficacy include Vitamin E, selegiline and ginkgo biloba. Potential new therapies, including anti‐inflammatory agents, monoamine oxidase type B inhibitors and oestrogen are undergoing trials in Australia and New Zealand and may be available soon. Behavioural and psychological symptoms of dementia should be managed first by non‐pharmacological approaches but antipsychotic agents may be needed ‐ newer agents are better tolerated and likely to be as effective as older agents. Depression in those with AD is best managed with newer agents such as selective serotonin re‐uptake inhibitors and moclobemide. Cost is a major consideration with cholinergic and newer antipsychotic therapies, and government subsidisation (eg. through the Australian Pharmaceutical Benefits Scheme) is yet to be provided.
Costs of Community Care Services for Individuals with Complex Needs
Authors: Kendig Hal , Wells Yvonne , Swerissen Hal , Reynolds Astrid
Published: December 2008

Objective: To determine to what extent costs of intensive community care can be predicted and by which factors.

Method: Costs of community care services were calculated for 497 clients of Linkages (Community Options) projects in Victoria, Australia, in 1992.

Results: Costs to government and carers were found to vary by project and were best predicted by client dependency, client incontinence, male carers and non‐resident carers. Additional costs related to length of time as a Linkages client.

Conclusion: Client and carer characteristics had limited capacity to predict costs (29% of variance explained).