bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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).
Reasons for Hospital Admission in New Zealand's Oldest Old
Authors: Wilkinson Tim J. 
Published: December 2008

Objectives: To determine:the important causes of morbidity in New Zealand's oldest old, as measured by those conditions requiring hospital admission;the types of conditions which show continued increases in hospital admission or bed occupancy rates with age;the types of conditions which have lower admission or occupancy rates among the oldest‐old group compared with the younger‐old groups.Design: Descriptive survey of all hospital admissions within an entire country over 12 months.Results: Bed occupancy rates increase with age. Hospital admission rates increase with age but decline for people aged 100 years and over. Admissions due to cognitive/mood disorders and ill‐defined conditions increase with age to over 100 years. The age specific rate of hospital admission due to fractures or accidents peaks for people aged 90–99 years. Admissions due to cancer, ischaemic heart disease or eye disorders peak for people aged 80–89 years. Stroke and cognitive/mood disorders contribute significantly to bed occupancy at all age groups although bed occupancy rates decline for fractures and stroke after the 90–99 year decade. Arthritis, stroke and cognitive/mood disorders contribute to bed occupancy relatively more than to admission rates.Conclusions: Stroke, cognitive/mood disorders, fractures and arthritis are significant causes of morbidity in New Zealand's oldest old. The rate of admission to hospital with fractures, accidents and stroke peaks for people aged 90–99 years and is less common in centenarians. Less specific presentations of disease occur in the older populations.
Satisfaction With Medical and Allied Health Services Among Aged People in Sydney
Authors: Dent O.F. , Broe G.A. , Creasey H. , Waite L.M. , Cullen J.S. , Grayson D.A. 
Published: December 2008

Objectives: To assess satisfaction with medical and allied health services among community‐living aged persons and to determine whether satisfaction had changed over a three‐year period. Method: An interview survey of a random sample of 320 people aged 75 years and older was conducted in the inner western suburbs of Sydney between August 1991 and September 1993 and repeated between August 1994 and October 1996 with 227 surviving members of the cohort. Questions covered the use of, and satisfaction with, medical and allied health services during the preceding 12 months. Results: The proportion Very satisfied’ with general practitioner (GP) surgery attendances and house calls over the two surveys ranged between 88% and 100%. The proportion ‘;very satisfied’ with specialist medical services ranged between 87% and 91%. The proportion ‘;very satisfied’ with allied health services ranged from 69% for optometry in 1992 to 93% for audiometry in 1995. There was no significant change over time. Conclusions: These older people displayed high levels of satisfaction with allied health services and very high levels of satisfaction with medical services.
Understanding conflict: Perception of Female Caregivers
Authors: Rahman Naila 
Published: December 2008

Objective: To explore the caring experiences of female caregivers. Method: In‐depth interviews were conducted on 30 females caring for an older relative at home. Results: Conflict was a significant outcome of caregiving. Stress, role conflict, imbalance in equity, and imbalance in norms and values emerged as major themes. Conclusion: This study, along with a few related studies, may help to form a new basis for the study of caregiving with an emphasis mainly on conflict.
Is Hostel Care Good for You? Quality of Life Measures in Older People Moving into Residential Care
Authors: Reberger Caroline , Hall Sonja E. , Criddle R. Arthur 
Published: December 2008

Objectives: For many older adults, moving into hostel accommodation can be a stressful and traumatic process. The impact of this move on the quality of life and function after a three‐month adjustment period was evaluated in this study. Method: A Folstein Mini Mental State Examination (MMSE), Modified Barthel Index (MBI), Short Form 36 (SF‐36) and demographic information was collected prior to entry to hostel accommodation. The SF‐36 was repeated three months after admission. The SF‐36 has eight domains: physical functioning, role physical, bodily pain, role emotional, mental health, vitality, general health, and social functioning. Results: Fifty subjects met the inclusion criteria and moved into hostel accommodation during the study period. The MMSE had a mean pM sd 26.6 pM 3.29 (highest cognition score = 30) and the MBI 93.4 pM 5.71 (highest level of independence score = 100), with no gender or age effect. The SF‐36 improved in 7/8 domains (p<0.05) after admission to hostel, with only mental health not improving significantly. Despite improving, physical functioning remained below the age and gender matched Australian norm for the SF‐36 in both males and females aged over 75. For women there also continued to be a reduction in social function, general health and mental health. Conclusions: This study showed that both men and women had an overall increase in their quality of life after admission to hostel care. A comparison of our group to the Australian age and gender matched norms for quality of life illustrated that for many in our group their quality of life compared favourably to people living in the community, and that moving into hostel accommodation had been shown to be a valuable option.
Over the Hill and Picking up Speed: Older Women of the Australian Longitudinal Study on Women's Health
Authors: Byles Julie 
Published: December 2008

Objective: The aim of the Australian Longitudinal Study on Women's Health is to explore the physical, psychological, social and environmental factors that affect the health of women in Australia. In this paper, we identify key health issues for the 12,900 women in the oldest cohort of the study and highlight issues to be explored longitudinally. Method: Women aged 70–75 years registered with the Health Insurance Commission were sent a postal questionnaire (response rate 40%). The questionnaire included 260 items on health, health related behaviours and health care use, and social circumstances. Results: Despite the high proportion of women reporting chronic medical conditions and recent symptoms, only 4% of the women rated their health as poor. Scores on the SF‐36 health‐related quality of life measure indicate that while physical health scores were lowest for the older cohort, mental health scores were higher than for the youngest (18–23 years) and mid‐age (45–50 years) cohort. In their comments, the older women emphasised the importance of their homes, social support and their active participation in their community as fundamental to their well‐being. Conclusion: This analysis highlights areas for follow‐up in the longitudinal study, importantly the older women in the study do not equate disease with poor health and a broader social view of health is justified
Predicting Depression in a Sample of Older Women Living in a Retirement Village
Authors: Rickwood Debra , Rylands Kylie J. 
Published: December 2008

Objective: To determine the strength of ‘;accepting the past’ as a predictor of depression in older women. Method: 73 older women living in a retirement village completed a self‐report questionnaire. Results: Depression was predicted by lower levels of social support, physical independence and postive affect, and more difficulty accepting the past. Conclusion: The mental health of older women in residential care may be improved by programs to facilitate accepting the past and improve social support.
Hitting a Century: Centenarians in Australia
Authors: McCormack John 
Published: December 2008

Background: Census data show that people aged 100 years or more are increasing in number. However, there is a dearth of local information on these people as a socio‐demographic group. This paper presents some aggregated quantitative information on these long‐lived people. Method: The study uses secondary sources of data to compose a preliminary picture of centenarians in Australia. Historical census records and unpublished census data, as well as government departmental data were obtained to present a range of centenarian characteristics. Results: While historical census data on centenarian counts are available, recent differences in age data recording lead us to estimate the current number of centenarians. This estimate however builds on a strong growth trend, and the number of centenarians appears likely to increase, possibly doubling by the year 2006. The data show heterogeneity in the centenarians' social circumstances such that they do not necessarily fit a frail stereotype. Conclusion: As centenarians can add considerably to our knowledge of individual and population ageing, further work should be undertaken on this group. A register of centenarians and a return to single year age recording of all people in the census is suggested.
Prevalence of Geriatric ‘;Syndromes' in a Tertiary Hospital
Authors: Nair B. , O'Dea J. , Lim L. , Thakkinstian A. 
Published: December 2008

Background: Australia has an ageing population. Older people are more likely to be hospitalised and to consume more health resources. Old age is associated with the ‘;syndromes' of confusion, incontinence, immobility, falls and polypharmacy. Prevalence of these syndromes in an Australian hospital setting is not available. Aim: To study the prevalence of these syndromes and evaluate the routine practice of health care professionals in an Australian teaching hospital. Methods: Assessment of 100 consecutive patients above the age of 70 years and 50 doctors and nurses. Results: The study found a high prevalence of these syndromes. Twenty‐nine percent had cognitive impairment, 54% had had falls, 37% had poor mobility, 40% had urinary incontinence and 43% took more than five medications. Health professionals underestimated the prevalence of these conditions in an inpatient setting and stated that they did not routinely look for these conditions. Conclusion: Assessment of these prevalent syndromes is suboptimal.
Anthropometric and Laboratory Markers of Nutritional Status in a Large Sample of Older Australians: the ALSA study
Authors: Whitehead C.H. , Giles L.C. , Andrews G.R. , Finucane P. 
Published: December 2008

Objectives:bL To determine which combination of available measures of nutritional status can adequately describe the nutritional status of a large sample of older patients.bL To describe the prevalence of malnutrition in this large sample of older community dwelling Australians and provide a set of values that could be used as reference data for future studies. Design: A descriptive study based on the baseline cohort of the Australian Longitudinal Study of Ageing (ALSA) using a principal component analysis and correlations between the variables. The prevalence of malnutrition is estimated using currently available definitions of malnutrition. Method: 1,404 community living older people (aged 70–103 yrs, mean 77 yrs) underwent measurement of body mass index (BMI), relaxed arm girth, arm muscle area, triceps, abdominal and supraspinale skinfold thicknesses and grip strength together with albumin and total lymphocyte count. All pairwise correlations were calculated between the variables separately for each gender and the relationship between all the variables along with age further explored by principal component analyses. Results: In both sexes, strong correlations were noted amongst BMI, skinfold thicknesses and arm girth (r values 0.43 to 0.81). Grip strength, albumin and lymphocyte count did not appear to be notably correlated with each other or with any of the other variables (r values 0.00 to 0.37). The principal component analyses indicated that the majority of the variation in the data could be explained in as few as three dimensions. The prevalence of malnutrition varied using available definitions from 0.7% to 17.9%. Conclusions: We conclude that the strength of correlations between variables is such that nutritional status could be measured with as few as three variables. BMI, albumin and possibly lymphocyte count seem an ideal combination. The prevalence of malnutrition depends greatly on which definition is chosen and the clinically significant level of malnutrition is unclear without more longitudinal prognostic data.
Mature Age Employment: Recent Developments in Public Policy in Australia and the UK
Authors: Taylor Philip , Steinberg Margaret , Walley Linda 
Published: December 2008

Objective: To examine recent policy developments in mature age employment in Australia and the UK. Method: Recent data and policy statements in the UK and Australia, supplemented by the findings from interviews undertaken with government and industry leaders in the UK in October/November 1998, reflecting similar work in Australia, were analysed and compared. Conclusions:•bL Population ageing, a long term decline in activity rates and skills among mature age workers and discrimination against them are important policy issues in both Australia and the UK (as in other countries).•bL A major policy difference is the use of antidiscrimination and related legislation in Australia; compared with a reliance on education and codes of practice in the UK. Sustained awareness raising is required, together with evaluation of the longer‐term impact on employer practices.•bL Employer involvement is low and systematic approaches are needed to identify and support good practice by employers towards older workers in both countries.•bL A comprehensive approach is crucial (whole of government, industry, unions), taking into account industry, occupational, locational and gender differentials.
Rights Focused Advocacy and Elder Abuse
Authors: Cripps David 
Published: December 2008

Objective: To study the effectiveness of the Rights Focused Advocacy Model in supporting older people to overcome situations of elder abuse. Method: 100 case records were retrospectively analysed, which represented approximately 20% of total clients over an eighteen‐month period, from November 1997 to June 1999. Data recorded included: type of abuse, risk factors (for older person and abuser) and outcome (ie. whether or not abuse had ended).
Results: 100 older people experienced 267 situations of abuse. The Rights Focused Advocacy Model enabled older people to take steps to stop abuse in 50% of those situations, and to take some action in 34% of situations. No change was recorded in 16% of cases.
Conclusion: Rights Focused Advocacy is a holistic model that is effective in supporting older people to take steps to overcome the abuse that they experience.