bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PREVALENCE OF DEPRESSIVE SYMPTOMS AND COGNITIVE IMPAIRMENT IN SUPPORTED RESIDENTIAL SERVICES IN VICTORIA—A PILOT STUDY
Authors: Flicker L. , Keppich‐Arnold S. , Chiu E. , Calder R. , Theisinger J. 
Published: December 2008

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

ABSTRACTThis exploratory study, funded by the Australian Rotary Health Research Fund, investigated the factors affecting the social interactions of older people.The study was based on interviews with one hundred people aged 65 years and over to determine their past activities, present pursuits and the activities, if any, in which they would like to be involved.This article, the second of two, examines the results relating to the activities and social interactions of older people.
PERSONAL POSSESSIONS AND SELF‐IDENTITY: THE EXPERIENCES OF ELDERLY WOMEN IN THREE RESIDENTIAL SETTINGS
Authors: Cram F. , Paton H. 
Published: December 2008

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

Objective: To examine the use of respite care in nursing homes and hostels and the destinations of respite residents on completion of their respite stay.Method: Administrative by‐product data on admissions and separations from nursing homes and hostels are analysed to show the length and pattern of stay of respite residents.Results: The data show that utilisation rate of approved respite beds is relatively low: 69% for hostels in 1994–95 and 50% for nursing homes. This is in spite of government subsidies available for respite care. Many respite residents become permanent residents. Thirty percent of hostel residents in 1992–93 and 42% of nursing home residents in 1993–94 became permanent residents after their first respite admission.Conclusion: The transfer from respite to permanency may be caused by changes in personal circumstances of respite residents and their carers after respite admission. But it may also indicate an inappropriate use of respite beds. The reasons behind the considerable proportion of residents moving to permanent care and the low level of use of respite beds are worth further study.
A Preliminary Survey of Patients Seen by the Kimberley Aged Care Assessment Team
Authors: Bruce David G. , Baird Maxine , Saddler A. Howard , Goldswain Peter 
Published: December 2008

Objectives: To assess whether cognitive or physical impairments are common in indigenous Australians living in the Kimberley.Methods: A retrospective review of the first 119 cases assessed by members of the Kimberley Aged Care Assessment Team.Results: Chronic dementia (40%), at least moderate degrees of physical impairment (55%) and longstanding urinary incontinence (43%) were common in the Aboriginal patients in this series. The Aborigines were on average a decade younger than patients referred to a metropolitan geriatric service. Potentially preventable conditions accounted for impairments in many of these patients.Conclusions: Cognitive and physical impairments are common in elderly aborigines. These problems are seen at an earlier age than in non‐indigenous Australians suggesting that risk factors for excess early mortality are also risk factors for chronic disabilities. Health programs aimed at prevention and support of these profoundly disabled people are required.
Family Caregiving of Older People with Dementing Illnesses in Nursing Homes: a Lifeline of Special Care
Authors: Fleming A. Andrew 
Published: December 2008

Objective: Explore the meaning of the care given by family caregivers to family members with a dementing illness after their placement in a nursing home.Method: A constructivist approach, informed by symbolic interactionism, and using grounded theory methods, served as the theoretical and analytical underpinnings of this study. In all, 14 family caregivers (predominantly daughters caring for mothers) were interviewed.Results: There is a dual meaning inherent in family caregiving activities in this context. It is perceived as a lifeline of special care for the family member in the nursing home, and is meaningful and constructive for the caregivers themselves.Conclusion: Understanding this ‘;dual’ meaning of family caregiving activities is highly relevant for health care workers and others who interact with family members in the nursing home situation.
Discriminating Factors Between Hip and Other Fractures in Older Women
Authors: Zivanovic Ekaterina , Lord Stephen R. , Ward John A. 
Published: December 2008

Objective: To elucidate discriminating factors between femoral neck and other fractures in older women.Method: A case‐control study of 110 women aged 60 to 91 years.Results: Both cases and controls had reduced bone density, with no significant difference evident between the groups. Hip fracture subjects were older, had lower BMI scores and were more likely to have fallen sideways or backward. The controls were more likely to be taking prednisone.Conclusions: The prevention of hip fractures may depend on strategies such as excessive weight loss prevention, enhancement of strength and provision of local hip protection, in addition to strategies aimed at maintaining bone density.
A Lavender Pink Grey Power: Gay and Lesbian Gerontology in Australia
Authors: Harrison Jo 
Published: December 2008

Objective: A small exploratory qualitative study investigated key political activists' predictions regarding the process by which gay and lesbian older people will be included in aged care policies in the future in Australia.Method: In‐depth semi‐structured interviews were conducted with six activists in aged care and human rights.Results: Findings are discussed in relation to three broad themes: barriers to change; who should do what?; and strategies for success.Conclusions: The study points to predictions about gay and lesbian aged policy which warrant further attention. It identifies a need for further research which investigates aspects of the findings, particularly the collaborative process between gerontologists and gay and lesbian activists. Such a process may lead to policies which emphasise social justice and the recognition of diversity in gerontology.
Further Validation of “Timed Up and Go” in Stroke Patients
Authors: Nair B. , Dobson A. , O'Dea I. , Hogben K. , D'Este K. , Page J. 
Published: December 2008

Objective: To compare the Barthel Index (BI), a well‐known and accepted measure of functional disability, with Timed Up and Go (TUG).Method: Thirty‐three stroke patients had their BI and TUG assessed by independent blinded observers.Results: There was good agreement between BI and TUG, with good repeatability.Conclusion: Thus TUG is a good measure of function pre‐discharge but needs to be further validated on more disabled patients.
Effects of Pet Ownership on the Health and Well‐being of Older People
Authors: Wells Y. , Rodi H. 
Published: December 2008

Objective: To examine the view that having a pet is good for the health and well‐being of older people, particularly those who are socially isolated. Method: Benefits and disadvantages of owning a pet were explored in two studies. Data from the Health Status of Older People project were used to compare the health, health behaviours and well‐being of those who owned and did not own pets. In addition, twenty older people were interviewed in‐depth about pet ownership and its impact on their lives. Results: Few health or well‐being outcomes were predicted by pet ownership. Having a pet did not compensate for social isolation. The qualitative data largely substantiate and provide possible explanations for the survey findings. Conclusion: Pets may have some limited value in promoting health and well‐being in older people.
Clinical Diagnosis and Disability Among Community Dwellers Aged 75 and Over: The Sydney Older Persons Study
Authors: Waite Louise M. , Creasey Helen , Grayson David A. , Edelbrock Dorothy , Cullen John S. , Brooks William S. , Casey Barney J. , Bennett Hayley P. , Broe G. Anthony 
Published: December 2008

Objectives: Disability is an important predictor of health and community service utilisation. Understanding its pathogenesis has implications for planning of future health services. The aim of our study was to examine the contribution of systemic, psychiatric and neurodegenerative diseases to disability in an “old‐old” population.
Methods: 647 men and women over the age of 75 participated in the Sydney Older Person's Study. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility was assessed using self report, informant and clinician assessments. Diagnoses of systemic, psychiatric, neurodegenerative diseases were made by clinicians. Individual disease contribution to disability was assessed using multiple regression analysis. Contribution to disability by the groups of systemic, neurodegenerative and psychiatric diagnoses was assessed, using hierarchical regression. Results: Neurodegenerative diseases were the major contributors to ADL impairment. Systemic and psychiatric diseases played a role in IADL and mobility impairment, as did the neurodegenerative diseases. Of the neurodegenerative diseases, dementia/cognitive impairment and Parkinsonism/gait slowing particularly contributed to disability. Self‐report under‐identified the role of the neurodegenerative diseases in disability. It also introduced a gender effect, that the clinical measures did not share to the same extent.
Conclusions: Neurodegenerative diseases are important contributors to disability and assessments and diagnosis of neurodegenerative diseases should be included in disability assessments. Self report under‐identifies the importance of these conditions.
Strategies Against Polypharmacy and Inappropriate Medication ‐ Are they Effective?
Authors: Chan FHW , Pei CKW , Chiu K C. , Tsang EKW 
Published: December 2008

Objectives: To evaluate the effectiveness of a drug rationalization programme in reducing the incidence of polypharmacy and inappropriate medication since an initial survey performed in the previous year. Method: A retrospective case notes study was performed on patients discharged from the medical! geriatrics wards during the period from 1st of July 1997 to 30th of September 1997. This was exactly one year after the initial study followed by the implementation of a drug rationalization programme. Data collection was carried out by the same two medical staff using a data collection sheet. Data collected included patient's sex, age, length of stay, diagnoses, medication on discharge (whether appropriate or inappropriate) and adverse drug reactions (ADRs).
Results: The total number of cases was 210. 39.5% of cases were male while 60.5% were female. The mean age was 80.2 years (min. 59 and max. 103). The mean length of stay was 22.72 days (min. 2 and max. 148). The mean number of active and inactive diagnoses on discharge was 0.69 and 3.36 respectively. The mean number of medication on admission was 4.65. The mean number of inappropriate medication on admission was 0.50 per patient. The number of patients with inappropriate medication(s) on admission was 73 (34.8% of patients) with 10.86% of all medications prescribed on admission being inappropriate. The mean number of medication on discharge was 3.56, and the mean number of inappropriate medication was reduced to 0.13 per patient. The number of patients with inappropriate medication(s) on discharge was reduced to 26 (12.4% of patients) with 3.62% of all medications prescribed on discharge being inappropriate. The most frequent class of inappropriate medication was drugs for the respiratory system both on admission and discharge at 35.5% and 48.2% respectively. The commonest reason for being an inappropriate medication was the use of drug, which had no apparent indication both on admission and discharge at 70.2% and 50% respectively. There were 16 incidences of ADRs found in 15 patients (min. 1, max. 2 and mean of 0.076 per patients).
Conclusion: This study had demonstrated the effectiveness of our drug rationalization programme. The percentage of inappropriate medication on discharge was significantly reduced from the previous study's 18.03% to this study's 3.62%. The percentage of inappropriate medication was also reduced from 10.86% on admission to 3.62% on discharge in this study. Education of physicians, as well as patients, is much needed.
Rituals of visiting people with dementia in residential care
Authors: Schofield Verna 
Published: December 2008

Objectives
: Visiting a family member with dementia in residential care can be an unpredictable and stressful experience, particularly in the early days of admission and little is known of how carers lessen their distress during this time.
Method
: A qualitative study of 25 family carers was carried out in which the carers were interviewed on three occasions for more than a year from shortly after their relative entering residential care. Three carer focus groups were also undertaken.
Results
: Many family carers developed routines in their visiting that indicated five different forms of ritual: repetitive visiting patterns, formalised elements to visits, symbolic caregiving, reward giving and visit reframing. These routines helped carers manage the experience of visiting. From the accounts of family members, residential staff often seemed unaware of the significance of the rituals and unknowingly discouraged them.
Conclusion
: These findings suggest that visiting involves complex processes that are insufficiently understood and their value underestimated. Strategies are discussed for assisting family carers to sustain their visiting practices. Further research is needed in this area to provide guidance for family members and those working in residential care. Key words: Dementia, ritual, residential care, caregiving, visiting, relationships, communication
Old people ought to be explorers: The questions of value
Authors: Brady Dr Veronica 
Published: December 2008

It is appropriate that our theme this afternoon is ‘driving change’. It is evident that our society is addicted to, some would say afflicted by, change and that older people, like everyone else are caught up in the process. It may be also that many of us who grew up in more stable, less dynamic times find it more difficult to deal with. My argument, however, is that we should not. That at least is the import of the quotation from Eliot's Four Quartets which gives me my title:Old men ought to be explorers Here and there does not matter We must be still and still moving Into another intensity. (Eliot, 1948: 22).
Grey nomads and grey voyagers
Authors: Westh Steve 
Published: December 2008

‘After six years of making films whose subjects have been ‘older people’ 1 have come to the conclusion that if there is such a thing as ‘old age’ it must refer to that final brief period when body and mind shut down and death is imminent. Everything before that is just living.IMPLICATIONS OF AN AGEING POPULATION 5–7 SEPTEMBER 2000HYATT REGENCY HOTEL PERTH, WESTERN AUSTRALIAThematic Keynote Highlights2000 FULBRIGHT SYMPOSIUM IMPLICATIONS OF AN AGEING POPULATIONThematic Keynote Highlightseditors:Ruth MarquisDon CameronRichard HugmanDuncan BoldyFreemasons Centre for Research into Aged Care ServicesCurtin University of TechnologyGPO Box U1987, Perth, Western Australia, 6845Telephone: 08 9266 7993 Facsimile: 08 9266 2508Email: B.J.Hornerfgi.curtin.edu.au
The interface of acute and aged care: the role of the nurse in a provincial area
Authors: Hegney Desley , McCarthy Alexandra , de la Rue Mary Beth , Gorman Don , Martin‐McDonald Kris , Fahey Paul , Prett Grace 
Published: December 2008

Objective: This study was to investigate issues that arose from pre‐admission to post‐discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.Method: The study involved a multi‐site, multi‐agency and multi‐method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post‐acute discharge.Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.
The host‐homes program: an innovative model of respite for carers of people with dementia
Authors: Holm Sonya , Ziguras Stephen 
Published: December 2008

Objective: To investigate the operation of an innovative community respite program run by the Brotherhood of St Laurence: the Banksia ‘host‐home’ program, which was designed to provide respite for up to six people with dementia in a care‐worker's home. The program was funded by the Commonwealth Department of Health and Aged Care as part of a funding program for pilot respite care projects.Method: Interviews were conducted with program staff, carers and care‐recipients (older people with dementia). Information from written records such as funding submissions was also used.Results: People using the program were those who experienced barriers utilising centre‐based programs for older people for a range of reasons including advanced dementia, hearing difficulties, difficulties in social interaction or confusion. Carers were very appreciative of the service, and care‐recipients appeared to enjoy the program immensely, citing caring staff, social contact and activities as things they appreciated most.Conclusions: The host‐home program provided an accessible respite option for those unable to use centre‐based services. It enabled more individually tailored activities, greater socialisation and greater attention from staff than possible in centre‐based services. The informal ‘homely’ feel of the program and the fact that relatives obviously enjoyed participating may have made carers feel more comfortable in using a respite service. Since the model creates the potential for cost‐shifting and because of difficulties in supervising staff in their own homes, guidelines and standards appropriate to host‐home programs should be established to ensure quality of care and to protect paid staff and service users.
Increased Sexual Dysfunction in Men with Storage and Voiding Lower Urinary Tract Symptoms
Authors: Morant Steven , Bloomfield Glenys , Vats Vasudha , Chapple Christopher 
Published: December 2008

ABSTRACT

Introduction
Sexual dysfunction (SD) and lower urinary tract symptoms (LUTS) are highly prevalent in men and increase with age. Previous studies have shown that LUTS and SD are highly associated in men, but most have not distinguished between voiding and storage LUTS.

Aims
Assess impact of voiding and storage LUTS on recorded diagnosis of SD in men in U.K. general practice.

Methods
Identified records of patients with SD and storage (e.g., overactive bladder) and voiding LUTS (e.g., benign prostatic hyperplasia) from a population-based study using The Health Improvement Network database with records from 333 general practices. Study period was 2000–2007; study population was men aged ≥ 18 years.

Main Outcome Measures
Prevalence rates of SD, and storage and voiding LUTS on January 1 of each year from 2000 to 2007.

Results
Overall prevalence of recorded SD rose from 1.7% in 2000 to 4.9% in 2007. The prevalence of storage and voiding LUTS also increased. Median age at diagnosis was 60 years for erectile dysfunction (ED), 62 years for other SD, 62 years for storage LUTS, and 61 years for voiding LUTS. Compared to men with no LUTS, odds ratios (95% CI) for ED were as follows: storage LUTS, 3.0 (2.6–3.4); voiding LUTS, 2.6 (2.4–2.7); and both voiding and storage LUTS, 4.0 (3.4–4.8). Among the 11,327 men with any recorded LUTS and ED at the beginning of 2007, LUTS diagnosis preceded SD in 63.1% of patients by a mean of 4.8 years.

Conclusions
Prevalence of SD was significantly higher in the presence of either storage or voiding LUTS compared to men with no recorded LUTS. The diagnosis of LUTS preceded SD in the majority of cases. Further research into the interrelationships between functional problems of the genitourinary tract may have implications for current treatment approaches and future therapeutic developments.