Elderly Care Management Research Articles

Anti‐Violence Human Resource Management and Workplace Violence: Perspectives From Australian Aged Care Managers and Employees

ABSTRACTIncidents of workplace violence are commonplace against nurses and personal care assistants (PCAs) employed in aged care facilities. This article examines ways in which managers and human resource (HR) departments manage workplace violence. In this context, understanding anti‐violence human resource management (HRM) practices and other ways in which incidents of violence are managed may have important implications for workforce sustainability. Greenwood and Freeman's [Greenwood, M., & Freeman, R. E. (2011). Ethics and HRM: The Contribution of Stakeholder Theory. Business & Professional Ethics Journal, 269–292.] conceptual model of employee engagement and “ethical” HRM underpins this study by focusing on stakeholder engagement and stakeholder agency. We take a qualitative approach to examine workplace violence in aged care facilities in Australia by conducting semi‐structured interviews with 60 participants. We report on narratives of participants highlighting the unethical use of HRM as evidenced by a lack of anti‐violence HRM in aged care facilities. To encourage greater workforce sustainability, we argue that HR departments and managers need to behave ethically and better support the management and mitigation of workplace violence against workers in aged care facilities. Our paper provides new theoretical and practical insights into understanding the role of stakeholder engagement and stakeholder agency, and the moral treatment of employees through the development of anti‐violence HRM within the aged care context.

The Evolving Role of Aged Care Managers in Australia: A content analysis of aged care manager job descriptions

The Evolving Role of Aged Care Managers in Australia: A content analysis of aged care manager job descriptions

Practical Exploration of Talent Cultivation for Smart Healthy Aging Serviceand Management Professionals

With the accelerated aging of China's population, the development of the profession of intelligent healthy aging service and management has received increasing attention. This paper discusses the background of this specialty, the list of competencies of professionals and the practical strategies of talent cultivation, aiming to improve the quality of professional talent cultivation. By analyzing the cultivation strategies of key competencies such as geriatric health assessment, smart elderly care technology application, elderly care service planning and management, psychological support as well as innovation and learning ability, the study emphasizes the importance of interdisciplinary curriculum integration, internship and practical training enhancement, industry-university-research cooperation and case study teaching.

Evaluation of a mental health service reform program, the Pathways to Community Living Initiative, for people with severe mental illness and complex needs.

The Pathways to Community Living Initiative (PCLI) aims to reform mental health care for people with severe and persistent mental illness (SPMI) and complex needs. This study reports independent evaluation findings on transitions from hospital and practice change in mental health services. Data for this mixed-methods evaluation were obtained from administrative collections and semi-structured interviews with PCLI program managers, teams and executive leads; aged care managers; and leaders in inpatient, community and older people's mental health services. Between July 2015 and December 2020, 674 participants (67% of those eligible for the PCLI) were transitioned from hospital to community. Of those transitioned, 21 required subsequent long-stay admissions. The PCLI introduced resources, clearly defined processes, and state-wide networks to guide changes in practice which are becoming embedded in the operations and governance of mental health services across New South Wales. Severe and persistent mental illness and complex needs can be managed in community settings with highly individualised planning and care, supported by specialised clinical teams in partnership with mental health, aged care and disability services. Evaluation findings highlight the importance of continued investment in rehabilitation psychiatry.

Information System for Elderly Care Management in Thai Supply Chain

An academic articles about information system for elderly care management in Thai supply chain aim to present elderly care management through a supply chain applying for better effective elderly care management The elderly care management needs to be appropriate to changes of globalized economy and society. The processes consisted of Suppliers, Agencies, Satisfaction and service, Customers ,All component connect with information communication technology in the Thailand with the supply chain. This truly added the society in Thailand .The supply chain and information system may be applied in the elderly care to support the tasks.

Digital System in Supply Chain for Elderly Care Management in Thailand

The review article title digital system in supply chain for elderly care management in Thailand aim to present tax management through a supply chain applying for better effective tax management The elderly care management needs to be appropriate to changes of globalized economy and society. The processes consisted of Suppliers, Government organization , Satisfaction and service , Customer, Satisfaction and feedback .All element connect with digital in the Thailand with the supply chain. This truly added the society in Thailand .The supply chain will be applicable for elderly care in Thailand.

Managers' experiences of providing end-of-life care under the Home Care Package Program.

The study explored the experiences of Australian aged care providers in supporting clients on a home care package to die at home. Semistructured interviews were conducted with 13 aged care managers responsible for delivering services under the Home Care Package Program. Interviews were analysed thematically. Four themes emerged that illuminated managers' experiences: struggling to meet a preference to die at home; lack of opportunities to build workforce capacity in end-of-life care; challenges in negotiating fragmented funding arrangements between health and aged care providers; and mixed success in collaborating across sectors. Aged care providers want to support older Australians who prefer to stay at home at the end of life. However, most clients are admitted to a residential facility when their care needs exceed a home care budget long before a specialist palliative care team will intervene. Budgets for health and aged care providers must be sufficient and flexible to support timely access to end-of-life care, to reward collaboration across sectors and to invest in building palliative care skills in the nursing and personal care workforce.

A Qualitative Analysis of Management Perspectives on Seeking to Implement the Foster Cat Project in Residential Aged Care in the Context of COVID-19

This study explores the challenges facing a pilot project aiming to foster homeless cats in an Australian residential aged care facility. The global COVID-19 pandemic stalled the project but also presented an opportunity to gain reflective insights into the perceived barriers, enablers and tensions involved in seeking to implement pet animal inclusion in residential aged care. Perspectives from aged care management, animal welfare services and researchers/project managers were all sought using semi-structured interviews, and themes developed using a qualitative descriptive analysis. Perceived barriers to the project before and after the pandemic were not dissimilar with four key themes emerging: competing priorities, risk and safety, resources, and timing. All existed differently across stakeholder groups creating tensions to be negotiated. These themes are then mapped to the competencies established by the International Union of Health Promotion and Education (IUHPE) for undertaking health promotion, demonstrating that this skill base can be drawn on when seeking to implement human-animal inclusive projects. Creating supportive healthful environments for frail older persons is a moral imperative of extended lives. Health Promotion skills as outlined in the Ottawa Charter and IUHPE competencies for health promotion workers need to be extended to include animal services, agendas and cultures to promote multi-species health promotion into the future.

Explainable indoor localization of BLE devices through RSSI using recursive continuous wavelet transformation and XGBoost classifier

Indoor localization systems with higher precision and integrity are being highly demanded because of their numerous applications in superstores, smart homes, smart cities, elderly care, and disaster management. Although there are many technologies for indoor positioning e.g., Wireless Fidelity (Wi-Fi), Bluetooth Low Energy (BLE), and Radio-Frequency Identification (RFID), the high precision localization is still challenging because of the multipath effect and non-line of sight propagation of radio waves in complex indoor environment. This research proposes an explainable indoor localization (EIL) method for higher precision and integrity in IPS. The proposed localization method considered received signal strength indicator (RSSI) from BLE devices for predicting their precise locations. A recursive continuous Wavelet transform (R-CWT) method is proposed to extract discriminative features from the beacon signals for efficient localization. The extracted features are then fed to the extreme gradient boosting machine for the accurate classification of indoor positions. Moreover, to ensure integrity in indoor position classification, the Shapley additive explanations (SHAP) method is introduced to interpret the results obtained from the gradient boosting machine. The proposed method (EIL) precisely localize BLE devices within 1.5 m in a superstore environment with an accuracy of 98.04% which is much higher than the reported accuracies in existing studies.

Using Cultural Lens Theory to Investigate the Impact of a Nursing Education Practicum in Aged Healthcare: Aotearoa New Zealand's Bi-cultural Framework.

AimThe aim of this paper is to apply Cultural Lens Approach theory to data collected from third year nursing students related to an assignment undertaken during their month-long practicum placement in an aged residential care facility. We explore the extent to which a national vision of bi-culturalism and inclusivity is evident in students’ quality improvement project topic selection and practice.BackgroundAotearoa New Zealand is a nation of dual heritage, informed by the cultures of Māori as the indigenous tangata whenua (people of the land), and Pākehā, (European) settlers. All public sectors, including all higher education providers and the curricula they deliver, are required to incorporate and promote a contemporary, bi-cultural world-view.MethodsStage one of the research reported in this paper involved a) document analysis of 93 students’ quality improvement project reports; b) focus groups with 18 students; and c) an online questionnaire for 16 key stakeholders including aged care managers, clinical nurse leaders and student nurse educators. Stage two reviewed the above data through a five-step Cultural Lens Approach process to identify cultural biases and assumptions.ResultsQualitative analysis revealed students’ increased professional confidence, improving communication and critical thinking skills. Responses as to development of cultural competence and cultural safety were mixed: a key barrier identified was that staff in the placement setting received minimal professional development to ensure appropriate tikanga (customary protocols and practice) for Māori residents was in place.ConclusionViewed through a cultural lens, a westernized concept of aged healthcare provision continues to prevail in most settings. Nursing students noted gaps between cultural learning and practice.

A Scoping Literature Review of Rural Institutional Elder Care.

Under circumstances of pervasive global aging combined with weakened traditional family elder care, an incremental demand for institutional elder care is generated. This has led to a surge in research regarding institutional elder care. Rural residents’ institutional elder care is receiving more attention as a major theme in social sciences and humanities research. Based on 94 articles related to rural institutional elder care, this study identified the most influential articles, journals and countries in rural institutional elder care research since 1995. This was done using science mapping methods through a three-step workflow consisting of bibliometric retrieval, scoping analysis and qualitative discussion. Keywords revealed five research mainstreams in this field: (1) the cognition and mental state of aged populations, (2) the nursing quality and service supply of aged care institutions, (3) the aged care management systems’ establishment and improvements, (4) the risk factors of admission and discharge of aged care institutions, and (5) deathbed matters regarding the aged population. A qualitative discussion is also provided for 39 urban and rural comparative research papers and 55 pure rural research papers, summarizing the current research progress status regarding institutional elder care systems in rural areas. Gaps within existing research are also identified to indicate future research trends (such as the multi-dimensional and in-depth comparative research on institutional elder care, new rural institutional elder care model and technology, and correlative policy planning and development), which provides a multi-disciplinary guide for future research.

The type and scope of physiotherapy is under-utilised in Australian residential aged care facilities: a national, cross-sectional survey of physiotherapists

BackgroundWith an increasingly ageing population in Australia, more older adults who are frail are living in residential aged care facilities (RACFs). The aim of this study was to detail the type, scope, and funding of physiotherapy utilised in Australian RACFs.MethodsRegistered physiotherapists (n = 219, 72% female, mean age (SD) = 38.6 (12.9) years) working in Australian RACFs participated in a nationwide, cross-sectional online survey. The survey was developed iteratively through a review of the literature and clinical guidelines, consensus of final survey items by an expert panel of five senior physiotherapists and aged care managers. Survey questions related to the characteristics of the physiotherapists (e.g., age, gender, employment status), characteristics of the RACFs (e.g., state, remoteness, sector), the type and scope of physiotherapy provided by respondents, and the availability of equipment and certain spaces (e.g., gyms) in the RACFs that respondents worked in. Survey responses were analysed and presented descriptively. Correlation using Spearman’s rho (ρ) and the associated 95% confidence intervals (CI) were used to determine whether the availability of equipment or space at the RACF was associated with the time dedicated to performing non-Aged Care Funding Instrument (ACFI) tasks.ResultsCommon reasons for physiotherapy referral were chronic pain management as per the ACFI framework (89.7%), falls (69.2%), and reduced mobility (35.9%). Rehabilitation or short-term restorative care was provided in only 22.2% of the facilities. The ACFI funded 91.4% of all participants, which limited physiotherapists to low-value chronic pain management including massage and electrical stimulation. Respondents spent 64.5% of their time on ACFI tasks, which equated to 19 h per week. More time was spent on non-ACFI tasks particularly when resistance bands (ρ = 0.28, 95%CI 0.14–0.41) and a dedicated therapy space or gym (ρ = 0.19, 95%CI 0.04–0.33) were available.ConclusionsThe expertise of physiotherapists is currently being under-utilised in Australian RACFs, which may be related to the availability of public funding, equipment, and space for therapy. Therefore, public health policy should address the urgent need for high-value, evidence-based physiotherapy that supports the reablement and independence of older adults living in RACFs.

Construction and practice of practical teaching system for intelligent health care service and management in vocational colleges

In the context of an aging population, the shortage of senior care practitioners and the lack of professional capabilities have become increasingly prominent. In order to adapt to the new situation of the development of senior care services, new standards and new requirements have been put forward for the practical teaching of smart and healthy senior care services and management. Through the construction and practice of the practical teaching system of smart and healthy elderly care services and management, the basic framework of the practical teaching system, the curriculum system, the platform construction and evaluation mechanism, and the construction effect are discussed, forming a "four-in-one" practice. The teaching system lays the foundation for deepening the practical teaching reform of smart and healthy elderly care services and management, and cultivating high-quality technical and skilled talents.

Assistive Robots Designed for Eldery Care and Caregivers

As per the World Population prospects (19th revision), in 2019 every 11th person (11% of the population) was aged 65 or older and by 2050 every 6th person (16% of the world population) will be aged 65 or older. This rapid growth in people aged 65 and above has and will continue to pose some health management concerns, especially in the elderly with chronic ailments. The need for care provision for the elderly has provoked an exploration of various solutions to address elderly care management. Non-pharmacological interventions that utilize technology, such as robotics, are solutions that have proven to prolong independence and delay the admission of elderly into assisted care facilities. This paper will explore the various types of robotic solutions that are currently available to offer elderly care. This study will look at robotic solutions that are humanoid, animal-like, and robots that do not resemble humans or animals and their applications in elderly care. The various applications of robotics and the respective types of robots utilized in the provision of care in elderly care will be discussed as well.

\u201cA good death but there was all this tension around\u201d- perspectives of residential managers on the experience of delivering end of life care for people living with dementia

BackgroundEnd of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia.MethodsFocus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis.Results20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding.ConclusionAged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.

Caring Leader Identity Between Power and Powerlessness

This paper investigates what happens when managers’ identity is centred on caring, an underappreciated aspect of leadership. Drawing on a case study of managers in elderly care, we distil an ideal-typical caring leader identity as well as contextualised interpretations that suggest both problematic and constructive aspects. The caring leader identity implies a self-understanding as being highly present, supportive and helpful to subordinates’ development. We find that the belief of making a decisive difference to others’ development by caring for them can be a deceptive fantasy that incites over-dependence among subordinates, particularly for ambitious managers who experience pressing situations and little power. Under better but likely less common conditions, managers can develop more modest expressions of a caring leader identity, leaving space for subordinates themselves to define problems and explore solutions.

First-line managers’ practices and learning in unpredictable work within elderly care

ABSTRACT Despite the number of studies confirming a high degree of unpredictability in managerial work, little is still known about how managers’ workplace learning happens within organisations in such circumstances. This paper therefore aims to contribute knowledge about managers’ learning in managerial practice when work is unpredictable, by investigating how first-line managers deal with unforeseen situations and how they learn in such circumstances in everyday work. Data was collected via qualitative interviews with 40 first-line managers in Swedish elderly care. By using a theoretical framework based on practice and workplace learning theories, the paper analyses how managers address unpredictability in work through three embedded practices: maintaining, modifying and inventing. The paper goes beyond research on leadership training and leadership development by contributing knowledge about the everyday learning of first-line managers when their work is unpredictable. The unpredictable managerial work does not always create chaos; instead, there are very orderly ways of learning from dealing with unforeseen situations. The unforeseen is not as unpredictable as it might seem in managerial work. On the other hand, that which is not yet known calls for an inventing practice, which results in managers learning to take new paths that can create new practices.

Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings.

Background:There are no studies on how the same psychosocial dementia care program is adapted to both in-home and residential care settings.Objective:To evaluate the time investment required by professionals to implement a psychosocial dementia care program to manage neuropsychiatric symptoms.Methods:A prospective observational study design was used. The program consisted of 1) a one-day training course, 2) three interdisciplinary discussion meetings in five months, and 3) a web-based tool for the continued assessment of neuropsychiatric symptoms. Care professionals implemented the intervention in in-home (19 in-home care management agencies and 14 multiple in-home service providers) and residential care settings (19 group homes and eight nursing homes) in Japan from October 2019 to February 2020. The level of neuropsychiatric symptoms for the participants was evaluated using the Neuropsychiatric Inventory (NPI: 0–144). The time investment was reported by participating professionals. A total of 125 persons with dementia were included at baseline.Results:Neuropsychiatric symptoms were significantly decreased at the final follow-up in all types of providers (Cohen’s drm = 0.44–0.61). The mean (SD) time required for the five-month implementation was 417.9 (219.8) minutes. There was a mean (SD) decrease of 8.6 (14.0) points in the total NPI score among the 103 persons with completed interventions. The time investment was significantly lower in in-home care management agencies than in group homes, and lower in follow-ups than at baseline assessment.Conclusion:The program implementation may incur a substantial time investment regardless of setting. An additional benefit scheme to reward the time investment would be helpful to encourage implementation until the follow-ups.

Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries

Abstract Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form. In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management. We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases. We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed. In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.

First-line managers dealing with different management approaches

PurposeThe purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management approaches at the intersection of the central and local parts of the organization.Design/methodology/approachThe present study has a qualitative approach and is part of a larger project on FLMs in elderly care. The results presented here are based on a secondary analysis of 15 of the total of 28 interviews carried out in the project.FindingsThe main results are twofold: the majority of FLMs perceived differences in management approaches between local and central management; the differences caused some struggle because FLMs perceived that the management system did not support the differences. The two main aspects that caused the FLMs to struggle were differences in the foci of the management levels and difficulties in influencing the conditions of management.Originality/valueThe results contribute to the debate on what aspects are important to sustainable management of elderly care. It is common knowledge that FLMs have a complex position, intermediate to the central, upper level management and their subordinates at the local level – levels with different foci and interests. The study contributes new knowledge about what these differences consist of and the dilemmas they cause and offers suggestions as to what can be done to reduce both energy waste and the risk of low job satisfaction.