Aged Care Professionals Research Articles

Registered nurses' perceptions and experience of working in aged care: A qualitative approach.

To understand and report on the perceptions and experiences of registered nurses in the aged care sector. An exploratory qualitative study. Semi-structured telephone interviews were utilised as the primary data collection method. Fifteen registered nurses were interviewed. All interviews were recorded, transcribed verbatim and analysed using conventional content analysis. Participants were quoted verbatim to ensure authenticity. The results indicated a demand for increased administrative and staffing support in the aged care workplace. Poor morale and unethical practices contributed to negative perceptions and attitudes among nurses towards aged care. Managing and communicating with older people was reported as challenging, which impacts nursing staff recruitment and retention. Future work is needed to ensure that outstanding clinical role models and leadership support nursing staff recruitment and retention. Incorporating aged care content into the nursing curriculum and providing professional development opportunities to aged care professionals would be the foundation towards solutions, as the study primarily explored nurses' perspectives.

Widening Participation in Creative Activities for Older Adults

Globally our society is shifting to an older demographic and our lifespan increasing. It is therefore critical that we find and promote solutions to ageing well. There is emerging evidence that engagement in creative activities benefits psychosocial wellbeing and supports cognitive health. However, there are aspects of creative ageing research and implementation that need further development and solution-based thinking. These can be summarized as, (1) providing strong evidence for the benefits of engaging in creative activities; (2) overcoming barriers for participants and researchers; and (3) making engagement in creative activities sustainable. To address these areas, we held a symposium in 2022 and invited stakeholders, including older-adult participants, researchers, practitioners, and aged-care professionals. Symposium participants were allocated into three groups, each with representation from different stakeholders. The groups discussed one of the above areas and then shared ideas with the symposium group. An expert panel led further discussions and sought suggestions for solutions. Key suggestions included involving older adults in research design and planning from the beginning of the process; solutions for accessibility and sense of safety including having “try out” sessions and buddying participants; and creating partnerships with community organizations to promote sustainability. This report summarizes our discussions and advocates for more forums to move the debate forward.

Benefits of Structured Engagement with Target Audiences of a Health Website: Study Design for a Multi-Case Study.

Access to evidence and practice knowledge precedes use, but availability does not guarantee reach and uptake by intended audiences. The CareSearch project provides online palliative care evidence and information to support health and aged care professionals as well as patients, carers and families to make informed decisions about care at the end of life. Already established in the palliative care sector, CareSearch commenced planning to extend its reach, and ensure website use is maximised for different audiences. This paper reports on the development of the Engagement Framework which will be used to guide and deliver an Engagement Project which will actively seek feedback and insights from intended users in a structured process. The process for developing the Engagement Framework commenced with a literature review of approaches used in knowledge translation, implementation science, and social marketing. The Engagement Framework comprising eight steps was then developed. The Engagement Framework outlines the series of tasks to be undertaken by team members when working with three target groups (Aged Care; Allied Health; and Patients, Carers and Families). A process/formative evaluation collecting data using qualitative methods is also described for use in the subsequent Engagement Project. The evaluation will explore the experiences of project participants as well as staff implementing the engagement activities. The three target groups will enable a cross-case comparison of the strengths and weaknesses of the approach. Planning, implementing and evaluating engagement with intended audiences, offers one mechanism to identify ways to increase interaction and integration with knowledge users.

Diversity training evaluation for community aged care: Tool development

Diversity characteristics such as culture, sexual orientation, and social situation potentially impact the participation of older individuals in healthcare. An awareness of diversity characteristics and their potential to impact on older people's access to health and aged care by professionals through training is important. This paper outlines the development and initial validation of a survey using adapted Delphi methodology and distribution to 195 health and aged care professionals pre- and post-diversity training. An initial pool of 31 items were developed with an expert reference group and reduced to 21 through exploratory factor analysis. A two-factor solution was extracted, measuring skills and attitudes of professionals relative to providing services to older people with diverse characteristics. Internal consistency of the items yielded a Cronbach alpha of 0.78. T-tests conducted on the pre- and post-survey data showed significantly higher scores on the domains of skills and attitudes following the training. Knowledge was not effectively captured using this method, with true-false or free-recall questions being a more appropriate approach. This tool fills a gap in the evaluation literature, providing an important first step to assess outcomes of diversity training in community aged care. Further validation is necessary for the tool to be used more widely in the sector.

‘I Want to Go Home Now’: Restraint Decisions for Dementia Patients in Western Australia

This article examines the current legal framework for restraint of persons with dementia in Western Australian aged care facilities and evaluates it in light of recent developments at the national and international levels. It highlights how the current legal framework fails to adequately protect people with dementia and aged care professionals, and considers options for reform. We argue that the viability of supported decision-making for restraint decisions needs to be carefully considered, and that law reform is necessary to ensure that the best decisions are made, the dignity of dementia sufferers is protected, and that there are safeguards to prevent abuse.

Alleged Financial Abuse of Those under an Enduring Power of Attorney: An Exploratory Study

This article examines the issue of alleged elder financial abuse arising from the misuse of an enduring power of attorney (EPA) and the experiences of those vulnerable elders in attempting to access justice to gain information about their situation and/or to remedy the abuse. To achieve this, case file notes from 100 individuals aged sixty-five years and over who sought assistance from an Australian not-for-profit advocacy organisation were analysed. In particular, this article focuses on the nature of the allegations of financial abuse to illustrate the complexities that exist for those in these circumstances. Second, it will consider both the barriers and enablers of access to justice evident in the case files of the individual alleged victims. Lastly, based on the evidence presented, it will consider how these circumstances can be better managed or improved upon, particularly from the perspective of service providers and aged-care professionals.

Improving the quality of life of aged care residents through the joy of food: The Lantern Project.

Mealtimes directly impact the quality of life of residents in aged care. The objective of The Lantern Project is to improve the dining experience of aged care residents to reduce malnutrition risk through improving dietary intake, meal. A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. This paper outlines the journey and timeline of The Lantern Project collaboration since its inception and the interplay between the monthly stakeholder meetings and inter-related research projects demonstrating improved outcomes. Transdisciplinary collaboration offers well-grounded benefits and realistic strategies sensitive to the complexity of the aged care setting.

Japanese health professionals' knowledge of dementia and educational needs: A population study.

Best-evidence dementia knowledge has the potential to improve care practices in aged care settings, although limited research has explored understanding among the Japanese workforce. This study examines the knowledge of dementia and educational needs among aged care professionals across Japan. An online survey methodology was used to assess the dementia experiences and knowledge among a national, random sample of 117 Japanese aged care professionals. Objectively measured scores on the Dementia Knowledge Assessment Scale were moderate and lower than the scores recorded with comparable international cohorts. Knowledge scores were positively correlated with formal dementia education and self-rated knowledge. Knowledge deficiencies were identified concerning differentiation of dementia symptoms, efficacy of pharmaceutical treatments, managing challenging behaviours and patient communication. These results may be used by academics, clinical educators and policy specialists to inform the development of workplace education in the Japanese aged care sector that aims to improve care quality.

Shame, hope, intimacy and growth: Dementia distress and growth in families from the perspective of senior aged care professionals.

Minimal research explores the impact of dementia and a dementia diagnosis on families from the unique vantage of senior health professionals. The participants of this study, eight senior aged care professionals, provided unique interpretative insights into family dynamics and sense-making on the journey with dementia, and their own role in that journey. Both positive and negative perspectives were sought. Data from semi-structured interviews were analysed using Interpretative Phenomenological Analysis (IPA). One superordinate theme, Dementia naiveté; redefined intimacy, overarched Embarrassed shame; Maintaining hope; Redefining a model of intimacy; and Redefined relational intimacy and growth Within these themes, the participants shed light on hurtful embarrassment and shame experienced by families associated with the diagnostic label given to a loved one. This label was perceived to either trigger separation, hurt and immobility through ignorance, or precipitate a frenzy of naive yet hopeful energy for seeking that elusive cure. The participants saw their role as one of enacting a new way of connecting what was with what could be. Thus, they modelled advocacy, integral care and relational intimacy. Validation came in witnessing a redefining of intimacy in many families who were able to embrace that holistic and empathic approach to the shifting presentation of dementia. Psychological well-being was observed to occur when families embraced growthful domains, e.g. acceptance, hope, relational closeness and altruistic concern for other families. Implications for future care models are discussed.

Clinical practice guidelines for dementia in Australia.

About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care.

Aged-Care Professionals' and Health Care Professionals' Self-Reported Impact of Printed Educational Material on Clinical Practice

This study aimed to evaluate the impact of the printed educational material (PEM), the Residential Aged-Care (RAC) Communiqué, on the changing clinical practice of health and aged-care professionals. The RAC Communiqué is a PEM that contains case narratives from Coroners' investigations into potentially preventable deaths in nursing homes. A population-based cross-sectional study was conducted, using an anonymous electronic survey distributed to all subscribers of the RAC Communiqué. The questionnaire consisted of 40 questions in five sections, such as respondent characteristics, respondent preferences and reading behavior, respondent opinion about the RAC Communiqué content, and the mode of its delivery, impact of the RAC Communiqué, and the details of changes in professional practice. The response rate was 58.3% (367/630). Respondents were mostly women aged 45 years and older (n = 319, 86.9%) with more than 10 years of experience (n = 241, 65.7%) in management (n = 171, 46.6%) or nursing (n = 65, 17.7%). Of the 367 respondents, 204 (55.6%) reported changing their practice. Multivariate analysis revealed that women (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.01-4.35) aged between 45 and 54 (OR = 2.06, CI = 1.13-3.75), who read most of the RAC Communiqué (OR = 2.77, CI = 1.34-5.72) and were subscribed for more than 1 year (OR = 3.58, CI = 1.61-7.95) were significantly associated with practice change. More than half of the survey respondents who read the RAC Communiqué self-reported a change in practice highlighting its impact and efficacy as PEM.

Utilization of distributed leadership modelling in the health and aged care sector: a systematic review of qualitative evidence protocol

Utilization of distributed leadership modelling in the health and aged care sector: a systematic review of qualitative evidence protocol

Utilization of distributed leadership modelling in the health and aged care sector: a systematic review of qualitative evidence protocol.

REVIEW QUESTION / OBJECTIVE This systematic review seeks to identify and explore the experiences of health and aged care professionals including health managers in the utilization of distributed leadership modelling. It also seeks to identify and explore their experiences in creating the conditions that enable or impede distributed leadership. INCLUSION CRITERIA Types of participants This review will consider any healthcare professionals, health service planners and or managers who have experienced utilization of distributed leadership. To be included, participants must have been actively engaged in distributed leadership. The review will include healthcare professionals including health managers who have been working in the acute, aged care and/or community sectors. Exclusion criteria will include participants who have not actively engaged in distributed leadership and hence have not provided insight into the utilization of distributed leadership. Phenomena of interest This review will consider studies that investigate the experiences of health and aged care professionals, including health managers, who have utilized distributed leadership modelling in the health and aged care sector. The review will also consider the barriers and facilitators to utilization of distributed leadership. Research studies that have investigated leadership broadly and not distributed leadership specifically will also be excluded. Context An international perspective will be considered regardless of relationship, age, sex, ethnic origin and socioeconomic status. A comprehensive coverage of all representations in health and aged care is required to distinguish between differences in experience and support systems as per the varied contexts of health and aged care professionals, i.e. TRUNCATED AT 250 WORDS

Assessing accuracy of knowledge of cognitive effects of normal ageing and mild stage of Alzheimer's disease

Objectives: This study aimed to develop and pilot the Alzheimer's Disease and Ageing Perception Scale (ADAPS), examine theory-consistent differences and convergent validity, and identify misconceptions of the cognitive effects of ageing and mild Alzheimer's disease (AD).Method: After piloting a large pool of items with a panel of ageing and dementia experts (n = 6), an item analysis yielded a 25-item version of the ADAPS (α = .70), comprising a Normal Ageing subscale (α = .68) and Mild AD subscale (α = .74). Participants from the general community (n = 251) and aged care professionals (n = 59) completed the ADAPS, Knowledge of Memory Ageing Questionnaire (KMAQ), and the Alzheimer's Disease Knowledge Scale (ADKS).Results: Compared to matched controls, aged care professionals demonstrated greater accuracy of knowledge on the Mild AD subscale (p < .05), but not the Normal Ageing subscale (p > .05) of the ADAPS. The pattern of significant correlations between the ADAPS, KMAQ, and ADKS supported the convergent validity of the ADAPS. The most common misconceptions on the ADAPS indicated a tendency for participants to overgeneralise the cognitive effects of normal ageing.Conclusion: This preliminary study introduces a new tool for assessing accuracy of knowledge of cognitive effects associated with normal ageing and mild AD, and may assist in identifying misconceptions of the ageing process.

Content validity of the ResCareQA: An Australian residential care quality assessment based on resident outcomes

Objective: To determine the face and content validity of the Residential Care Quality Assessment (ResCareQA) developed to fill the current gap in quality assessment tools within the Australian residential aged care system. The ResCareQA contains 24 questions across four domains: Resident Health (seven questions), Personal Care (five questions), Resident Lifestyle (five questions) and Care Environment (seven questions), and allows the easy calculation of 36 clinical indicators for an overall assessment of quality in the residential care setting. Design: Face and content validity were assessed by using modified Delphi process to consult an expert panel of experienced aged care professionals and a consumer representative. Setting: The Delphi questionnaire was distributed via email and all panellists completed it online in their own home or place of work. Subjects: The expert panel constituted six members, all of whom were experienced residential aged care professionals. Main outcome measures: The Delphi survey aimed to reach agreement about the face and content validity of the assessment tool. Results: All agreed the ResCareQA had good face and content validity, although some minor changes were suggested to improve content validity. Conclusion: The ResCareQA provides a comprehensive but easy to administer means of monitoring quality in residential aged care facilities, with the tool usually completed in less than 30 minutes. Example questions are included with this article.

An instrument to assess nurses’ and care assistants’ self-efficacy to provide a palliative approach to older people in residential aged care: A validation study

ObjectiveThis study investigated the psychometric properties of the ‘Palliative care self-efficacy scale’, an instrument designed to assess clinicians’ degree of confidence in engaging in patient and family interactions at the end-of-life. DesignThe instrument was administered to 405 aged care professionals employed in nine aged care facilities. Exploratory factor analysis and internal consistency statistics were undertaken. ResultsA two-factor solution of the ‘Palliative care self-efficacy scale’ was extracted with factor loadings above the 0.4 cutoff. Cronbach's alpha of the scale and subscales ranged from 0.87 to 0.92. The ‘Palliative care self-efficacy scale’ demonstrates good validity and reliability. ConclusionsThe ‘Palliative care self-efficacy scale’ can be a useful tool in assessing and monitoring clinicians’ perceived capacity to provide a palliative approach. Further evaluation in other samples and settings is required.

Education and training of aged-care providers.

Population ageing has become a global concern. As persons age they are likely to experience multiple changes, declines, and losses, resulting in multifaceted needs. Psychosocial needs are varied and diverse, reflecting the extreme heterogeneity of the older population and the frequent co-morbidity of physical and mental problems. Training of care providers to work with older people requires an interdisciplinary focus, with biological, psychological, and social aspects of ageing as integral parts of the curriculum. Models for training of aged care professionals include the integration, separate course, area of concentration, and interdisciplinary approaches. In addition, supervised experiences and training in interpersonal skills are required for all service providers. The applications of training models in gerontological and counselling training are described. Implications for education and training of aged-care providers are discussed.