Aged Care Services Research Articles

Challenges and Strategies for Community Elderly Care Services in the Era of Digital Governance

With our country's technological advancements, digital governance is increasingly penetrating all aspects of social life, particularly in the public service sector. As the "silver-haired group" grows, so does the demand for and attention to community elderly care services. The introduction of digital governance offers new opportunities in this field, yet it presents significant challenges. The integration of intelligent technology in community elderly care, facilitated by digital advancements, enhances service efficiency and quality, enabling more convenient and personalized care for the elderly. However, the implementation faces specific challenges: digital anomalies where technology usage exceeds conventional norms, a digital divide marked by the elderly's limited ability to utilize new intelligent devices and services, and insufficient professional training for caregivers. These issues complicate the promotion of digital governance in elderly care services. Addressing these problems involves several strategic measures: refining systems to bridge the digital divide, enhancing the training and familiarity of digital technologies among the elderly, and improving caregiver professionalism. Additionally, establishing robust data security management and privacy protection mechanisms, along with advancing the legal framework surrounding eldercare, are crucial. Moreover, it is vital to provide more emotional care, enhance the elderly's sense of belonging, and meet their emotional needs to support the effective integration of digital governance into community elderly care services.

Analysis of the Problem of “Multi-Party Cooperation” in Solving Elderly Care and Suggestions for Elderly Care in China Under the Model of Integrated Elderly Care and Medical Services

Analysis of the Problem of “Multi-Party Cooperation” in Solving Elderly Care and Suggestions for Elderly Care in China Under the Model of Integrated Elderly Care and Medical Services

A collaborative pharmacist-led intervention to prevent hospital readmissions among elderly patients discharged from the emergency department: a retrospective cohort study

Unplanned hospital readmission is a safety and quality healthcare measure, conferring significant costs to the healthcare system. Elderly individuals, particularly, are at high risk of readmissions, often due to issues related to medication management. Pharmacists play a pivotal role in addressing medication-related concerns, which can potentially reduce readmissions. This retrospective single-centre cohort study, conducted from November 2022 to February 2023 in an emergency department, aimed to determine if integrating emergency medicine pharmacists into Emergency Department care models reduces unplanned hospital readmissions within 28 days and to identify the interventions they employ. The inclusion criteria included patients aged ≥ 65, taking ≥ 3 medications, and presenting with falls, cognition changes, or reduced mobility and were planned for discharge to home from the emergency department. Collaborating with the Emergency Department Aged Care Service Emergency Team, a pharmacist provided comprehensive medication management consultations, discharge liaison services, and other pharmacy related interventions to eligible participants whenever the pharmacist was available. Patients who met the eligibility criteria but did not receive pharmacist interventions due to the pharmacist's unavailability served as the control group. This method was chosen to ensure that the control group consisted of comparable patients who only differed in terms of receiving the pharmacist intervention. The study included 210 participants, with 120 receiving pharmacist interventions and 90 acting as controls. The results revealed a significant reduction in unplanned hospital readmissions among participants who received pharmacist interventions (10.0%, n = 12) compared to controls (22.2%, n = 20), with a notable difference of 12.2% (95% confidence interval 2.4–23.4%, p = 0.01). A total of 107 interventions were documented, emphasising medication selection recommendations (28.0%) and identification of adverse drug reactions/drug-drug interactions (21.5%) as primary areas of focus. These findings suggest that integrating skilled pharmacists into Emergency Department Aged Care Service Emergency Team (ASET) lowered the rate of unplanned hospital readmission within 28 days resulting in improved hospital performance metric outcomes. This highlights the potential role of pharmacists in addressing medication-related issues and enhancing the quality and safety of healthcare delivery, particularly for elderly patients transitioning from the ED to home care settings.

Stretching the social protection system beyond capacity: tensions between governance capacity and conceptualisations of elder care in nursing homes in Indonesia

PurposeAgeing is a global concern that poses many challenges for governments, particularly in relation to the pressing issue of how to provide adequate social protection for the increasing number of elderly. Alongside rapid social and demographic transformation, Indonesia is especially challenged by the increasing number of elderly in need of formal care that is stretching the capacities of government and necessitates improvements in the social protection system. This study examines governance capacity in nursing homes and offers recommendations for improving the social protection system.Design/methodology/approachThe research presents a qualitative case study of government aged care centres in East Java and the experiences of residents and staff of three centres managed by the Provincial Social Service of East Java. The case study is based on ethnographic fieldwork, semi-structured interviews with 32 informants comprising directors, managers, staff and elderly residents of nursing homes.FindingsThe research finds that while social protection is in place, governance capacities at the provincial and local level are thinly stretched. The research highlights the tensions between existent governance capacities – in terms of mobility, decision-making, implementation and established local structures of governance and management – and the inability to meet the increasing demands for government elder care services and resources amidst broader societal transformations such as shifts in cultural framing of familial care of elderly. The findings point to the importance of understanding the dynamic relationship between governance capacity and the shifting terrains of elderly care due to societal transformation.Originality/valueThe research brings attention to the pivotal role that governance capacity plays in shaping the experiences and challenges of local government level elder care provision and the growing need for elder care in the face of an ageing population and shifts in kinship and family elder care arrangements. Elder care is not simply about addressing basic needs but also the quality and dignity of elderly and this is not easy to address where social protection systems are stretched beyond capacity. Recommendations are provided for enhancing government policy and expanding the scope for building cross-sectorial partnerships.

Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017-2019: a population-based retrospective cohort study.

To characterise the socio-demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility. Population-based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data. Aboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 - 31December 2019. Socio-demographic and aged care assessment characteristics; health conditions and functional limitations recorded at the time of the assessment; subsequent aged care service use. The median age of the 6209 people assessed for aged care service eligibility was 67 years (interquartile range [IQR], 60-75 years), 3626 were women (58.4%), and 4043 lived in regional to very remote areas of Australia (65.1%). Aboriginal health workers were involved in 655 eligibility assessments (10.5%). The median number of health conditions was six (IQR, 4-8); 6013 (96.9%) had two or more health conditions, and 2592 (41.8%) had seven or more. Comorbidity was most frequent among people with mental health conditions: 597 of 1136 people with anxiety (52.5%) and 1170 of 2416 people with depression (48.5%) had seven or more other medical conditions. Geriatric syndromes were recorded for 2265 people (36.5%); assistance with at least one functional activity was required by 6190 people (99.7%). A total of 6114 people (98.5%) were approved for at least one aged care service, 3218 of whom (52.6%) subsequently used these services; the first services used were most frequently home care packages (1660 people, 51.6%). Despite the high care needs of older Aboriginal and Torres Strait Islander people, only 52% used aged care services for which they were eligible. It is likely that the health and aged care needs of older Aboriginal and Torres Strait Islander people are not being adequately met.

Discriminative and exploitive stereotypes: Artificial intelligence generated images of aged care nurses and the impacts on recruitment and retention.

This article uses critical discourse analysis to investigate artificial intelligence (AI) generated images of aged care nurses and considers how perspectives and perceptions impact upon the recruitment and retention of nurses. The article demonstrates a recontextualization of aged care nursing, giving rise to hidden ideologies including harmful stereotypes which allow for discrimination and exploitation. It is argued that this may imply that nurses require fewer clinical skills in aged care, diminishing the value of working in this area. AI relies on existing data sets, and thus represent existing stereotypes and biases. The discourse analysis has highlighted key issues which may further impact upon nursing recruitment and retention, and advocates for stronger ethical consideration, including the use of experts in data validation, for the way that aged care services and nurses are depicted and thus valued.

Validation of a national leadership framework to promote and protect quality residential aged care: protocol for a Delphi study

IntroductionAustralia’s ageing population is driving an increased demand for residential aged care services, yet concerns about the quality and safety of such care remain. The recent Royal Commission into Aged...

Revealing the enhancement effect of social capital on the individual performance of core members in elderly caring organizations: A study from Anhui, China.

Aging is a challenge to global development. This challenge is particularly significant for China because it has the largest elderly population worldwide. The proportion of aging population continues to increase, and solely relying on government efforts to meet the needs of the elderly is inadequate. Hence, involvement of social organizations in elderly care services is needed. Their core members exhibit higher sense of responsibility and identification with the organization than regular members, thus profoundly affecting organizational development. Based on the Social Capital Theory, this study employed a multistage stratified random sampling method to examine the social capital stock of elderly social organizations and their core members across six cities in Anhui Province, China. Chi-square tests analyzed the relationship between the core members' demographic factors and individual performance. Independent-sample t-tests assessed the relationship between social capital and individual performance. Finally, binary logistic regression models determined the factors influencing the individual performance of core members. Social networks within core members' social capital and the internal social capital of elderly caring social organizations (ESOs) affect the individual performance of core members. Therefore, organizations should provide more training opportunities for core members to expand their networks. Cultivating a shared language and vision as components of social capital can enhance organizational cohesion and operational stability.

Addressing healthy aging in China: Practices and prospects.

One important challenge for global development is aging. China is one of the world's countries with the highest elderly population and the most rapid aging; in 2022, the percentage of the population over 65 was 14.9%; by 2050, it is expected to rise to 26.1%. China's health security, elderly care, and healthcare services are facing serious challenges as a result of this aging trend. With 80% of provinces including medical and elderly care in national basic public health care programs, China has adopted a proactive national plan to combat population aging. Moreover, geriatric departments have been established at 69.3% of public general hospitals at secondary and higher tiers, 48% of provinces have devises preventive interventions for disability and dementia in the elderly, 48 percent of provinces are serving as test regions for medical care related to rehabilitation, and 49 cities are involved in long-term care insurance (LTCI) trials that encompass 170 million people. There are 4,259 medical and health care facilities that provide hospice care services, 152 hospice care pilot regions, and 87,000 pairs of contracts between medical and health care facilities and elderly care providers. These developments provide a strong basis, but there are still major obstacles to overcome. The Chinese Government is urged to adopt early preventive measures, offer more ongoing, practical, and cost-effective diagnostic and treatment services, allocate resources equitably, and use intelligent technologies to enhance elderly care. The ultimate goals are to lessen the financial burden, enhance the health of the elderly, and offer a vital global resource.

Development of Quality Scale for Elderly Care Service in Chinese Community

Development of Quality Scale for Elderly Care Service in Chinese Community

Research on Innovative Path of Smart Elderly Care Services Based on the "Internet plus" Background

In the 21st century, China's economy has developed rapidly, but at present, the pace of population aging is constantly accelerating, and social problems are becoming increasingly prominent. With the development of high-tech information technology such as the Internet, "Internet plus" has gradually become an important driving force for the development of a new round of industrial revolution. As far as the elderly care service industry is concerned, only by integrating the "Internet plus" and traditional elderly care service model, and upgrading the traditional elderly care service model, can more elderly people enjoy intelligent services in their later years, and promote the sustainable development of the elderly care service industry. This article reviews the current research status of smart elderly care services at home and abroad, the challenges faced by smart elderly care in China, and the innovative path of smart elderly care service models through literature analysis and other research methods. It points out the practical path of smart elderly care services and provides reference for the formulation of practical and sustainable smart elderly care service plans for the elderly.

Capital or burden? The impact of social networks on elderly care services consumption: Evidence from China

Understanding how to expedite the provision of elderly care services to align with the evolving needs of elderly consumers has emerged as a pivotal concern for societies actively embracing aging, particularly in China where the aging population is rapidly growing. Drawing on a field survey, we elucidate the formation of elderly care service consumption through the lens of social capital. Our findings reveal that demand is influenced by social engagement facilitated by social capital, with this effect being more pronounced for bridging capital. Moreover, we ascertain that in China, where 'Guanxi' (close relationships) holds significant importance, the positive impact of social capital on elderly consumers transcends mere informational gains, extending to reciprocity and trust characteristics facilitated by network centrality. Interestingly, our study challenges the applicability of the Theory of Attention Competition in the elderly care service market. In response, we have identified two practical strategies for elderly care service institutions. Firstly, there is a need to create additional opportunities to enhance the depth and scope of social participation among the elderly. This would enable them to access updated information about elderly care service offerings through multiple channels, thereby fostering a better understanding of their specific needs in this domain. Secondly, tailored promotion strategies should be developed to accommodate the diverse characteristics of elderly consumers, ensuring that the services offered align closely with their individual preferences and requirements.

Analysis of the Construction of Rural Home-Based Elderly Care Service System

As my country's aging problem worsens, more and more attention is being paid to the construction of elderly care services in rural areas. This article aims to investigate the current status, problems, and challenges of rural home care services through the analysis of research literature. In the research, it was determined that the number of elderly people living alone in empty nests in rural areas increases every year, and problems such as inadequate elderly care services, low use of community elderly care facilities, and inadequate medical services are becoming more common. its importance is increasing. The current rural home care system has many drawbacks and disadvantages. It is recommended to fulfill the federal government's responsibility for community elderly care services, establish urban elderly care services, improve community elderly care services, and home care of the elderly, and participate in city and community care services for the elderly. Integration of medical and nursing care in rural areas.

Barriers Experienced by Community-Dwelling Older Adults Navigating Formal Care: Evidence From an Australian Population-Based National Survey.

This study aims to identify the relationship between psychosocial factors and unmet needs among community-dwelling older adults who have received or who expect to receive formal home-based aged care services. A subsample of the national Survey of Disability, Ageing and Carers was used to examine the prevalence of having any unmet needs among older adults navigating care. We also examined associations between older adults' psychosocial factors and their unmet needs using logistic regression. Regression analyses highlighted that perceived social isolation (OR = 1.62, 95% CI: 1.30-2.01), high/very high psychological distress (OR = 2.11, 95% CI: 1.52-2.93), and occasional assistance from informal support (OR = 1.92, 95% CI: 1.22-3.05) were associated with increased odds of having unmet needs, after adjusting for other covariates. Our study suggests that older adults facing psychosocial difficulties or lacking informal support are more likely to encounter barriers in accessing formal care. Future policy should address the psychosocial needs and support networks of older adults.

The quality of residential aged care in the context of the Australian aged care reforms: A scoping review.

Australia has been undergoing a major aged care reform process since 2012 focused on consumer-oriented home and community-supported care, but little is known about the impact of these reforms on residential aged care delivery. This study aimed to review research about the quality of residential aged care service delivery during the implementation period of these reforms. The review followed a five-stage scoping review framework and searched five databases for articles published between 2012 and February 2022 (the 10-year implementation period of the reforms). Initial searches identified 495 articles. Articles were imported to Covidence™ for title, abstract and full-text screening. Twenty-two articles were included in the review. Articles were framed using the micro (residents and families)/meso (staff)/macro (governance, government) continuum in the operation of residential aged care facilities. Most articles focused on workforce perspectives. Attention was paid to workforce issues and a limited focus was on consumer experience and expectations. There is a need for an evaluation of the reforms as a vehicle for promoting consumer empowerment. Many contributing factors to quality of care were identified, and there were some quality issues that were contrary to the intended objectives of the reforms. These warrant closer attention.

Exploring the Sustainability of Integrated Elderly Care and Medical Services Policies in China from the Perspective of Policy Tools

The trend of increasing population aging has led to an international and Chinese domestic consensus on the need to integrate elderly care and medical services. Against this background, China's existing policies address the integration of elderly care and medical services (IECMS) successively. However, it is worth pondering whether China's policies on the IECMS have been effectively developed. Previous studies on the IECMS policies in China have mostly focused on the national level, and the evaluation dimensions of these studies are not comprehensive enough. Based on this, this study took the policy tools as primary perspective, constructed a three-dimensional analysis framework that included time and specific models of IECMS, and used content analysis to analyze and evaluate the policy texts related to the IECMS in Jinan City. The aim is to explore policy tools to improve integrated elderly care and medical services, promote the sustainable development of integrated elderly care and medical services in China, and provide Chinese experience for other countries. This study found that the use of policy tools in Jinan City had a trend toward comprehensiveness and diversification, but there is still room for further comprehensiveness and diversification. Moreover, there is an apparent preference in the use of policy tools, as evidenced by the most frequent use of environmental policy tools, and at the same time an imbalance in the internal structure of the three types of policy tools. Furthermore, the policies of Jinan City were not sufficiently targeted to operationalize policy tools into specific models of IECMS. Accordingly, we provide corresponding recommendations, including stating that the IECMS policies should be multifaceted and innovative, even-handed, precise, and timely to restore policy order in the aftermath of the COVID-19 pandemic.

The Medical-Care-Integrated Elderly Care Services Policy in China based on Policy Tools: A Content Analysis

The Medical-Care-Integrated Elderly Care Services Policy in China based on Policy Tools: A Content Analysis

A REVIEW PAPER ON ASSESSING THE EFFICACY OF AGE CARE ADMINISTRATION IN MANGALORE: CHALLENGES AND OPPORTUNITIES IN THE INDIAN CONTEXT

The literature review on the efficiency of age care administration in Mangalore highlights current practices, challenges, and cultural influences. It reveals persistent issues like inadequate funding, lack of trained personnel, and cultural insensitivity despite existing innovative efforts. Integrating modern management techniques with traditional caregiving is crucial for improvement. The review calls for comprehensive policy reforms, enhanced caregiver training, and greater community involvement to enhance age care services in Mangalore. This analysis also identifies significant opportunities across management, education, business, real estate, finance, coaching, and social work sectors to contribute to effective age care strategies. KEY WORDS : Age Care Administration, Elderly Care, Cultural Sensitivity, Financial Management in Age Care, Caregiver Training, Policy Impact.

A Most Significant Change evaluation of a new co-designed tool to measure holistic well-being in consumers of community aged care services.

To evaluate a Wellbeing Check-in tool and process for use with BlueCare's home care package (HCP) clients by care and well-being practitioners. The tool had been co-designed with HCP clients and trialled with 15 clients. The Most Significant Change (MSC) methodology was used to gather stories from five practitioners, five HCP staff and seven clients. A workshop with senior staff was held to determine themes and whether the tool met its aims. Out of 22 MSC stories, 18 were judged in scope by workshop participants. Eight themes were then identified. Four themes reflected the content of the narratives (i.e. what was discussed): Isolation and connection; Grief; Faith/explicit spirituality; and Client preference. The other four themes reflected the process (i.e. what the discussions meant to participants): Being there/Meaningful conversations; Impact on significant others; New insight; and Purpose of the check-in. These eight themes largely reflected the aims of the Wellbeing Check-in tool in terms of providing a means to optimise connectedness, well-being and spiritual care in accordance with the client's needs, goals and preferences. Unanticipated findings included its benefits for family members and uncertainty about the aim or value of the tool, which highlighted the need for BlueCare to be clear about the purpose of the tool in promoting it to clients and their informal carers. The Wellbeing Check-in tool was found to be fit for purpose. A tool used flexibly to prompt discussion about well-being can be helpful to clients and pastoral care staff.

One and the same or different? An empirical comparison of aged care recipient and non-aged care recipient preferences for quality of aged care amongst older Australians

The Quality of Care Experience Aged Care Consumers (QCE-ACC) is a new preference-based instrument recently adopted by the Australian government nationally as a new quality indicator for aged care. This study employed a discrete choice experiment (DCE) approach to develop an aged care user-specific value set for the QCE-ACC instrument. This is crucial for establishing the relative importance of key QCE-ACC dimensions for informing quality assessment and economic evaluation in aged care. We further empirically compared the preferences of aged care recipients and non-aged care recipients amongst the older Australian population (65 years and above) for quality of care experience using the QCE-ACC. A total of 201 older people (age 74.2 ± 6.2; 59.7% female) receiving aged care services completed the DCE survey between August and September 2022. The comparison of relative importance indicated some divergence in the preferences between the aged care recipients and non-aged care recipients. Amongst aged care recipients, being treated with “Respect & Dignity” was the most important quality of care experience defining dimension, with “Health & Wellbeing” ranked second and “Skills & Training” (of staff) ranked third. However, within non-aged care recipients, “Skills Training” (of staff) was considered the most important quality of care dimension. Distinction in the QCE-ACC utility weights distributions and mean values were also observed, suggesting that aged care recipients may have different opinions about the quality of aged care compared to those who have not accessed aged care services. The findings shed light on the unique preferences of aged care recipients, indicating that aged care recipients and non-aged care recipients’ preferences for quality of aged care are not interchangeable. The value set developed in this study is specifically tailored for assessing the quality of aged care using the QCE-ACC instrument from the perspective of aged care users in Australia.