Aged Care Services Research Articles

The impact of smart elderly care service acceptance on elderly service usage behavior in Xi’an: An analysis of mediating effects based on the UTAUT model and the moderating role of digital literacy

As the aging trend intensifies, the Chinese government prioritizes technological innovation in smart elderly care services to enhance quality and efficiency, catering to the diverse needs of the elderly. This study examines the acceptance and usage behavior of smart elderly care services among elderly individuals in Xi’an, using a modified Unified Theory of Acceptance and Use of Technology (UTAUT) model that includes digital literacy as a moderating variable. Data were collected via a survey of 299 elderly individuals aged 60 and above in Xi’an. The study aims to identify factors influencing the acceptance and usage behavior of smart elderly care services and to understand how digital literacy moderates the relationship between these factors and usage behavior. Regression analysis assessed the direct effects of Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC) on usage behavior. These dimensions were then integrated into a comprehensive index Service Acceptance to evaluate their overall impact on usage behavior, with behavioral intention examined as a potential mediating variable. Results indicate that EE and SI significantly impact the adoption of smart elderly care services, whereas PE and FC do not. Behavioral intention mediates the relationship between these variables and usage behavior. Additionally, gender, age, and digital literacy significantly moderate the impact of service acceptance on usage behavior. This study provides valuable theoretical and practical insights for designing and promoting smart elderly care services, emphasizing the importance of usability and social promotion to enhance the quality of life for the elderly.

Residential medication management reviews: a call for improved collaboration and systems integration in aged care

Purpose Residential Medication Management Reviews (RMMR) are a key component of safe, high-quality aged care service delivery. The RMMR is an interdisciplinary approach to medication management that relies on collaboration, communication and integration of systems. Acting as an improvement opportunity, the purpose of this paper is to present findings from a regional study, aimed at assessing the impact of RMMR on falls and hospital admissions and identifies barriers to impactful research in this area. Design/methodology/approach A three-year retrospective quantitative longitudinal practice audit was conducted in a regional state-managed high-care residential facility in Queensland, Australia. Data was collected pre-RMMR and six months post-RMMR. Findings The data collected was insufficient to achieve statistical significance or demonstrate the impact of RMMR on health outcomes. Factors impeding the research included limited ability to collect the data due to the lack of integration of information systems and limited stakeholder engagement resulting in poor recruitment. This highlights the need for improvement in RMMR processes and practices, and indeed wider research collaboration in the aged care sector. Research limitations/implications Thís paper acts as a call to action to improve research and interprofessional collaboration in Australian aged care. Originality/value The aged care industry needs high-quality research to drive practice improvement and collaborative care and service delivery. This paper advocates for improvements in the aged care sector with respect to research engagement and communication pathways between service providers. Advancement in systems integration for information sharing, recruitment of participants and stakeholder engagement will support evidence-based practice and process change.

Outputs from a model of co-research with older care-experienced people in Sweden to advance eldercare services.

Within the contemporary policy turn towards co-production and co-research in Sweden, older people, practitioners and researchers alike have expressed uncertainty about how to undertake co-research. Moreover, scepticism persists about the merits and contributions of co-research and co-production to research and service development. In this paper, we aim to describe a co-research model developed with older care-experienced lay co-researchers and explore the utility of our model's outcomes to social care research and practice. In a Participatory Action Research project, we established a team of three co-researchers by professional experience and eight lay co-researchers by lived experience who were over age 75. Our team undertook a complete study cycle from inception and funding through to knowledge exchange and dissemination. Our process lasted one year and comprised three phases: the group alone establishing collective knowledge, testing knowledge in peer interviews with acquaintances, exchanging knowledge in events with multi-sector actors. We generated and analysed data concurrently in fortnightly workshops and round-table meetings using procedures inspired by framework analysis to produce themes illustrated by vignettes. We highlight our co-research model's utility to social research, policy and practice under three themes. Expressly, how our approach (1) reaches and engages older people who are isolated at home, (2) generates out-of-the box thinking and innovative solutions for service development and research, (3) recognizes and benefits from older people's authentic experience and knowledge. We critically reflect upon these three themes and the conditions that lead towards or away from the adoption of key co-research principles. Public services and research and development units working in the interests of older people can take inspiration from our co-research model when seeking to meet the challenges brought by new reforms towards closer community involvement. Despite messiness in the process, integrating and embedding principled co-research and co-production can bring clarity and structure to the issues that matter most to older people, and draw organisations closer to the communities they serve.

Responsive service design and workforce strengthening: Recommendations to improve aged care for Aboriginal and Torres Strait Islander peoples.

This study aimed to develop innovative and practical strategies and recommendations for aged care policy and practice that support the needs of Aboriginal and Torres Strait Islander peoples. A research symposium was held in June 2023 on Kaurna Country at the South Australian Health and Medical Research Institute. The symposium brought together 70 attendees including aged care consumers, Federal and State Government representatives, advocacy services, health, aged care and social service providers, and health and aged care researchers. Two roundtable sessions titled 'Responsive Service Design' and 'Workforce Strengthening' were conducted following a World Café approach. Data were analysed thematically. This paper proposes recommendations relating to innovation and improvement within aged care policy and practice. Recommendations for responsive service design and workforce strengthening include the following: (1) promote genuine engagement and involvement, (2) establish partnerships between sectors, (3) ensure compliance, (4) innovative communication and feedback pathways, (5) holistic approaches to well-being, (6) prioritise cultural safety and (7) flexible recruitment and retention strategies. Working together and building partnerships between diverse stakeholders including community members, workforce, service providers and policymakers is required for sustainable and meaningful innovation within the aged care sector. Our recommendations, driven by community needs, provide an opportunity to ensure the innovation and implementation of ongoing aged care reforms meet the needs and expectations of Aboriginal and Torres Strait Islander peoples.

Analysis of Status Quo of Guangxi Elderly Care Service Model Based on Panel Data: Prospects and Challenges

Analysis of Status Quo of Guangxi Elderly Care Service Model Based on Panel Data: Prospects and Challenges

A Sustainable urban renovation assessment model (SURAM) for enhancing elderly-friendly environments

The rapid increase in the aging population has raised significant concerns about the living conditions and well-being of elderly residents in old communities. This study addresses these concerns by proposing a Sustainable Urban Renovation Assessment Model (SURAM) specifically designed to enhance elderly-friendly environments in Chongqing City. The model encompasses multiple dimensions, including the comfort of public facilities, service safety and convenience, medical travel services, infrastructure security, life service convenience, neighbor relations, ambulance aid accessibility, commercial service facilities, privacy protection, elderly care facilities and service supply, and medical and health facilities. By employing factor analysis, the study reduces the dimensionality of the 49 indicator factors, allowing for a more focused and comprehensive evaluation of the effectiveness of aging-friendly renovation efforts. The main factors identified in the proposed model include community infrastructure security, elderly comfort of community public facilities, completeness and convenience of surrounding living services, and security and convenience of elderly care services. The results reveal that the age-appropriate comfort of public facilities plays a significant role in achieving successful aging-appropriate renovation outcomes. The findings demonstrate that by addressing specific needs such as safety, accessibility, and convenience, communities can significantly improve the quality of life for elderly residents. Moreover, the application of SURAM provides actionable insights for policymakers, urban planners, and community stakeholders, guiding them in implementing targeted initiatives for sustainable and inclusive urban development.

Culturally Aligned Aged-Care Services: Addressing Needs and Barriers in General Santos City, Philippines

The aging population in General Santos City, Philippines, presents unique challenges in accessing and delivering appropriate aged-care services. This study aimed to identify the preferred aged-care services among the elderly population in General Santos City, considering their cultural values and needs, and to propose a framework for developing culturally aligned aged-care support services for the elderly in General Santos City. A mixed-methods research design was employed, combining qualitative and quantitative approaches. In-depth interviews with 30 elderly residents, community leaders, and caregivers were conducted to gather information on their preferences and needs for aged-care services. Thematic analysis was used to analyze the qualitative data. A survey questionnaire was also used to collect quantitative data on the demographic characteristics of the respondents and their perceptions of the importance of various aged-care services. The findings indicated healthcare services, home-based care, and social support as essential components of aged-care services. Barriers to accessing services included availability, affordability, accessibility, and awareness. Culturally sensitive, family-centered, and community-based care was preferred. The study also found that the elderly in General Santos City have a strong preference for culturally aligned aged-care services that are family-centered and community-based. They also expressed a need for affordable and accessible healthcare services, as well as social support services to reduce isolation and promote mental well-being. In conclusion, the study highlights the need for a holistic aged-care approach that integrates healthcare services, home-based care, and social support, while considering cultural values and addressing barriers to access. The proposed aged-care services emphasize culturally sensitive, family-centered, and community-based models of care. These models should be tailored to the specific needs of the elderly population in General Santos City, taking into account their cultural values and beliefs.

Explaining Variation in Decision‐Making Authority for Care Managers in a Decentralised Welfare State

ABSTRACTLocal policy documents play a key role in the provision of social services in decentralised welfare systems. Previous Swedish research shows great municipal variation in local policies for delegation, which determines social workers' legal rights to make decisions about the welfare service given to older people. In this paper, we examine the association between local conditions and the variation of restrictiveness in local policies on delegation for elder care services, by combining data on political rule and economic, demographic, and geographic characteristics of all Swedish municipalities (n = 290), with data on delegation policy. Based on logistic regression models, the results indicate that population density, political rule and average income are correlated with the probability of restrictiveness in delegation. Our findings highlight the importance of understanding local conditions while allocating the responsibility for the provision of welfare in decentralised states with varying local prerequisites. They further highlight the need for studies investigating the consequences of varying local political policies on the outcome of the elder care services provided to older adults.

Impact of family members’ perception bias on service strategies of elder care institutions

Family members play an important role in the decision-making process of the elderly in accepting elder care services, which inevitably influences the operational strategy of elder care institutions (ECIs). Previous literature has focused on the disagreements between the elderly and their family members, but a research gap remains in examining the effects of family members’ perception bias on ECIs’ decisions to outsource service and on the elder care service market in general. Our study bridges this gap by employing a game-theoretic model that incorporates monopoly and duopoly markets to explore these effects. Our findings indicate that family members’ perception bias for ECIs’ services negatively impacts ECIs’ prices, demand, and profit. Moreover, we find that in the monopoly market, an ECI should adopt the outsourcing strategy to reduce losses if family members’ perception bias is higher. In the duopoly market, when family members’ perception bias is higher, if one ECI adopts the outsourcing strategy, then the other ECI should opt for the self-providing strategy, and vice versa. Furthermore, we observe that a higher perception bias decreases family surplus and social welfare in the monopoly market. However, it may sometimes benefit family surplus and social welfare in the duopoly market. Our results offer insightful takeaways for ECIs’ operational strategies and policymakers’ welfare policies in the elder care service market.

Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): protocol for a stepped-wedge cluster randomised controlled trial

BackgroundThe health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses’ accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources. When these challenges mount, residents are put at greater risk of adverse outcomes, such as avoidable clinical deterioration and hospital transfers. This study describes the adaptation and implementation of the emergency nursing framework, HIRAID® (History including Infection risk, Red Flags, Assessment, Interventions, Diagnostics, reassessment, communication and plan)—a tool to assist nurses’ assessment, decision-making and care in residential aged care.MethodsThe HIRAID® framework will be adapted for residential aged care using a real-time Delphi and panel of aged care and nursing experts. The co-designed HIRAID® Aged Care framework will be trialled in 23 residential aged care homes in Sydney, Australia, in a modified stepped-wedge cluster randomised controlled trial design. All homes will be randomised into one of four clusters. Outcomes of interest include the rate of clinical deterioration events resulting from nurses’ actions, the rate of hospital transfers determined to be inappropriate, performance against the national mandatory aged care quality indicators, resident satisfaction with care, nurse and medical staff satisfaction with communication, and the quality of nursing documentation. These outcomes will be evaluated using a combination of qualitative and quantitative analysis of routinely collected resident data, expert assessments of facility documentation events against validated criteria, and pre- and post-intervention surveys of residents, family carers, nurses, and medical staff.DiscussionThis protocol describes a pragmatic trial that aims to translate an evidence-based framework from the emergency care context into residential aged care. The adapted HIRAID® Aged Care framework will be the first of its kind to standardise and guide holistic nursing assessment, decision-making, and documentation in residential aged care in Australia.Ethics and disseminationThis research has been approved by the Western Sydney Local Health District Human Research Ethics Committee: 2023/ETH00523. A waiver of consent has been approved to access resident health data and nursing documentation at each participating site.Trial registrationAustralian and New Zealand Clinical Trial Registry, ACTRN12623000481673. Registered 12 May 2023.Protocol versionVersion 1.0 6 February 2024.

Research on How the Digital Economy Contributes to Achieving A High-Level and Balanced Development of the Elderly Care Service Industry

Abstract China’s aging population has gained significant attention. Population aging implies that the demand for elderly care services will be on the rise. However, China’s aging exhibits a notable characteristic of getting old prior to achieving affluence, which directly constrains the enhancement of the level of elderly care services. The Communist Party of China and the government attach considerable importance to the issue of population aging and pensions. The Third Plenary Session of the 20th CPC Central Committee adopted the Decision of the CPC Central Committee on Further Comprehensively Deepening Reform and Promoting Chinese-Style Modernization, emphasizing that “we should actively respond to population aging and improve the development of elderly care and elderly care industry policy mechanisms.” Regarding the supply of pension services, due to the professional and long-term nature of pension services, the supply cost remains high. The contradiction between the low level of demand and the high cost of supply might lead to the “low-level equilibrium trap” of the elderly service industry. The digital economy has achieved remarkable effects in promoting the elderly care service industry. It has played a vital role in optimizing the allocation of elderly care resources, reducing the cost of elderly care services, and creating a superior elderly care ecosystem. In this context, it holds considerable academic value and practical significance to study the impact of the digital economy on the development of pension service industry, to analyze the digital divide and bridge the path for the development of the pension service industry, and to explore the countermeasures and ideas of the digital economy to facilitate the high-level, balanced, and high-quality development of the pension service industry.

Elderly Care Provision under National Policy on Older Persons 2013: A Cross-Sectional Study in Dhaka City, Bangladesh

Bangladesh is undergoing a notable demographic transition, characterized by a substantial rise in the proportion of elderly individuals within its population. This demographic transition presents a range of economic, social and cultural issues that necessitate prompt attention and intervention. The aim of this study was to examine the current state of elderly care services and facilities available for older adults in urban landscape by taking into account the ‘National Policy on Older Persons 2013.’ This study was conducted in Dhaka city by employing a cross-sectional study design. The study population covers elderly people aged 60+ years, living in Dhaka City for more than five years continuously and are able to speak well with someone. The study was based on a sample of 240 and the respondents were chosen using convenient sampling technique. The data were collected through face-to-face interview using structured questionnaire and they were analyzed utilizing descriptive statistics. This study found that the existing elderly care services and available opportunities are below the satisfactory level for most of the older adults of the city, even though the ‘National Policy on Older Persons 2013’ was adopted a decade ago. The elderly people in Dhaka city encountered a number of difficulties considering their physical health, psychological and social well-being. In the case of availability of the affordable and quality healthcare services for older adults in their community, 30.4% of the respondents said that the availability, accessibility and affordability of quality healthcare services are very poor, followed by 24.6% below average and 26.3% at the average level. Nearly 75% of the study people said that they had ever experienced unfair treatment for being aged. Indeed, they receive care and support in an inconsistent, disorganized and incoherent manner. The study clearly revealed that there is a need to prioritize person-centered care as well as integrated care system for the effective management of the ageing population in Bangladesh. Jagannath University Journal of Science, Volume 11, Number 1, June 2024, pp. 118−134

Supportive Leadership for Impact on Building Organisation Resilience

The health, aged and social care service sectors routinely need to deal with the consequences of stress in the delivery of care and support services; trauma; interpersonal conflict; accidents; rationing; and sustainability. For sustained and healthy functioning health workers need intrinsic and extrinsic support for resilience or the ability to maintain confident, steady and healthy functioning in response to such consequences of stress [1]. Those providing direct and indirect care [2] and those working in varied and challenging areas and location of care delivery [3] need constructs and skills to build and deal with resilience individually as well as in conjunction with collective opportunities within their organisations (teams, units, groups and organisations).....

Research on the Current Status of Pension Models for Individuals with Mental Disorders in China

Objective: By analyzing the existing literature, this paper aims to explore the current situation of the pension model for patients with mental disorders in China and put forward corresponding suggestions for improvement. How: This study analyzes the current situation of the pension model for patients with mental disorders in China by referring to the views of experts and scholars, relevant cases and statistical data through the literature and review of CNKI. Focusing on the existing elderly care service system, policy support and social cognition, this paper reveals the main characteristics and existing problems of the current Chinese elderly care model for people with mental disabilities. By comparing the advanced pension models at home and abroad, this paper puts forward some suggestions on strengthening policy support and improving service system. Results: The research shows that China's existing pension models mainly include family care, institutional pension and community service. The main problems facing: insufficient service supply, shortage of professional talents, social cognition and discrimination. Home care is still the main way, more than 70% of people with mental disorders rely on home care, but face great pressure and challenges; The construction of institutional elderly care and community service systems is gradually developing, but there are still insufficient resources, low service quality, and uneven distribution between urban and rural areas. Policy suggestions: Strengthen the construction and improvement of community support system; Improve professional training to ensure service quality; Use scientific and technological means to assist the elderly and ease the shortage of human resources. It is suggested that we should strengthen the construction of community support system and improve the level of professional service in the future. Conclusion: In China, the mode of nursing care for patients with mental disorders is in the transition period, and family nursing is still the mainstream, but it also faces great challenges. Institutional care and community services have developed, but they are not yet sufficient to replace the role of the family. The future development direction should be multi-dimensional, forming a diversified and three-dimensional elderly care service network.

The importance of recognition: predictors and outcomes of carer recognition among working carers of ageing relatives

ABSTRACT Many people manage the dual roles of employment and providing unpaid care for an older relative. Although this is increasingly common, carers frequently observe that their caring role is undervalued. This lack of recognition and the adverse consequences that flow from it are of increasing interest to policymakers, advocacy bodies, and employers who have advanced legislative, policy, and workplace accreditation initiatives to enhance recognition of caring. However, the design and impact of these initiatives are constrained by the scarcity of research on carer recognition, its predictors, and its outcomes. Drawing on data from the Australian National Carer Survey, we utilise path analysis to test a conceptual model outlining how life experiences shape carer recognition and subsequent personal outcomes. Our findings provide support for the mediating role of carer recognition linking care-related disruptions in multiple domains (aged care services, employment, family) with carer outcomes (social connectedness, personal well-being, psychological distress, personal time alongside caring). Employees who experienced less disruption in aged care services, employment, and family domains reported higher carer recognition and better outcomes than employees with more disruptive experiences in each domain. The findings suggest new points of intervention to enhance carer perceptions of recognition, and in turn, carer outcomes.

Service specification for senior care workers with traditional Chinese medicine specialty

Abstract Senior care workers specializing in traditional Chinese medicine (TCM) healthcare have become an indispensable force in institutional care, community care, and home care. The first Chinese nursing service team aimed to improve the health of the elderly by providing continuous services for physical and mental well-being, disease prevention, physical amelioration, and overall health enhancement using TCM concepts, methods, and technologies. The primary purpose of formulating this TCM health and elderly care worker service specification was to standardize services within the TCM elderly care industry, ensuring that the elderly receive better health and elderly care services supported by technical expertise. This specification outlined the basic requirements for TCM health and elderly care workers, including standards for service content, service quality control, service evaluation, and improvement. It primarily focused on the content and requirements of TCM health and elderly care services, such as constitution identification, life care, acupoint healthcare, and TCM auxiliary nursing for elderly individuals with chronic diseases. This specification is applicable to TCM health and elderly care personnel at various levels of hospitals and healthcare institutions and is noted for its strong applicability and effectiveness.

Unveiling the Nexus: Elevating marketing strategies for enhancing satisfaction and loyalty in elderly health care services

The study aimed to examine whether there is an association of marketing mix, and perception with customer’s satisfaction, and loyalty among elderly people. A total of 400 participants were included in the study. The study population comprised individuals aged 65 years and above from Assam, India including both males and females. Participants were primarily selected from residential homes, old age homes, and various common gathering places such as parks, shops, Namghar (a holy place), and community halls. The study indicated a significant correlation between the dimensions of the marketing mix, perception, satisfaction, and loyalty. Moreover, the findings from the linear regression analysis, revealed customer satisfaction towards the marketing of healthcare services can be attributed to product, price, place, process, and physical evidence (7 P’s) and customer perception (R2=.54; .53 respectively). Additionally, customer loyalty towards the marketing of healthcare services is influenced by product and price (7P’s), and customer perception (R2=.54; .2 respectively). This study contributes to understanding the overlooked aspect of marketing to the elderly population, providing valuable insights for healthcare companies to develop improved marketing strategies. Hence, irrespective of the organization's size, type, or location, whether it's a startup or an established entity, privately owned or government-operated, local or global, the role of business managers is vital in making informed decisions and establishing strategic priorities to allocate resources efficiently in order to meet evolving customer demands and achieve business success. As a result, commercial enterprises need to develop tools, concepts, and strategies to effectively navigate the dynamic and unpredictable marketing landscape.

Impact of medical-nursing combined policy pilot on hospitalization frequency of middle-aged and older patients with chronic diseases: a quasi-experimental study based on China Health and Retirement Longitudinal Study.

To address the growing burden of older adult care, the Chinese government has introduced a policy that integrates medical care with elder care, launching two batches of national pilot projects. A majority of the older adult population suffers from one or more chronic diseases, with many experiencing multiple chronic conditions, necessitating support from both elder care and medical services. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2020, this study employs the difference-in-difference (DID) model to analyze the impact of the integrated medical-nursing policy on the physical health of older patients with chronic diseases. The study found that the average annual number of hospitalizations for older individuals with one or more chronic diseases was 0.276. The integrated medical-nursing policy reduced hospitalizations by 0.0405. Additionally, the average annual hospitalization rate for older individuals with two or more chronic diseases was 0.339, higher than the former group. The integrated medical-nursing policy reduced hospitalizations by 0.0738 in this group. The pilot study demonstrates that the implementation of the integrated medical-nursing policy has significantly improved the physical health of older patients with chronic diseases. The government should promote these policies on a larger scale, explore various forms of integrated medical care, and provide more comprehensive medical and elder care services for older patients with chronic diseases.

Reflections on the Challenges of Old-age Security and Policy Options for an Ageing Population

The global phenomenon of population aging is advancing at an unprecedented pace, particularly in China, where the accelerating aging process poses substantial challenges to the existing pension security system. The issue of elderly care has emerged as a critical topic in the realms of society, economy, and politics, impacting national sustainability and social stability. The challenges brought about by an aging society extend beyond the pressures of pension payments and insufficient elderly care services, encompassing risks related to funding sources and management, as well as concerns over the fairness of the security system. In the face of these challenges, there is an urgent need to optimize pension policies, advance pension system reforms, enhance the elderly care service system, and strengthen the coordination between social and medical security to construct a more equitable and sustainable pension security framework. Measures must be collaboratively advanced through top-level institutional design, policy execution efficiency, and societal involvement to provide robust support in addressing the challenges of aging. This paper will delve into the impact of population aging on the pension security system, analyze the current state and shortcomings of policies, and propose strategies to enhance the system's resilience, offering insights and recommendations for strengthening the pension security framework.

What Evidence Exists to Support Palliative Allied Health Practice in Aged Care: A Scoping Review.

Background: As our population ages, the demand for aged care services and palliative care is expected to increase. Allied health professionals have a diverse set of skills to offer in the management of older adults. This scoping review aimed to identify what evidence exists to support the best practice of allied health clinicians in palliative and aged care. Methods: Searches were conducted using broad keywords and MeSH headings with relevance to palliative, ageing and allied health care in the databases Ovid MEDLINE (R), CINAHL, EMCARE, INFORMIT, REHABDATA, PEDRO and SCOPUS, as well as the grey literature. Results: Only 15 studies met the inclusion criteria. A prominent finding was that regular exercise interventions delivered improved mobility, balance, sleep and quality of life outcomes when measured (n = 5). Broader allied health input and outcomes, such as nutrition, were not well described, other than to suggest an interprofessional approach contributed to health benefits where these were observed. Conclusions: The lack of research creates uncertainty about what excellent care looks like and how it can be measured, making it harder for allied health professionals to advocate for funded time in providing care at the end of life and leading to poorer outcomes for older adults.