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As consumer-directed care programmes become increasingly common in aged care provision, there is a heightened requirement for literature summarising the experience and perspectives of recipients. We conducted rapid evidence reviews on two components of consumer experience of home- and community-based aged care: (a) drivers of choice when looking for a service (Question 1 (Q1)); and (b) perceptions of quality of services (Question 2 (Q2)). We systematically searched MEDLINE and EMBASE databases, and conducted manual (non-systematic) searches of primary and grey literature (e.g. government reports) across CINAHL, Scopus, PsychINFO, and Web of Science, Trove and OpenGrey databases. Articles deemed eligible after abstract/full-text screening subsequently underwent risk-of-bias assessment to ensure their quality. The final included studies (Q1: N = 21; Q2: N = 19) comprised both quantitative and qualitative articles, which highlighted that consumer choices of services are driven by a combination of: desire for flexibility in service provision; optimising mobility; need for personal assistance, security and safety, interaction, and social/leisure activities; and to target and address previously unmet needs. Similarly, consumer perspectives of quality include control and autonomy, interpersonal interactions, flexibility of choice, and safety and affordability. Our reviews suggest that future model development should take into account consumers’ freedom to choose services in a flexible manner, and the value they place on interpersonal relationships and social interaction.

The extant literature on Jewish Holocaust survivors’ experiences of receiving aged care services typically focuses on the risk that formal care settings may reactivate traumatic memories. Absent from previous research have been the viewpoints of older survivors themselves regarding their aged care experiences. An interpretive phenomenological approach was used to investigate Jewish Holocaust survivors’ lived experience of using community aged care services. Thirteen in-depth interviews were conducted and analysed using thematic analysis. The credibility of the findings was ensured by methodological triangulation and peer debriefing. Four major themes emerged from the analysis: wanting carers to do their job well; being supported to maintain autonomy; having a good relationship with the carer; and being understood as an individual. Although Holocaust survivors described the lived experience of using community aged care services in terms of universal themes similar to those identified with other groups of care recipients, the data revealed that this experience is intertwined with individual earlier-life traumatic experiences. This study has implications for training age care staff who work with Holocaust survivors and older trauma survivors from other refugee backgrounds.

As in other ageing populations, dementia, musculoskeletal conditions and cardiovascular disease affect a high proportion of Australians aged over 65 years, and the prevalence of these conditions increases significantly with age. People with these conditions may need to access a range of care services over time to enable them to remain living in their homes. Many eventually need to move into a nursing home.In contrast to the considerable recent literature on the funding of long-term care systems for population ageing, studies on the care pathways followed by individuals are much less common. This paper explores the effect of disease on use of community care services and nursing homes over time, focusing on people with dementia, cardiovascular disease and musculoskeletal conditions. Care-use transitions are identified using linked administrative client data for a cohort of 33,300 community-living Australians who had an aged care assessment in 2003-04 and who had not previously used aged care services.The different symptoms and courses of diseases meant that the patterns of aged care service use, both in terms of care services accessed and the timing of this access, varied considerably for people with different health conditions. These differences persisted across a range of client characteristics. In particular, people with dementia or cerebrovascular disease as their main health condition were more likely to enter nursing home care than those with heart disease or musculoskeletal conditions.The variation in use of aged care services according to disease group need to be taken into account in any projections of demand for aged care. Such projections must allow for predictions of disease prevalence, or else they will yield inaccurate predictions of demand for both community and residential care.

Conventional wisdom promotes gradual retirement rather than an abrupt end to the working life. This paper compares the outcomes of abrupt and gradual retirement one and three years after the transition to retirement began using data from an Australian panel study. The outcomes included changes in health, positive and negative affect, wellbeing and marital cohesion. For many outcomes there was no difference between gradual and abrupt retirements, but those who retired abruptly were more likely to rate their health as having deteriorated and more likely to report better adjustment to retirement. Control over retirement decisions was also explored; it emerged as a more important factor in retirement wellbeing than whether the transition was gradual or abrupt. The absence of interaction or additive effects between the retirement pathway and the level of control over the process confirmed this result. Thus there is no simple answer to the question in the title. Retiring gradually allows time for people to make changes to their lifestyle, but having control over the timing and manner of leaving work had a greater positive impact on psychological and social wellbeing, and this persisted three years after retirement. The findings suggest that policies and employment practices that promote employees' control of their retirement decisions will enhance wellbeing in later life and facilitate longer workforce participation.Conventional wisdom promotes gradual retirement rather than an abrupt end to the working life. This paper compares the outcomes of abrupt and gradual retirement one and three years after the transition to retirement began using data from an Australian panel study. The outcomes included changes in health, positive and negative affect, wellbeing and marital cohesion. For many outcomes there was no difference between gradual and abrupt retirements, but those who retired abruptly were more likely to rate their health as having deteriorated and more likely to report better adjustment to retirement. Control over retirement decisions was also explored; it emerged as a more important factor in retirement wellbeing than whether the transition was gradual or abrupt. The absence of interaction or additive effects between the retirement pathway and the level of control over the process confirmed this result. Thus there is no simple answer to the question in the title. Retiring gradually allows time for people to make changes to their lifestyle, but having control over the timing and manner of leaving work had a greater positive impact on psychological and social wellbeing, and this persisted three years after retirement. The findings suggest that policies and employment practices that promote employees' control of their retirement decisions will enhance wellbeing in later life and facilitate longer workforce participation. © Cambridge University Press 2007.