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The article focuses on the Australian Association of Gerontology position paper summary of lesbian, gay, transgender and intersex (LGBTI) ageing research in Australia. Topics inlcude the LGBTI ageing research that has been published in Australia and overseas and other relevant literature reviews, the survey of LGBTI ageing researchers in Australia and identified some priority future research areas, and the LGBTI ageing policy context in Australia found there have been significant developments.

An introduction is presented in which the editor discusses articles in the issue on topics including use of medication in residential aged care facilities; effect of dementia on daily life; and improvements in the care for older cognitively impaired patients with benefits for families.

The article discusses the highlights of the poster presentations at the 2018 Annual Scientific Meeting Organising Committee held in Sydney, New South Wales in Australia. Topics covered include fractured neck of femur pathway, co-development of a model of care for a multidisciplinary memory clinic in South Western Sydney, and evaluation of patient and carer perceptions towards enteral tube feeding in hip fracture inpatients.

Abstracts of poster presenters - free papers are presented including "An Audit of Electronic Consults in Geriatric Medicine" by Hyun Suk Lee et al, "Older People Improving Their Mental Health by Taking Up Physical Exercise: Evidence From Malaysia" by Devi Peramalah et al and "Percentage of Women Achieving Non-Osteoporotic BMD T-Scores At The Spine and Hip Over 8 Years of Denosumab Treatment" by S. Ferrari et al.

Objective: As governments grapple with ageing populations, there is a need to understand more about the aged care workforce and how it is managed. Methods: We undertook a scoping review according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) guidelines. Scopus and PubMed were used to identify papers published between 2010 and 2020. We mapped the breadth and scale of the evidence base according to the QuInnE indicators of job quality. Results: Out of 642 titles and abstracts that were screened, 122 were selected. Outcomes were measured across a range of domains, including wages, employment quality, education and training, working conditions, work/life balance and consultative participation and collective representation. These were distributed unevenly, revealing evidence gaps. Conclusions: We identified significant knowledge gaps regarding Australia's aged care workforce at a time when the sector is coming under fresh scrutiny and projections indicate that it will face critical labour shortfalls going forward. [ABSTRACT FROM AUTHOR]

Objective: The 2019 Royal Commission into Aged Care Quality and Safety highlighted the need for First Nations peoples to have improved, culturally safe care. This paper is a call to action for First Nations peoples to be involved in developing culturally safe care and services to be embedded within Australian aged care services. Methods: The first screening examined the Australian literature (peer‐reviewed articles published since 2010 in English) detailing key aspects relevant to Cultural Safety for First Nations peoples supported by aged care services in Australia. The second screening assessed whether the findings of these studies aligned with the key aspects of Cultural Safety of First Nations peoples in aged care. Results: The initial literature search yielded 198 papers, of which 13 met the inclusion criteria for the final review. Topics that required further interrogation included barriers to communication, racism and discrimination, impacts on health outcomes, health‐care workforce education needs and the importance of cultural connections to Country and kin. These topics influenced the perception of First Nations peoples feeling culturally safe when supported by aged care services. Conclusions: The literature identified a need to recruit more First Nations peoples into the aged care workforce, involve more First Nations family and community members in aged care and retain a consistent workforce overall. Together these strategies were seen to address the barriers that continue to affect aged care provision for First Nations peoples. [ABSTRACT FROM AUTHOR]

Objective: To review research published in the AJA in terms of authors' positions and disciplinary backgrounds, and the settings in which research was done. Methods: Eighty two papers by 373 authors, in Vol. 35 No 1, March 2016, to Vol 37 No 2, June 2018, were reviewed. Results: Different clusters of authorship were found for research using surveys or database analyses, research in hospitals and aged care settings. Two out of three authors held academic positions, and professional practitioners in hospitals were much more likely to have academic affiliations than in aged care settings. Differing research cultures are seen to contribute to these outcomes. Conclusions: Editorial policies have been central to maintaining publication standards. The Journal's publication partners could take a number of actions to advance recognition of professionals in different roles as authors and to expand the range of research published, especially nursing and social science research. [ABSTRACT FROM AUTHOR]

Objective: The online program began in 2012 to support aged care workers without a tertiary education or vocational qualification. This paper documents changes in the student profile since initiation of the program, and how the program may support recommendations of the Royal Commission into Aged Care Quality and Safety and engage other educators, providers and policymakers. Methods: Four hundred and seventy‐one commencing undergraduate students completed a 16‐item online survey in 2017 to document demographics and reasons for study. Categorical associations were assessed with univariate logistic regression in R v3.6. Results: Most students (71%; 336) were aged between 41 and 60 years but the program now included younger (<41 years) and older (>80 years) people. Unlike the 2012 students, about 41% had tertiary‐level qualifications, and 56% were employed in professional positions, including registered nurse, general practitioner and allied health professional. Professional and practice development was the primary reason for study; significantly so for younger (<41 years) participants in aged and dementia care (χ2 (5) = 18.15, p = 0.003) and for those with previous university experience (χ2 (4) = 22.17, p = 0.001). Older (≥61 years) participants enrolled to gain greater knowledge about dementia (χ2 (4) = 17.60, p = 0.002). Conclusions: Understanding the changed student profile guided program refinement to ensure the provision of effective, evidence‐based education in dementia understanding and care. Work now focusses on increasing partnerships with aged care organisations, community and postsecondary training institutions to support a continuum of workforce development options, guided by the recommendations of the Royal Commission. [ABSTRACT FROM AUTHOR]

Objective: Through interviews with older adults and professionals in Chongqing, China, this paper explores the challenges and opportunities faced by smart cities that undertake to better support ageing‐in‐place. Methods: We undertook a qualitative multi‐methods approach, engaging 46 professional stakeholders and 64 older people to examine the role of smart cities in enabling older people to age‐in‐place in Chongqing, China. Results: With the development of smart cities, technology has the potential to facilitate ageing‐in‐place by creating opportunities for heathy and active ageing. This study identified specific priorities in delivering age‐friendly smart cities, including the following: shaping smart environments around the everyday lives of older people, designing inclusive and equitable smart cities and ensuring strong forms of institutional governance, trust and relationship building with older people. Conclusions: The age‐friendly city and communities movement (AFCC) and smart city policy instruments have potential for realising active ageing by supporting mobility, access to services and civic participation. However, there exists a disconnect between smart city policy and practice in delivering tangible well‐being outcomes for older people. Addressing this requires greater cross‐sectoral working, reconciling smart city policy priorities with AFCC domains and creating the institutional and governance framework to enable socially sustainable cities to support ageing‐in‐place. [ABSTRACT FROM AUTHOR]

Objective: To investigate the experience of nurses involved in decision‐making to transfer residents from a residential aged care facility (RACF) to their local hospital emergency department. This paper reports on the findings of the second phase of a two‐phase study. Methods: Qualitative semi‐structured interviews with 19 aged care nurses were conducted. Interviews were audio‐taped and transcribed verbatim, and a thematic analysis was carried out. Results: The analysis revealed five major themes that influenced decision‐making in relation to the transfer of a resident from the residential aged care facility to the emergency department: conflict with key stakeholders; knowledge and experience; policy and process; stakeholder perception; and recognition and support. Conclusions: Robust outreach programs, support from other health‐care professionals, and improving interdisciplinary understanding and communication between aged care nurses, paramedics and the emergency department would be advantageous to ensure effective care delivery and decision‐making. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores how changes in demography, service use and the aged care system have implications for the appropriateness of the denominator in the aged care provision ratio. Methods: Official statistics were analysed to create five alternative scenarios for residential care planning in a 2000‐2027 time series. Results: The four age‐based denominators and a revised denominator incorporating age‐ and sex‐specific disability rates generated diverse levels of absolute supply. The 75+ denominator produced 1400 fewer beds than the 70+ denominator by 2018, but over 14 000 additional beds by 2027. Conclusion: The 70+ based ratio developed almost forty years ago has served its purpose reasonably well. However, changes in the nature of the aged care system, different patterns of use by age and sex, and demographic changes suggest that long‐term aged care planning requires careful review in choosing a more robust version of the provision ratio for the future. [ABSTRACT FROM AUTHOR]

Objectives: Centre-based aged care services are a key site of early intervention and support for people with dementia and their carers. This paper examines the impact of new aged care funding structures on centre-based aged care service accessibility and delivery. It also examines the challenges and opportunities for change facing the sector in the light of the COVID-19 pandemic. Methods: Semi-structured interviews were conducted online with 29 managers or supervisors of centre-based aged care services in Greater Sydney. Results: The analysis reinforced the essential role of centre-based aged care services in improving the cognitive, physical and psychological health of older people with dementia and their carers. However, the changing funding context and the COVID-19 pandemic have created challenges in access to centre-based services, particularly for the most vulnerable. The challenges created by the COVID-19 pandemic also opened opportunities for the introduction of new models of service practice to meet the individual needs of older people and their carers. Conclusions: Greater investment in, and flexibility in the funding for, centre-based aged care services is needed to facilitate access for people with dementia and their carers and improve their health and well-being. [ABSTRACT FROM AUTHOR]

Objectives: Australia's aged care workforce is facing pressures due to increased demands from an ageing population. This paper reflects upon whether existing workspace environmental design evaluations are supporting the aged care workforce. Methods: This brief report was informed by a 2018 Optimising Aged Care Workspace Environment Symposium with three streams: (a) Developing, (b) Implementing and (c) Evaluating Aged Care Workspace Environments. Results: Symposium key messages included the following: 'evidence (lived experiences and feedback) from both older people and the aged care workforce needs to inform both development and implementation of aged care environment design'. The Evaluating Aged Care Workspace Environments stream key messages included the following: 'evaluation approaches are required that are responsive and appropriate to the complex dynamic aged care workspace contexts'. Conclusion: To better inform the design of future aged care settings and support the aged care workforce, principles‐focused evaluations of existing aged care settings with input from the aged care workforce are required. [ABSTRACT FROM AUTHOR]

Objectives: Lack of physical activity presents substantial health risks to older adults living in residential aged care facilities. The objective of this review was to examine the suitability of physical activity outcome measurement instruments among cognitively sound residents. Methods: Search terms were used to explore health, nursing and social science databases to identify applicable English‐language research from January 2000 to July 2020. Results: Sixteen papers met the inclusion criteria. The findings show that a diverse range of outcome measurement instruments have been used to evaluate physical activity intervention effectiveness. Most were found not to be validated for use specifically with residential aged care populations. Conclusions: A range of Outcome Measurement Instruments (OMI) appear to effectively measure physical activity intervention outcomes among residential aged care older adults. Results highlighted the need for greater rigour in study design and selection of valid and population‐appropriate instruments for use with this population. [ABSTRACT FROM AUTHOR]

Electronic information systems are becoming increasingly common in residential aged care in Australia. These systems contain valuable data generated during day‐to‐day care delivery for older adults. These data (termed 'routinely collected residential aged care provider data') are currently underutilised, however have potential significant benefits for both care delivery and research purposes. Routinely collected residential aged care provider data are more readily accessible, contain up‐to‐date information and can be linked to existing national or state‐based administrative data sets, while providing more granular details about care delivered at the coalface. The aim of this paper is to provide clinicians, researchers, policymakers and providers with an understanding of the strengths of these types of data, as well as identifying areas that require future development to maximise their potential to drive improvements in resident care and outcomes. These considerations include data quality, data standardisation and models for data governance, consent and consumer involvement. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the potential of photographs as a tool to facilitate storytelling, reminiscence and social connections for older residents living in residential aged care and caregiving staff. Methods: Fourteen residents and three staff attended two sessions in which residents brought and shared personal photographs. Narrative enquiry was used to elicit individual and collective stories. Results: Narrative analysis of residents' selected photographs overwhelmingly showed a younger self (n = 6), highlighting relationships (n = 6) and achievements (n = 6). Sharing images with other residents and staff enhanced new connections and personal communications. Conclusion: This research highlights the communicative value of photographs in aged care. Residents were able to reflect upon shared personal and global events—from the role of pets in their lives to public events such as the Queen's visit to Australia—and through discussion build a collective shared narrative. This enabled new connections and sharing of stories between staff and residents. [ABSTRACT FROM AUTHOR]

Objectives: Nursing staff in residential aged care facilities (RACF)s often make decisions about the transfer of residents to the emergency department (ED). This paper describes the protocol of a study that aims to understand decision‐making process utilised by RACF registered nurses (RNs) and to explore the perceptions of RNs about the decision and communication process between RACF and ED. Methods: The proposed mixed‐method study will survey and interview RACF RNs to understand their decision to transfer a resident and collect information about older people referred to the ED. Data collection will involve telephone survey, ED information system (EDIS) data and semistructured interviews. Results: The project outcomes will provide an understanding of existing ED service provision, communication between facilities and the reasons for transfer of older person to ED. This may inform redesign in communication processes between the ED and local RACFs and outreach care from the ED to RACFs. [ABSTRACT FROM AUTHOR]

Objective: To assess consumer‐level socioeconomic factors associated with waiting times for access to aged care services, specifically community‐based care and permanent residential care. Methods: Administrative data on assessment outcomes and admissions to services were linked with survey data at the person‐level and were used to implement a competing risks regression model. We estimated the association between health needs, and socioeconomic variables and subsequent waiting periods for individuals with approval for access. Results: The main consumer‐level factors driving waiting time were the individual's assessed needs, including health status, whether they lived alone and age. We found no evidence that socioeconomic status was associated with waiting times for community‐based care; however, admission to residential care reflected socioeconomic factors including education levels and geographical isolation. Conclusion: This paper provides baseline evidence for factors affecting wait times in aged care, essential for evaluating subsequent policy reforms aimed at reducing wait times and increasing equity of access and consumer choice. [ABSTRACT FROM AUTHOR]

The article discusses the concept of ageing in place (AIP), a policy tool used to encourage older adults to continue living independently in their home or neighbourhood. Topics include the various comorbidities that older adults living alone may experience, the different models used to manage comorbidities, and the current predicament of AIP programs in terms of different stakeholder demands.

Objectives: Australia is lagging behind other countries in implementing quality indicators (QIs) in home-and community-based aged care. This research aimed to identify and appraise home care QI sets used internationally for older adults, to inform the future development and utilisation of QIs in the Australian context. Methods: A systematic search of eligible studies outlining the development and validation of home care QI sets for older adults was undertaken. QIs were categorised using the Donabedian model to identify potential gaps in coverage of key areas of care quality. Each QI was classified as potentially “derivable” or not from existing national routinely collected datasets. Methodological quality was determined using the Appraisal of Indicators through Research and Evaluation instrument. Results: Three sets of home care QIs developed and used internationally for older adults were identified. Two of the QI sets focused predominantly on clinical and functional aspects of care. Of 45 unique QIs, the majority were outcome measures (93%), with only three QIs measuring care processes (7%), and zero indicators measuring quality in terms of the structure of care (e.g., waiting time to access services). Nearly half of the individual indicators identified would require Australian home care providers to undertake additional data collection. There were significant methodological limitations in the development of QI sets, particularly in the scientific evidence domain. Conclusions: This review identified important gaps in existing QI sets, which should be considered by policymakers, researchers, and other stakeholders when developing and applying QIs in the Australian setting. [ABSTRACT FROM AUTHOR]

Objectives: This paper visually explores older aged care resident's day‐to‐day lived experience, as well as providing a brief introduction to the participatory documentary photography method of photovoice. Methods: Ten residents from one Australian residential aged care facility collaborated with researchers and care staff to photograph, reflect on and share their lives. Photographs were shortlisted in individual and group discussions. Results: Residents' photographs and narratives provide a visual understanding of what they value. Photographs captured three core themes: the restorative joy of nature (frangipanis); active engagement through leisure activities (football); and the value of social interactions and connections, especially with fellow residents and staff (friendship). Conclusions: As old age and aged care remain virtually invisible within popular visual culture, this research highlights the communicative value of participatory photography for challenging stereotypes, as well as the opportunities, challenges and value of visual methods with this cohort. [ABSTRACT FROM AUTHOR]

Objective: This paper describes a workshop process conducted to guide funding priorities for the Ageing Well National Science Challenge in New Zealand (NZ). Methods: Based on the Checklist for Health Research Priority Setting, stakeholders networking workshops were conducted in five main cities in NZ (n = 133 attendees). Each workshop involved an introductory presentation; small group work exploring the a priori areas of: mind health, social well‐being, health services and age‐friendly environments; capturing key ideas on flip charts; feedback; and discussion of documented content. Results: Suggested strategies to address these issues incorporated reduction in segregated "villages," delivery of integrated care and provision of age‐friendly transport. Proposed examples of monitoring impact included increased tertiary participation by older people and presence of more housing options. Conclusion: Actively engaging older adults and community stakeholders in setting research priorities provided a unique opportunity to understand the key areas older adults think important for future research. [ABSTRACT FROM AUTHOR]

This paper outlines the development of culturally safe services for older lesbian, gay, bisexual, transgender and intersex people. It draws on a framework for cultural safety, developed in New Zealand which incorporates an understanding of how history, culture and power imbalances influence the relationship between service providers and Maori people. This has been adapted to the needs of older lesbian, gay, bisexual, transgender and intersex Australians. [ABSTRACT FROM AUTHOR]

Objective: 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. Methods: A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. Results: 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. Conclusion: Transdisciplinary collaboration offers well‐grounded benefits and realistic strategies sensitive to the complexity of the aged care setting. [ABSTRACT FROM AUTHOR]

An editorial is presented in which author discusses evidence based advocacy on aging in the periodical. It mentions information on Royal Commission into Aged Care Quality and Safety which required to provide an interim report by 31 October 2019 and a final report by 12 November 2020 on aging; and also mentions information on article on the topics including Human Rights in Australia.

An introduction is presented in which author discusses articles on topics including focuses on gaining in-depth understanding of issues as a precursor to meaningful efforts to address them and explore priorities of multiple groups in relation to public campaigning in the area of dementia.

An introduction is presented in which the editor discusses various topics tackled within the issue, including rural ageing, information and communication technology (ICT), and decision-making of older people.

Aim To examine processes of aged-care needs assessment for Aboriginal people in remote central Australia to assist development of appropriate models of aged care. Method A qualitative study involving 11 semistructured interviews with aged-care assessors and two focus groups with Aboriginal community members. Results This paper reports four major themes concerning how needs assessments relate to realities of service delivery: cultural perspectives on aged care, context of service delivery, equity and access to services, and program (mis)alignments. Conclusion Disparities exist between assessment recommendations and service availability, with a potential mismatch between Aboriginal understandings of needs, interpretations by individual assessment staff and program guidelines. Incorporating a conceptual framework, such as the International Classification of Functioning, Disability and Health, into service guidelines to ensure structured consideration of a person's holistic needs may assist, as will building the capacity of communities to provide the level and type of services required. [ABSTRACT FROM AUTHOR]

This paper aims to describe a practical example of the use of adapted versions of a resident satisfaction questionnaire for quality improvement purposes in a large aged care service organisation. Residential care and home care questionnaires each covered 11 aspects, the 'housing' questionnaire nine. Each aspect included Likert scale-type satisfaction questions. Questionnaires were distributed for completion by residents or by a friend/family member where a resident was unable to self-complete (e.g. because of dementia). Over the six separate customer satisfaction surveys conducted by the organisation since 1999, the analysis scheme has been refined and forms the basis of a report to the Board highlighting major findings and making recommendations regarding future actions. Most recently, the Board has decided to focus on three main areas, with actions identified for each, namely satisfaction with staff (e.g. enhanced staff training), social activities and involvement (e.g. increased occupational therapy), and opportunities for enhanced feedback. [ABSTRACT FROM AUTHOR]

Aim This paper explores the experiences of older people with intellectual disability ( ID) who moved from a group home to residential aged care, from the perspective of family members, aged care staff and former group home staff. Method Interviews were conducted with staff and family members associated with 10 people with ID who recently moved from disability group homes into nine aged care residential facilities. Dimensional analysis was used to analyse 31 interviews. Results Aged care staff focused primarily on health outcomes and identified and addressed several previously undiagnosed conditions. The primary concern of staff from the residents' former group homes was social isolation. Families acknowledged the health benefits but were equally concerned about social isolation. Conclusion The findings highlight the importance of addressing health and social needs of people with ID and indicate that an increased accountability for both social and clinical outcomes is required. [ABSTRACT FROM AUTHOR]

Objective: To examine changes in accommodation payments to residential aged care facilities following the introduction of consumer choice reforms in 2014. These reforms have allowed residents to choose between making lump sum refundable deposits and/or rental‐style payments. Methods: Quantitative analysis was undertaken for facility‐level quarterly data of 136 separate facilities, which were operated by six providers over the period under study. Results: While the total pool of payments has grown strongly, consumers have increasingly favoured rental‐style payments over lump sum refundable deposits. Conclusion: Consumer choice has changed the landscape of accommodation payment receipts in the provision of residential aged care services. Greater understanding is needed on how consumer preferences impact on the financial risk borne by providers and their ability to invest in future capacity. [ABSTRACT FROM AUTHOR]

An introduction is presented which discusses articles within the issue on aged care services to the increasing number of Australians living with dementia.

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

An introduction is presented which discusses articles within the issue on topics including aged care services to the increasing number of Australians living with dementia.

Objectives: To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards. Methods: Facility‐level analysis of audits, sanctions and non‐compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks. Results: Non‐compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non‐compliance notices were less likely in Victoria, Queensland and the Northern Territory (NT), more likely in South Australia (SA), and comparable in Western Australia (WA), Tasmania and the Australian Capital Territory (ACT). RACFs with more than 100 beds and RACFs located in remote and outer regional areas (vs. major cities) also increased the likelihood of non‐compliance notices. Compared with NSW, sanctions were less likely in Victoria, Queensland, NT and WA and comparable in SA, Tasmania and ACT. Additionally, the likelihood of sanctions was higher for RACFs with more than 40 beds. For both non‐compliance notices and sanctions, no significant relationship was found with RACF ownership type. Conclusions: We partially confirmed other Australian findings about the relationship between RACF structural characteristics and regulatory sanctions and reported new findings about non‐compliance notices. Routine and standardised public reporting of RACF performance is needed to build trust that Australia's latest aged care reforms have led to sustained quality improvements. [ABSTRACT FROM AUTHOR]

Objectives: The constructs of health, well‐being and quality of life are not routinely understood or measured for people accessing aged care services. This study aimed to identify and validate theoretical domains of health, well‐being and quality of life for recipients of care, their informal carers and staff, and inform the development of a person‐centred outcomes measurement framework. Methods: First, a rapid review to identify recurrent domains of health, well‐being and quality‐of‐life in aged care, using systematic searches of electronic databases, and review of grey literature, following the PRISMA guidelines. Second, establish content validity of identified domains using (a) Delphi technique with n = 134 aged care staff, care recipients and caregivers, and (b) comparability with categories within the International Classification of Functioning, Disability and Health (ICF) and ICF Geriatric Core Set. Results: From 972 records detected in the rapid review, 19 peer‐reviewed research articles and 27 grey literature sources were included in the content analysis. Twenty‐four domains and 109 concepts were identified, and health, quality of life, security and food and nutrition were ranked as the most important. One domain, cognition, linked to both the Geriatric Core Set and ICF, and 37% of domains and 39% of concepts were evident within the ICF. Conclusions: This study identified and validated 24 important domains of health, well‐being and quality of life for the older person receiving care, their informal carers and staff. These domains can be used to guide the selection of outcome measures and facilitate person‐centred care and care planning. [ABSTRACT FROM AUTHOR]

Objectives: In Australia, temporary agency workers are a relatively small but enduring component of the residential aged care workforce. However, evidence from other countries suggests reliance on agency workers has a detrimental effect on the quality of care (QoC). We examined whether QoC outcomes differ for Australian residential aged care facilities (RACFs) based on their reliance on agency care staff. Methods: A retrospective observational study was conducted using de‐identified datasets obtained under the legal authority of the Royal Commission into Aged Care Quality and Safety. Regression analysis was conducted using data comprising 6221 RACF‐year observations, across 5 years (2015–2019), from 1709 unique RACFs in Australia. Results: After controlling for other determinants of QoC, RACFs with a greater reliance on agency care staff have poorer QoC outcomes, with significantly higher rates of complaints, missing persons, reportable assaults, hospitalisations, and accreditation flags. Conclusions: Consistent with international evidence, we found that the QoC of Australian RACFs is sensitive to the reliance on agency staff in delivering direct care to residents. These findings illustrate the importance of workers' employment conditions, alongside other workforce characteristics, in driving the quality of residential aged care. [ABSTRACT FROM AUTHOR]

Objectives: The analysis presented here describes the care needs of older adults with and without cognitive impairment. To describe the health characteristics of older adults with and without cognitive impairment who receive home care or Aged Residential Care services in New Zealand. Methods: A descriptive analysis of the initial interRAI assessment for adults older than 55 years was undertaken. Data were grouped by level of assessed cognitive impairment. The population proportions for each level of the following scales were calculated: Changes in Health, End‐stage Disease, Signs, and Symptoms Scale (CHESS), pain, pressure injury risk, Activities of Daily Living (ADL), depression screening, and body mass index (BMI). Results: The analysis included 93,680 assessments. The mean age was 83 years (SD = 8.7) a positive association was observed between age and cognitive impairment (p < 0.01). People with cognitive impairment were less likely to have been recently hospitalised or to have attended ED (p < 0.01). Significant associations with effect sizes ≥3 were observed for cognitive impairment and ADL (p < 0.01, γ = 0.63), pain (p < 0.01, γ = −0.32), and risk of pressure injury (p < 0.01, Cramer's V = 0.271). Conclusions: The results reinforce a need to be alert to the differential care needs of older adults with moderate/severe cognitive impairment. The findings may act as a trigger for practitioners to focus assessment on aspects of care that, due to context, may otherwise be underassessed or untreated. [ABSTRACT FROM AUTHOR]

Objective: To examine the language of the behaviour assessment in the new Australian National Aged Care Classification (AN‐ACC) funding instrument. We explored whether the (BRUA) will support an inclusive and progressive approach for people living with dementia in residential aged care. Methods: Databases were searched to identify publicly available literature relating to the development of the AN‐ACC and BRUA, and hand searches of reference lists and selected websites were completed to identify additional grey literature, dementia language and best practice guidelines. Criteria for language use were extracted and compared with the BRUA in the light of the current national aged care reform agenda, as well as research with and perspectives of people with lived experience of dementia. Results: The language within the BRUA did not align with international dementia language guidelines, and the content presented was disrespectful to those with lived experience. The assessment appears inconsistent with international best practices and is potentially discriminatory within the aged care cohort. Conclusions: The BRUA is intended as a funding instrument and not as a care planning tool, yet the negative representation of the lived experience of people with dementia embedded within a mandated assessment is likely to influence industry practice by condoning unsuitable language and attitudes amongst assessors, providers and staff. For better alignment with the current positive agenda for aged care reform in Australia, we recommend continued review and updating of this tool to avoid unintended consequences. [ABSTRACT FROM AUTHOR]

The article offers information on Geriatric Medicine for Dysphagia and aspiration in older people in Australia and New Zealand. Topics include risk for aspiration include those with stroke, Parkinson's disease, dementia and reduced level of consciousness, and any severely ill or disabled persons; and nutritional support to patients with a non‐progressive cause of aspiration such as stroke.

Objective: To explore the gaps and anomalies in Australia's national aged care workforce data with a particular focus on casualisation and insecure employment in residential aged care. Methods: Secondary analysis of data from the National Aged Care Workforce Census and Surveys, the Aged Care Workforce Census and the Australian Bureau of Statistics Characteristics of Employment Survey. Results: There are significant and disturbing gaps in our knowledge of the aged care workforce deriving from disruptions to the time series as a result of methodological changes, reduced reliability resulting from declining response rates and the historical weighting system. Scope is also a critical factor due to data inadequacies relating to a non‐Pay As You Go (non‐PAYG) workforce and regarding the use of minimum hours contracts. This reduces our understanding of insecure employment. Conclusions: Australia needs better quality and more reliable data on its aged care workforce if the labour shortages confronting the sector are to be better understood and addressed. There is a critical need to determine the optimum strategy to obtain such data, whether by specific research projects of sufficient scale to accurately document the scale and scope of these issues, or in creative strategies to make use of automatically generated data. [ABSTRACT FROM AUTHOR]

Objective: To explore the perceptions of the Australian public regarding Australia's aged care workforce, including their willingness to pay more tax to fund better pay and conditions for aged care workers. Methods: An online survey was developed and administered to a representative sample of Australian adults (aged ≥18 years) by age group, gender and Australian state. Survey respondents completed a series of attitudinal statements to elicit their perceptions of the value of Australia's aged care workforce and were asked to indicate their willingness to pay additional tax to fund better pay and conditions for aged care workers. Those who gave a positive response were then asked to indicate what percentage of additional tax per year they would be willing to pay to ensure better pay and conditions for aged care workers. Results: A total of 2033 adult respondents completed the survey. A majority (78%) of respondents either 'agreed' or 'strongly agreed' that aged care workers should be paid more. Approximately half of the respondents (50.57%) expressed a willingness to pay more tax to ensure better pay and conditions for aged care workers. The mean willingness to pay was 1.31% additional tax overall, and mean percentage additional tax values were relatively consistent across key socio‐demographic indicators. Conclusions: A majority of the Australian public are in favour of improving the wages and employment conditions of aged care workers. However, only one in two Australians is willing to pay more tax to ensure better pay and conditions for aged care workers. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to capture stakeholder views and issues arising from the implementation of the innovative single-site employment guiding principles (SSE-GP) that the Australian Government, in consultation with the sector, introduced into hot spot residential aged care facilities (RACFs) in July 2020 in response to COVID-19. Methods: Interviews with 74 stakeholders around Australia were conducted in October–November 2020. Provider interviews included employees and managerial and human resources staff in profit and non-profit services who did, and did not, have COVID-19 outbreaks. Sector interviews included representatives from peak bodies, unions, government, academics, advocates, labour hire and registered training organisations. Results: There was broad but not total agreement on SSE-GP's effectiveness. Beyond specific SSE-GP feedback, six strategic workforce issues were identified. The quality of resident care was mixed, sometimes improved and sometimes diminished. The extent of employees' multiple jobholding surprised many providers, and rostering and unplanned absenteeism are a substantial strain for both providers and employees. Innovative work practices are often difficult for smaller providers lacking employment relations specialists. Future SSE-GP is seen by larger providers as voluntary and organisation-rather than facility-specific, and unions saw only mandated SSE-GP as appropriate for future outbreaks. Last, all staff, management and executives had additional stress that placed their well-being at risk. Conclusions: Although SSE-GP revealed new and existing weaknesses in the Australian RACF workforce, the broad industry consultation and collaboration demonstrated that the sector can meet COVID-19' s urgent and complex challenges. The experience provided lessons for further workforce challenges that remain to be addressed. [ABSTRACT FROM AUTHOR]

Aim To outline the experiences and needs of lesbian, gay, bisexual and trans ( LGBT) Australians living with dementia - and their partners. Methods In-depth interviews were conducted with LGBT people, their partners and service providers. Results LGBT people living with dementia experience unique challenges including the failure of some families of origin and service providers to understand and value their sexual orientation or gender identity. The fear of discrimination by service providers results in greater reliance on intimate partners for care and compounds social isolation. Conclusions The unique experiences of LGBT people with dementia are not well understood. There is a need to recognise historical experiences, including familial relationships, and provide advocacy to ensure sexual and gender rights are not violated. There is also a need to ensure that the experiences and perspectives of LGBT people living with dementia inform the development of services. [ABSTRACT FROM AUTHOR]

The article offers information on Australia & New Zealand Society for Geriatric Medicine (ANZSGM) Annual Scientific Meeting 2015 on May 6-8, 2015 at The Pan Pacific Hotel in Perth, Western Australia.

Objective: Residential aged care (RAC) quality is often measured as part of regulatory compliance. To inform care delivery and service improvements, we developed a consumer experience survey. Methods: Validation study incorporating 2018–2019 survey data (n = 1504 individuals, 25 RAC homes) and test‐retest reliability evaluation. Results: Most of the respondents were women (67%) with 38% of the surveys completed by residents, 39% with staff support, and 23% by family members. Moderate‐to‐high correlations (0.46–0.84) between individual items indicate the survey is a coherent measure of satisfaction; good inter‐item correlation was found across all sections (0.61–0.70) with high internal consistency (Cronbach's alpha 0.90–0.94); and moderate correlation for test‐retest reliability was found on the same individual when providing an overall recommendation score (individual ICC 0.684). Conclusions: The RAC Consumer Experience Survey is a validated measure of lived experience and satisfaction that aligns closely with the Australian Aged Care Quality Standards, affording providers a standardised tool for benchmarking and informing care quality across the sector. [ABSTRACT FROM AUTHOR]

Objective: With a growing emphasis on personalised care, there is a need for effective workforce training to enable person‐centred care (PCC) in aged care practice. The Australian aged care workforce is very diverse; thus, tools to evaluate compassion and PCC training need to reflect an understanding of these concepts relevant to the Australian context. There are currently no tools validated for use in aged care settings in Australia. Methods: Two existing compassion and PCC questionnaires were modified for an Australian audience using cognitive interviews with aged care workers. The reliability of the modified questionnaires was assessed. Results: The modified questionnaires were found to have acceptable inter‐reliability and test‐retest intra‐class correlation for the subscales and overall. However, the investigation also found low Cohen's kappa values between the test and retest responses for the individual items, subscales and overall, and had low inter‐class correlation for individual items, indicating poor inter‐rater agreement. High inter‐item correlation scores also suggest the questions encapsulate overly similar constructs. Conclusions: While further investigation of the psychometric properties of the new items is needed, these modified questionnaires may offer a method of assessing and re‐assessing compassion and PCC using language that is understandable to the Australian aged care workforce. Tools to accurately measure Australian aged care staff perceptions of compassion and their ability to deliver PCC are important to improve the quality of care provided in aged care and facilitate the delivery of PCC in aged care settings. [ABSTRACT FROM AUTHOR]