Search

Falls are the leading cause of injury and hospitalisation for older adults (aged 65 years or older) worldwide. Data collected by community aged care providers are an underutilised source of information about precipitating risk factors and consequences of falls for older adults living in the community. The objective of this longitudinal, observational study was to describe and compare the characteristics of older Australians who did and did not have falls reported by community aged care staff. We analysed 19 months of routinely collected care management and incident data for 1,596 older clients from a large Australian community care provider. Differences in sociodemographic characteristics, care needs and community care service use were compared between those who had one or more reported falls and those who had none. Fall‐related outcomes (injuries, hospitalisations, relocation to residential aged care) were examined. The average age of clients was 82 years and most were women (66%). Seventy‐seven (4.8%) clients had one or more reported falls over the study period (total falls = 92). Clients who had falls reported by care staff were more likely to be older adults, male and use more hours of community care services per week. There were 38 falls‐related injuries, 5 falls‐related hospitalisations and 20 clients relocated to residential aged care after a reported fall. This study demonstrates the potential for using routinely collected community aged care data to understand risk factors and monitor longitudinal outcomes for a population at high risk of falls. [ABSTRACT FROM AUTHOR]

Objective: To utilise routinely collected data to examine changes in the client profile of a large aged care provider before and after commencement of the 2017 policy reforms, whereby home care packages were allocated to individuals rather than providers. Methods: Interrupted time series analysis was used to measure changes in service uptake and cessation. Chi‐square and t tests were used to compare client profiles in the 12 months before and after policy changes. Results: A total of 4132 people used home care services with the provider between March 2016 and March 2018. Fewer people commenced services post‐reforms, and they were more likely to be younger and have a partner. There was no change in the number choosing to terminate services post‐reforms. Conclusion: Vulnerable older Australians may experience greater difficulty accessing services under the new system, suggesting greater scrutiny of the reforms in achieving policy objectives is required. Analyses of routinely collected data sets can support this evaluation process. [ABSTRACT FROM AUTHOR]

Abstract: Rich social relationships contribute to improved well‐being and health outcomes, yet aged care client assessments tend to focus almost exclusively on physical issues. We aim to explore the experiences of aged care staff following their use of social engagement and well‐being instruments as part of routine assessments for home‐care clients. The social engagement (Australian Community Participation Questionnaire, ACPQ) and well‐being (ICEpop CAPability Measure for Older Adults, ICECAP‐O) instruments were embedded into the centralised information system of an Australian aged care provider. Staff administered these instruments during routine client assessments across a 9‐month period involving 289 assessments. Semistructured interviews with 12 staff members were conducted and themes explored using qualitative content analysis. Key factors related to the acceptability of instrument adoption were found. Staff reported the instruments were convenient to use and were valuable in eliciting information for care plan development. Staff found that the instruments complemented their standard assessment procedures and did not disrupt their routine workload. They emphasised that the information gained greatly assisted their discussions with clients, identified social needs, and enhanced client involvement in decisions about desired services. There were also some challenging elements, including staff concerns regarding their ability to deal with emotional responses from clients evoked by the survey questions. ACPQ and ICECAP‐O are useful tools for identifying psychosocial client needs, are feasible for use by large‐scale aged care organisations and provide valuable information to guide decision‐making about services. Future research should identify the long‐term effects on improving social participation and client outcomes. [ABSTRACT FROM AUTHOR]

• Social networks have a critical role in delaying dementia. • Being male, using more aged care services was related to higher cognitive function. • Higher social networks with family and friends was linked with better cognition. Social engagement has been linked to preserved cognitive functioning in later life. Yet, little is known about the specific network factors that best predict cognitive function in older adults. This study aimed to (i) characterize the quality and quantity of interpersonal relationships and (ii) explore the relationship between social network types and cognitive function in older adults receiving home- and community-based aged care services. Participants (n = 175) receiving aged care services participated in a structured interview regarding their cognitive function (Telephone Interview for Cognitive Status-Modified), social networks (Lubben Social Network Scale-12) and quality of life (European Quality of Life Scale). Socio-demographic and aged care service use factors were obtained from provider electronic management systems. Multiple regression analyses were conducted to examine the relationships between the size and composition of clients' social networks, aged care service use and cognition. The sample had a median age of 81 years (range 61-96) and most were women (65.8%). Over a third (37.6%) had cognitive impairment and reported moderately high social networks. Males had higher social networks, were receiving fewer hours but more types of services, and had significantly better cognitive performance. Age, network size and composition were not associated with cognitive performance. More extensive social networks were associated with maintenance of cognitive health for older adults in community aged care. Whether this is causal or a marker of better cognitive health requires a longitudinal approach, and ideally should be tested with interventions at community levels. [ABSTRACT FROM AUTHOR]