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Traditional emergency departments (EDs) are overcrowded and sometimes not suitable for older adults with complex needs. Specialised geriatric urgent care pathways for selected patients can alleviate ED demand and improve patient experience. To address urgent care needs for older adults in Southern Adelaide, the Complex And RestorativE (CARE) service was established. CARE offers alternative, geriatrician‐led treatment pathways consisting of a ward‐based treatment centre and an in‐home visiting team called Eyes on Scene (EoS). Both pathways offer medical, nursing and allied health treatment. Routinely collected clinical data were analysed to explore the reach of the service and the incidence and nature of adverse events. Between September 2021 and March 2023, the CARE service attended to 5324 older adults requiring urgent care. A significant proportion of patients were discharged to or remained in their regular place of residence, with few requiring inpatient admissions or referrals to other facilities. A total of 7% of patients required transfer to ED and adverse events were rare. The CARE service demonstrates a feasible and safe alternative model of urgent care for older Australians. [ABSTRACT FROM AUTHOR]

People with changes in cognition and changes in sensory function often feel uncomfortable in hospital and residential care home environments. Understanding the person's sensory preferences and aversions is important in providing high-quality care but current assessments have limitations. Our objective was to develop a tool to identify the sensory preferences and aversions of people experiencing cognitive changes while staying in hospital or residential care homes. The working group developed a tool comprising 11 items, which was named the "Sensory Preferences and Aversions questionnaire for the Care of older adults with dementia in residential Environments" (SPACE) tool. The tool was administered with 56 people with cognitive changes (mean age 78, mean MMSE score 16/30). Data elicited from the tool revealed the varied preferences of individuals, which demonstrates the importance of eliciting this information. For example, while 82% of participants liked listening to music, the remainder did not. Information elicited from the tool was useful in guiding care planning including identifying activities that may be of interest to the person. It was able to effectively elicit information about preferences, aversions, and strategies that could be applied when the person became distressed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the cost‐effectiveness of a 12‐week Exercise Physiology (EP) program for people living in a residential aged care facility. Methods: A within‐study pre‐ and postintervention design to calculate incremental cost‐effectiveness ratios per quality‐adjusted life years gained. A health service provider perspective was used. Results: Fifty‐nine participants enrolled in a 12‐week program. The program cost was A$514.30 per resident. At a willingness‐to‐pay threshold of A$64 000, the likelihood of being cost‐effective of the program is approximately 60%, due to a small increase in participants' quality of life, as reported by care staff. The model showed great variance, depending on who rated the participants' quality of life outcomes. Conclusion: It is uncertain that a 12‐week EP program is cost‐effective based on the evidence of the current trial. However, it appears that a low‐cost program can produce small improvements for residents in care facilities. [ABSTRACT FROM AUTHOR]

• Little is known regarding changes in primary health care utilisation following LTC entry. • After hours and urgent after hours GP attendances increased almost 2-fold after LTC entry. • Only a third of residents received a GP health assessments or care planning after LTC entry. • Utilisation of pain, palliative and geriatric specialist medicine attendances were low (<3%). • There is an opportunity to improve the utilisation of primary health care services to ensure that residents' complex care needs are adequately met. To examine utilisation of primary health care services (subsidised by the Australian Government, Medicare Benefits Schedule, MBS) before and after entry into long-term care (LTC) in Australia. A retrospective cohort study of older people (aged ≥65 years) who entered LTC in Australia between 2012 and 2016 using the Historical Cohort of the Registry of Senior Australians. MBS-subsidised general attendances (general practitioner (GP), medical and nurse practitioners), health assessment and management plans, allied health, mental health services and selected specialist attendances accessed in 91-day periods 12 months before and after LTC entry were examined. Adjusted relative changes in utilisation 0–3 months before and after LTC entry were estimated using risk ratios (RR) calculated using Generalised Estimating Equation Poisson models. 235,217 residents were included in the study with a median age of 84 years (interquartile range 79–89) and 61.1% female. In the first 3 months following LTC entry, GP / medical practitioner attendances increased from 86.6% to 95.6% (aRR 1.10 95%CI 1.10–1.11), GP / medical practitioner urgent after hours (from 12.3% to 21.1%; aRR 1.72, 95%CI 1.70–1.74) and after-hours attendances (from 18.5% to 33.8%; aRR 1.83, 95%CI 1.81–1.84) increased almost two-fold. Pain, palliative and geriatric specialist medicine attendances were low in the 3 months prior (<3%) and decreased further following LTC admission. There is an opportunity to improve the utilisation of primary health care services following LTC entry to ensure that residents' increasingly complex care needs are adequately met. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy can delay functional decline and improve quality of life of older people. Yet people may not seek occupational therapy services as they may not be aware of their scope or benefits. The aim of this study was to ascertain what the general public in Australia knows about occupational therapy services for older people. Methods: A cross‐sectional cohort study completed via a consumer panel provider PureProfile (https://www.pureprofile.com/au/) a company specialising in online survey programming to registered participants of the general public ('panel'). For a fee, a client can include a question in a weekly survey, and receive approximately 1000 responses (including detail about the respondents' gender, age group and place of residence). We asked a free‐text question about the participants' understanding of occupational therapy and its role in supporting older adults. We used descriptive statistics to summarise sociodemographic data. Thematic approach to analysis was used to explore themes from the free text responses. Chi‐squared test for independence was used to explore association and/or differences between age group, gender, place of residence and understanding about occupational therapy for older people. Included were people aged ≥18 years living in Australia. Results: We received 1004 responses; about half were female (50.9%) and one‐fifth (20.1%) aged 65 or over. Of the 1004 respondents, approximately 10% could provide a good or advanced description of occupational therapy. Over half of the participants had some, but limited knowledge about the profession with references to general rehabilitation, physical therapies and return to work type interventions. Conclusion: Knowledge about the role of occupational therapy in supporting older people is limited. There is a need to address misconceptions that occupational therapy is only concerned with workplace or physical health‐related matters to enable better service engagement in the consumer‐driven care model in Australia. [ABSTRACT FROM AUTHOR]

Background/aim: Randomised trials have demonstrated that occupational therapy can delay functional decline, improve quality of life and increase leisure participation in people with dementia. However, surveys conducted with occupational therapists suggest that clinical practice does not reflect the type of intervention shown to be effective in research studies. Case note audits can be used to quantify practice and demonstrate how and where provision of care could improve without the potential bias associated with self‐report. Method: A total of 87 occupational therapy case notes were audited from different service contexts in two states in Australia. The case notes were reviewed against criteria including duration of service, assessments conducted and interventions used. Descriptive statistics were used to present the data and examine associations between intervention, age of the person with dementia and whether or not the person lived alone. Results: Services tended to be short‐term with an average of 2.1 consultations per referral. The most common assessments related to home safety, falls risk and function. Intervention most commonly focussed on referrals to other services, environmental modification advice and assistive device prescription. Conclusion: This audit reveals that current occupational therapy practice for people with dementia focusses on assessment and management of risk and is usually limited to a couple of consultations. Future work should seek to evaluate if such approaches to care are effective for people with dementia. [ABSTRACT FROM AUTHOR]