Search

The article focuses on the stigma and mental health problems in kids and adults including causes like negative attitudes and beliefs, impact on relation with caregivers and the issue of socio-cultural context.

The diversity of terms and meanings relating to housing with services for older people confounds systematic analysis, especially in international comparative research. This paper presents an analysis of over 90 terms identified in literature from the United Kingdom, the United States of America, Canada, Australia and New Zealand reporting types of housing with services under the umbrella of ‘service integrated housing’ (SIH), defined as all forms of accommodation built specifically for older people in which the housing provider takes responsibility for delivery of one or more types of support and care services. A small number of generic terms covering housing for people in later life, home and community care, and institutional care are reviewed first to define the scope of SIH. Review of the remainder identifies different terms applied to similar types of SIH, similar terms applied to different types, and different terms that distinguish different types. Terms are grouped into those covering SIH focused on lifestyle and recreation, those offering only support services, and those offering care as well as support. Considerable commonality is found in underlying forms of SIH, and common themes emerge in discussion of drivers of growth and diversification, formal policies and programmes, and symbolic meanings. In establishing more commonality than difference, clarification of terminology advances policy debate, programme development, research and knowledge transfer within and between countries. [ABSTRACT FROM PUBLISHER]

Current approaches to the assessment of cognitive capacity in many jurisdictions seek to balance older people's empowerment with their protection. These approaches incorporate a presumption of capacity, a decision-specific rather than global assessment of that capacity, and an obligation to provide the support needed for adults to make or communicate their own decisions. The implication is that older people are assisted to make decisions where possible, rather than using substitute decision makers. For older people, decision making about financial matters is a contentious domain because of competing interests in their assets and concerns about risk, misuse and abuse. In residential-care settings, older people risk being characterised as dependent and vulnerable, especially in relation to decisions about financial assets. This paper reports an Australian study of the factors that facilitate and constrain residents' involvement in financial decision making in residential settings. Case studies of four aged-care facilities explored how staff interpreted the legislative and policy requirements for assisted and substitute decision making, and the factors that facilitated and constrained residents' inclusion in decisions about their finances. The observed practices reveal considerable variation in the ways that current legislation is understood and implemented, that there are limited resources for this area of practice, and that policies and practices prioritise managing risk and protecting assets rather than promoting assisted decision making. [ABSTRACT FROM AUTHOR]

Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self-financing increase. Although many informal caregivers act as asset managers and/or substitute decision-makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi-level and multi-strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets. [ABSTRACT FROM AUTHOR]

Family involvement in managing the financial assets of older people is an area of policy and practice importance. This importance relates to the complexity of older people's assets, systems of paying for care and concerns around substitute decision-making and financial abuse. Although a common task of informal care, little is known about older people's experiences and wishes in relation to asset management. This paper reports on a qualitative study of the experiences and perspectives of thirty-four older people receiving such assistance. It identities three scenarios that promote or inhibit independence in this context and draws out the challenges for this emerging area of practice with older adults and their families. [ABSTRACT FROM AUTHOR]

Few child protection managers come to their roles with the management knowledge, skills and training to prepare them for the challenge of frontline child protection management. Without ongoing developmental support, it is likely that many will struggle, a number will leave their organisations, and critical child protection outcomes, such as increased child safety and wellbeing, will not be achieved. This paper reports on a 10-month mentoring programme provided as part of a larger research project focused on promoting outcome-focused management in statutory child protection area offices in Queensland, Australia. The 14 mentoring participants reported significant benefits of mentoring, with many experiencing fundamental shifts in their management approach. The research has important implications for social work education in terms of better providing for the educational needs of child protection managers. [ABSTRACT FROM AUTHOR]

The study aimed to describe the types of care allocated at the end of acute care to people diagnosed with TBI and to identify the factors associated with variations in referral to care. A retrospective analysis of medical records of 61 patients was conducted based on a sample from two hospitals. While 60.7% of the study sample were referred to formal rehabilitation care, this was primarily non-inpatient rehabilitation care (32.8%). Discriminant analysis was used to determine medical and non-medical predictors of referral. Results indicated that place of treatment and age contribute to group differences and were significant in separating the inpatient rehabilitation group from the non-inpatient and no rehabilitation groups. Review by a rehabilitation physician was associated with referral to inpatient rehabilitation but was not adequate to explain referral to non-inpatient rehabilitation. An in-depth exploration of post-acute referral is warranted to improve policy and practice in relation to continuity of care following TBI. [ABSTRACT FROM AUTHOR]

The article discusses the rights of older people to be protected from abuse and exploitation with a focus on the phenomenon of delegated decision-making on their behalf. It states that older people have the right to appoint a Power of Attorney or an Enduring Power of Attorney, who is commonly a family member, especially which most of these people are suffering debilitating diseases or are not familiar with existing laws provided for them by the Australian government. It adds that older people are in need of specialized advice from people who can explain to them the legislative amendments to the Aged Care Act 1997, Powers of Attorney Act 1998, and Retirement Villages Act 1988. The authors claim that, unlike in the U.S., most older Australians trust their guardians or attorneys.

The article presents the study that was carried out into some aspects of access to health and welfare services in two areas of Brisbane, Queensland. The two areas where the survey was conducted were Inala and Nudgee. Both areas are on the outskirts of Brisbane. The people living in these areas are often far removed from a range of health and welfare services that are located in the center of the city. The survey examined the pattern of usage of a number of centrally and locally situated services. The central services were public hospitals, dental hospitals and a number of governmental and non-governmental social welfare agencies. The local services were general practitioners, dentists, pre-school facilities and some social welfare agencies. Analysis of the data thus gathered reveals a depressing picture of health and welfare services in these two areas. The picture may or may not be accepted by different observers, as being of poverty but few would surely disagree with the view that the words harsh, bleak and difficult could be applied to the texture of life. People are faced with barriers of ignorance, distance and cost in attempting to achieve a proper standard of health and social welfare services.

Background: Nurse turnover in the residential aged care industry is a pressing issue. Researchers have shown ongoing interest in exploring how the factors that are amendable to change in aged care policy, regulation and funding and in organizational procedures (e.g. job demands, coping resources and psychological health of nurses) impact on turnover. However, the findings are mixed. Objective: This study tested two theoretical models of turnover to examine the structural relationships among job demands, coping resources, psychological health and turnover of residential aged care nurses. Although many previous studies operationalized turnover as intention to leave, the present study investigated actual turnover by following up with the same individuals over time, and thus provided more accurate predictive models of turnover behaviour. Design and methods: The sample, 239 Australian residential aged care nurses, came from the Nurses and Midwives e-cohort Study. Job demands, coping resources, and psychological health were measured using standardized instruments. Structural equation modelling was used to test the measurement and structural models. Results: Controlling for a number of workforce and individual characteristics, coping resources (measured by job control, supervisor support, and co-worker support) were negatively and directly associated with turnover. Additionally, the findings supported the Job Demand-Control-Support model in that higher coping resources and lower job demands (indicated by psychological demands, physical demands, and effort) were related to better psychological health (measured by vitality, social functioning, role emotional, and mental health), and higher job demands were related to lower coping resources. Conclusions: Findings suggest that aged care policy makers and service providers might consider increasing coping resources available to nurses and minimizing job demands of care work to reduce turnover and improve nurses’ psychological health. Moreover, findings from this Australian study may provide valuable practical and policy implications for other developed countries. [ABSTRACT FROM AUTHOR]

The law regulating medical end-of-life decisions aims to support patients to receive high-quality health care. It does so through ensuring treatment received reflects the person's wishes and values and protecting health professionals who provide adequate pain and symptom relief even if that treatment may coincidentally hasten death. However, good decision-making is predicated by those involved, including patients themselves and those supporting patients, being familiar with the law and the role it plays in the decision-making process. This article reports on a study exploring the role that law plays in end-of-life decision-making from the perspective of terminally-ill patients, their substitute decision-makers and family members. While participants' decision-making practices were often underpinned by a legal framework, the role of the law was largely invisible. Community education is needed for the public to know their legal rights and responsibilities, and to understand that the law plays a role in supporting end-of-life decision-making., Competing Interests: This research was supported under the Australian Research Council's Linkage Projects Funding scheme (project number: LP 140100883) and contributions from our Industry Partners the Cancer Councils of Queensland, New South Wales and Victoria.

The law has a clear role to play in supporting patients and their substitute decision-makers (SDMs) to be involved in end-of-life (EOL) decision-making. Although existing literature suggests that knowledge of EOL law is variable among health professionals, there is little information about the extent and sources of such knowledge within the general community. A telephone survey of a representative sample of adults in three Australian States used six case scenarios to examine the extent to which adults know their legal duties, rights and powers as patients or SDMs; the sources from which people derive relevant legal knowledge; experiences of EOL decision-making; and individual characteristics associated with levels of knowledge. The results show considerable variation in levels of legal knowledge dependent primarily of the area of decision-making presented, some sizeable gaps in people's knowledge of EOL law, and varied awareness of how to access appropriate information on this subject. This study points to the need to increase community legal literacy around EOL decision-making, enhance awareness of the role of law in these circumstances and promote the availability of reliable and accessible information on the law at the time when it is needed., Competing Interests: None.