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Objective: Carers for people with dementia commonly experience difficulty assisting the care‐recipients with their daily activities and may adopt specific strategies to decrease the difficulties experienced. The objective of this qualitative study was to explore and understand the strategies used by carers to assist with daily activities for persons living with dementia. Methods: Individual semi‐structured interviews via face‐to‐face or telephone mode were conducted with 62 carers of persons living with dementia in Australia. Carers were asked about the strategies they have used previously, or are currently using, to assist with daily activity completion. Data were analysed via constant comparison and thematic analysis. Results: All carers reported the need for strategies to accommodate the varying behaviour and functioning of the care‐recipients. Participants reported a total of 207 strategies that fell into four main categories: (i) engage; (ii) adapt; (iii) orientate; and (iv) sense. The most used strategies were reported as those aimed at adapting the activity by using equipment to facilitate completion. Conclusions: Carers help persons living with dementia complete their daily activities by developing their own strategies based on the care‐recipients' needs and personal preferences through a trial‐and‐error process. Carers can benefit if more advice is provided to them by health/social care professionals regarding what strategies may be helpful. Further studies are needed to develop these strategies into an educational package so that carers can be guided to use these strategies appropriately. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic has had a substantial impact on the utilisation of hospital and emergency department (ED) services. We examined the effect of a rapid response service on hospital re‐presentations among people discharged from the ED and short‐stay wards at a tertiary referral hospital. Methods: This retrospective cohort study compared 112 patients who completed the Care in the Community program with 112 randomly selected controls. Both cases and controls were discharged from hospital between September 2020 and June 2021. Intervention patients were evaluated by a multidisciplinary team, who implemented a goal‐directed program of up to 4‐weeks duration. Logistic regression, negative binomial regression and Cox proportional hazards regression were used to evaluate outcomes at 28 days and at 6 months. Results: The median time between referral and the first home visit was 3.9 days. In adjusted analyses, the intervention reduced hospital re‐presentations at 28 days (odds ratio:.40, 95% confidence interval (CI):.17–.94) and lengthened the time to the first hospital re‐presentation (hazard ratio:.59, 95% CI:.38–.92). Although the intervention did not reduce the total number of hospital re‐presentations at 6 months (adjusted incidence rate ratio:.73, 95% CI:.49–1.08), it reduced total time spent in hospital by 303 days (582 vs. 885). Conclusions: This study is among the first to investigate the effect of a community‐based intervention on hospital re‐presentations during the COVID‐19 pandemic. It provides evidence that a sustainable 4‐week intervention is associated with reduced hospital re‐presentations and time spent in hospital. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians.Design: Culture and Health Advisory Groups were used in Stage 1 to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the geriatric medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n = 166). In Stage 3, the predictive accuracy of items was assessed in a random sample of community-dwelling elderly persons stratified by language background and cognitive diagnosis and matched for sex and age (n = 90).Measurements: A research psychologist administered all cognitive items, using interpreters when needed. Each patient was comprehensively assessed by one of three geriatricians, who ordered relevant investigations, and implemented a standardized assessment of cognitive domains. The geriatricians also collected demographic information, and administered other functional and cognitive measures. DSM-IV criteria were used to assign cognitive diagnoses. Item validity and weights were assessed using frequency and logistic regression analyses. Receiver-operating characteristic (ROC) curve analysis was used to determine overall predictive accuracy of the RUDAS and the best cut-point for detecting cognitive impairment.Results: The 6-item RUDAS assesses multiple cognitive domains including memory, praxis, language, judgement, drawing and body orientation. It appears not to be affected by gender, years of education, differential performance factors and preferred language. The area under the ROC curve for the RUDAS was 0.94 (95% CI 0.87-0.98). At a cut-point of 23 (maximum score of 30), sensitivity and specificity were 89% and 98%, respectively. Inter-rater (0.99) and test-retest (0.98) reliabilities were very high.Conclusions: The 6-item RUDAS is portable and tests multiple cognitive domains. It is easily interpreted to other languages, and appears to be culturally fair. However, further validation is needed in other settings, and in longitudinal studies to determine its sensitivity to change in cognitive function over time. [ABSTRACT FROM AUTHOR]