Aging and Health

2016

Ongoing Research - Functional Decline

The research group at the International Centre for Allied Health Evidence (iCAHE) have a 15 year collaborative history of aged care research, longitudinal epidemiological studies and cross-sector research into discharge planning quality (engaging tertiary, sub-acute and primary sectors). With extensive experience in research into quality care, evidence-based practice implementation and policy development, and networks that include Australian health policy experts and local healthcare networks to bring evidence translation experience across the healthcare sector. Our findings will underpin future research into timely and appropriate community-based interventions to arrest or slow the progress of early FD, before the changes become irreversible. Not only will this reduce high (and avoidable) tertiary healthcare costs, but it will enrich communities by having healthier, higher-functioning older people contributing to community life, for longer.

The following section reports on a list of resources and publications produced from this research. 

Ongoing Research - Discharge Planning

Discharge planning is become increasingly important as the average time that patients stay in hospital declines. iCAHE has developed a number of tools designed for patients, carers, community service staff, medical practitioners and residential care staff. Whilst the focus of iCAHE is on allied health these tools are relevant across a range of disciplines and fields, and are suitable for most hospital discharge facilitations and post-discharge assessment

iCAHE researchers have developed five congruent, interlinked but independent survey instruments which assess the quality of discharge planning from different stakeholders perspectives (medical practitioners, residential care administrators, community service providers, patients and carers). These survey instruments have sound psychometric properties (Grimmer and Moss 2001, Graumlich et al 2008) and are recommended for use by evaluators and researchers to capture the specific elements of best practice discharge planning. These instruments can be readily scored by hand, or simple statistical analysis programs can be written to capture composite information on the specific domains of discharge planning quality represented in some of the questionnaires. These instruments have all been labelled with the acronym PREPARED (Prescriptions, Ready to re-enter community, Education, Placement, Assurance of safety, Realistic expectations, Empowerment, Directed to appropriate services). These elements reflect the core purposes of best-practice discharge planning.  

The following section reports on a list of resources and publications produced from this research. 

2015

Functional decline in community-dwelling older people and the Medicare 75+ Health Assessment. Final Report. Prepared for the Australian Primary Health Care Research Institute, The Australian National University

This is the Final Report prepared for an Australian Primary Health Care Research Institute (APHCRI) 2014 funded project: Functional decline in community-dwelling older people and the Medicare 75+ Health Assessment. The overall aim of this research was to improve the sensitivity and timing of identification of FD in community-dwelling older people, focusing on primary care settings, so that older people’s entry onto the trajectory of FD could be prevented or slowed sufficiently early, to be effective in supporting them to live independently for as long as they desired in the community home of their choice. This Final Report brings together salient methods and findings of Project Stages 1, 2 and 3 (provided for reference in Appendices 1-3). The final Report makes recommendations for policy and practice in relation to the 75+ Health Assessment (HA) and the context in which it is most effectively delivered. Appendix 4 provides a publication to date, from Stage 1 of this project (Beaton et al 2014).

Engaging baby boomers with policy makers Results of a systematic review and proposed consumer engagement framework. Prepared for Office for the Ageing, Policy and Commissioning, Department of Health South Australia

A key question confronting the Office for the Ageing is how to engage effectively with baby boomers on health issues related to ageing. The Office is committed to ensuring the methods and practice of consumer engagement, particularly baby boomers, is guided by current best practice. This rapid review aimed to address the following questions:

  1. What approaches or strategies have been used by policy makers to effectively engage baby boomers on issues related to ageing?
  2. What outcomes have been reported for these strategies or approaches?
  3. What are the barriers to effective engagement of baby boomers with policy makers?
  4. What strategies or incentives can be used to ensure that boomers become engaged with policy makers?

 

2013

Functional decline in community-dwelling older people and the Medicare 75+ Health Assessment.  Technical Report 1: A Systematic Review.  Prepared for the Australian Primary Health Care Research Institute, Australian National University.  

This report outlines the findings of Stage 1 of the Australian Primary Health Care Research Institute (APHCRI) 2014 funded project: Functional decline in community-dwelling older people and the Medicare 75+ Health Assessment. It encompases two comprehensive systematic reviews of the literature regarding early measures of functional decline, and international primary care screening approaches and items for older people. The final report was completed in 2015. Prior to commencement, the Research Team, in consultation and with the approval of APHCRI, changed the original research proposal for the 2015 report, which can be found above. 

Building a complexity competent workforce project: Evidence informed development of a tool to screen for decline. A technical report prepared for the Southern Adelaide Local Health Network

Early identification and subsequent timely intervention older people has been reported as effective in improving health outcomes, as appropriate and timely community services can be put in place toFacilitate ongoing independent community living. Many risk factors for decline are potentially modifiable with community support interventions, or comprehensive geriatric assessment and management which target those most likely to benefit. It is in this context, support workers and allied health assistants can play a vital role in early detection of decline in elderly people.While support workers and allied health assistants could play an important role the early detection and timely intervention for decline, they need to be supported with adequate training, establishing competencies, support mechanisms (such are supervision and mentoring) and tools to detect decline. Provision of tools to detect decline may enable support workers and allied health assistants to accurately detect those elderly people who may be at risk of decline.

iCAHE performed a two stage investigation: a rapid review followed by tool development. The aim of this rapid review was to identify currently available tools from the literature which can be used by assist support workers and allied health assistants to accurately detect decline in older people.

Areas of study and research

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