Will residential aged care facilities meet long-term demand?

Purpose – This paper aims to provide an invaluable insight into long-term forecasting of demand for aged care facilities. This will ensure the provision of adequate supply by government bodies, stakeholders and developers in order to meet the anticipated level of demand, without creating an over-supply or an under-supply scenario.

Design/methodology/approach – Using an innovative approach, different data sources were collectively used to forecast separate individual supply and demand levels, which were then examined together in order to measure the difference between the two variables between 2009-2020. A case study approach was used for Victoria, Australia.

Findings – The paper finds that, although there is excess supply between 2009-2010 and 2019-2020, the period between 2010 and 2019 will experience an under-supply period which cannot be easily rectified over the short term.

Research limitations/implications – The case study was limited to residential care facilities in Victoria, Australia, although some countries have substantially different age profiles and accommodation supply for older residents. Forecasts are based on information sources from various data suppliers and collectively analysed.

Practical implications – The results are also of direct interest to place managers and planning authorities who are charged with providing medium- and long-term visions and plans for specific locations. This type of research is essential when planning for the eventual aging of the population, where the methodology can be replicated in different areas. Most importantly, this research approach provides a solid basis for decisions regarding the supply of residential aged care facilities as opposed to a simple estimate.

Originality/value – The study adopted a unique approach to analysing the individual supply and demand components for aged care facilities over the long term. This approach is able to accurately determine when there will be an under-supply or over-supply situation and thus provide the opportunity to address the difference before it occurs. This will allow informed decisions about planning aged care facilities in the future to be made as required.

An evaluation of a community aged care nurse practitioner service

Evaluation aims: An evaluation is presented that aimed to augment current understandings of the nurse practitioner role by investigating potential outcomes of a community aged care nurse practitioner (ACNP) service on clients and the health care team.

Background: In Australia, the nurse practitioner role is being implemented in a variety of health care settings and is characterized by extended practice: prescribing of medications, requests for diagnostic investigations, referral to medical specialists and admitting clients to inpatient facilities.

Design: An exploratory qualitative evaluation method through data collection by interview and thematic analysis was undertaken.

Method: All clients referred to the ACNP service between June and August 2003, and a convenience sample of health professionals, were invited to participate in individual semi-structured interviews.

Results: Findings suggested that an ACNP could provide a high quality of holistic nursing care and positively affect clients' physical and psychological symptom management, enhance clients' quality of life, assist with supplies, provide health education and assist with advocacy. Health professionals commented on effective collaboration with the ACNP service during their partnerships in client care provision.

Conclusions: Overall, the positive effects of the ACNP service on clients and the health care team support the full implementation of the role within the community setting.

Relevance to clinical practice: Funding support for the nurse practitioner role is a vital addition to consideration in the development of international policy on advanced practice nursing. Without adequate funding, the full benefits of the nurse practitioner role in clinical practice, as suggested by the findings presented in this evaluation, will be compromised.

Improving health with nutritional interventions in residential aged care

In a group of Australian aged care residents, dietary energy and nutrient intakes were generally inadequate, despite sufficient energy being served. Six months of multivitamin supplementation improved nutritional status and bone quality; and six months of fortified milk consumption improved serum 25(OH)D and folate levels, and increased vitamin D and folate intakes.

The clinical utility of a suite of continence assessment tools for use in residential aged care facilities

According to the Institute of Medicine of the National Academies, 80% of direct care in nursing homes in the USA is provided by workforce that has least formal education about patient care (1). This situation is echoed in Australian residential aged care facilities where the day-to-day management is largely provided by unregulated workers (i.e. nursing assistants, personal carers and nursing aides) and is overseen by registered nurses. Some facilities additionally have access to expert advice from continence nurse advisors. In order to assist the residential aged care workforce to provide continence care that is evidence-based, a team of researchers developed and trialled a suite of continence assessment tools that were mainly targeted to unregulated workers. This paper presents information on the development of the tools (Stage 1) and on their evaluation (Stage 2).

An evaluation of the beyondblue depression training program for aged care workers

Background: The prevalence of depression among older people receiving care is high, yet the rate of treatment of this disorder is low. One way to improve the pathway to care is to train care staff to recognize the symptoms of depression and raise their confidence in responding to them. In this study we evaluated the efficacy of the beyondblue Depression Training Program to achieve this aim.
Methods: Staff (N=148) from low level care facilities and community care facilities in metropolitan Melbourne completed the beyondblue Depression Training Program, while staff in other facilities (N = 96) acted as controls. Pre-program, post-program and follow-up questionnaire data were collected and referrals for depression by staff were recorded.
Results: Training improved carers’ knowledge about depression, their self-efficacy in responding to signs of depression and their attitudes towards working with depressed aged care recipients. In addition, training increased the number of referrals for depression made by carers.
Conclusion: Training aged care staff in depression can improve the pathways to care for depressed care recipients, and has the potential to improve the quality of life of older people.

Introducing health information systems to aged care in Vietnam

Similar to many other countries worldwide, Vietnam is facing a challenge of an ageing population. This challenge is even more difficult to overcome because Vietnam is a developing country lacking an established aged care infrastructure and system. Many aspects of aged care have largely been relied on families of aged people due to a strong influence of Confucian philosophy. Looking after aged parents has always been seen as a responsibility and filial piety of children and their extended families. Therefore, providing healthcare for aged people in their family and community context is important. The paper offers a rich description and an analysis of the current situation of the health state of and healthcare for aged people in Vietnam. The paper also suggests directions for integrating information communication technology into aged care in Vietnam.

Supporting information needs of senior citizens in community aged care

To address the challenge of an ageing population in an information society, it is important to introduce information systems to assist the aged people in maintaining and improving their quality of life. An understanding of what information aged people need, how they seek and use information, and how they adopt Information and Communication Technology (ICT) is required. This paper reports the findings of an empirical study undertaken in Australia to understand the information needs of senior citizens who reside in the community. The study aims to understand how ICT can support the independent living of senior people in the community from both the social and health perspectives. We offer a new understanding of the information needs of aged people in the community and extend the information systems research in aged care. This research also contributes to the development of innovative ICT enabled aged care service solutions in community aged care.

A suite of evidence-based continence assessment tools for residential aged care

The management of incontinence in residential aged care facilities presents staff with considerable challenges. In order to support the residential aged care workforce to provide evidence-based continence care, we developed a suite of evidence-based continence assessment tools and an accompanying educational resource for use in the residential aged care sector. The tools comply with international and accreditation standards. They address urinary and faceal incontinence and other bladder and bowel symptoms. They also include a number of cues to guide staff to assess and manage residents’ continence care needs and refer as needed. An evaluation of the tools conducted in 18 residential aged care facilities across three states revealed that staff members found the tools helpful, clear, simple and user-friendly. This paper provides a description of the newly developed suite of continence assessment tools for residential aged care and the accompanying education resources, and presents staff perspectives on their clinical usefulness.

Coproduction in practice : participatory action research to develop a model of community aged care

Coproduction has become synonymous with innovative approaches to public service delivery in European Union countries as well as in Australia. Coproduction has the potential to bring together individuals, communities, and organisations in a process to collaboratively develop new models and services which improve public services. Yet, Australian policy makers and practitioners who would like to deploy coproduction within the context of older adult social care can only draw on a handful of papers and reports that could guide implementation. This paper fills this gap by reporting on the implementation of a multi-stakeholder coproduction approach to the development of a consumer directed care model for older people with complex health issues. The paper describes and critically highlights methodological challenges encountered during the 12 month-long participatory action research phase of a larger project involving older people with complex care needs, their carers, and government and non-government stakeholders. The paper outlines key considerations regarding (1) the involvement of older people with complex needs, (2) collaboration with industry partners, (3) engagement of government representatives, and (4) reflects on implementing participatory research projects within a context of outsourcing and interlinked supply chains. While not all challenges encountered could be resolved, the coproduction approach was successful in bringing together a wide range of stakeholders with competing agendas in an iterative process geared to resolve a plethora of concerns raised by older people, carers and services providers. This paper provides an example for others seeking to use coproduction and participatory methods to provide person-centred care services for older people.