Investigations of access for people with disability and older people

The phenomenon of access was investigated in regard to people with disability and older people. Access is described as a journey which involves navigation of numerous access opportunities and barriers and achievement of an access goal. While differences existed, numerous access issues and solutions are relevant to the two groups.

Passing time in Clifton Court : an ethnographic study of a unit for confused older people

An exploration of how the residents of a 30 bed unit for confused older people spent their time and a description of the impact upon this of any associated factors. The study demonstrates that it is possible for for elders with dementia and mental health problems to enjoy a range of activities, however, these need to be individualised to take into account the skills they have to meet the challenges with which they are presented. The informed contribution from the activities personnel and the support of nurses is vital to ensure a high quality of social interaction. Sound leadership at the clinical level is essential.

Promoting a team ball game (Lifeball) to older people : who does this game attract and who continues?

Issue addressed: To describe the demographic and health-related characteristics (physical activity, self-reported health status, quality of life and falls history) of older people who enroll in a team-based game, Lifeball, and examine associations between continuation and participant characteristics. Reasons for stopping, participants' perceptions of the game and changes in health-related characteristics over 12 months were examined.

Methods: Telephone surveys were conducted with a cohort of Lifeball players at: baseline, soon after commencing playing and 12 months later.

Results: At baseline, participants were aged 40 to 96 years (mean 67). Most were female (84%), in good to excellent health (86%) and reported being sufficiently (>150 minutes per week) physically active (69%). Almost half (43%) were still playing 12 months later (continuers). Continuers were more likely to perceive Lifeball had helped them to: feel fitter and healthier (91%); improve their social life (73%); and be more active (53%). No significant changes in continuers' physical activity, self-reported health status and quality of life measures were reported. The main reason for stopping playing was illness/injury unrelated to Lifeball.

Conclusions: Lifeball mainly appealed to healthy, active older people.

Managing constipation in older people

The study consists of two parts: a systematic review that critically analysed existing Chinese medicine clinical trials in managing constipation and, a cluster randomised controlled trial investigating the effects of education and acupressure on constipation in older people. Participants in the experimental group reported significant improvements in their constipation symptoms.

How is the diagnosis of asthma in older people established in clinical practice?

What we need to know
• How is breathlessness perceived and defined in older people?
• What impact does breathlessness have on quality of life?
• Can history taking and physical examination be tailored to efficiently cover all the organ systems associated with
breathlessness?
• Can a self- or carer-rated questionnaire be used to identify asthma in patients with breathlessness?
What we need to do
• Develop self- and carer-rated questionnaires that measure change in function and quality of life before and after
treatment.
• Validate objective measures of physical function and airflow that are sufficiently sensitive to measure change with
treatment.
• Develop a diagnostic guideline in general practice that includes measures of mood and cognitive function and
involves carers where necessary.
• Provide rehabilitation and restorative care services.

Promoting social inclusion of frail older people living in the community

The increasingly diverse needs and wants of Australia's ageing population, like those in many other societies, are drawing attention to aged care as an increasingly important area of broader health and social policy. Active qgeing and a focus on enabling people to remain living in their own homes in the community are two of the key components of this policy shift.

The policy shift towards active ageing recognises and aims to support the desires of older people to remain active members of their communities as they age. Active ageing is 'the process of optimising opportunities for physical, social and mental wellbeing throughout the life-course, in order to extend healthy life expectancy, productivity and quality oflife in older age' (AIPC 2008: 26).

According to the World Health Organization (WHO), the rights, needs, preferences and capacities of older people should be central to active ageing policies, and these should be framed by a life-course approach to ageing (WHO 2002). The development of age-friendly communities, social inclusion and engagement are emerging as key policy issues in the context of an ageing population.

Recent research demonstrates the importance of a sense of belonging in maintaining a sense of identity and increasing the wellbeing of an individual. The sense of belonging that comes about through community engagement also plays a role in successful adjustment to ageing, including prolonging good health and reduced risk of entry into residential aged care.

Finding a place for personal growth in an Australian community singing group for older people

--[if gte mso 9]> --> --[if gte mso 9]> Normal 0 false false olderText>falseolderText> EN-AU JA X-NONE -->--[if gte mso 9]> --> --[if gte mso 10]> --> --StartFragment-->As in many countries, Australia is faced with an aging population. This creates challenges for the maintenance of well-being which can be enhanced by active engagement in society. Music engagement encompasses a range of social participation and has the potential to recognise the contribution of older people to their local communities. Engagement in music by older people (50+) is positively related to individual and community well-being.  Music participation can contribute to a better quality of life, particularly in relation to health and happiness. The possible forms of music engagement are myriad.

This paper focuses on two members of a mixed voluntary singing group formed by older residents of an outer suburban community in Melbourne, Australia.  This study frames music as a positive way for older people to find a place for personal growth and fulfilment in a singing group. This phenomenological qualitative single case study focuses on two members of a small singing ensemble, the Skylarkers, formed to perform at retirement villages, nursing homes and facilities for senior citizens. In this study, data were gathered by interviews and analysed using interpretative phenomenological analysis.

Two significant themes emerged. The first concerned the nature of the choir and its fluid membership and notions of self-identity. The second theme concerns the validation offered to individual members by active music participation through which they gained a sense of purpose, fulfilment and personal growth. This emphasis is unusual in discussions of community music engagement that ordinarily identify the importance of social connections. Groups such as the Skylarkers provide a place for members to continue their active engagement with music performance and music learning.--EndFragment-->

A systematic narrative review of consumer-directed care for older people: implications for model development

Consumer-directed care is increasingly becoming a mainstream option in community-based aged care. However, a systematic review describing how the current evaluation research translates into practise has not been published to date. This review aimed to systematically establish an evidence base of user preferences for and satisfaction with services associated with consumer-directed care programmes for older people. Twelve databases were searched, including MedLine, BioMed Central, Cinahl, Expanded Academic ASAP, PsychInfo, ProQuest, Age Line, Science Direct, Social Citation Index, Sociological Abstracts, Web of Science and the Cochrane Library. Google Scholar and Google were also searched. Eligible studies were those reporting on choice, user preferences and service satisfaction outcomes regarding a programme or model of home-based care in the United States or United Kingdom. This systematic narrative review retrieved literature published from January 1992 to August 2011. A total of 277 references were identified. Of these 17 met the selection criteria and were reviewed. Findings indicate that older people report varying preferences for consumer-directed care with some demonstrating limited interest. Clients and carers reported good service satisfaction. However, research comparing user preferences across countries or investigating how ecological factors shape user preferences has received limited attention. Policy-makers and practitioners need to carefully consider the diverse contexts, needs and preferences of older adults in adopting consumer-directed care approaches in community aged care. The review calls for the development of consumer-directed care programmes offering a broad range of options that allow for personalisation and greater control over services without necessarily transferring the responsibility for administrative responsibilities to service users. Review findings suggest that consumer-directed care approaches have the potential to empower older people.