Federally funded aged care provision in regional Victoria : Examining current provision and estimating future infrastructure requirements using existing population-based benchmarks

The following paper examines federally accredited and funded aged care provision in regional Victoria. Benchmarks that have been set by the Australian Department of Health and Ageing, are used to measure and compare the relative number of high and low level aged care positions and Community Aged Care Packages in six regional Victorian centres.
Using population forecasts, the additional aged care positions that each centre will require to meet the provision benchmarks in the year 2021 have been estimated. These figures are then translated into infrastructure requirements for the regional Victorian city of Greater Bendigo. This is done by surveying Greater Bendigo’s existing residential aged care facilities. Strategies for the provision of additional high and low level residential aged care infrastructure are explored using a matrix governed by size and configuration. Variations in these two aspects are shown to affect the location options for future facilities in Greater Bendigo. The implications of the benchmarks are also investigated in terms of facilities for the provision of Community Aged Care Packages.
The research is funded by a double ARC APAI grant between the Built Environment Research Group at Deakin University, The Centre for Sustainable Regional Centres at La Trobe University, the City of Greater Bendigo and the City of Warrnambool.

Ethnic aged discrimination and disparities in health and social care : a question of social justice

Older overseas-born Australians of diverse cultural and language backgrounds experience significant disparities in their health and social care needs and support systems. Despite being identified as a 'special needs' group, the ethnic aged in Australia are generally underserved by local health and social care services, experience unequal burdens of disease and encounter cultural and language barriers to accessing appropriate health and social care compared to the average Australian-born population. While a range of causes have been suggested to explain these disparities, rarely has the possibility of cultural racism been considered. In this article, it is suggested that cultural racism be named as a possible cause of ethnic aged disparities and disadvantage in health and social care. It is further suggested that unless cultural racism is named as a structural mechanism by which ethnic aged disparities in health and social care have been created and maintained, redressing them will remain difficult.

The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

Background : Acute respiratory illnesses (ARIs) during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children.
Methods : We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs.
Results : Impact diaries were available for 72% (523/725) of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95% confidence interval $263 to $354). Influenza illnesses had a mean cost of $904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories.
Conclusion : From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options.

Pretend play, social competence and involvement in children aged 5-7 years : the concurrent validity of the child-initiated pretend play assessment

Background and aims: The aims of this study were to investigate the relationship between pretend play, social competence and involvement in school-based activities in children aged 5–7 years and to determine whether children's social competence and level of involvement could be inferred from their scores on the Child-Initiated Pretend Play Assessment.
Procedure: The pretend play skills of 41 primary school-aged children aged 5–7 years were assessed on a one-on-one basis. Classroom teachers of the children assessed the children's social competence using the Penn Interactive Peer Play Scale and their involvement in school based activities using the Leuven Involvement Scale for Young Children.
Main findings: Significant positive relationships were found between elaborate pretend play and object substitution scores, involvement scores and peer play interaction scores (P < 0.05, P < 0.01). A significant negative relationship was found between elaborate pretend play scores, and social disconnection and social disruption scores (P < 0.05). Play deficit indicators were significantly negatively related to involvement scores (P < 0.01). This suggests that children with proficient pretend play skills are socially competent with peers and are able to engage in classroom activity. Children who scored poorly on the play assessment were more likely to have difficulty interacting with their peers and engaging in school activities.
Conclusion: Social competence and involvement skills are related to a child's ability to engage in pretend play. A child's social skills and ability to engage in school activities as assessed by teachers can be inferred from their scores on the Child-Initiated Pretend Play Assessment.

Professional carers' knowledge and response to depression among their aged-care clients : the care recipients' perspective

Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

Enhancing nutritional research within an aged care facility

Aim: The present study examined the barriers to the implementation of a nutritional intervention project and sought ways to enhance future projects.

Methods: The study, utilising a qualitative approach, included participants from key areas involved in the project and who were employed by either the university or regional aged care facility.

Results: Through analysis the themes 'successes', 'stumbling blocks' and 'solutions' emerged. Within these themes descriptive stories of what worked, what did not work and suggestions for future projects are depicted.

Conclusions: Communication was the connecting element of each theme, suggesting effective verbal and written communication that ensures ownership by all involved is essential for successful clinical research projects. Strategies to enhance this process have been included to assist future researchers.