Intercultural residential care in New Zealand

Along with other Organization for Economic Cooperation and Development (OECD) countries, New Zealand’s society is aging such that an increase in the number of older people requiring residential care is predicted. What cannot be foreseen is how culturally defined health beliefs affect the care given to older people in residential care. In this article, the authors describe and discuss the culturally based health beliefs of some Pacific Islands caregivers and predominately European (Pakeha) older people resident at one long-term care facility in Auckland, New Zealand. The delivery of care is influenced by culturally related beliefs about “being old.” Racism is evident in residential care, and the authors discuss the reactions of caregivers, residents, and management. This research extends the discussion of caregiving and receiving into the cross-cultural setting, and the findings highlight a number of elements in cultural differences between carer and cared-for that might affect care practices at the residential facility studied.

Ageing, technology anxiety and intuitive use of complex interfaces

This paper presents the outcome of a study that investigated the relationships between technology prior experience, self-efficacy, technology anxiety, complexity of interface (nested versus flat) and intuitive use in older people. The findings show that, as expected, older people took less time to complete the task on the interface that used a flat structure when compared to the interface that used a complex nested structure. All age groups also used the flat interface more intuitively. However, contrary to what was hypothesised, older age groups did better under anxious conditions. Interestingly, older participants did not make significantly more errors compared with younger age groups on either interface structures.

Searching for value : the influence of policy and reform on nurses’ sense of value in long-term aged care in Australia.

Contemporary literature on long-term aged care focuses heavily on issues associated with the recruitment and retention of nursing staff, such as job satisfaction and attitudes towards caring for older people. This paper aims to highlight one aspect of a larger study of registered nurses' experiences in long-term aged care in Australia and the influence that government policy and reform has in shaping that experience. This insight into aspects of nurses' everyday experience also contributes to a broader understanding of job satisfaction in long-term care. Findings from this study suggest that registered nurses experience tension in their search for value in their practice, which incorporates professional, political and social mediators of value and worth. These issues are discussed in relation to the impact of policy and reform on nurses' sense of value in long-term aged care and highlight the need for sensitive policy initiatives that support issues of value in nursing practice.

Modelling the salient factors influencing retired business professionals' participation in episodic skilled volunteering in rural settings

Retired business professionals represent an unexplored source of skill support for struggling rural communities. This research examined the feasibility of drawing on this valuable pool of knowledge and experience by engaging retirees in short term, project based volunteering roles in rural, not for profit agencies. Using the theory of planned behaviour and the functional approach to volunteering, the program of study generated a model comprising the key psychological and contextual factors determining the volunteers' decision to provide skill assistance in rural settings. The model provides a useful resource for creating suitable volunteering opportunities and for informing volunteer recruitment strategies.

Livable Housing Design : Who will take responsibility?

Current housing design and construction practices do not meet the needs of many people with disability and older people, and limits their inclusion and participation in community and family life. In spite of a decade of advocacy for regulation of access within residential environments, the Australian government has opted for a voluntary approach where the housing industry takes responsibility. Housing industry leaders have indicated that they are willing to transform their established practice, if it makes good business to do so, and if there is a demand from home buyers. To date, there has been minimal demand. In 2010, housing industry and community leaders formalised this commitment in an agreement, called Livable Housing Design, to transform housing design and construction practices, with a target of all new housing providing minimal access by 2020. This paper reports on a study which examined the assumption behind Livable Housing Design agreement; that is, individuals in the housing industry will respond voluntarily and take responsibility for the provision of inclusive housing. From interviews with developers, designers and builders in Brisbane, Queensland, the study found a complex picture of competing demands and responsibilities. Instead of changing their design and construction practices voluntarily to meet the future needs of users over the life of housing, they are more likely to focus on their immediate contractual obligations and to maintain the status quo. Contrary to the view of the government and industry leaders, participants identified that an external regulatory framework would be required if Livable Housing Design’s 2020 goal was to be met.

Examining correlates of self-reported and objectively measured physical activity among retirement village residents

Aim Physical activity (PA) patterns of retirement village residents were investigated using self-report and objective measures. Methods Residents (n = 323) from retirement villages in Perth, Australia, were surveyed on PA behaviour and various demographic, residency, health-related and mobility factors. Most participants wore accelerometers for 7 days. Retirement village managers (n = 32) were surveyed on village descriptive characteristics, including the provision of amenities and facilities. Logistic regression models examined village and resident characteristics associated with PA. Results Based on objective measurement, only 27.1% of participants were sufficiently active (n = 288). Walking was one of the most popular PA modes. Few village characteristics were associated with PA; however, villages located in more walkable neighbourhoods increased participants’ odds of transport walking. Travelling outside the village daily also increased PA odds. Conclusions Most residents were insufficiently active to gain health benefits. Considering individual and environmental factors, within the retirement village and neighbourhood settings, and associations with PA, warrants attention.

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients

Background There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. Methods A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. Results The mean or median age of participants was 70 or more years in eight of the 16 (n=2,659/5,613; 47%) structured telephone support studies and four of the 11 (n=894/2,710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Conclusion Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure.

Ageing in suburbia : designing for demographic change in Australia and New Zealand

In the next half-century, Australia's population of people aged over 65 is set to almost double. As a consequence, there is an urgent need in both Australia and New Zealand, where older people value their independence, for housing that fully supports them in their own suburban homes. With only a handful of models in place, Mark Taylor, Professor of Architecture at the University of Newcastle, Australia, and Laurie Buys, a Professor in the School of Design at Queensland University of Technology in Brisbane, have tracked down some promising precedents for suburban living in adapted homes and within community-based shared housing.

The lag effects and vulnerabilities of temperature effects on cardiovascular disease mortality in a subtropical climate zone in China

This research quantifies the lag effects and vulnerabilities of temperature effects on cardiovascular disease in Changsha—a subtropical climate zone of China. A Poisson regression model within a distributed lag nonlinear models framework was used to examine the lag effects of cold- and heat-related CVD mortality. The lag effect for heat-related CVD mortality was just 0–3 days. In contrast, we observed a statistically significant association with 10–25 lag days for cold-related CVD mortality. Low temperatures with 0–2 lag days increased the mortality risk for those ≥65 years and females. For all ages, the cumulative effects of cold-related CVD mortality was 6.6% (95% CI: 5.2%–8.2%) for 30 lag days while that of heat-related CVD mortality was 4.9% (95% CI: 2.0%–7.9%) for 3 lag days. We found that in Changsha city, the lag effect of hot temperatures is short while the lag effect of cold temperatures is long. Females and older people were more sensitive to extreme hot and cold temperatures than males and younger people.

Supporting residents’ expression of sexuality : the initial construction of a sexuality assessment tool for residential aged care facilities

Background: Sexuality is a key component of quality of life and well-being and a need to express one’s sexuality continues into old age. Staff and families in residential aged care facilities often find expressions of sexuality by residents, particularly those living with dementia, challenging and facilities often struggle to address individuals’ needs in this area. This paper describes the development of an assessment tool which enables residential aged care facilities to identify how supportive their organisation is of all residents’ expression of their sexuality, and thereby improve where required. Methods: Multi-phase design using qualitative methods and a Delphi technique. Tool items were derived from the literature and verified by qualitative interviews with aged care facility staff, residents and families. The final item pool was confirmed via a reactive Delphi process. Results: A final item pool of sixty-nine items grouped into seven key areas allows facilities to score their compliance with the areas identified as being supportive of older people’s expression of their sexuality in a residential aged care environment. Conclusions: The sexuality assessment tool (SexAT) guides practice to support the normalization of sexuality in aged care homes and assists facilities to identify where enhancements to the environment, policies, procedures and practices, information and education/training are required. The tool also enables facilities to monitor initiatives in these areas over time.

Examining the predictive value of combining the theory of planned behaviour and the volunteer functions inventory

The functions of the volunteer functions inventory were combined with the constructs of the theory of planned behaviour (i.e., attitudes, subjective norms, and perceived behavioural control) to establish whether a stronger, single explanatory model prevailed. Undertaken in the context of episodic, skilled volunteering by individuals who were retired or approaching retirement (N = 186), the research advances on prior studies which either examined the predictive capacity of each model independently or compared their explanatory value. Using hierarchical regression analysis, the functions of the volunteer functions inventory (when controlling for demographic variables) explained an additional 7.0% of variability in individuals’ willingness to volunteer over and above that accounted for by the theory of planned behaviour. Significant predictors in the final model included attitudes, subjective norms and perceived behavioural control from the theory of planned behaviour and the understanding function from the volunteer functions inventory. It is proposed that the items comprising the understanding function may represent a deeper psychological construct (e.g., self-actualisation) not accounted for by the theory of planned behaviour. The findings highlight the potential benefit of combining these two prominent models in terms of improving understanding of volunteerism and providing a single parsimonious model for raising rates of this important behaviour.

Visual function and the ageing visual system

The population is ageing. Globally, the number of older adults (aged 60 years or over) is expected to more than double, from 841 million people in 2013 to more than 2 billion in 2050.1 In light of the increasing size of the older adult population, there is a pressing need to better identify the nature of, and mechanisms underlying, age-related vision impairment and the functional impact it has on the performance of everyday activities in older adults. The content of this feature issue reflects the diversity of research currently being undertaken on the topic of the ageing visual system and the important visual challenges that this presents for our ageing patient population. The scope is broad and includes topics relating to three main related themes: 1) The treatment of age-related ocular disorders and diseases and their consequences, including presbyopia and AMD; 2) The impact of age-related visual changes on everyday activities in older people, including mobility, driving and falls, and; 3) The interaction of age-related visual impairments and other age-related impairments including hearing and cognitive changes.

E-health: potential benefits and challenges in providing and accessing sexual health services

BACKGROUND: E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. DISCUSSION: The paper used the dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) as a guiding principle to discuss potentials of E-health in providing and accessing sexual health services. There are important issues in relation to utilising and providing online sexual health services. For healthcare providers, e-health can act as an opportunity to enhance their clients' sexual health care by facilitating communication with full privacy and confidentiality, reducing administrative costs and improving efficiency and flexibility as well as market sexual health services and products. Sexual health is one of the common health topics which both younger and older people explore on the internet and they increasingly prefer sexual health education to be interactive, non-discriminate and anonymous. This commentary presents and discusses the benefits of e-sexual health and provides recommendations towards addressing some of the emerging challenges. FUTURE DIRECTIONS: The provision of sexual health services can be enhanced through E-health technology. Doing this can empower consumers to engage with information technology to enhance their sexual health knowledge and quality of life and address some of the stigma associated with diversity in sexualities and sexual health experiences. In addition, e-sexual health may better support and enhance the relationship between consumers and their health care providers across different locations. However, a systematic and focused approach to research and the application of findings in policy and practice is required to ensure that E-health benefits all population groups and the information is current and clinically valid and effective, including preventative approaches for various client groups with diverse needs.

“You could scream the place down”: Five poems on the experience of aged care

This article presents five poems constructed from interviews with older people adjusting to living in residential aged care. They are part of the “Inside Aged Care” project, on-going longitudinal phenomenological research tracking the lived experience of aged care from the perspective of residents, family members and service providers. Poetry, through the process of poetic transcription, provided an engaging, evocative and almost visceral way to help us appreciate what it might be like to be ageing in aged care. To date, despite a growing body of work documenting the importance and impact of research in the form of poetry, applying a literary lens is rare in gerontological research. At a very practical level, therefore, we hope these poems help older people, their families, students and those working in aged care better understand the unique world and perspective of new aged care residents.

EUTOPIA 75+ : exploratory futures scenarios for baby boomers’ preferred living spaces

Australia is experiencing the global phenomenon of an ageing population with the baby boomer generation starting to reach retirement age in large numbers. As a result, there is a growing need for appropriate accommodation and this will continue to grow for the foreseeable future. However, the needs of the fit, mobile and techno savvy baby boomers are likely to be far different from those of previous generations of older people, but are as yet unknown and unanticipated. This paper reports on the findings of a Futuring research project to explore the preferred housing futures for the baby boomer generation in the city of Brisbane, an aspiring creative city in South East Queensland (SEQ), Australia. Their future home design and service needs are predicted by firstly employing a global environmental scan of related and associated ageing futures issues. This was followed by a micro-Futuring workshop, based on Inayatullah’s Futures Triangle Analysis, to identify a range of scenarios. The key aspects of the workshop culminated in the development of a Transformational Scenario – EUTOPIA 75+. From this, a suite of six design recommendations for seniors’ housing design and smart services provision are synthesised to give a sense of direction of preferred living styles, especially in terms of physical housing spaces, with a view to identifying new house design opportunities for the allied industries and research organisations. The issues identified are also of concern for aged care service providers, retirement living developers, and for academics involved in the social and physical design of living spaces for older people.