Australasian Journal on Ageing media releases 2003

NEWS ITEMS FROM RESEARCH ON AGEING

Australasian Journal on Ageing presents research on ageing from Australia, Asia and the Pacific.

The March 2003 issue (Vol 22.1 ) has articles and reports on a number of social and medical issues of concern and interest to those caring for older people and for the community generally. Highlights are summarised below.

They include how resident-staff interactions in aged care can discourage independence, whether GPs should be paid to give information to older people, mismanagement of older people's assets, and official recommendations on management of driving and dementia.

Full copies of any article are available - FOR MEDIA ONLY - from the COTA National Seniors Policy Secretariat by phoning 03-9820 2655 or email aja@cota.org.au. Please acknowledge AJA as source of information in any article or report.

Older patients are more positive about the use of written education materials than their doctors, and they want more written information than is provided to them by their GPs, who overestimate what they have actually provided to their patients. 28% of one group surveyed had not provided written material to patients, but this rose to 46% for older patients. Older people may need to be more assertive about requesting written information, and GPs may better serve their patients' needs by making written information more readily available. Better access to materials and more financial incentive to give them out might also increase GP's use of written materials, the Qld survey concludes.

A qualitative study of interactions between aged care staff and residents in one nursing home has found limited verbal communication and physical contact between staff and residents. Few attempts were made to encourage independence. In this study residents were alone for 40% of the time, with no staff, visitors, relatives or other residents around them.

This would suggest that the bio-medical model of care, in which the paternalistic relationship between residents and staff encourages child-like independence and notions of being helped and protected, was being followed in this particular facility, although government policies aim to encourage greater autonomy for people in aged care facilities.

The authors suggest that these findings suggest greater effort needs to be made to put strategies in place to maintain and promote independence for as long as possible.

Ms Deanne Gaskill, Senior lecturer, School of Nursing, Queensland University of Technology

Driving and Dementia. Position Statement by Australian Society for Geriatric Medicine

The ASGM has recommended 6 monthly reviews of safe driving capacity for patients who retain a driving licence in early dementia, along with other educational, and assessment strategies to address the increasing number of drivers with dementia on Australian roads.

Recent research in the AJA has shown significant levels of GP ignorance of this problem, and a reluctance to be part of action leading to licence cancellation, despite legitimate concern about the capacity of dementia sufferers to drive safely.

The 26 point AGSM position paper, and background paper outlining the issues, should be required reading for all GPs and people involved in road safety, and assessment of people with dementia.

Mismanagement of older people's assets- what do workers know and do about it?

One third of health and aged care workers were aware of financial abuse occurring amongst older people they worked with, however they felt constrained about intervening appropriately, according to a Qld. study. There needs to be greater understanding of the dimensions of financial abuse, evaluation of the effectiveness of current mechanisms to handle it, more professional and community education about the problem, and additional support for workers seeking to intervene.

Having a family member in residential aged care can be distressing, and staff members need to bear this in mind when communicating with residents' relatives. The health of these relatives, the time pressures they experience because of the placement, and how well they believe the resident has adjusted to life in the facility will all influence the way that they feel. Staff members need to be aware of these issues so they can be handled appropriately.

Dr Christine Toye, School of Nursing and Public Health, Edith Cowan University

Older people who are socially isolated end up staying in hospital longer and require more medical assistance than those with informal or community networks to assist in their care, according to a Sydney study of the interrelationships between formal and informal unpaid services. It is not so much the disease that can predict use of support services, but the disability that is the consequence of the disease. Higher socio economic and educational levels are associated with greater levels of community service use.

Audiologists and optometrists should be included in health services teams for older people, as sensory loss, of both hearing and vision, has far-reaching effects on the lives of community-based older people. Their range of community contacts reduce with sensory loss, due to communication difficulties, mobility restrictions and lack of confidence in their physical environments.

A/Prof Louise Hickson, Communication Disability in Ageing Research Unit, Uni. of Qld

Hip fractures as a result of falls in hospital, which are common amongst elderly patients, can be reduced by the use of hip protectors on those most at risk of falling. Staff acceptance was high according to this study, and patients were still using them after discharge. If well implemented in the rehabilitation ward environment hip protectors should significantly reduce the incidence of hip fracture and the pain, on-going hospitalisation and loss of independence which can occur as a result.

28% of hostels surveyed in SA did not have a resident, joint resident/staff or family committee, although nearly all thought they provided adequate means for residents to express their wishes and concerns. One of the main requirements for hostels is to provide residents with opportunities for choice and decision making .Residents have in the past rated choice and control very highly and those who participate in the decisions that affect their daily lives generally have better quality of life.