Showing papers in "Australasian Journal on Ageing in 1987"

Units for the confused and disturbed elderly: development, design, programming and evaluation

Abstract: In New South Wales, the implementation of the ‘new’ Mental Health Act and the deinstitutionalisation of Mental Hospital patients following the Richmond Report, have lent urgency to the need to develop specialised units and services for the confused and disturbed elderly. Experience gained working with this population in a traditional Mental Hospital has led to both an appreciation of the limitations of therapeutic programmes implemented within this setting and the designing of purpose built units appropriate to the needs of these patients. Units which will facilitate a Reality Orientation/Behavioural approach within a simple, domestic scale environment are now being built. This paper presents the developmental stages of this concept, describes the units' design and programmes and outlines the assessment and selection procedures.

Ageism: public prejudice and private preconceptions*

Abstract: The concept of “ageism” or automatic prejudice towards elderly people solely on the basis of their age, is not new. Recently, however, comment has been developed, especially in relation as to how ageism may be decreasing the quality of life and appropriate care of our senior citizens. Professor Robert Butler, to whom authorship of the term is ascribed identified five myths on which he believed ageism is built. This paper greatly expands the number of these myths and discusses some ways in which they may be addressed to reduce the level of ageism in society.

Surveying the aged in australia

Abstract: Surveys of the aged in Australia are characterised by a limited discussion of the methodology. However it is essential, especially in surveys aiming to discern levels and types of need among older populations, that the degree of representativeness of the survey be clearly established. A move towards needs-based service delivery systems in Australia will depend upon relevant information being collected from representative samples of older people. The methodology for such data collection needs to be improved. This paper reviews various sampling strategies, and reports upon the methodology employed in obtaining and interviewing a random sample of people aged 70 years or more living at home in Adelaide's “middle suburbs”.

Survey of knowledge of staff about urinary incontinence

Abstract: Urinary incontinence is a common, distressing and costly condition afflicting up to 25% of hospitalized patients and 60% of nursing home patients most of whom are elderly. It is important for nurses and doctors to have a good knowledge base and positive attitudes in order for them to deal optimally with this condition. A survey of 106 nurses and doctors was conducted in a large general acute teaching hospital. The survey assessed both attitudes and knowledge to various aspects of the causes, investigation and management of incontinence. It was found that (1) most staff had little teaching on this subject, (2) most staff had a poor knowledge base as to causes, investigation and management, (3) about 40% of nurses felt urinary incontinence was an attention seeking act, (4) State enrolled nurses who had the greatest contact with such patients had the poorest knowledge base. The results of this survey support the need for more undergraduate and inservice training, and particularly for the appointment of hospital based Clinical Nurse Specialists, with expertise in continence management.

Visitors to nursing homes: few or many?

Abstract: The presence of family and friends in nursing homes ensures that residents continue to have meaningful and personal relationships with others. With the aim of filling a gap in the Australian gerontological literature on the institutionalised aged, this study reports on the contacts that the elderly in nursing homes have with family and friends. A questionnaire was administered to assess whether residents at eight nursing homes had contact with people living in the community during the week prior to the interview, and examine whether there are differences between residents in who contacts them. The results reveal that like their American and English counterparts, the Australian aged living in nursing homes are not generally forgotten by their family or friends; the childless residents are not without visitors; and who comes to visit varies with the marital status of the resident.

Aged women from non english speaking backgrounds

Abstract: Aged women from all groups in Australia experience common problems. Financially they are less well off than are men, they are more likely to be widowed and to be living alone. In addition to these experiences aged women from non-English speaking backgrounds can also experience difficulties through their inability to communicate, especially in formal and semi-formal situations. Inter-family value shifts also threaten self image and the quality of life. Ethnically segregated retirement villages can be instrumental in enabling people to retain control of their lives, in enhancing social networks and in preserving family relationships.

Community options: a new approach in assessment and the delivery of services in the aged care field.

Abstract: This paper draws attention to a pilot programme sponsored by Aged Cottage Homes Inc. in South Australia with the aim of reducing the movement into residential care of elderly people assessed as urgently needing and eligible to enter such forms of care. The programme focuses directly on those factors precipitating movement into residential care. By negotiating with existing service providers, advocating on behalf of users of the programme, establishing new services which are specific to user needs, the Community Options programme has demonstrated that many users of aged accommodation services can be supported to live in their own homes. The benefits of the programme include enhanced lifestyles for elderly people, individuality of specific programs for users, close and continuing contact with users, and the process is cost effective in terms of government outlays.

Coming to terms with burden in home care

Abstract: Nursing home care has come to be seen as the least preferred form of care for the frail elderly from two perspectives. From the government’s point of view, nursing homes are expensive to run, and with the implementation of the McLeay Report (1982), we have seen a determined effort by policy makers to keep the elderly in the community for as long as possible. While the government’s reaction to nursing homes is horror at the expense, the elderly themselves and often their families are afraid of them (Social Welfare Action Group, 1982). Nursing homes, as the community sees them, are institutions which threaten cherished values and basic rights. Institutionalization involves a loss of freedom schedules and rules restrict choice. Institutionalization also involves a loss of individuality one’s possessions are relinquished and one’s privacy is disturbed. Nursing homes also separate the elderly from the community with residents being physically and sometimes psychologically distanced from family, friends, and neighbours. The alternative, of course, is home care, and this is the sort of care received by most frail elderly. There are hidden costs in this practice, however, costs which are borne largely by those people who find themselves in the role of primary caregiver. For those frail elderly who are only slightly handicapped, assistance is likely to come from a number of sources. A neighbour might pop in with the mail or watch to see that a blind goes up first thing in the morning, Meals on Wheels might provide the midday meal, a daughter might deliver the groceries in the afternoon, and a son might ring to check that all is well. As dependency increases. however, the various sources of assistance diminish in number until the provision of care is concentrated in one person. What is more, there is a pattern in the selection of the caregiver. If a spouse is available and able, he or she will become the carer. If not, a child will step into the caregiving role, most commonly a daughter, but sometimes a daughter-in-law. In other words, when the McLeay Report (1982) refers to the desirability of community and informal support rather than institutionalization, what they are talking about in a significant proportion of cases is care by spouses and care by daughters and daughters-in-law. There is a dangerous tendency to assume that care is dispersed among a group of people. Repeatedly studies have shown in both Australia and overseas, that when the going gets tough, one person takes on the responsibility.

User charges for community services

Abstract: User charges have been suggested as a means of limiting demand for subsidised community services, yet the practicalities and effectiveness of this strategy remain largely unknown. Discussion of user charges has also been stimulated recently with the development of Regional Geriatric Assessment Teams and the restructuring of community services under the Home and Community Care Program. The first part of this paper presents an empirical analysis of user charges practices and policies in twelve Local Government Areas in metropolitan Melbourne that are served by the same Regional Geriatric Assessment Team. The significance of user charges in the financing of community services relative to subsidies from Commonwealth and State Governments and contributions from Local Government are also examined, and relationships between levels of funding and provision are analysed. The second part of the paper discusses a number of implications of the findings from the perspectives of users, providers and Commonwealth and State Governments. User charges appear to have limited effectiveness in containing demand for services, and the considerable variation found in all aspects of user charges creates both vertical and horizontal inequities. These problems compound the uneven access to services arising from variability in levels of central government subsidies, with resultant constraints on the operation of Regional Geriatric Assessment Teams.

A comparison of the psychological well-being of never-married and married aged living in urban australia

Abstract: This study, based upon analyses of the A.N.U. Ageing and The Family Project's survey, disputes the negative stereotype often applied to older people who have never-married. It shows that those who are physically and mentally able and living within the community are no more likely to suffer from depression, dissatisfaction and social relationships, loneliness, or anxiety than their married peers. The results show that never-married older people are self-sufficient individuals who enjoy spending time alone, and living without the complications associated with marriage. Social factors have little importance in the maintenance of the never-married's morale, while the opposite is true of the marrieds. In any future research on the social consequences of marital status in later life it would seem apposite to include some form of personality measure.

Grey what?: pensioner perceptions of grey power

Abstract: This article explores aspects of ageing and politics including pensioners' perceptions of the ‘Grey Power’ concept. First, the reasons behind the voting behaviour of some pensioners are examined, in order to illuminate the political ‘world view’ of older Australians. Then, the issue of changes in voting is investigated, with the finding that these pensioners were quite stable in their voting choices. While the majority of pensioners were unaware of ‘Grey Power’, they provided a diverse range of reactions to this political idea. Finally, strategies are suggested towards the development of Grey Power and the empowerment of the elderly.

“learning” and educational programs for “senior” australians

Abstract: Although there is a change in the learning process itself, the ability to learn even in extreme old age, is more dependent on personal motivation, and one's ‘self-concept as a learner’, rather than on age itself. Strategies for teaching the elderly are also treated in the paper as well as brief descriptions of new educational programs introduced in South Australia, Victoria and New South Wales in the last few years.

Some issues in library services for the aged

Abstract: Australia's elderly do not use library services as frequently as other age groups. There are a variety of explanations for this under-utilisation ranging from the attitudes of the elderly through the library materials available to physical demands on aged users. This article examines some recent literature and survey data to review these impediments to more effective use of library services by aged Australians. It argues that the “disengagement theory” is not an adequate explanation. Greater library sensitivity to the needs of the elderly and modifications of library services to minimise the effects of physical circumstances of the elderly appear likely to have impact on aged user rates. Thus libraries can redress the problem of low aged participation by catering for the special needs of this growing (potential) user group.