It Takes a Village
VERILY Project on Online, Dementia-friendly Rural Communities: Perspectives from Australia
Paper Presentation in a Themed Session Irene Darmadi Blackberry, Clare Wilding, Jane Farmer, Debra Morgan, Megan O'Connell, Michael Bauer, Margaret Winbolt, Jennene Greenhill, David Perkins
Carers in rural communities are targeted because this group are often disadvantaged and have less access to support services. If carers and communities can be better supported, then their capacity to assist and care for people with dementia is increased, thus potentially reducing the need for more expensive and more disruptive residential care, or multiple acute care admissions. The VERILY project is implemented using mixed qualitative and quantitative methods in tweleve rural communities (eight in Victoria, two in New South Wales, and two in South Australia) comprising of volunteer-led peer support and mentoring hubs to assist older people to use online information and communication technology, an integrated smartphone app and website, and a carer peer support groups that meet by videoconference. The model utilises innovative technology and skills building to increase whole of rural communities’ capacities to provide support for and care of local people who have dementia, and their friends and family. This project will result in the development of a toolkit that can be used by other rural communities in Australia to establish and adapt their own local, online, dementia-friendly rural communities.
Is Loneliness Associated with Increased Health Care Utilization in the Oldest Old?: Findings from a Large, Longitudinal Population Study
Paper Presentation in a Themed Session Hanyuying Wang
This study examines the impact of loneliness on health care service use over a seven-year period in the oldest old. Data were drawn from wave 3 to wave 5 of the Cambridge City over-75s Cohort Study (CC75C). Loneliness was assessed by a single-item scale ‘Do you feel lonely?’, with answers categorized into ‘not lonely’, ‘slightly lonely’ and ‘lonely’. The health care utilization was measured through a series of self-reported number of home help service use, community nurse contact, meals on wheels service use, day centre visit, hospital visit, and the time since last saw a general practice (GP). The associations between loneliness and health service use were examined by using the Generalized Estimating Equations (GEE). Two models were fitted: the first model was to test the effects of baseline loneliness on health care utilization, and the second model was to test the impact of changes of loneliness on health care service use. Results revealed that the baseline slightly lonely was associated with a shorter time since last saw a GP; when taking changes of loneliness into account, individuals who felt lonely were about three times more likely to contact community nurses and use meals on wheels services, respectively. Loneliness was a significant risk factor for certain types of health care utilizations, independently of participants’ health conditions in the oldest old. This finding has implications on public health and practice that public officials should raise the public awareness of loneliness and place prevention of loneliness as a priority.
Changing Family Situations and Elderly Care: A Case Study of the Bang Si Tong District in Thailand
Paper Presentation in a Themed Session Yusuke Miyoshi
In this presentation, we discuss the relationship between rapid aging and unique family structural changes in Thailand. Previous research argued that the “socialization of care” advanced alongside modernization and the aging progress. Similar to other Asian countries, Thai society has modernized and aged. However, in Thailand, over the last 30 years, the proportion of nuclear family households has decreased, and extended family households containing three generations and skipped generation families, have increased. This is in contrast to the modernization of Thailand. Why has the proportion of extended families increased? From an analysis of the Survey of Older Persons in Thailand (SOPT) census, the proportion of care by skipped family members such as nephews, nieces, and grandchildren, has increased as the number of children people have has decreased. In addition, from fieldwork research in the Bang Si Thong District, on the outskirts of Bangkok, we discovered that because some older people do not have children or their children cannot take care of them (People do not expect public care systems in Thailand), they were cared for by other relatives. These relatives did not live together in the past but lived together to take care of their older relatives. From the analyses, we discovered this phenomenon of “extended familiarization of care,” where relatives who are not nuclear family members actively take care of older people as a substitute for children because of undeveloped public care systems. As such, we assume that this is leading to unique family structural changes in Thailand.
