Residential Matters
Promoting Resident Choice and Control in Aged Care: What Do Residents Want?
Paper Presentation in a Themed Session Jessica Byers
Residential aged care in Australia is shifting from the traditional provider-driven, medical model to one directed by the resident. This change recognizes the link between autonomy and the well-being of older adults, which is reinforced by Australia’s new aged care quality framework emphasizing “consumer dignity and choice”. Many providers are unprepared for this change; they are unsure what residents will request and fear being unable to meet resident needs. This study describes choice as expressed by residents to prepare providers for consumer-directed care (CDC). Interviews were conducted with ninety-six residents in six Australian Aged Care Homes. Interviews addressed sixteen activities of daily living (ADLs), with residents describing preferences for each ADL. Results: Resident preferences covered four themes. i) Non-response: this captured vague, positive evaluations of care, related to fear of being “difficult” and a desire to maintain good staff relationships; ii) Care approach: residents felt rushed during ADLs, preferring staff to be gentle; iii) Care involvement: residents want to contribute to care decisions but feel unable to because they are ill-informed or not consulted; iv) Connectedness: residents requested more opportunities for meaningful conversations, activities and relationships. This study highlights resident desire for greater choice and control and the simplicity of resident preferences. To deliver CDC, providers will need to update processes to promote collection of, and response to resident preferences, and revise staff routines and approaches to care to foster CDC. Most importantly, staff need to become skilled communicators to empower residents to share their true preferences.
Implementing Consumer Directed Care in Australian Residential Aged Care: An Evaluation of a Multi-site Pilot Study
Paper Presentation in a Themed Session Marita Mc Cabe
In Australia, Consumer Directed Care (CDC) has been widely implemented in the community aged care sector. In residential aged care facilities (RACFs), person centered care models have been adopted. However, there has been a move towards CDC in RACFs in recent years. This paper presents an evaluation of a program training staff to implement CDC in RACFs. It presents information on the program and the facilitators and barriers identified in relation to implementing CDC. Staff (n=150) and residents (n=142) were recruited from nine RACFs in Australia. The program focused on improving communication between residents and staff so the true preferences of residents could be determined. It also encouraged shared leadership and helped staff determine the organisational changes needed to implement CDC in their facility. Data were gathered from staff on the facilitators and barriers to implementing CDC. From the beginning of the program to three months follow-up there were improvements in resident quality of life and their sense of choice and control. The barriers were RACF culture, resources required to implement CDC and communication between other staff and residents. Facilitators of CDC included staff supporting each other, respect and clear processes. Implications: The implementation of CDC in RACFs leads to an improvement in resident lives. However, educating staff on CDC and obtaining resident choices is not sufficient. There is a need for significant changes in staff empowerment, time management and communication. This is a process that will take some time to achieve.
Housing Issues for Mobile Seniors in Poland: How Current Housing Needs Are Not Meeting Market Demands
Paper Presentation in a Themed Session Gretchen (Greta) Garniss
Programs, policies, and research in the senior housing demographic focus on the social, medical and economic area of aging. Housing for mobile seniors is an area that is neglected in research. While development of nursing/care homes and social housing units is important, the senior demographic is mobility diverse. Needs of mobile seniors are not being met in many international markets. Briefly reviewing historical and current real estate activity in housing development and surveying active seniors through original research are the basis of this paper that promotes more diverse housing choices and development for mobile seniors. This study focuses on Poland because it is the largest country in Central and Eastern Europe and there are similar real estate and senior housing issues across this region. It is hoped that as a result of this research, Poland could be used as a model to diversify and improve housing conditions for seniors at all levels of mobility not only in Poland, but across Central and Eastern Europe.
The E’s in Research - Expertise and E-Delphi
Paper Presentation in a Themed Session Samantha Neylon
Due to fiscal and resource limitations, it may be prudent for residential aged care providers to refurbish facilities rather than undertake new builds. Several minor refurbishment elements have positive impacts on resident functionality and these were examined in four environmental assessment tools. Views on all nominated tools from experts were sought to enable local stakeholders identify a single tool to pilot in the context of minor refurbishments. A two round adapted e-Delphi survey was completed by international experts in aged care design and environments across a variety of disciplines. Their comments and evaluations on the content and applicability of the four tools were gathered. Data was analysed using descriptive statistics and content analysis. The four tools were subsequently ranked using a weighting system. A purposive sample of eighteen experts from eight countries participated. When reviewing the tools, the experts concurred in the themes of tool thoroughness, cultural specificity, accessibility, ease of use and time taken to complete. They presented a range of advantages and challenges for each tool. Residential Aged Care Audit Tool followed by Evaluation of Older People’s Living Environments was ranked as the top two tools. The use of e-Delphi enabled a broad range of international expertise to provide perspectives and hierarchical presentation of four assessment tools. These findings will enable local stakeholders to determine a single tool to pilot at a residential aged care facility undertaking minor refurbishments. Similar adapted e-Delphi process may be useful for other areas seeking more informed local stakeholder decision making.
