Improving Quality Of Life Of People With Dementia Living In Residential Care Facilities A Randomised Trail Of Educat Int
Funder
National Health and Medical Research Council
Funding Amount
$777,409.00
Summary
The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to ....The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.Read moreRead less
A Controlled Trial Of Topical Lavender Oil As A Treatment Of Behavioural Symptoms Of Dementia
Funder
National Health and Medical Research Council
Funding Amount
$211,179.00
Summary
Many nursing home residents with dementia have challenging behavioural symptoms. This study will test if pure lavender oil, when massaged onto the forearms of confused nursing home residents, relieves their agitation better than a placebo oil. Researchers will measure residents' behaviour directly and will not be aware which oil is being applied.
Development Of Quality Indicators For The Frail Elderly In Acute Care
Funder
National Health and Medical Research Council
Funding Amount
$372,311.00
Summary
Frail older people are particularly vulnerable to a range of mishaps while in hospital. Good care can reduce the frequency and extent of these problems. Quality indicators (QIs) assist hospitals, and clinical service units within them, to appraise their performance, and to compare it to other hospitals. QIs for the measurement of outcomes for the frail aged in the acute care setting do not exist in Australia or overseas. We aim to develop these indicators during this study.
Pelvic Floor Muscle Training For The Management Of Urinary Incontinence In Elderly Women: A Randomized Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$321,240.00
Summary
Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. P ....Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. Pelvic floor muscle training is safe and effective and should thus be offered as the first choice of treatment for stress urinary incontinence. However there is still no strong evidence for the effectiveness of this intervention in the elderly and because of a perception by medical practitioners that pelvic floor muscle re-education is only effective in younger women, relatively few elderly women are referred to physiotherapy for management of incontinence. Although in clinical practice it is customary to complement pelvic floor muscle training with other forms of conservative management of incontinence such as bladder training, a recent influential study suggested that pelvic floor muscle training and bladder training were equally effective in patients with stress urinary incontinence. It is important to distinguish the relative effectiveness of these interventions used in isolation in order to ensure that urinary incontinence is managed in the most effective and efficient way. This project will therefore investigate the effectiveness of two conservative interventions, pelvic floor muscle training and bladder-behavioural training in women with stress urinary incontinence over 70 years of age. Moreover, strong evidence that conservative intervention is effective for urinary incontinence in the elderly will result in appropriate intervention being offered routinely as the first choice of treatment in older women.Read moreRead less
A Randomised Clinical Trial Of Physical Activity For The Treatment Of Older Adults With Mild Cognitive Impairment
Funder
National Health and Medical Research Council
Funding Amount
$280,250.00
Summary
Australia's population is aging rapidly and so is the frequency of age-related diseases. Dementia and depression are the most frequent mental health disorders of older people. They are also the leading causes of years of life lost due to disability in Australia. The results of recent studies have shown that memory difficulties and dementia are associated with potentially modifiable risk factors, such as physical activity. The purpose of this study is to investigate whether a physical activity pr ....Australia's population is aging rapidly and so is the frequency of age-related diseases. Dementia and depression are the most frequent mental health disorders of older people. They are also the leading causes of years of life lost due to disability in Australia. The results of recent studies have shown that memory difficulties and dementia are associated with potentially modifiable risk factors, such as physical activity. The purpose of this study is to investigate whether a physical activity program for older adults decreases cognitive decline and conversion to dementia in a population at risk: mild cognitive impairment (MCI). 168 subjects with MCI will be randomised (by chance, like the flip of a coin) to either the intervention program of physical activity or usual care - their cognitive (such as memory) performance will be compared at the end of 24 months.Read moreRead less
The Anorexia Of Ageing: Gastrointestinal Control Of Appetite And Feeding In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$190,500.00
Summary
On current projections, the proportion of the Australian population over 65 years will double to 25% in the next 25 years. Ageing is associated with a reduction in appetite and food intake, which has been called the anorexia of ageing. After about age 70, on average, this is associated with loss of body weight, mainly of muscle. The physiological anorexia and weight loss of ageing predispose to pathological weight loss and malnutrition, which is associated with increased morbidity and death rate ....On current projections, the proportion of the Australian population over 65 years will double to 25% in the next 25 years. Ageing is associated with a reduction in appetite and food intake, which has been called the anorexia of ageing. After about age 70, on average, this is associated with loss of body weight, mainly of muscle. The physiological anorexia and weight loss of ageing predispose to pathological weight loss and malnutrition, which is associated with increased morbidity and death rates. High rates of under-malnutrition have been reported among older institutionalised people in the USA and Australia, with lesser, but still substantial, numbers of community-dwelling older people also undernourished. We found recently that 43% of 250 older recipients of domiciliary care services living in their homes in Adelaide were either malnourished or at risk of malnutrition, and had significantly worse outcomes than their well-nourished counterparts over the following year, including increased falls and hospitalisations. Little research has been done to identify underlying causes and develop treatments for this problem. Recent studies, including ours, have shown that upper gastrointestinal (GI) factors (stomach mechanics, rate of gastric emptying, GI hormones including ghrelin, cholecystokinin [CCK] and amylin) have important effects on appetite and food intake, and are often affected by ageing in ways that reduce food intake The proposed studies will investigate this upper GI control of appetite and its contribution to the anorexia of ageing. We will investigate the effects of ageing on gastric factors, including ghrelin release, the satiating effects of CCK and amylin, and the appetite stimulating effects of ghrelin. The expected outcome of this project is a greater understanding of the causes of the anorexia of ageing, enabling the logical development of effective prevention and treatment strategies.Read moreRead less
Epidemiology Of Osteoporotic Fractures In The Very Frail Elderly: Risk Factors, Quality Of Life And Mortality
Funder
National Health and Medical Research Council
Funding Amount
$340,550.00
Summary
Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study i ....Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study is examining risk factors for fractures in the frail and institutionalised older person by asessment of quantitative bone ultrasound, falls risk, vitamin D status and other biochemical markers of bone in an attempt to identify predictors that can be modified to reduce fractures, improve quality of life and reduce mortality due to osteoporotic fractures.Read moreRead less
Community Engagement for Productive Ageing: Models to support rural healthy ageing through the maintenance of community involvement and contribution. Governments at all levels are concerned about the looming social and economic challenges flowing from an ageing population. At present, ageing services are largely focussed on caring for the frail dependent aged. Yet, ultimately, the key to meeting the ageing challenge will lie in how successful we are in supporting our healthy independent aged to ....Community Engagement for Productive Ageing: Models to support rural healthy ageing through the maintenance of community involvement and contribution. Governments at all levels are concerned about the looming social and economic challenges flowing from an ageing population. At present, ageing services are largely focussed on caring for the frail dependent aged. Yet, ultimately, the key to meeting the ageing challenge will lie in how successful we are in supporting our healthy independent aged to stay contributing and productive members of their community. By developing evidence-based interventions that focus on preventing social disengagement before it occurs, the project provides a cost effective approach to ensuring that Australia's rapidly growing aged cohort remain social assets and do not become social burdens.Read moreRead less