Respite Care

This study focuses on the ways in which the organisational context can influence the development of severe pressure ulcers. Severe pressure ulcers are important indicators of failures in the organisation and delivery of treatment and care. We have a good understanding of patients' risk factors, but a poor understanding of the role played by the organisational context in their development. The study was undertaken in six sites in Yorkshire, England. The settings were sampled in order to maximise diversity, and included patients' own homes, acute hospital medical and surgical wards, a community hospital and a nursing home during a period of respite care. Data were collected about eight individuals who developed severe pressure ulcers, using a retrospective case study design. The data sources included interviews with individuals with severe pressure ulcers, and with staff who had treated and cared for them, and clinical notes. 4 accounts indicated that specific actions by clini...

Past studies have shown that acculturation and self-efficacy can affect respite care knowledge, which are notable issues among immigrant caregivers due to the rapid increasing aging family members. The aim of this study was to investigate relationships among acculturation, self-efficacy, and respite care knowledge in immigrant caregivers, and to determine the mediating effects of self-efficacy on the relationship between acculturation and respite care knowledge. A cross-sectional design was used. We enrolled 134 female immigrant caregivers who had married Taiwanese men and lived with care recipients who used LTC services. Based on Baron and Kenny' mediating analytic framework, multiple regression and Sobel tests were used to examine whether self-efficacy mediated the relationship between acculturation and respite care knowledge. The findings showed that after controlling for confounding factors, acculturation and self-efficacy separately affected respite care knowledge (B = 0.229, standard error (SE) = 0.084; B = 0.123, SE = 0.049, respectively). Acculturation had a positive impact on respite care knowledge through self-efficacy (B = 0.181, SE = 0.084). Therefore, self-efficacy partially mediated the effect of acculturation on respite care knowledge, and accounted for 20.9% of the total mediating effect in this study. Acculturation predicted immigrant caregiver' respite care knowledge partially through self-efficacy. The association between acculturation and respite care knowledge was partially mediated by immigrant caregivers' self-efficacy. As a result, it was proposed that boosting self-efficacy could increase and drive immigrant caregivers' respite care knowledge. To assist this population in obtaining enough resources, targeted educational programs to promote immigrant caregivers' self-efficacy should be designed and implemented. Furthermore, health care practitioners should be aware of the relevance of immigrant caregivers' acculturation.

This localised study focuses on the availability; suitability and utilization of respite care services for families caring for older relatives in southern Sydney, NSW, an issue identified by the first author in the course of her employment as a community nurse. Respite care services were examined from the perspective of family carers (N=18), referring health professionals (N=18), respite referral services and respite care providers (N=9). The data was obtained from semi-structured in-depth interviews, surveys, and focus group discussions. Apart from the respite referral services all participants identified access to and utilization of respite care were constrained by actual and perceived limitations in service availability, referral processes, service flexibility and quality of care outcomes. Recommendations for improving access include re-evaluation of the centralised referral system, establishing more effective communication processes between all three groups and other health staff, and introducing focused aged care education for respite care staff.

The document has been prepared within the Care Economy programme implemented by UNDP North Macedonia in partnership with the national stakeholders. The views expressed herein do not necessary reflect the official positions of the United Nations.

Parents of children with autistic disorder experience a unique form of stress that varies significantly according to socio-cultural contexts. This review aims to investigate the stress levels of parents with children with autistic disorder and identify variables that predict parenting stress. A search of CINAHL, Springer, Pub Med, and EBSCO databases between the years 2001-2015 was conducted using the following keywords: parent stress, impact stress on parent, child with autistic disorder, psychological well-being, and 35 articles out of 56 articles were included in this review. The literature showed that socio-demographic variables influenced parental stress levels. The highest levels of stress were reported for the cases: mothers younger than 30 years old, children younger than 6 years old, a recent diagnosis, low educational level, low monthly income. Additionally, a major impact of autistic disorder on parents in relation to their mental health and the family-child relationship was discussed.

Parents of children with autistic disorder experience a unique form of stress that varies significantly according to socio-cultural contexts. This review aims to investigate the stress levels of parents with children with autistic disorder and identify variables that predict parenting stress. A search of CINAHL, Springer, Pub Med, and EBSCO databases between the years 2001-2015 was conducted using the following keywords: parent stress, impact stress on parent, child with autistic disorder, psychological well-being, and 35 articles out of 56 articles were included in this review. The literature showed that socio-demographic variables influenced parental stress levels. The highest levels of stress were reported for the cases: mothers younger than 30 years old, children younger than 6 years old, a recent diagnosis, low educational level, low monthly income. Additionally, a major impact of autistic disorder on parents in relation to their mental health and the family-child relationship was discussed.

Long-term care insurance (LTCI) is an essential system in the context of fast-growing population aging, yet it lacks evidence on how to improve the acceptance and coverage of non-compulsory LTCI in China. Using a survey experiment, we randomly assigned 1025 older adults to control group, disability information group and dementia information group, and explored whether information about the adverse health outcomes would change their willingness to LTCI insure. We found that disability and dementia information signi cantly changed respondents' willingness to LTCI insure, and health status had negative moderating effects on the relationship between information interventions and the change of LTCI intentions. Also, we found respondents with lower education and living in non-pilot cities were more sensitive to information interventions. We recommend LTCI information campaigns differentiating information by dementia-related and disability-related risks; by LTCI pilot and non-pilot cities; by education levels and by physical and mental health status. With the world's fastest aging population, China's increasing life expectancy and declining birth rates challenges the provision of healthcare . In 2020, there were 264 million people aged 60 years old and over, accounting for 18.7% of the Chinese population, forecast to rise to more than 500 million by 2050 (The National Bureau of Statistics, 2021; United Nations, 2022). Within the aging population, 52.7 million suffered disabilities, estimated to reach 82.7 million by 2030 and 89.6 million by 2050. . The number of over 60-year-old Chinese suffering dementia was 15.07 million in 2018, and is expected to rise to 50 million by 2050 . Older adults with disabilities and dementia pose a serious challenge to the sustainability of China's long-term care (LTC) system . With the reduction in the size of the Chinese family, the effects of the one-child policy, urban migration and the decline in informal family provided LTC, the demand for formal LTC has surged . To address this challenge, the Chinese government launched in 2016 a longterm care insurance (LTCI) scheme in 15 pilot cities, expanding to 49 cities by 2020, to provide the old aged with disabilities and dementia accessible and affordable long-term care services (National Healthcare Security Administration, 2021). LTCI aimed to alleviate the shortage of caregivers for severely disabled patients by providing nursing service payments in public care facilities and also some support for home-based care services (Jiang & Yang, 2023). China's National Medical Insurance Administration aims to build a nation-wide and uni ed LTCI system independent from China's basic pension and medical social insurance system (Information O ce of the State Council, 2023). How to promote the expansion of China's LTCI is an urgent challenge for China.

What is known about this topic • Homeless persons are often exposed to important risk factors that can affect both their physical and psychological well-being; however, they remain largely out of reach for social and healthcare programmes. • To identify factors that may facilitate or hinder the utilisation of services, there is a need to explore the perspectives of homeless persons regarding the services that are designed for them. • Qualitative data from this study indicate that factors such as satisfaction with services affect perceived improvement and intention to change.

The authors of this argumentative article emphasize that the range of the current crisis cannot be depleted in the diagnosis which is based on cyclic consideration. It is both systematic and structural, which is derived from the genesis and the modus of neoliberalism, which has become dominant during the previous decades. Other than that, it is emphasized that the current crisis is 'great', because it forces relevant actors to face the structural characteristics of contemporary shareholder-capitalism. The crisis also puts to a test the self-reflection of the economic science which faces certain deficits. The authors believe that, given the tendencies in today's economy, there can be different scenarios for exiting the crisis and projecting a new modus of capitalism in the following period. Having in mind the openness of the present and the uncertainty of the future, the authors describe those scenarios without projecting which one of them will be dominant.

Ex e cu t ive Su m m a r y Background 7 Obj e ct ives of t he st udy 7 Research m et hods: lit erat ure review 7 Research m et hods: consult at ion 8 Key findings: lit erat ure review 8 Key findings: consult at ion 12 Policy im plicat ions 13 Recom m endat ions for furt her research on respit e services 14 Recom m endat ions for im proving research m et hods 14 Dissem inat ion and im plem ent at ion of research findings 15 Th e Re por t Re vie w of r e spit e se r vice s for ca r e r s for pe ople w it h de m e n t ia © NCCSDO 2005 4 5.7.3 Ensuring services are t ailored t o t he age, cult ure, condit ion and st age of illness of t he care recipient 5.7.4 Maint aining or im proving t he well-being of t he care recipient 5.7.5 Recognising t he im port ance of appropriat ely t rained and caring st aff 5.7.6 Underst anding t he significance of 'affordable' services Se ct ion 6 Re vie w su m m a r y, im plica t ion s for policy a n d r e com m e n da t ion s for fu r t h e r r e se a r ch a n d im pr ovin g r e se a r ch de sign s

As a part of the resettlement programme, three young men with learning disabilities and behaviour disorder moved to a flat in the community providing one-to-one staffing. A fourth man received respite care. A multiprofessional team evaluated various aspects of their care and found that they showed an increase in engaged behaviour, a decrease in disturbed behaviour reflected by increase in MRC-HBS scores and a decrease in violent incidents. They also needed less psychotropic medication. Following resettlement, their relatives were more satisfied with the care they received and found visiting easier. The young men's quality of life had improved and staff morale was high.

Parents have an important role in supervising and directing their autistic teenagers while carrying out daily routines at home so they can become independent teens. The purpose of this case study is to provide an overview of how teenagers with autism carry out their daily activities and what their daily activities are at home. Data collection methods used in this study were in-depth interviews and observations. The results of this study indicate that teenagers with autism are involved by parent in carrying out daily activities at home such as folding clothes, cleaning the kitchen floor, and washing rice and vegetables while at the same time parent accompany, supervise and guide her daughter. Very important for mother to teaches and trains her autistic teenager in daily living activities at home to be independent.

Telephone (03) 9483 1183 www.bsl.org.au Holm, Sonya It's the simple things that matter: an evaluation of the Banksia host-home respite program ISBN 1 876250 45 3 1. Aged-Respite care-Australia. 2. Respite care-Australia. 3.Respite care-Evaluation. I. Ziguras, Stephen. II Brotherhood of St. Laurence. III. Title.

The “host-home” program, which operates as part of Banksia Respite Services in Carrum Downs, Victoria, is designed to assist full-time carers of older people who have dementia. Paid workers take two or three older people into their own homes for up to six hours. The report found that the program enabled better access to respite for people who experienced barriers to attending centre-based programs, and allowed for individual tailoring of personal care. It recommended that guidelines and standards appropriate to host-home programs be established to ensure quality of care and to protect paid staff and service users.

To investigate the operation of an innovative community respite program tun by the Brotherhood of St Laurence: the Banksia 'host-home' program, which was designed to provide respite for up to six people with dementia in a care-worker's home. The program was funded by the Commonwealth Department o f Health and Aged Care as part o f a funding program for pilot respite care projects. Method: Interviews were conducted with program staff, carers and care-recipients (older people with dementia). Information from written records such as funding submissions was also used. Results: People using the program were those who experienced barriers utilising centre-based programs for older people for a range o f reasons including advanced dementia, hearing difficulties, difficulties in social interaction or confusion. Carers were very appreciative o f the service, and care-recipients appeared to enjoy the program immensely, citing caring staff, social contact and activities as things they appreciated most. Conclusions: The host-home program provided an accessible respite option for those unable to use centrebused services. I t enabled more individually tailored activities, greater socialisation and greater attention from staff than possible in centre-based services. The informal 'homely' feel o f the program and the fact that relatives obviously enjoyed participating may have made carers feel more comfortable in using a respite service. Since the model creates the potential for costshifting and because of difficulties in supervising staff in their own homes, guidelines and standards appropriate to host-home programs should be established to ensure quality o f care and to protect paid staff and service users.

Parents of children with intellectual disabilities (ID) consistently report higher levels of parenting stress than parents of typically developing children, which has psychological and physical consequences for both the parent and child. Further, high levels of parenting stress are often associated with poor outcomes in behavioral interventions for children with ID. Thus, parental stress and mental health concerns in general are critical targets for intervention. Nevertheless, there are few evidence-based treatments aimed at reducing stress in parents of children with ID. Parent-led support groups are the most common type of intervention for these parents; however, little empirical evidence is available to support the efficacy of these interventions. Other evidence-based interventions include mindfulness, cognitive-behavior therapy, respite, and behavioral parent training interventions. We argue for a combined intervention model that addresses both parental stress and child behavior problems directly in order to optimize outcomes for children with ID and their families. Intellectual disabilities . Developmental disorders . Parenting stress . Children with ID . Review Interventions Targeting Stress and Mental Health Concerns Parent-Led Support Groups Parent-led support groups are the most commonly used type of intervention for parents of This article is part of the Topical Collection on Intellectual Disability

The Exposure of Workplace Conflict on Residential Mental Health Clients by Shawna D. Stoneking MS, Walden University, 2008 BS, New York Institute of Technology, 2006 Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University February 2016 Abstract Individuals who receive residential mental health services rely on caregivers for support, supervision, and a safe living environment. Residential clients exposed to workplace conflict among staff may feel insecure and mistrust their caregivers, which in turn could negatively impact quality of life and treatment outcomes. The theory of therapeutic alliance proposed by Zetzel, emphasizing the client’s perception of the therapist as a nurturing beneveolent figure, was used as the conceptual framework for this phenomenological study. Semi-structured interviews were conducted with 6 adults, recruited with homogenious sampling, who had experienced conflict among s...

The National Disability Insurance Scheme (NDIS) represents a transformative approach to the funding and delivery of disability services in Australia. By prioritising participant choice, control, and personalised supports, the scheme has redefined the role of service providers across the sector. This paper offers a general overview of the NDIS and examines the essential contribution of registered providers in supporting participants to access care that aligns with their individual goals and circumstances. It further explores the operational context of Concept Care Disability Solutions Pty Ltd., a Sydney-based provider offering a wide range of supports to both NDIS and non-NDIS clients. The discussion highlights how providers contribute to the effectiveness of the scheme through person-centred service delivery, compliance with national quality standards, and a commitment to accessible, responsive care. In doing so, the paper underscores the broader significance of professional, community-focused providers in realising the objectives of the NDIS.

Here, we review the role of carers in general and specifically within the learning disability services. The role of carers is recognized but not always appreciated by the healthcare services despite guidance from the Department of Health and the Royal College of Psychiatrists. Service users in learning disability have complex needs, and carers provide life-long care. Carers have reported positive and negative experiences in their caring role; however, the negative experiences of caring can be minimized by providing better support and education to the carers. The resources available to provide this support are not equally accessible to all carers, e.g. respite care. Carers will have to go through many changes in service provisions. In return for the care they provide, carers would like services to listen to them. Regular carers' needs should be assessed and personcentred support must be offered to carers by responsible services.

Objective. To describe the theory, elements and practice of a successful caregiver training programme; and report the 8-year outcome. Design. Prospective, randomized control trial and longitudinal follow-up over approximately 8 years. Setting. Psychiatry unit, general teaching hospital, Sydney, Australia. Participants. 96 persons less than 80 years old with mild to moderate dementia and their cohabiting caregivers. Interventions. All patients received a 10-day structured memory retraining and activity programme. Caregivers in the immediate and wait-list caregiver training groups received a structured, residential, intensive 10-day training programme, boosted by follow-ups and telephone conferences over 12 months. Those in the wait-list group entered the programme after waiting 6 months. The third group of caregivers received 10 days' respite (while patients underwent their memory retraining programme) and 12 months booster sessions as for the other groups. Main outcome measures. Nursing home admission; time until patient death. Main results. 64% of patients whose caregivers were in the immediate training group, 53% of wait-list group patients and 70% of memory retraining patients had died. Nursing home admission had occurred in 79% of the immediate training, 83% of the delayed and 90% of the memory retraining group. Eight-year survival analysis indicated that patients whose caregivers received training stayed at home signi®cantly longer ( p 0X037) and tended to live longer ( p 0X08). Conclusions. Caregiver training programmes demonstrably can delay institutionalization of people with dementia.

Objective. To describe the theory, elements and practice of a successful caregiver training programme; and report the 8-year outcome. Design. Prospective, randomized control trial and longitudinal follow-up over approximately 8 years. Setting. Psychiatry unit, general teaching hospital, Sydney, Australia. Participants. 96 persons less than 80 years old with mild to moderate dementia and their cohabiting caregivers. Interventions. All patients received a 10-day structured memory retraining and activity programme. Caregivers in the immediate and wait-list caregiver training groups received a structured, residential, intensive 10-day training programme, boosted by follow-ups and telephone conferences over 12 months. Those in the wait-list group entered the programme after waiting 6 months. The third group of caregivers received 10 days' respite (while patients underwent their memory retraining programme) and 12 months booster sessions as for the other groups. Main outcome measures. Nursing home admission; time until patient death. Main results. 64% of patients whose caregivers were in the immediate training group, 53% of wait-list group patients and 70% of memory retraining patients had died. Nursing home admission had occurred in 79% of the immediate training, 83% of the delayed and 90% of the memory retraining group. Eight-year survival analysis indicated that patients whose caregivers received training stayed at home signi®cantly longer ( p 0X037) and tended to live longer ( p 0X08). Conclusions. Caregiver training programmes demonstrably can delay institutionalization of people with dementia.

To identify the multi-dimensional characteristics and need for inter-disciplinary input associated with in-patient respite care. Methods: During the period January-December 2007, 91 in-patient respite users, aged ≥60 years, were assessed on admission for respite care at St. Vincent de Paule Residence.

a national survey to Swedes 60-90 years old (n=1225; response rate 42%) to illustrate a substantial change in the demographic landscape of late life singlehood. More people enter later life as divorcees or become divorced at a high age. Among Swedes 60+ divorcees outnumber widowed people, and the incidence of late life divorce has more than doubled since the millennium in what has been called the "grey divorce revolution". Many other Western countries follow the same demographical trend, posing important questions about the transformation of late life singlehood. Based on two Swedish studies we will show that the structure of the late life single community is becoming less gender skewed as a consequence of the emerging society of divorcees, and that in this society relationship careers are increasingly complex, attitudes to repartnering increasingly liberal and partner sanctification seldom an issue. We conclude by proposing the concept "society of divorcees" for this new demographic landscape of late life singlehood, argue that research is needed to capture this new reality, and discuss the implications of this change for access to social support later life.

Objectives: To assess the long-term impacts of Sweden's Contact Family Program (CFP) for children on participants' future outcome profiles, here conceptualized as combinations of outcomes related to mental health problems, public welfare receipt, illicit drug use, placement in out-of-home care, educational achievement, and offending. Methods: We analyzed longitudinal register data on more than 950,000 children born 1980-90, including 6693 children who entered CFP at 2-5 years of age, with a follow-up until 2008. Children's outcome profiles were identified by latent class analysis. The average program impact was estimated by means of propensity score matching. Results: Long-term outcomes for those who had received the intervention were not better than for matched peers who did not receive the intervention. Simulation-based sensitivity analyses indicate that some of our estimated negative treatment effects may be affected by unobserved factors related to program participation and outcomes. However, both selection and outcome effects must be extremely strong in order to generate notable positive effects of CFP participation. Conclusions: The results did not find support for CFP effectiveness in reducing risks of compromised long-term development in children. Since the intervention reaches a highrisk group of children and is popular among users, volunteer families and professionals, the program should be reinforced with knowledge-based components that target known risk factors for child welfare recipients.

Respite services play an important role in supporting older adults and their carers. When an older person is unable to fully represent themselves, provision of respite care relies on effective information-sharing between carers and respite staff. This study aimed to explore, from carers' perspectives, the scope, quality and fit of information-sharing between carers, older people and respite services. An explorative, cross-sectional qualitative study involving a purposive sample of 24 carers, recruited via carer support groups and community groups in voluntary organisations, was undertaken in North East Scotland. Data were collected from August 2013 to September 2014, with participants taking part in a focus group or individual interview. Data were analysed systematically using the Framework Approach. The multiple accounts elicited from carers identified how barriers and facilitators to information-sharing with respite services changed over time across three temporal phases: &#39...

Using a constructivist framework, ideas about healthy and unhealthy caring, from a number of populations, were drawn together and applied to carers of the aged. It was acknowledged that the ongoing decline displayed by the elder constantly threatens the carer's core needs and values (see: Braithwaite, 1992) thus necessitating reconstruing by the carer . In this study the relationship between the carer's self-determined style of approaching or avoiding reconstruing (Berzonsky,1990 and tendency to relate through the caring role, a concept taken from codependency theory, (Whitefield, 1991), were studied in terms of their ability to determine the level of burden experienced by the carer, tendency to use and be satisfied with community services and the presence of codependency issues. Differences in self-determined construing style were identified and service use could be predicted in terms of this. However, construing style type did not predict satisfaction with services or codependency issues. It was also found that carers who form serial caregiving relationships, reported more frequently that they descended from a disrupted family of origin and, when caring, engaged in a broader range of negative caring behaviours, while experiencing the same level of burden and using more community services, than did people caring for the first time. This was taken as support for a codependency model of the carer. However, it was felt that, with improved measurement, the constructivist model would have greater future research utility.

El proyecto Colegio público en Villa el Salvador busca resolver las necesidades actuales del alumno brindándole una calidad espacial conforme a las nuevas metodologías de aprendizaje. Rompe con la organización tradicional de los colegios que cuentan con clásicos espacios monótonos, mediante espacios de estudio y respiro, conexión entre el interior y exterior del aula y plazas de recreación para incentivar la creatividad y motivación por el aprendizaje. El proyecto busca promover el desarrollo mediante la educación no solo de los alumnos, sino también de la comunidad vecina, incentivándolos por medio de espacios públicos a su disposición. De esta manera se suma un valor social al proyecto a través de esta participación comunitaria.

Most vacations seem to have strong, but rather short-lived effects on health and well-being (H&W). However, the recovery-potential of relatively long vacations and the underlying processes have been disregarded. Therefore, our study focused on vacations longer than 14 days and on the psychological processes associated with such a long respite from work. In the present study, we investigated (1) how health and well-being (H&W) develop during and after a long summer vacation, (2) whether changes in H&W during and after vacation relate to vacation activities and experiences and (3) whether changes in H&W during and after vacation relate to sleep. Fifty-four employees reported their H&W before, three or four times during and five times after vacation. Vacations lasted 23 days on average. Information on vacation experiences, work-related activities and sleep was collected during vacation. Vacation activities were assessed immediately after vacation. H&W increased quickly during vacation, peaked on the eighth vacation day and had rapidly returned to baseline level within the first week of work resumption. Vacation duration and most vacation activities were only weakly associated with H&W changes during and after vacation. Engagement in passive activities, savoring, pleasure derived from activities, relaxation, control and sleep showed strong relations with improved H&W during and to a lesser degree after vacation. In conclusion, H&W improved during long summer vacations, but this positive effect was short-lived. Vacation experiences, especially pleasure, relaxation, savoring and control, seem to be especially important for the strength and persistence of vacation (after-) effects.

where he also directs the Western Water Policy Program. His research is primarily focused on legal and policy arrangements for the allocation, management and use of western USA water resources, given stressors associated with population growth and climatic change.

The Health Research Board (HRB) is the lead agency supporting and funding health research in Ireland. We also have a core role in maintaining health information systems and conducting research linked to national health priorities. Our aim is to improve people's health, build health research capacity, underpin developments in service delivery and make a significant contribution to Ireland's knowledge economy. The HRB is responsible for managing five national information systems. These systems ensure that valid and reliable data are available for analysis, dissemination and service planning. Data from these systems are used to inform policy and practice in the areas of alcohol and drug use, disability and mental health. The main subjects of HRB in-house research are child health, disability, mental health and alcohol and drug use. The research that we do provides evidence for changes in the approach to service delivery. It also identifies additional resources required to support people who need services for problem alcohol and drug use, mental health conditions and intellectual, physical and sensory disabilities. The Disability Databases Unit manages two national service-planning databases for people with disabilities on behalf of the Department of Health and Children: the National Intellectual Disability Database (NIDD), established in 1995, and the National Physical and Sensory Disability Database (NPSDD), established in 2002. These databases inform decision making in relation to the planning of specialised health and personal social services for people with intellectual, physical or sensory disabilities. The HRB Statistics series compiles data on problem alcohol and drug use, child health, disability and mental health from a single point or period in time.

A study of six play services for disabled school children used mixed methods to investigate the perspectives of mothers and children. This paper reports the range of mothers' satisfaction as expressed in semistructured interviews. There was a high level of satisfaction. Play services were seen as alleviating difficulties by providing an element of respite, and as providing child‐centred benefits such as play, companionship and varied experiences. Grounds for dissatisfaction included insufficient availability of services, lack of information about them, insufficient attention towards children from staff, and activities which were not age appropriate.

AimThe number of children and young people presenting to emergency departments (EDs) with anxiety and depression is increasing. We aimed to determine parent perspectives on: (i) barriers to accessing non‐ED mental health services; and (ii) improving access in the paediatric mental health service system.MethodsQualitative study with parents of children and young people aged 0–19 years who attended one of four EDs across Victoria between October 2017 and September 2018 and received a primary diagnosis of anxiety or depression. Exclusion criteria: child or young person without a parent/guardian, or presented with self‐harm or suicide attempt. Eligible participants completed semi‐structured phone interviews. Interviews were recorded and transcripts were coded and analysed using content analysis.ResultsA total of 72 parents completed interviews. The average child age was 14 years (standard deviation 2.5) and two thirds identified as female (64%). A total of 57% of children and young peop...

Background and Objectives: Family care partners of people with dementia are not typically the focus of health care and aged care providers. They experience unmet needs, missed opportunities for support, and barriers to wellbeing that impact the dyad. This longitudinal study aimed to understand the experience of care partners, mapping their journey as they navigate health care and aged care systems as well as other supports. Research Design and Methods: Fifteen family care partners participated in this longitudinal, qualitative study. For 6 months they recorded details (provider, date, purpose, outcome, and satisfaction rating) of interactions with health and aged care services. Monthly semistructured interviews reviewed experiences, prompted by logbooks. Thematic analysis identified factors that influenced care partners' experiences and mapped the typical journey. Results: Data indicated that participants' needs fluctuated, with 3 key time points of heightened need: dementia diagnosis, in-home care, and transition into residential care. Thematic analysis identified 3 corresponding themes of carer need and risk: "psychological support/distress, " "social connection/social isolation, " and "knowledge/disempowerment. " Discussion and Implications: Findings suggest a critical role of time in dementia care journeys, impacting the support that care partners need from health care and aged care systems. The potentially foreseeable, time-based nature of unmet needs suggests that education and training of practitioners can highlight the needs of carers for knowledge, support, and connection, and the importance of prioritizing them differentially according to the stages of the carer journey.

Box plot comparison of men's and women's wellbeing scores (WEMWBS) in the service user group. P. 51: Figure 7:Box plot comparison of men's and women's loneliness scores (DJ tot) in the service user group. P. 53: Figure 8: Difference in GDS score (time 2 minus time 1) against the average score for each individual in the HENPOWER service user group

Background:Limited access to medical and social services during the coronavirus outbreak has contributed to the exclusion of vulnerable populations, such as people with dementia and older adults. These limitations and the resulting social isolation have highlighted the importance of social relationships and their relationship to the mental health of these people. In the context of dementia, ‘social health’ (SH) can be defined as the role of social abilities for achieving a dynamic balance between opportunities and limitations. The concept encompasses the capacity and independency of an individual to participate in social activities alongside the influences of the surrounding social network.Methods:Using a qualitative and quantitative approach, we will present social health and its determinants of people with dementia related to social care service closures and self-isolation during the SARS-CoV-2 pandemic. We present an analysis of the survey data from the cross-country population- ...

Background:Emerging evidence describes impacts of the COVID-19 pandemic upon people living with dementia and their informal carers, however without evidence-based global comparisons to date. The aim of this international study was to explore and compare the impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries.Methods:People with dementia and informal carers from the UK, Australia, Italy, India, and Poland participated in remote semi-structured interviews. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.Results:Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and is...

The aim of this study was to provide a detailed profile of the hours of care Australian mental health carers provide for different types of caring tasks. The UQ Carer Survey 2016 was administered online to 105 adults caring for someone aged 16 years or older whose main condition is mental illness. Mental health carers reported providing on average 37.2 h of care per week to their main care recipient. Carers spent most of their active caring time providing emotional support, and the least of their time assisting with activities of daily living. Carers highlighted that this care time fluctuates with the undulating nature of mental illness, and many noted additional hours devoted to being 'on call' in case of emergency. Carers provide large amounts of support on a long-term and often unpredictable basis. Government services need to match the undulating nature of the illness by providing more flexible support options for mental health carers.

A systematic review of evidence of the effectiveness of educational and supportive strategies for enabling caregivers of people with Alzheimer’s disease (AD) or related dementias to maintain participation in that role was conducted as part of the American Occupational Therapy Association’s Evidence-Based Literature Review Project. Forty-three articles met inclusion criteria. Results suggest that interventions that jointly engage people with AD and their caregivers in education and training in the home setting are more successful than strategies that focus solely on people with AD. Greater carryover is noted when education and training are implemented at the time that the caregiver identifies concerns. Interventions should provide caregivers with problem solving, technical skills, support, simple home modification strategies, and referral to community resources. Interventions mediated by technology have a positive effect on the caregiver and are especially important for those who liv...

A systematic review was conducted to determine the effectiveness of interventions to prevent falls in people with Alzheimer’s disease (AD) and related dementias. Twelve research reports met inclusion criteria. Studies reported on three types of intervention: (1) exercise- and motor-based interventions, (2) nursing staff–directed interventions, and (3) multidisciplinary interventions. Strategies were offered as single or multifaceted intervention programs. All types of intervention resulted in benefit, although the evidence for effectiveness is tentative because of the studies’ limitations. More research is needed to better understand appropriate dosages of intervention. No evidence was found for the effectiveness of prevention programs accessed as part of occasional respite care. Occupational therapy was seldom involved in the interventions researched. Because effective fall prevention programs are embedded in people’s daily routines and encouraged participation in occupation, the c...

This paper presents results from interviews with 48 New York families of children with severe disabilities or chronic illnesses who were served by Sick Kids (need) Involved People (SKIP) of New York, Incorporated, a case management and advocacy service. The report is divided into sections on the families and their children, daily routine, specialized care, impact on the family, informal supports, financing home care, services to the child, family supports, effectiveness of SKIP management, families' views of the future, crucial issues, and conclusions. In the concluding section an impression emerges of a schizophrenic system of public and private supports for home care for children with severe disabilities and specialized health care needs. The experience of families did not support the rhetoric of public officals on the centrality of home, community, and family in service delivery. An appendix outlines methodological considerations in evaluating family support programs. Listed ...

Cette étude qualitative visait à recueillir chez les professionnels d'un Centre de Lutte Contre le Cancer les attentes et les réticences qu'ils pouvaient avoir vis-à-vis des interventions de pair-aidance. Des entretiens individuels semi-structurés ont été menés auprès de 12 professionnels issus de professions différentes. Une retranscription intégrale des entretiens puis une analyse thématique de leur contenu ont été conduites. L'analyse des données a permis de faire émerger trois thèmes principaux quant aux attentes exprimées par les soignants : le besoin d'un accompagnement plus soutenant des patients, rompre leur isolement dans la maladie et enrichir le réseau de soins. L'analyse a également permis de faire émerger trois thèmes principaux quant aux réticences exprimées par les soignants : les freins liés à l'intervention des pairs-aidants, les enjeux psychologiques de cette intervention et les freins institutionnels à l'implémentation d'interventions de pair-aidance. Cette étude montre que la pairaidance permettrait de répondre à des attentes des professionnels mais que son implémentation doit être pensée au vu des réticences qu'ils peuvent exprimer.

This study examines the social environments, staff behavior, and social interaction o f elderly clients in two adult day care centers. Goffman's (1961) description of the psycho-social effects of the "total institution" is used as a framework for conceptualizing the effects of "partial institutions" on older persons. Using qualitative research techniques, we observed the environ ments, activities, and interactions o f approximately seventy-two clients in two adult day care settings. When the staff and environment were more infantilizing, provided less autonomy, and fewer opportunities for privacy regulation, the clients had lower social interaction with peers. In contrast, w hen the center had a more adult setting, with age appropriate activities, there was greater privacy regulation, autonomy, social contact, and friend ships among clients.

Hybrid coronary revascularization incorporates a surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery through a thoracotomy and percutaneous implantation of drug eluting stents in diseased non-left anterior descending coronary arteries. Hybrid coronary artery revascularization can be performed as a 1-stage procedure in a hybrid operating room or as a tightly scheduled 2-stage procedure. Hybrid coronary artery revascularization is seldom the selected modality for coronary revascularization due to the lack of a hybrid operating room in many hospitals, the recommended thoracotomy approach for bypass, or the rigid schedule of surgical and endovascular revascularization. A 2-stage approach, using a sternotomy as compared to standard thoracotomy, and a flexible schedule between surgical and endovascular procedures may facilitate the adoption of hybrid coronary revascularization with noncomplex multi-vessel stable coronary artery disease.

Background. Functional decline in conjunction with low levels of physical activity has implications for health risks in older adults. Previous studies have examined the associations between accelerometry-derived activity and physical function, but most of these studies reduced these data into average means of total daily physical activity (e.g., daily step counts). A new method of analysis "functional data analysis" provides more in-depth capability using minute-level accelerometer data. Methods.