Year: 2010

Staff: Prof Susan Koch - Latrobe University, Dr Dina LoGuidice - Melbourne Health, Ms Maree Mastwyk - St Vincent’s Health, Dr Kathryn Ellis - AIBL study, Courtney Hempton, Dr Briony Dow, Nicolas Cortes, Prof David Ames

Summary:

A study on elder abuse recently completed at NARI suggests that agreement is urgently needed on what constitutes elder abuse. The research showed that health professionals were more likely to correctly identify abusive and potentially abusive strategies than carers and older people. However, up to two-fifths of health professionals did not identify two strategies that were categorised as definitely abusive to older people.

The project team also included Melbourne Health, St Vincent’s Health and La Trobe University. The 697 study participants read a fictional scenario about a man caring for his mother with dementia and then completed a questionnaire, indicating whether or not 13 particular actions were appropriate. The correct responses were based on the views of an expert panel and government policy, which states elder abuse as being ‘any act occurring within a relationship where there is an implication of trust, which results in harm to an older person’. The following two strategies from the study’s questionnaire fit the definition of elder abuse: the son ‘locks his mother in the house while he is at work’, rated as abusive by 59.2% health professionals and 47.2% older people; and the son ‘sits his mother in an armchair with a table over her lap so she cannot get up while he is out shopping’, rated as abusive by 77.5% health professionals and 57.3% of older people.

In other results, health science students were more likely to identify abusive situations than health professionals, highlighting the need for this latter group to improve their knowledge so they can effectively manage and also advise carers about challenging behaviour. The study reflected similar findings to a smaller UK study on which this research was based.

Publications: Hempton C, Dow B, Cortes-Simonet EN, Ellis K, Koch S, LoGiudice D, Mastwyk M, Livingston G, Cooper C, Ames D. Perception of elder abuse in Australia. International Journal of Geriatric Psychiatry.

Year: 2009-10

Staff: Irene Blackberry, Betty Haralambous, Xiaoping Lin, Nicolas Cortes, Jean Tinney, Briony Dow

Summary:

This project developed and evaluated “Positive Ageing”, a chronic disease self-management program and peer support network to engage older people from culturally and linguistically diverse backgrounds, many of whom were hard to reach but were at risk of developing chronic diseases or developing secondary complications. This project provided older people who had one or more lifestyle risk factors with preventive strategies that they could sustain after the project has ended. This program was piloted with a Vietnamese group in the City of Yarra and an Arabic group in the Cities of Hume and Moreland. The Peer Educator approach was chosen because of its effectiveness as an education and information sharing mechanism, as seniors’ valuable life experiences enabled them to identify, empathise and pass on important messages to their peers within the seniors’ community. This project was a partnership between the National Ageing Research Institute (NARI), the Chronic Illness Alliance and the Council on the Ageing - Victoria (COTA-VIC).

Key findings from this study:

• Vietnamese participants were interested in more information about arthritis, the relationship between arthritis and diet and learning about the good aspects of a traditional Vietnamese diet.

• The Arabic participants experienced something completely new to them and the immediate impact of the program appears to be a sense of improved well-being. This might be considered a first step to greater health improvements if the groups were offered more information and more programs of a similar nature.

• Lack of English and inability to read and write in their own language were the major barriers experienced by some participants, though not all. This means more visual and aural resources were required. Health literacy was possibly another barrier although this was not recognised by the participants themselves. Another major barrier was travelling time to the program. Some people travelled several hours by public transport to attend.

Click here for the full project report by NARI

Funding source: Department of Health and Ageing through the ‘Sharing Health Care Initiative’.

Year: 2009

Staff: Briony Dow, Elizabeth Cyarto, Freda Vrantsidis, Claudia Meyer & Nicolas Cortes

Summary:

This project was funded by the Productive Ageing Centre of National Seniors Australia to develop a healthy ageing quiz to help older people, and people approaching older age, evaluate their current lifestyle choices. The project included four components: a literature review to identify the lifestyle factors associated with healthy ageing and the current guidelines related to these health domains; focus groups with older people to determine the health and lifestyle factors most important to them and to obtain their views of the draft quiz; an expert panel review; and pilot testing with a large sample of older Australians to establish the validity and reliability of the quiz.

Questions included in the healthy ageing quiz relate to physical activity, falls and balance, smoking and alcohol use, weight and diet, chronic conditions and doctor visits, sleeping, participation in social, productive and mentally challenging activities, social connections and support, optimism and adaptation. It also provides specific recommendations for improvements in each health domain.

The quiz was found to correlate highly with other health questionnaires and self-reported health status; test-retest reliability was also high. Positive feedback was generally received in relation to the format, layout and content of the quiz (including the Actions To Help You Age Well). The paper-based version of the Healthy Ageing Quiz is currently undergoing graphic design and an on-line version is also being developed.

Click here to view the online version of the Healthy Ageing Quiz

Click here to download PDF version of the Healthy Ageing Quiz

Click here for the brief report by National Seniors Productive Ageing Centre

Click here for the full project report by NARI

Funding source: Productive Ageing Centre of National Seniors Australia.

Year: 2005-2008

Staff: Lynn Fitzpatrick (Real Animals Pets and People), Kirsten Moore, Amanda Bingham, Gihan de Mel, Briony Dow, Betty Haralambous

Summary:

There is an enormous range and volume of literature on the subject of human-animal relationships and the positive influence of companion animals on the emotional, mental, physical and social health and well being of most who share their lives with one. This research was driven by the high number of requests for assistance for animal support services coming through established HACC funded companion animal support programs as well as anecdotal evidence from service providers indicating a lack of options for clients in need of low cost or free companion animal support services. The project involved a survey of community care service providers (n=75) and potential and actual community care recipients (n=601) regarding the importance of pets for the health and wellbeing of older people and people with disabilities and the need for low cost companion animal support services.

Funding source: N/A

Publications: Bingham A., de Mel G., Dow B., Fitzpatrick L., Haralambous B., Moore K. (2008) Identifying the Need for Companion Animal Support for the Home And Community Care Target Population. ISBN 9780734039705.

Final Report available here....

Summary:

This study aimed to identify the gaps in current knowledge and research on depression and anxiety amongst older adults (those aged over 65 years) in Australia.

It included the following activities:

• A review of published peer reviewed literature;
• A survey of people currently undertaking research into older age depression;
• Advisory group consultations;
• Analysis of findings of a consumer survey (conducted by beyondblue);
• A review of beyondblue’s Depression Monitor.

The project has identified some gaps in current research on late-life depression and anxiety in Australia, including:

• Little research regarding people with special needs, such as older Indigenous people, older people from CALD backgrounds and people in rural and remote areas.
• A need for more research into the role of primary health care in detecting and managing depression and anxiety.
• Less research in late-life anxiety compared to late-life depression.
• Limited research on the efficacy of psychological approaches to treatment of late-life depression and anxiety.

Based on the findings a range of recommendations were proposed.

Publications:

Final Report available here....

Summary Report: Scoping study of health professional education and training in older age depression and anxiety available here....

Year: 2009-2010 (Completed)

Staff: Sue Williams, Betty Haralambous, Emma Renehan and Esther Cramer

Summary:

Playgroup Victoria and Barwon Health – Percy Baxter Lodges collaborated with NARI on a DHS funded “Count Us In” project investigating an Intergenerational Playgroup in a Residential Aged Care Facility. The aim of this project was to establish and evaluate a playgroup in a residential aged care facility that would promote greater intergenerational understanding and facilitate meaningful individualised social inclusion for the residents and for members of the playgroup. Questionnaires with staff, residents and parents were completed on two occasions - prior to the commencement and after the completion of a six months trial of the weekly playgroup. A focus group for residents was held at the completion of the program.

The playgroup initiative at Percy Baxter Lodge had an overwhelmingly positive effect for residents, the playgroup participants and for the facility as a whole. The major findings of the impact of the playgroup on the participants were:

• Enjoyment
• Intergenerational interactions
• Reflection and reminiscence of childhood and parenting
• Changes in attitudes, expectations and perceptions of different generations and aged care facilities

Information was also gained about the practicalities and implementation issues related to establishing and running a playgroup in a residential aged care facility. A resource booklet, “Playgroups in Aged Care Facilities” was developed from project findings.

Funding source: Department of Human Services

Publications:

Final Report available here....

 

Year: 2005-2006

Staff: Keith Hill, Jane Sims, Betty Haralambous, Sue Hunt and the Project Expert Advisory Group

Summary:

The Australian Government’s Department of Health and Ageing commissioned the National Ageing Research Institute to develop a discussion paper and recommendations for physical activity for older Australians. The project commenced in mid November 2005, and was completed at the end of April 2006.  The scope included community and residential care settings.  The key elements of the project included:

• Phase 1: Conceptual framework development
• Phase 2: Reviewing evidence (systematic reviews, and more recent randomized controlled trials) and existing guidelines
• Phase 3: Formulating the recommendations
• Phase 4: Refinement of the recommendations, including consultation forums with consumers
• Phase 5: Presenting the deliverables.

The Australian Government Department of Health and Ageing is currently determining the strategy for dissemination of the recommendations.

Funding source: Australian Government Department of Health and Ageing

Publications: Sims J, Hill K, Hunt S, Haralambous B, Brown A, Engel L, et al. National physical activity recommendations for older Australians: Discussion document. Canberra (AUST): Australian Government Department of Health and Ageing; 2006.

Discussion document available here....

Recommendations available here

Further information is available on Department of Health and Ageing website.

Year: 2007-2008

Staff: Leslie Dowson, Kirsten Moore, Jean Tinney, Kay Ledgerwood

Summary: Sleep is necessary for good health at all stages of life. The need for restorative sleep is not dependent on age, and should not be assumed to lessen with age. Generally, some changes in sleep may be considered part of normal ageing; however, normal changes should not cause personal dissatisfaction with quantity or quality of sleep. This literature review aims to explore the prevalence and causes of sleep disturbances in older populations, with an emphasis on those in residential care and including the large percentage of older people living with dementia in residential care. It also aims to explore evidence-based strategies to improve sleep in residential care, and offer recommendations for further research based on sound evidence and protocols.

Funding source: Aged Care Branch, Victorian Department of Human Services

Literature review: The full literature review can be downloaded here ....

Year: 2007-2008

Staff: Betty Haralambous, Freda Vrantsidis, Emma Renehan, Kay Ledgerwood, Keith Hill, Sue Hendy, Stephanie Harper, Mitsuko Penberthy

Summary: In partnership with the Council on the Ageing, NARI recently completed a project that investigated the health and wellbeing benefits for older people starting the Living Longer, Living Stronger strength training program. Living Longer Living Stronger (LLLS) is a community based strength training program for people 50 years and over, endorsed by the Council on the Ageing, and is a high quality, affordable, program available in 120 locations throughout Victoria. Sixty six people were recruited and assessed at baseline; 35 completed a 4 month assessment and 24 remained to complete the 8 month assessment. Withdrawals were due to health, family and other time commitments and most who withdrew indicated that they would like to return to the program in the near future.

Improvements were identified for the 35 participants who completed a 4 month assessment and for the 24 participants who completed an 8 month assessment. Balance (step test), gait (stride length), cardiovascular fitness (distance covered in 6 minutes), leg strength (sit to stand), activities of daily living (physical performance test) and reported health transition (SF-36; comparing health today to a year ago) all improved significantly. Where no significant improvement was evident, performance levels were generally maintained; very few measures reported a drop in performance.

Funding Source: William Buckland Foundation

Reports: The final report can be downloaded here...

Year: 2005-06

Staff: Briony Dow, Kirsten Moore

Summary: This project was a small scale study aimed to examine the feasibility of undertaking a larger randomised controlled trial (RCT) of a computer intervention aimed at reducing social isolation and depression amongst older carers. This feasibility study involved 14 older carers living in the Pyrenees area of rural Victoria (Grampians region). The study was conducted by NARI with assistance from Infoxchange and Carers Choice.  This study found that it would be feasible to conduct a larger randomised controlled trial to establish whether Internet and email usage can reduce depression and social isolation amongst older carers. The carer participants increased their confidence in using the Internet and email and all intended to continue using their computers after the study period. Depressive symptoms were reduced amongst participants and they identified many other social and psychological benefits of being able to use computers, send and receive emails and use the Internet. The main recommendation from this study was to conduct a larger randomised controlled trial of the intervention. 

Funding source: beyondblue: the national depression initiative

Reports: The full report can be downloaded here ....

Year: 2003-04

Staff: Betty Haralambous, Joan Nankervis, Kirsten Moore, Melita Taylor

Summary: The aim of this project was to identify the enablers, barriers and structural supports that affect an older person's ability to comply with health promoting behaviour.

The project entailed a comprehensive literature review and a series of focus groups. Focus groups were held with service providers from Primary Care Partnerships and Falls and Balance Clinics and with older people using services in order to identify the issues that promote and prevent older people from taking up health promoting behaviours and activities. A project report has been produced, including recommendations for health professionals on strategies that will further facilitate health-promoting behaviour.

Funding source: Victorian Department of Human Services

Reports: The following documents from the "Achieving Health Promotion Behaviour Change Among Older Victorians" study are accessible here:
- Literature Review, available here ....  , and
- the Final Report, available here ....

Year: 2003

Staff: Betty Haralambous, Deborah Osborne, Marcia Fearn, Kirsten Moore, Joan Nankervis, Keith Hill

Summary: The aim of the project was to explore the role of psychological, physiological, socio-cultural and socio-environmental factors relating to participation in physical activity. It was designed to explore similarities and variations in local environments, the Western Metropolitan Region and the Eastern Metropolitan Region. These regions reflect differences by socio-economic status, contain a high proportion of people from culturally and linguistically diverse (CALD) backgrounds, and represent two of most rapidly ageing regions in Melbourne. A major component of the project was the use of a qualitative approach, specifically focus group methodology, to explore factors relating to participation in physical activity. There was clear acknowledgement from the focus group participants that physical activity was important to health. In addition, a number of themes emerged from the focus groups.

"This research was undertaken by the National Ageing Research Institute as part of research program agreed by the Department of Human Services. The recommendations and views expressed in the document do not necessarily represent the views or policies of the Department of Human Services."

Funding source: Victorian Department of Human Services

Reports: The following documents from the "Participation in Physical Activity Amongst Older People" study are accessible here:
- Final Report, available here ....  
- Appendix 7a, available here ....
- Appendix 7b, available here ....

Year: 2003-04

Staff: Lisa Engel, Keith Hill

Summary: This project investigated the impact of using a pedometer on time spent walking in older people with Type 2 diabetes. The study used a randomised control and intervention group design. Both groups received a coaching program to support uptake of walking programs and assist with goal setting, the intervention group also used pedometers to monitor performance. Results at 3 months and 6 months showed significant improvements on key outcomes including walking time for both groups, but there was no significant differences between the groups.

Funding source: The Diabetes Australia Research Trust

Year: 2002-03

Staff: Keith Hill, Natalie ElHaber, Barb Whiteford (Care Connect), Marie Vosti (Care Connect), Pek Hill (Sunbury CHC)

Summary: A small pilot study was undertaken to evaluate the feasibility of a simplified type of tai chi (Tai Chi for Arthritis) for frail older people receiving community services. Nine participants commenced the twice weekly, four month program. Five completed the program. Those completing the program achieved small improvements in most of the balance and mobility related measures, and reported subjective improvements associated with the program. Tai Chi for Arthritis appears a suitable and practical form of exercise for frailer older people, and this approach warrants a larger study to identify the effectiveness across a range of health domains.

Funding source: Care Connect Inc.

Reports: The final report "Tai Chi for arthritis: a feasibility study with frail older people receiving community services" is available here ....

Year: 2001-03

Staff: Keith Hill, Robyn Smith, Marcia Kays, Mary Rydberg (Villa Maria Carer Services), Rachel Oliphant (Villa Maria Carer Services)

Summary: Over 100 carers participated in a supported physical activity program through 9 community centres in the Eastern Metropolitan Region. The carers participated in up to twice weekly programs of strength training, tai chi, or yoga for a six month period. Results indicated significant improvements in a number of measures.

Funding source: Villa Maria Carer Services

Year: 2000-01

Staff: Keith Hill, Whanseok Choi, Joanna Condron, Robyn Smith

Summary: The effectiveness of 24 form Beijing style tai chi was evaluated on balance and mobility related outcomes. The tai chi was conducted three times weekly for three months. Nineteen participants with an average age of 71 years completed the program. Results indicated improvements in balance and gait.

Funding source: MacPherson Smith Trust