New directions in centre-based aged care in Australia: Responding to changing funding models and the COVID-19 pandemic.

OBJECTIVES: Centre-based aged care services are a key site of early intervention and support for people with dementia and their carers. This paper examines the impact of new aged care funding structures on centre-based aged care service accessibility and delivery. It also examines the challenges and opportunities for change facing the sector in the light of the COVID-19 pandemic. METHODS: Semi-structured interviews were conducted online with 29 managers or supervisors of centre-based aged care services in Greater Sydney. RESULTS: The analysis reinforced the essential role of centre-based aged care services in improving the cognitive, physical and psychological health of older people with dementia and their carers. However, the changing funding context and the COVID-19 pandemic have created challenges in access to centre-based services, particularly for the most vulnerable. The challenges created by the COVID-19 pandemic also opened opportunities for the introduction of new models of service practice to meet the individual needs of older people and their carers. CONCLUSIONS: Greater investment in, and flexibility in the funding for, centre-based aged care services is needed to facilitate access for people with dementia and their carers and improve their health and well-being.

Reducing educational disparities between Australian adolescents in regional and metropolitan communities: The compensatory effects of extracurricular activities.

Australian adolescents living in regional communities are significantly more likely to perform worse at school, relative to those in metropolitan communities. These disparities are partially due to the development of lower educational expectations among regional adolescents. In the current study, we tested whether the differences in educational expectations across communities were reduced when adolescents engage in extracurricular activities, and any subsequent downstream effects on academic outcomes. The current study used a subsample of 1,477 adolescents recruited as part of the Longitudinal Study of Australian Children who have graduated from high school. Using a random-intercept cross-lagged panel model, we found that residing in a regional community at the start of secondary education predicted worse academic performance when graduating 6 years later. This association was partially mediated by lower educational expectations and school functioning, measured biennially. However, the significant difference between adolescents in metropolitan and regional communities dissipated when participants engaged in three or more types of extracurricular activities. These results highlight that increasing access and support to participate in extracurricular activities in regional communities may contribute to reducing inequities in educational outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Why caregivers of people with dementia and memory loss don't use services.

OBJECTIVES: To develop a typography of the characteristics of caregivers of community dwelling people with dementia or memory loss who do not use services and empirically investigate the reasons for service non-use. METHOD: The findings of a literature review were used to develop a typography of caregivers' non-use of services. This typography was applied to a sample of community-based caregivers. RESULTS: One in three caregivers were using no services and one in four only one service. Despite considerable proportions reporting low levels of life satisfaction and high levels of overload and resentment the main reasons caregivers gave for not using services were that they did not consider they needed the services. Other reasons for service non-use included care recipient reluctance to use services, lack of knowledge of services or being in the process of applying for services. Service availability or affordability were not identified as major impediments to service use. Presence of a physical disability and contact with a social worker were associated with service use. CONCLUSIONS: Caregivers of people with dementia incur significant strain and have substantial need for a variety of services. Nevertheless many caregivers were not using support services, mainly because of perceived lack of need or lack of awareness. Better public promotion of services, destigmatising dementia and encouraging referrals from health professionals could help overcome the barriers to service use.