A scoping review of barriers to accessing aged care services for older adults from culturally and linguistically diverse communities in Australia.

The ageing population of the culturally and linguistically diverse (CALD) population is increasing in Australia. This is because the number of early migrants in Australia is ageing, coupled with increasing family reunification. This scoping review aimed to describe the nature and extent of research on the barriers to aged care services for CALD older adults in Australia using Penchansky and Thomas's Access to Care Framework of five A's dimensions: availability, accessibility, accommodation, affordability, and acceptability. Arksey and O'Malley's five-step scoping review framework was adopted to search 6 databases from inception till August 2024. Title/abstract and full-text screening were conducted using predefined inclusion and exclusion criteria, with supplementary search of references from included articles to identify additional articles. Findings show that while all the five A's of access to care services were barriers for CALD older adults, accommodation and acceptability of services were the major areas of concern due to the lack of cultural sensitivity of such services in Australia. An additional barrier captured and termed as Awareness was noted in some of the included studies, highlighting the need to expand the five A's to 6 A's. Researchers, practitioners, and policymakers on ageing could leverage these findings to improve cultural practice sensitivities when supporting these populations.

S.3827 and a Systematic Review of State-Level Multisector Plans for Aging: How Incorporating Volunteer Caregiving Can Mitigate Service Gaps.

Recognizing the growing need to establish and enhance the necessary service infrastructure to better address the diverse needs of a rapidly aging US population, S.3827 (ie, Strategic Plan for Aging Act) seeks to provide federal support for the creation and implementation of Multisector Plans for Aging (MPAs). Passage of S.3827 can motivate states to strategically plan for a growing elder cohort, as only 8 states currently have developed and are implementing their own MPAs. In this policy brief, we detail the benefits of developing and implementing an MPA at the state level as well as the broad benefits of passing S.3827. We also conduct a systematic review of the 8 MPAs which have been developed and are currently being implemented, focusing on areas of significant overlap (eg, support for paid formal caregiving and support for informal family caregivers) and potential gaps. We conclude with a review of the volunteer caregiving movement and a discussion on how incorporating volunteer caregiving into an MPA can address local elder needs and mitigate service gaps, particularly among older adults who lack access to formal paid caregivers or informal family caregivers. Should S.3827 pass, we argue that state legislatures and stakeholders in eldercare should seriously consider incorporating the volunteer caregiving model into their strategic plans for aging.

Co-producing and co-assessing a new service solution for enhancing health and social care integration: a participatory research protocol.

BACKGROUND: This paper describes a study protocol for co-producing and co-assessing a new sustainable and scalable service solution that enhances health and social integration by involving providers and volunteers delivering services for elderly people in the province of Cremona (Italy), where the elderly population will reach 27% in 2023. METHODS: This upcoming study involves mixed-method participatory research and is structured in three study phases and related objectives. First, it will co-produce a new, accessible and sustainable service solution using an iterative design and management method, Plan-Do-Check-Act by involving professionals and volunteers of a heterogeneous group of health, social and third sector organizations located in the city of Cremona (Italy). Second, the study protocol will co-assess the outcomes of the new service solution using a mixed-method approach for measuring the outcomes on: professionals and volunteers (micro level) and their health, social and third sector organizations (meso level). Third, this study will co-investigate the scalability of the new solution promoting health and social integration in other similar urban areas of the Province of Cremona via the Intervention Scalability Assessment Tool (macro level). The data will be collected through the analysis of official documents, websites, policies and participatory workshops. DISCUSSION: This protocol proposes an innovative intervention, a novel participatory approach, and an unexplored scalability assessment tool in the context of health and social care integration. This study aims to support professionals from health and social care service providers and volunteers from third-sector organizations to collaborate and integrate each other's resources. In doing so, the participatory approach will facilitate the co-creation of an effective response to the need of health and social integration, and the development of trustful relationships between health and social care service providers. Moreover, the adoption of Plan-Do-Check-Act and Intervention Scalability Assessment Tool will ensure the quality, scalability and sustainability of the new service solution in other settings.

Characteristics of family physicians with additional training or focused practices in caring for older adults: Population-based retrospective cohort study.

OBJECTIVE: To identify FPs with additional training and focused practice activities relevant to the needs of older patients within health administrative data and to describe their medical practices and service provision in community-based primary care settings. DESIGN: Retrospective cohort study. SETTING: Ontario. PARTICIPANTS: Family physicians with Certificates of Added Competence in care of the elderly from the College of Family Physicians of Canada or focused practice billing designations in care of the elderly. MAIN OUTCOME MEASURES: Evidence of additional training or certification in care of the elderly or practice activities relevant to the care of older adults. RESULTS: Of 14,123 FPs, 242 had evidence of additional scope to better support older adults. These FPs mainly practised in team-based care models, tended to provide comprehensive care, and billed for core primary care services. In an unadjusted analysis, factors statistically significantly associated with greater likelihood of having additional training or focused practices relevant to the care of older patients included physician demographic characteristics (eg, female sex, having completed medical school in Canada, residential instability at the community level), primary care practice model (ie, focused practice type), primary care activities (eg, more likely to provide consultations, practise in long-term care, refer patients to psychiatry and geriatrics, bill for complex house call assessments, bill for home care applications, and bill for long-term care health report forms), and patient characteristics (ie, older average age of patients). CONCLUSION: The FP workforce with additional training or focused practices in caring for older patients represents a small but specialized group of providers who contribute a portion of the total primary care activities for older adults. Health human resource planning should consider the contributions of all FPs who care for older adults, and enhancing geriatric competence across the family medicine workforce should be emphasized.

Age-Friendly Health Systems Integration into Rural Primary Care Clinics: A Journey of One Geriatric Workforce Enhancement Program.

This study explores the implementation of the Age-Friendly Health Systems (AFHS) 4Ms Framework into primary care clinics in rural Arkansas, facilitated by the AGEC and funded by The Health Resources and Services Administration's Geriatric Workforce Enhancement Program (GWEP) grant. Implementation success is evaluated by monitoring merit-based incentive payment system (MIPS) measures and other variables, providing insight into the effectiveness of integrating AFHS and enhancing older adult care. AGEC employed implementation strategies (train-the-trainer, audit and feedback, and clinical reminders using Electronic Medical Record (EMR)), the i-PARIHS implementation framework, and the RE-AIM evaluation framework to facilitate integration of the AFHS 4Ms Framework into partnered rural federally qualified healthcare clinics (FQHC). AGEC aimed to equip the healthcare workforce through comprehensive training sessions and resource provision. Additionally, the EMR system modifications guided clinicians in aligning care with the AFHS 4Ms Framework. This multifaceted approach ensured a systematic and tailored implementation, enhancing the capacity of rural FQHCs in Arkansas to deliver Age-Friendly care. Improvements were observed in MIPS outcome measures, including increased completion of fall and depression screens, Annual Wellness Visits (AWV) and Advance Care Plans (ACP). These changes reflect a proactive impact on comprehensive care delivery for older adults. Since adopting the AFHS 4Ms Framework, these rural Arkansas FQHC clinics have significantly enhanced their older adult care, earning recognition as AFHS Clinics by the Institute for Health Improvement (IHI). Primary care practices nationwide can implement similar evidence-based approaches to improve care for the expanding older adult population in the U.S.

Assessment of the readiness of health facilities in urban areas to deliver geriatric-friendly care services: a cross-sectional study in Kampala City, Uganda.

BACKGROUND: With the global rise in the elderly population, ensuring geriatric-friendly healthcare services is paramount. This study aimed to assess the current readiness of health facilities in Kampala City, Uganda, to provide geriatric-friendly care services. METHODS: We conducted a cross-sectional study in 35 health facilities (HF) including Private for-profit (PFP), Private not-for-profit, and public (government-run) facilities at different levels i.e., Health Centre III, Health Centre IV, and Hospitals, within Kampala City, Uganda. Data was collected using a self-administered health facility assessment tool. Facilities scoring 80-100 were classified as fully ready to offer geriatric-friendly care, 51-79 indicated moderate readiness, and 0-50 indicated low readiness. RESULTS: The overall readiness index (RI) across all facilities was low, 44.09 (SD ± 14.18). The National Referral Hospital (NRH), PFPs, and HFs in Kampala Central had the highest RI of 55.34. 47.63 and 51.09 respectively. The low readiness of HF to provide geriatric-friendly care was due to the low scores in leadership and governance (13.49), financing (19.29), human resource (42.66), and Health Management Information System (47.99) WHO building blocks. HCIVs had a higher readiness index than the other HF levels (Coefficient: 17.40, 95% CI: 4.16 to 30.64, p = 0.012). HFs in Kawempe had a significantly lower RI than those in Makindye and Kampala Central (Coefficient: -13.80, 95% CI: -24.48 to -3.11, p = 0.013). CONCLUSION: The findings of our study indicate that public and private health facilities in Kampala City are not ready enough to provide geriatric-friendly care services.

Needs assessment survey among healthcare professionals to implement the 4Ms framework: a cross-sectional study from Qatar.

BACKGROUND: Worldwide, the evidence-based 4Ms framework of the Age-Friendly Health System (AFHS) improves the experience of caring for older adults. This study aimed to examine healthcare professionals' perceptions, attitudes, and behaviors regarding the AFHS and 4Ms before they were implemented. METHODS: This study was a questionnaire-based survey of 252 healthcare professionals in geriatrics and long-term care departments, Rumailah Hospital, Acute Care Services in Hamad General Hospital, and home healthcare services to assess their perceptions, attitudes, and behaviors regarding 4Ms from November 1, 2022, to July 31, 2023. RESULTS: Most respondents acknowledged the benefits of providing care through AFHS. However, only 62% of respondents reported using the 4Ms framework. The most commonly used types of age-friendly care provided by health care professionals were reviews of high-risk medication use (64.2%) and screening for mobility limitations (55.8%). CONCLUSION: The findings suggest that there is a need for more training and education regarding the 4Ms framework for health care providers. This training should focus on specific aspects of the framework, such as how to assess what matters most to older adults; how to manage their mobility, mentation, and medication; and how to coordinate care across settings.

Reasons for underutilization of community care facilities for the elderly in China.

BACKGROUND: China's government has invested a great deal of resources to improve the coverage rate of community care facilities for the elderly. However, the facilities that have been built are underutilized. METHODS: Referring to the Anderson model, a framework for analyzing the utilization of community care facilities for the elderly was constructed. Descriptive statistics on survey data from 17 communities demonstrated the status of the utilization, and binary logistic regression analysis examined the influencing factors of the utilization. RESULTS: Built community care facilities for the elderly are underutilized and there are significant differences in the influencing factors of the utilization between daily care facilities, medical care facilities, recreation facilities, and spiritual comfort facilities. CONCLUSIONS: The main reasons for the underutilization can be delineated as follows: (1) The demand for community care facilities is outstripped by the supply, resulting in a surplus; (2) Complex constraints on demand for facilities due to insufficient enabling resources; (3) Inadequacy of community care facilities in meeting expectations. (4) High substitutability of community care facilities; (5) Bureaucratic pressure hindering facility development. To address the underutilization of community care facilities, it is recommended to clarify the community responsibility boundaries for elderly care and the role that the market plays in community care facilities for the elderly.

[Palliative care and care for the elderly: Worlds to be reconciled around an ethic of vulnerability]. / Soins palliatifs et soins au grand âge : des univers à réconcilier autour d'une éthique de la vulnérabilité.

The ageing of Western societies is leading to a marked increase in mortality. Death and old age are now intertwined. This situation should be of particular concern to palliative care. But in reality, palliative care remains too inaccessible to the oldest sections of the population. Why this paradox? After reviewing the clinical and organisational reasons that are often given, we invite you to take a more global look, one that is both sociological and ethical.

Challenges and opportunities in the Polish healthcare sector from the implementation of telemedicine solutions in the field of gerontology and geriatric medicine: own experience.

OBJECTIVE: Aim: To analyze and summarize the implementation of telemedical solutions in geriatrics and gerontology within the Polish healthcare sector, aiming to develop innovative strategies for improving elderly care through telemedical technologies. PATIENTS AND METHODS: Materials and Methods: An interdisciplinary pilot project in geriatrics was implemented, focusing on health, organizational, and technological areas. The project involved continuous monitoring of health parameters, remote consultations, and the use of telemedical devices and platforms. Key data collection tools included digital clinimetric outcomes from the FRA-MNA-SARC model, with data transmitted to a telemedical platform. RESULTS: Results: The pilot project demonstrated significant positive outcomes for senior participants. Continuous monitoring of health parameters allowed for early detection and timely intervention, leading to noticeable improvements in chronic disease management. This proactive approach reduced emergency hospital visits and enhanced overall health stability. The medication adherence support system, with automated reminders, ensured patients took their medications as prescribed, resulting in improved compliance and health outcomes. Telemedical solutions efficiently reduced the need for frequent in-person visits, allowing healthcare providers to monitor progress and adjust therapies in real-time. The project also effectively engaged patients and caregivers, increasing confidence in health management and providing valuable support and real-time information. CONCLUSION: Conclusions: Implementing telemedical solutions in geriatrics within the Polish healthcare sector shows significant potential to improve elderly care. Telemedicine can effectively support chronic disease management, enhance seniors' quality of life through continuous health monitoring, and provide a practical framework for personalized and efficient healthcare delivery.

Recorda SP: programa indutor da valorização e protagonismo da pessoa idosa (parte 2)

Especial Mês da Enfermagem e a vida em Ativa Idade

#SamuExplica - Prevenção de acidentes no trânsito com os idosos

Entenda a doação de sangue na terceira idade

Queimaduras

Diabetes

Colesterol

No dia 8 de agosto foi celebrado o Dia Mundial de Combate ao Colesterol!

Dia a dia na Unidade de Referência à Saúde do Idoso (Ursi)

Disfagia