The 'Big Five'. Hypothesis generation: a multidisciplinary intervention package reduces disease-specific hospitalisations from long-term care: a post hoc analysis of the ARCHUS cluster-randomised controlled trial.

Introduction: long-term care (LTC) residents have higher hospitalisation rates than non-LTC residents. Rapid decline may follow hospitalisations, hence the importance of preventing unnecessary hospitalisations. Literature describes diagnosis-specific interventions (for cardiac failure, ischaemic heart disease, chronic obstructive pulmonary disease, stroke, pneumonia-termed 'big five' diagnoses), impacting on hospitalisations of older community-dwellers, but few RCTs show reductions in acute admissions from LTC.

The Aged Residential Care Healthcare Utilization Study (ARCHUS): a multidisciplinary, cluster randomized controlled trial designed to reduce acute avoidable hospitalizations from long-term care facilities.

Objective: To assess effect of a complex, multidisciplinary intervention aimed at reducing avoidable acute hospitalization of residents of residential aged care (RAC) facilities.

Design: Cluster randomized controlled trial.

Setting: RAC facilities with higher than expected hospitalizations in Auckland, New Zealand, were recruited and randomized to intervention or control.

Aged Residential Care Health Utilisation Study (ARCHUS): a randomised controlled trial to reduce acute hospitalisations from residential aged care.

Background: For residents of long term care, hospitalisations can cause distress and disruption, and often result in further medical complications. Multi-disciplinary team interventions have been shown to improve the health of Residential Aged Care (RAC) residents, decreasing the need for acute hospitalisation, yet there are few randomised controlled trials of these complex interventions. This paper describes a randomised controlled trial of a structured multi-disciplinary team and gerontology nurse specialist (GNS) intervention aiming to reduce residents' avoidable hospitalisations.

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

Background: in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years.

Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: a descriptive study.

Objective: To describe changes in aged care residents' dependency over a 20-year period.

Design: All residents in 1988, 1993, 1998, and 2008 were assessed using the same 23-item functional ability survey.

Setting: Residential aged care facilities in Auckland, New Zealand.

A complex intervention to support 'rest home' care: a pilot study.

Aims: To describe an intervention supporting Aged Related Residential Care (ARRC) and to report an initial evaluation.

Methods: The intervention consisted of: medication review by a multidisciplinary team; education programmes for nurses; telephone advice 'hotlines' for nursing and medical staff; Advance Care Planning; and implementing existing community programmes for chronic care management and preventing acute hospital admissions. Semi-structured interviews were conducted with members of the multidisciplinary team, rest home nurses and caregivers.