Advance planning for research participation: Time to translate this innovation into practice.

Objectives: Advance planning for research is a process that involves thinking about, discussing and expressing preferences for taking part in research during future periods of incapacity. The process may include making an advance research directive and naming trusted people to be involved in decisions about research participation. Advance research planning could help to overcome barriers to including people with dementia in research.

Advance Care Planning Practices in the Nursing Home Setting: A Secondary Analysis.

Background And Objectives: Advance care planning is intended to support residents' preferences regarding health decisions, even when they can no longer participate. Little is known about the power discourses influencing how residents, family members, and health care workers engage in advance care planning and how advance care directives are used if a conflict arises. A large critical ethnographic study was conducted exploring decision making when a resident's health deteriorates in the nursing home setting.

Consumer expectations and experiences of quality in Australian home-based community services.

Australians want to live at home as they age and seek support from health and social care services to achieve this. The consumer driven market-based approach to community services in Australia has resulted in an increases in user's expectations of quality. What constitutes a quality service from the consumer's perspective is an important agenda to understand as the focus of care delivery moves to the domiciliary setting.

Recognition and assessment of resident' deterioration in the nursing home setting: A critical ethnography.

Aims And Objectives: To explore the recognition and assessment of resident deterioration in the nursing home setting.

Background: There is a dearth of research exploring how nurses and personal-care-assistants manage a deteriorating nursing home resident.

Design: Critical ethnography.

Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice.

Background/aim: The first evidence-based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence-based recommendations for occupational therapists. The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy.

Clinical practice guidelines for dementia in Australia.

About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings.

"We Have to Work Within the System!": Staff Perceptions of Organizational Barriers to Decision Making for Older Adults With Dementia in Australian Aged Care Facilities.

The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs.

A meta-synthesis of factors influencing nursing home staff decisions to transfer residents to hospital.

Aim: To report a meta-synthesis of qualitative research studies exploring the role of nursing home staff in decisions to transfer residents to hospital.

Background: Nurses and nurse assistants provide the majority of care to residents living in nursing homes and may be the only health workers present when a resident deteriorates. To inform future strategies, it is vital to understand the role of nursing home staff in decisions to transfer to hospital.

Social participation and family carers of people living with dementia in Australia.

This paper reports on a study exploring the experiences and meaning of social participation for family carers of people living with dementia. Participants were 33 family carers (17 spouses and 16 adult children) of older adults diagnosed with dementia (any stage or type) who responded to advertisements by the national Alzheimer's association, Alzheimer's Australia. Data were collected through semi-structured face-to-face and/or telephone interviews using an interview guide, which included prompts such as 'Tell me about what social participation means to you', and 'How did this change…'.

Supporting residents' expression of sexuality: the initial construction of a sexuality assessment tool for residential aged care facilities.

Background: Sexuality is a key component of quality of life and well-being and a need to express one's sexuality continues into old age. Staff and families in residential aged care facilities often find expressions of sexuality by residents, particularly those living with dementia, challenging and facilities often struggle to address individuals' needs in this area. This paper describes the development of an assessment tool which enables residential aged care facilities to identify how supportive their organisation is of all residents' expression of their sexuality, and thereby improve where required.

"The Red Dress or the Blue?": How Do Staff Perceive That They Support Decision Making for People With Dementia Living in Residential Aged Care Facilities?

Respect for a person's right to make choices and participate in decision making is generally seen as central to quality of life and well-being. When a person moves into a residential aged care facility (RACF), however, decision making becomes more complicated, particularly if the person has a diagnosis of dementia. Little is known about how staff in RACFs perceive that they support decision making for people with dementia within their everyday practice, and this article seeks to address this knowledge gap.

Perceptions of structural empowerment: nurse leaders in rural health services.

Aim: To provide insight into the perceptions of structural empowerment of nurse leaders working in rural and regional Victoria, Australia.

Background: Fostering nurse leadership in rural health services may be informed by gaining insight into rural nurse leaders' perceptions of structural empowerment.

Method: A sample of nurse executives (n = 45) from hospitals throughout rural Victoria, Australia completed the Conditions of Work Effectiveness Questionnaire II (CWEQ-II) aimed to measure structural empowerment.

'We need to know what's going on': views of family members toward the sexual expression of people with dementia in residential aged care.

This paper reports on a study which explored the views and attitudes of family members towards the sexual expression of residents with dementia in residential aged care facilities in two states in Australia. Recruitment was challenging and only seven family members agreed to an interview on this topic. Data were analysed using a constant comparative method.

Factors that influence the approach to leadership: directors of nursing working in rural health services.

Aim: To identify factors that influence directors of nursing in their approach to leadership when working in rural Victoria, Australia.

Background: In rural areas, nurses account for the largest component of the health workforce and must be equipped with leadership knowledge and skills to lead reform at a service level.

Method: A qualitative descriptive design was used.

Being central to decision making means I am still here!: the essence of decision making for people with dementia.

The ability to make choices and decisions, and to have those decisions upheld, is central to self-determination. For people living with a diagnosis of dementia, however, it can be difficult to remain involved in decision making. While many studies show that people with mild or moderate dementia have the ability to participate in decision making, there are also indications that the attitudes of those around them, including health professionals and family carers, can sometimes be a barrier, and there is generally little understanding about the nature of decision making for this population.

General practitioner service provision in residential aged care facilities: 1998-2011.

Aim: To examine the general practitioner (GP) consultation patterns for primary health-care services provided in residential aged care facilities (RACFs) by consultation type.

Method: Analyses of service provision and RACF population data for the period 1998-2011. All Medicare-subsidised services provided by GPs across Australia in RACFs were included and categorised by consultation type and by time of service delivery (business or after-hours).

Using participatory action research to foster nurse leadership in Australian rural hospitals.

This paper outlines the processes and results of a participatory action research study undertaken to identify issues that may impact on strategies to foster nurse leadership in rural hospitals. Five Directors of Nursing from rural regions of Victoria, Australia participated. The group activities involved discussion and analysis of previous research, a review of current literature and critical reflection of the leadership performance of their organization.

The person-centred care of older people with cognitive impairment in acute care scale (POPAC).

Aim:   To construct and evaluate psychometric properties of the person-centred care of older people with cognitive impairment in acute care settings (POPAC) scale.

Background:   Older people with cognitive impairment are admitted frequently to acute care, with needs not always met through standard practice. Best practice models have been suggested, but few assessment scales exist.

A scoping review identifying contemporary issues in rural nursing leadership.

Purpose: Rural nurse leaders on a global scale are being challenged to create structures and processes to enable excellence in nursing care. The purpose of this scoping review is to offer an indication of the available literature relating to contemporary issues in rural nursing leadership. A review of contemporary issues facing rural nurse leaders is timely to assist strategy development that will achieve the goal of excellence in nursing.

What is pain? A phenomenological approach to understanding.

This paper presents four phenomenological accounts of pain which describe: the pain at the time of the experience; the meaning the pain had at the time of the experience (reflection in); and the meaning of the experience looking back on it (reflection upon). Specifically, the accounts describe pain that is emotional, cognitive and physical (acute and chronic). By exploring the essence of pain using very personal accounts, we encourage nurses to reflect on how their own understanding of pain and individual responses to pain can impact on how they in turn recognise, assess and manage pain in older people and especially those living with dementia.

Successful aging: development and testing of a multidimensional model using data from a large sample of older australians.

Objectives: To develop a multidimensional statistical model that could assess the contribution of, and interrelationships between, measures likely to contribute to an individual's successful aging, defined as aging well across a number of dimensions.

Design: Cross-sectional.

Setting: Data collected from 8,841 Australians aged 16 to 85 during the 2007 National Survey of Mental Health and Well-Being conducted by the Australian Bureau of Statistics.

Effectiveness of staffing models in residential, subacute, extended aged care settings on patient and staff outcomes.

Background: A key concern for managers and nurse administrators of healthcare settings is staffing. Determining and maintaining an appropriate level and mix of staff is especially problematic for those working in the long-term aged-care sector, where resident needs are complex and recruitment and retention of staff is challenging.

Objectives: To identify which staffing models are associated with the best patient and staff outcomes.

The Tool for Understanding Residents' Needs as Individual Persons (TURNIP): construction and initial testing.

Aims And Objectives: To construct and evaluate an intervention tool for increasing the person-centredness of care in residential aged care services.

Background: Providing care that is person-centred and evidence-based is increasingly being regarded as synonymous with best quality aged care. However, consensus about how person-centred care should be defined, operationalised and implemented has not yet been reached.

Job satisfaction amongst aged care staff: exploring the influence of person-centered care provision.

Background: There are challenges in attracting and sustaining a competent and stable workforce in aged care, and key issues of concern such as low staff job satisfaction and feelings of not being able to provide high quality care have been described. This study aimed to explore the association between person-centered care provision and job satisfaction in aged care staff.

Methods: Residential aged care staff (n = 297) in Australia completed the measure of job satisfaction and the person-centered care assessment tool.