An increasing focus in aged care policy is supporting older people to age at home. However, there is little recognition of the health and independence of older private renters living in a space they ...do not own or control. This paper draws on in-depth interviews and assessments undertaken in the homes of 27 older tenants in the Brisbane environs aiming to understand how renting privately influenced their ability to meet their basic needs. An analysis of the findings highlights the disadvantage experienced by many older private renters. Most older private renters were unable to meet their basic needs given unaffordable rent whilst reliant on the aged pension. Further, with limited access to community aged care including home modifications, the health and independence of older private renters was found to be at risk.
IMPLICATIONS
Community aged care is difficult for older private renters to utilise in Australia, with unaffordable services and tenancy law limiting access to community aged care services including home modifications.
It is vital social workers advocate for the community aged care needs of older private renters in practice and policy settings.
Tablet crushing is a common practice used by patients and their carers, mainly to facilitate swallowing. Various tablet-crushing devices with different designs are currently available on the market. ...This study aimed to compare the usability of different tablet-crushing devices in people with and without limited hand functions. The hand function of 100 adults recruited from the general community (40 of whom self-reported a limited hand function) was assessed using the hand and finger function subscale of the Arthritis Impact Measurement Scale version 2. The hand strength was measured using a dynamometer. Participants crushed tablets using 11 crushing devices and completed a Rapid Assessment of Product Usability and Universal Design questionnaire for each device. Hand-held twist-action crushers with an ergonomic grip received the highest usability scores among both groups, irrespective of the cost (
< 0.05). Crushers with bags were scored lower by those with limited hand functions, although the score improved if the device was automatic. Preferences regarding electronic crushers significantly changed once the cost was revealed. Economical twist-action crushers with ergonomic grips and without bags or cups were the most favoured crushers.
Increasing numbers of older people seek to age at home in their community in western countries including Australia. Whilst this aligns with community aged care policy, the nature and suitability of ...their housing to enable ageing in place, receives less policy attention. The increasing representation of older tenants in the private rental market, with limited resources and precarious tenure highlights the need to understand ageing in place in a privately rented home. This study aimed to explore the relationships between housing accessibility, financial status, health, and independence for older Australians renting privately. Home visits were conducted with 27 older adults, where the SF8, ADL Staircase, the Housing Enabler, the Financial Capability Questionnaire, and the 30:40 indicator of housing stress were completed. This preliminary research found that older private renters lived in inaccessible homes, with high scores on the Housing Enabler (mean = 185) indicating poor access. Inaccessible housing was correlated with worse physical health, lower perceived independence, less independence in instrumental activities of daily living, and activities of daily living being difficult to perform. Older tenants living with higher levels of financial disadvantage were also found to be less independent and have poorer mental health. The research reveals important policy implications for community aged care, housing, and social security, including removing barriers to enable free and easy access to home modifications for older renters experiencing financial disadvantage. Future research should examine a nationally representative, diverse sample of owners, private renters, and social housing tenants to further understand the influence of the home environment, including tenure, on the health and well-being of older adults as they age in place.
To understand the current utilisation of the clinical framework for delivery of health services to manage compensable musculoskeletal injuries from the perspectives of insurer case managers and ...clinical panel members.
Using a qualitative descriptive approach, 15 semi-structured interviews were conducted with members of key organisations including WorkSafe Victoria and Transport Accident Commission Victoria. All interviews were recorded and transcribed verbatim and analysed using thematic analysis.
Four over-arching themes were identified: (i) current use of the framework and principles is suboptimal leading to several problems including lack of evidence-based treatment by clinicians; (ii) barriers to optimal use of the framework include lack of adequate training of healthcare professionals on the framework principles and financial aspects of the compensation system; (iii) utilisation of the framework could be improved with training from peak associations, insurers, and regulating bodies; and (iv) optimal use of the framework will result in better health and work outcomes.
The current use of the framework and its principles is suboptimal but can be improved by addressing the identified barriers.
IMPLICATIONS FOR REHABILITATION
Rehabilitation of compensable musculoskeletal injuries is often complex.
Implementing the "Clinical Framework for Delivery of Health Services" can lead to provision of time and cost effective, evidence-based rehabilitation for compensable injuries, ultimately improving patient outcomes.
Clinicians can enhance the implementation of the framework principles by integrating evidence-based practice and recommendations from clinical practice guidelines in treatment of compensable musculoskeletal injuries.
Implementation of the framework principles may be enhanced by reviewing the compensation funding model to allow the healthcare practitioners adequate time and remuneration to adopt the framework principles when treating persons with compensable injuries.
There has been a significant focus on medical interventions to improve sexual function and support other aspects of sexuality after spinal cord injury. However, it is not well understood what ...non-medical approaches are described within existing literature. This study sought to identify, summarise and describe existing literature on non-medical approaches to sexuality following spinal cord injury.
This scoping review included studies identified by systematic searching of 10 databases. Findings were thematically analysed in order to summarise and report the results.
Thirty articles met the inclusion criteria. Three themes were identified, including: the importance of individuality and timing, the health care professional role, and, provision of non-medical interventions and strategies. Analyses suggested the importance of providing individualised client-centred care and utilising a team approach. Many non-medical interventions and strategies were identified; however, most studies discussed that information provided and/or access to information is limited.
Although non-medical approaches may be used in practice, provision of support appears to be limited with no consistent approach. Practice implications include the importance of addressing individualised factors, broadening scope of practice, and increasing the resources available for clients and professionals.
Implications for rehabilitation
Non-medical approaches to support sexuality after a spinal cord injury exist, however, there appears to be no consistent approach.
Individualised person-centred care which addresses personal factors and includes intimate partners is essential when supporting sexuality.
The health care professional team should seek to address the wider understanding of sexuality which extends beyond a purely medical focus.
More sexuality resources and training should be available for both people with spinal cord injuries and health care professionals.
This study aimed to explore individuals' experiences of return to work (RTW) following minor to serious road traffic injury (RTI) in Queensland, Australia; seek their recommendations if any, on how ...to provide support for RTW after RTI; and identify the strategies and resources used to return and remain at work after their RTI.
The interpretive description methodological approach was used. Semi-structured interviews were conducted with eligible participants (n = 18) aged 18-65 y who had experienced a minor to serious RTI at least 6 months earlier. Thematic analysis was used to analyse the data.
Five themes emerged: (1) physical and mental consequences of RTI negatively impact RTW; (2) money matters; (3) RTW support makes a difference; (4) feeling alone and confused in the RTW process; and (5) several strategies and resources helped with return/stay at work after RTI. Regular contact and cooperation with employers and insurers, job modifications, and using social media to obtain information and social support were helpful RTW strategies. Participants recommended timely and appropriate medical care, financial assistance, and educational support.
Policy changes to reduce financial stress, increase employer support, and improve injured individuals' knowledge following a RTI are recommended in jurisdictions operating a fault-based scheme.
IMPLICATIONS FOR REHABILITATION
This study identified several factors that can influence return to work (RTW) following minor to serious road traffic injuries (RTIs) in a jurisdiction operating a fault-based compensation scheme.
Legislative changes that provide financial assistance to all injured people regardless of their fault-status could reduce financial stress arising from reduced work ability following a road traffic injury.
Increasing employer' awareness of the importance of return to work for those with road traffic injuries and reimbursement for possible expenses of providing RTW support for these individuals could increase employability of injured people following RTI.
Improving injured individuals' knowledge about return-to-work processes after a road traffic injury could accelerate recovery and return to work.
There is limited evidence to guide therapists in home modification outcome evaluation. Involving consumers in evaluating home modifications is critical to progressing practice. This study ...investigated the home modification experience and outcomes most valued by older adults and individuals with a disability in Australia.
An interpretive description approach was used. Twenty participants aged 24-93 who had received major home modifications were interviewed and transcripts were analysed thematically.
Two major themes emerged: life before and during modifications - "it was all hard," and life after modifications - "to have a life." People's prior experience of home, the circumstance of and time to plan modifications, the perceived value of the modifications, and the home modification process and funding influenced perceptions of outcomes. Valued home modification outcomes included those that enable people to experience emotional and physical health, and safety; do what they want; maintain the image of the home; and plan for the future. Experiences and perceptions of modifications ranged from supportive to disruptive.
These findings point to the need for therapists to deeply understand and evaluate their clients' experiences of home and life as an initial and critical step in the home modification process.
Implications for rehabilitation
Major home modifications result in broad and meaningful outcomes of importance to clients.
Occupational therapists need to partner with clients to understand their life before and during modifications to achieve positive outcomes.
Evaluation of major home modifications needs to be integrated and prioritised in daily practice.
Background/aim
The use of standardised measures in home modification practice is rare, in part due to a lack of suitable tools. One promising outcome measure designed for home modification practice ...is the In‐Home Occupational Performance Evaluation (I‐HOPE). This study aimed to investigate the clinical utility of the I‐HOPE for major home modification practice in Australia.
Methods
The I‐HOPE was trialled in one major home modification service by five occupational therapists who participated in two focus groups. Feedback using a purposefully developed questionnaire was also collected from 25 adult clients who completed the I‐HOPE. Data from the focus groups were thematically analysed, and the questionnaire responses were analysed using template analysis.
Results
The analysis revealed four themes: client experience, training and resources, suitability to major home modification practice and improvements and future use. Therapists valued the person‐focused nature of the I‐HOPE; however, there were some clinical utility issues identified including confusion of the rating scales for clients, length of time to complete the tool and the need for more training and a clearer instruction manual.
Conclusion
It is suggested that the I‐HOPE is a person‐focused and valuable tool for community occupational therapy practice in the Australian context but may not be suited to specialised major home modification services. An app or online version of the tool for client use, and the availability of training resources which are accessed online would enhance the clinical utility of the tool.
