Suchergebnisse

First published in 1982, this book defines sheltered housing, traces its development in Western society and analyses its success under variations in Great Britain. The analysis focuses on those aspects of the sheltered housing programme that had relevance to the development of housing policy in Europe and North America.

Background: Transport providers and policy makers should be guided by research evidence when
developing age-friendly transportation services. There are significant gaps in the literature regarding older
peoples' preferences for bus headways, distance to the bus stop and destinations. Therefore, the aims of
this study are to 1) quantify the preferred headways for older people, 2) quantify the preferred distance to
the bus stop for older people, and 3) list and rank the preferred destinations of older people. Methods: A
survey of community-dwelling older people in Hervey Bay and Brisbane (both in Australia) was conducted
to quantify the preferences of older people regarding headways, distance to the bus stop and destinations.
Results: One hundred participants completed the survey. The majority of older people preferred headways
of a maximum of 30 minutes during the day and hourly at other times. The preferred distance to the
bus stop was 200m or less. Preferred destinations included cross-suburban travel, leisure destinations,
shops, central business district, medical services and other towns. Conclusion: These results contrast
with usual practice and industry conventions. Transport providers and policy makers who are interested in
providing age-friendly services should attempt to meet these guidelines. They may need to consider innovative
approaches in order to meet these requirements.

This article reports on an evaluation of the Health Advisory Network (HAN) of WesternAustralia, an innovative organization consisting of consumer and provider organizations, established by the state government mainly to provide advice to the Minister for Health and the Commissioner, on the planning, policy, and administration of the state's health services. The evaluation consisted of two parts, covering case studies of issues processed and an analysis of HAN members' perceptions. The general conclusion was that the network should be continued, and that with further development, it might serve as a model for the establishment of similar networks related to the provision of public services.

Restorative home-care services, or re-ablement home-care services as they are now known in the UK, aim to assist older individuals who are experiencing difficulties in everyday living to optimise their functioning and reduce their need for ongoing home care. Until recently, the effectiveness of restorative home-care services had only been investigated in terms of singular outcomes such as length of home-care episode, admission to hospital and quality of life. This paper reports on a more complex and perhaps more significant measure – the use and cost of the home-care and healthcare services received over the 2-year period following service commencement. Seven hundred and fifty older individuals referred for government-funded home care were randomly assigned to a restorative or standard service between June 2005 and August 2007. Health and aged care service data were sourced and linked via the Western Australian Data Linkage System. Restorative clients used fewer home-care hours (mean [SD], 117.3 [129.4] vs. 191.2 [230.4]), had lower total home-care costs (AU$5570 vs. AU$8541) and were less likely to be approved for a higher level of aged care (N [%], 171 [55.2] vs. 249 [63.0]) during follow-up. They were also less likely to have presented at an emergency department (OR = 0.69, 95% CI = 0.50–0.94) or have had an unplanned hospital admission [OR (95% CI), 0.69 (0.50–0.95)]. Additionally, the aggregated health and home-care costs of the restorative clients were lower by a factor of 0.83 (95% CI 0.72–0.96) over the 2-year follow-up (AU$19,090 vs. AU$23,428). These results indicate that at a time when Australia is facing the challenges of population ageing and an expected increase in demand for health and aged care services, the provision of a restorative service when an older person is referred for home care is potentially a more cost-effective option than providing conventional home care.

Abstract Background Personal alarms support independent living and have the potential to reduce serious consequences after a fall or during a medical emergency. While some Australian states have government funded personal alarm programs, others do not; but user-pays services are available. Although several studies have examined the profiles of alarm users, little is known about the risk profile of non-users. Specifically, whether there are "at risk" individuals who are unable, or choose not to purchase a service, who experience a home-based emergency in which an alarm could have mitigated an adverse outcome. This study aimed to describe the 'risk profile' of purchasers and non-purchasers of alarms; explore the reasons behind the decision to purchase or not to purchase and identify how often emergency assistance was needed and why. Methods Purchasers and non-purchasers were followed for one year in this prospective cohort study. Demographic, decision-making and risk factor data were collected at an initial face-to-face interview, while information about emergencies was collected by monthly calls. Results One hundred and fifty-seven purchasers and sixty-five non-purchasers completed the study. The risk profiles between the groups were similar in terms of gender, living arrangements, fall history and medical conditions. Purchasers (Mean = 82.6 years) were significantly older than non-purchasers (Mean = 79.3 years), (t(220) = −3.38, p = 0.000) and more functionally dependent on the IADL (z = −2.57, p = 0.010) and ADL (z = −2.45 p = 0.014) function scores. Non-purchasers (Mean = 8.04, SD = 3.57) were more socially isolated with significantly fewer family networks than purchasers (Mean = 9.46, SD = 3.25) (t(220) = −2.86, p = 0.005). Both groups experienced similarly high numbers of emergencies, 38.2 % of purchasers and 41.5 % of non-purchasers had at least one emergency where an alarm could have assisted. Main reasons for non-purchase were: cost (77 %), limited alarm range (51 %), no need (39 %) and lack of suitable contacts (30 %). Conclusion There are older individuals who are at high risk of an emergency who are choosing, often for financial and lack of family support reasons, not to purchase a personal alarm service. Greater availability of government funded subsidy schemes would enable these individuals to access a service. Increasing the range over which alarms work could increase their appeal to a broader range of older persons living in the community. Future research should consider how .