AAG DIGITAL EVEN Oral Presentations - Australian ...

AAG Australian Association of Gerontology

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MORE THAN 250 PRESENTATIONS/DISCUSSIONS -

DIGITAL EVEN

FOR THE

Oral Presentations

54th AAG Conference – Digital Event (2021) Oral Presentation Abstracts

Page 1 of 242

Abstract Booklet

Oral Presentations

Please note there may be formatting, repagination issues due to extracting data. While AAG have made every attempt to ensure that the information contained in this booklet has been extracted accurately, AAG assumes no responsibility or liabilities for any errors or omissions. All information in this booklet is provided “as is”. The information contained in this booklet is current as at the date of the booklet and may not reflect any event or circumstances which occur after the date of this booklet. 26/11/2021


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Table of Contents

Proactively witnessing falls in older inpatients may not result in less serious fall related injuries ............................. 25

Dr Sameer Abdoolakhan1, Dr Kevin Ong2....................................................................................................................... 25 1Royal Perth Hospital, 2Armadale Kelmscott District Memorial Hospital ................................................................. 25

Association of Weight loss, Weight status, and Abdominal Obesity with all-cause Mortality in Older Adults ............ 26

Mrs Tagrid Alharbi1........................................................................................................................................................ 26 1Monash University................................................................................................................................................... 26

The Effectiveness of Technological Interventions for Addressing Social Isolation and Loneliness among Older People .................................................................................................................................................................................. 27

Dr Rachel Ambagtsheer1,2, Dr Kim Borg3, Dr Louise Townsin1, Dr Maria Alejandra Pinero De Plaza2,4, Dr Michael Lawless2,4 ....................................................................................................................................................................... 27

1Torrens University Australia, 2CRE for Frailty and Healthy Ageing, 3Monash University, 4Flinders University ....... 27

Self-Assessed Health Status, Proprioception and Falls – how are they related? ......................................................... 28

Ms Susan Antcliff1, Dr Jeremy Witchalls1, Professor Gordon Waddington1, Dr Sarah Wallwork2, Dr Marijke Welvaert3

...................................................................................................................................................................................... 28 1University Of Canberra, 2University of South Australia, 3Australian National University ........................................ 28

Measuring incidence and risk of falls – be careful what and how you ask! ................................................................ 29

Ms Susan Antcliff1, Dr Jeremy Witchalls1, Professor Gordon Waddington1, Dr Sarah Wallwork2, Dr Marijke Welvaert3

...................................................................................................................................................................................... 29 1University Of Canberra, 2University of South Australia, 3Australian National University ........................................ 29

Improving resident-focused documentation and saving nurse time: evaluation of a digital system in aged care ....... 30

Dr Kasia Bail1, A/Prof. Bernice Redley2, Professor Diane Gibson1, Eamon Merrick3, Prof. Karen Strickland1, Alicia Hind1, Prof. Catherine Paterson1, Ass/Prof. Natasha Jojo1, Bridget Smith1, Beatrice Vann4 .................................................... 30

1University Of Canberra, 2Deakin University , 3Auckland University of Technology , 4Health Care Consumers Association ................................................................................................................................................................ 30

Virtual visits: Reminiscence in residential aged care with digital mapping technologies ............................................ 31

Dr Steven Baker1, Dr Sarah Webber, Assoc Prof Jenny Waycott ................................................................................... 31 1Griffith University .................................................................................................................................................... 31

Elder Mediation: Reflections on Theory and Practice ................................................................................................. 32

Assoc Prof Lise Barry1, Ms Megan Frost2 ....................................................................................................................... 32 1Macquarie Law School, 2Relationships Australia ..................................................................................................... 32

Measuring quality of care in aged care ...................................................................................................................... 33

Assoc Prof Frances Batchelor1,2,3, Dr Christa Dang1, Ms Anabelle Peck1, Dr Steven Savvas1, Dr Anita Goh1,2, Prof Briony Dow1,2,3 .......................................................................................................................................................................... 33

1National Ageing Research Institute, 2University of Melbourne, 3Deakin University ............................................... 33


Page 3 of 242

Stroke survivors admitted to GEM wards are different to those admitted to rehabilitation wards. ........................... 34

Mrs Lucy Bell1, Mrs Ettie Ben-Shabat1, Mrs Mellisa Raymond1,2, Mr Brian Anthonisz3, Mrs Anne Holland4,5, Mrs Sze-Ee Soh6,7 ............................................................................................................................................................................. 34

1Physiotherapy Department, Alfred Health, 2College of Science, Health and Engineering, La Trobe University, 3Head of Rehabilitation Services, Alfred Health, 4Professor of Physiotherapy (Research), Monash University and Alfred Health , 5Department of Allergy, Immunology and Respiratory Medicine Central Clinical School, Monash University, 6Department of Physiotherapy, Monash University, 7Department of Epidemiology and Preventative Medicine, Monash University ................................................................................................................................... 34

Impact of emergency department length of stay on older persons' anxiety and comfort .......................................... 35

Prof Julie Considine1,2, Ms Debra Berry1,2, Professor Bodil Rasmussen1,3, Prof Alison Hutchinson1,4, Assoc Prof Helen Rawson6, Dr Peter Jordan5, Dr Maryann Street1,2 ......................................................................................................... 35

1School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 2Centre for Quality and Patient Safety Research – Eastern Health Partnership, 3Centre for Quality and Patient Safety Research – Western Health Partnership, 4Centre for Quality and Patient Safety Research – Monash Health Partnership, 5Eastern Health, 6Monash University ......................................................................... 35

Geriatric oncology in the Instagram Era: Adopting PhotoVoice to enable empowerment and shared decision making .................................................................................................................................................................................. 36

Prof Irene Blackberry1, Dr Christopher Steer2,3, Dr Tshepo Rasekaba1, Ms Kim Young1, Ms Nicole Webb2, Mr Darren Jayasuriya3, Ms Kylie Owen1, Dr Mira Kapur3 ............................................................................................................... 36

1La Trobe University, John Richards Centre, 2Border Medical Oncology and Haematology, 3UNSW ....................... 36

Building an empathic workforce using virtual reality technology ............................................................................... 37

Dr Clare Wilding1, Ms Kim Young1, Ms Caroline Cummins2, Mr Craig Bowler3, Mr Trent Dean2, Ms Elizabeth Gill2, Ms Karen Cronin2, Dr Ali Lakhani1, Prof Irene Blackberry1 ................................................................................................... 37

1La Trobe University, 2Mercy Connect, 3Valley General Hospital ............................................................................. 37

Older People's Advocacy against the backdrop of the Royal Commission and Covid-19 ............................................ 38

Dr Barbara Blundell1, Mr Craig Gear2, Ms Anna Harrington .......................................................................................... 38 1Curtin University, 2Older Persons Advocacy Network ............................................................................................. 38

In their own words: sexual health priorities of older Australians ............................................................................... 39

Mx Louise Bourchier1, Prof Meredith Temple-Smith2, Prof Jane Hocking1, Dr Susan Malta1,3 ....................................... 39 1Melbourne School of Population and Global Health, University of Melbourne, 2Department of General Practice, University of Melbourne, 3National Ageing Research Institute ................................................................................ 39

A nursing framework for early detection and management of post-operative delirium in older people .................... 40

Mrs Alera Bowden1, Professor Victoria Traynor2 ........................................................................................................... 40 1Illawarra Shoalhaven Local Health District, 2University of Wollongong .................................................................. 40

Navigating systems of care: structural burden for carers of migrants with dementia ................................................ 41

Assoc Prof Bianca Brijnath1,2,8, Dr Josefine Antoniades1,2, Dr Andrew Gilbert1,3, Dr Samantha Croy4, Dr Antonia Thodis1,5, Professor Jon Adams6, Dr Dianne Goeman7, Professor Colette Browning9,10, Professor Mike Kent2, Professor Katie Ellis2 ...................................................................................................................................................................... 41

1National Ageing Research Institute, 2Curtin University , 3La Trobe University , 4Murdoch Children’s Research Institute, 5Swinburne University of Technology, 6University of Technology Sydney, 7University of Newcastle, 8Monash University , 9Federation University , 10Australian National University ...................................................... 41


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Technology and Dementia: What does good technology look like from a carer's perspective? .................................. 42

Dr Ruth Brookman1, Dr Celia Harris1 ............................................................................................................................. 42 1Western Sydney University ..................................................................................................................................... 42

Health Equity And Wellbeing Among Older People’s Caregivers in New Zealand During COVID-19 Restrictions ........ 43

Prof Vanessa Burholt1, Dr Deborah Balmer1, Dr Rosemary Frey1, Moema Gregorzewski1, Dr John Parsons1, Dr Teuila Percival2, Rangimahora Reddy3, Dr Mary Simpson4, Dr Janine Wiles1 .......................................................................... 43

1University of Auckland, 2Moana Research, 3Rauawaawa Kaumātua Charitable Trust, 4University of Waikato ...... 43

2020: the year of living bravely .................................................................................................................................. 44

Prof Julie Byles1, Prof Deborah Loxton1 ......................................................................................................................... 44 1The University of Newcastle .................................................................................................................................... 44

I'm a gerontologist, but ... a view from the professorial to the personal .................................................................... 45

Prof Julie Byles1 .............................................................................................................................................................. 45 1The University of Newcastle .................................................................................................................................... 45

Trauma-Informed Geriatric Care to Improve Staff Skills and Reduce Patient Distress: An Interrupted-Time Series Study ......................................................................................................................................................................... 46

Dr Monica Cations1, Associate Professor Kate Laver1, Professor Maria Crotty1,2, Assoc Prof Craig Whitehead1,2 ........ 46 1Flinders University, 2Southern Adelaide Local Health Network .............................................................................. 46

Trends in Mental Health Service Utilisation by Australia’s Older Adults .................................................................... 47

Mr Jonathan David Bartholomaeus1, Mr Luke Collier1, Dr Monica Cations3, Assoc Prof Gillian Caughey2, Assoc Prof Maria Inacio2 ................................................................................................................................................................. 47

1Registry Of Senior Australians, South Australian Health and Medical Research Institute, 2Allied Health and Human Performance, University of South Australia, 3College of Education, Psychology and Social Work, Flinders University .................................................................................................................................................................................. 47

Quality and Safety Indicators for Home Care in Australia .......................................................................................... 48

Assoc Prof Gillian Caughey1,2, Ms Catherine Lang1, Dr Sarah Bray1, Assoc Prof Craig Whitehead3,4, Professor Renuka Visvanathan5,6,7, Prof Keith Evans8, Ms Megan Corlis9, Dr Victoria Cornell10, Prof Steve Wesselingh8, Assoc Prof Maria Inacio1,2 ......................................................................................................................................................................... 48

1Registry Of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), 2Allied Health and Human Performance, University of South Australia, 3Division of Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network (SALHN), 4College of Medicine and Public Health, Flinders University, 5The Queen Elizabeth Hospital, Central Adelaide Local Health Network (CALHN), 6NHMRC CRE Frailty and Ageing, University of Adelaide, 7Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, 8South Australian Health and Medical Research Institute (SAHMRI), 9Clinical and Health Sciences, University of South Australia, 10ECH Inc ......................................................................................................................................... 48

Association of the COVID-19 pandemic and stay-at-home lockdowns on mental health in Australia ......................... 49

Dr Marina Cavuoto1, Ms Jessica Nicolazzo1, Ms Alexandra Lavale1, Dr Rachel Buckley2, 3, 4, A/Prof Yen Ying Lim1, Matthew Pase1, 5 ........................................................................................................................................................... 49

1Turner Institute for Brain and Mental Health, Monash University, 2Melbourne School of Psychological Sciences, University of Melbourne, 3Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 4Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, 5Harvard T.H. Chan School of Public Health, Harvard University .............................................................. 49


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Update and validation of the Healthy Ageing Quiz .................................................................................................... 50

Dr Jessica Cecil1, Assoc Prof Frances Batchelor1, Prof Pazit Levinger1, Ms Leona Kosowicz1, Prof Briony Dow1 ........... 50 1National Ageing Research Institute ......................................................................................................................... 50

Rethinking Intersectionality in Social Gerontological Research: A Case Study ............................................................ 51

Ms Jin Chen1 .................................................................................................................................................................. 51 1Flinders University ................................................................................................................................................... 51

Evaluating the Co-Design of Age-friendly Dining: Lessons from the Dining Co. Project .............................................. 52

Ms Jin Chen1, Dr Edoardo Rosso2 ................................................................................................................................... 52 1Flinders University, 2ACH Group .............................................................................................................................. 52

“What Can You Expect At Your Age?!”: Older people’s experience of age discrimination in healthcare .................... 53

Ms. Aakriti Chhetri1, Dr Anthony Brown1, Ms. Yumi Lee2 .............................................................................................. 53 1Health Consumers NSW, 2Older Women's Network NSW ...................................................................................... 53

Maintaining active minds and bodies through online music reproduction and improvisation classes ........................ 54

Dr Anthony Chmiel ......................................................................................................................................................... 54

Opportunities for social participation in residential aged care: survey data from a Victorian, state-wide project ..... 55

Dr Samantha Clune1, Prof Deirdre Fetherstonhaugh2, Dr Jo-Anne Rayner2, Ms Linda McAuliffe2 ................................ 55 1Australian Institute Of Primary Care And Ageing, 2Australian Centre for Evidence Based Aged Care .................... 55

Social participation in residential aged care: what is most important for older people? ............................................ 56

Dr Samantha Clune1, Prof Deirdre Fetherstonhaugh, Dr Jo-Anne Rayner, Ms Linda McAuliffe .................................... 56 1Australian Institute Of Primary Care And Ageing .................................................................................................... 56

Addressing recruitment challenges: designing enjoyable and effective data collection methods. ............................. 57

Ms Kathy Constantin1 .................................................................................................................................................... 57 1Swinburne University of Technology ....................................................................................................................... 57

Re-balancing residential aged care provision: targets, trajectories, and tears ............................................................ 58

Mr Mark Cooper-Stanbury1 ........................................................................................................................................... 58 1University Of Melbourne ......................................................................................................................................... 58

The role of Australian health professionals in helping people choose their home care package services ................... 59

Dr Victoria Cornell1, Dr Braam Lowies ........................................................................................................................... 59 1ECH .......................................................................................................................................................................... 59

Point prevalence of frailty and pain in adult inpatients of an acute private hospital ................................................. 60

Dr Rosemary Saunders1, Dr Kate Crookes1, Dr Marcus Ang1,2, Dr Beverley Ewens1, Dr Olivia Gallagher1, Ms Renée Graham1, Ms Sue Haydon2, Dr Jeff Hughes3, Ms Debra Scaini2, Dr Joyce Siette1, Dr Christopher Etherton-Beer4 ........ 60

1Centre For Research In Aged Care, School Of Nursing And Midwifery, Edith Cowan University, 2Hollywood Private Hospital, 3PainChek, 4School of Medicine and Pharmacology, University of Western Australia .............................. 60

Cycling Without Age .................................................................................................................................................. 61


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1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Rowes Bay Residential Aged Care, 4Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 5Centre for Health Communication and Participation, La Trobe University, 6Southern Synergy, Department of Psychiatry at Monash Health, Monash University, 7School of Public Health & Preventive Medicine, Monash University ................................................................................................................................... 61

Digital Wallpaper ....................................................................................................................................................... 62 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Galleon Gardens Residential Aged Care .......................................................................................... 62

General practice consultations in residential aged care facilities during the COVID-19 pandemic period .................. 63

Dr Zhaoli (Joy) Dai1, Mr Guilherme S Franco1, Dr Shirmilla Datta2, Dr Precious McGuire2, Professor Andrew Georgiou1

...................................................................................................................................................................................... 63 1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, 2Eastern Melbourne Primary Health Network .......................................................................................................... 63

Reporting and resolution of complaints for people accessing aged care .................................................................... 64

Dr Christa Dang1, Ms Anabelle Peck1, Assoc Prof Frances Batchelor1,2,3, Dr Steven Savvas1,2, Dr Anita Goh1,2,4, Prof Briony Dow1,2,3,5 ............................................................................................................................................................. 64

1National Ageing Research Institute, 2University of Melbourne, 3Deakin University, 4Royal Melbourne Hospital, 5Australian Association of Gerontology .................................................................................................................... 64

What concerns do older people have about their aged care? .................................................................................... 65

Ms Anabelle Peck1, Dr Christa Dang1, Assoc Prof Frances Batchelor1,2,3, Dr Steven Savvas1,2, Dr Anita Goh1,2,4, Prof Briony Dow1,2,3,5 ............................................................................................................................................................. 65

1National Ageing Research Institute, 2The University of Melbourne, 3Deakin University, 4Royal Melbourne Hospital, 5Australian Association of Gerontology ..................................................................................................... 65

Improving the system of home care: What needs to change? .................................................................................... 66

Ms Anabelle Peck1, Dr Joan Ostaszkiewicz1, Prof Colleen Doyle1,2,3, Assoc Prof Frances Batchelor1,2,4, Dr Anita Goh1,4,5, Dr Christa Dang ............................................................................................................................................................. 66

1National Ageing Research Institute, 2Deakin University, 3Swinburne University, 4University of Melbourne, 5Royal Melbourne Hospital .................................................................................................................................................. 66

Neighbourhood living for people with dementia: Could dementia villages be the answer? ....................................... 67

Dr Nathan D'Cunha1,2, Dr Jane Thompson2, Professor Diane Gibson1, Professor Sue Kurrle2,3 ...................................... 67 1Faculty of Health, University Of Canberra, 2The Neighbourhood, Canberra, 3Faculty of Medicine and Health, University of Sydney ................................................................................................................................................. 67

What does trauma-informed aged care look like? ..................................................................................................... 68

Dr Lenore de la Perrelle1, Dr Monica Cations1, Associate Professor Tim Windsor1, Mr Nathan Klinge2 ........................ 68 1Flinders University, 2RSL Care SA ............................................................................................................................. 68

Potential for relationships and engagement with pets, wildlife and nature to support older adults’ wellbeing ......... 69

Dr Kelli Dendle ............................................................................................................................................................... 69 1QUT .......................................................................................................................................................................... 69

Fish Feeders SA. A collaborative partnership between 5 local governments in South Australia ................................. 70


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Mr Lui Di Venuto1, Mrs Debra Whetstone ..................................................................................................................... 70 1City Of Onkaparinga, 2City of Charles Sturt ............................................................................................................. 70

Integration of Elder Abuse Services within the Orange Door (Victorian Specialised Family Violence Hub) ................. 71

Mrs Jenni Dickson1 ......................................................................................................................................................... 71 1Better Place Australia .............................................................................................................................................. 71

When the cupboard's bare, we still find something there, harnessing resources to benefit older clients .................. 72

Mrs Bernadette Dimla1 .................................................................................................................................................. 72 1University Of Sunshine Coast .................................................................................................................................. 72

What next for carers following the Royal Commission into Aged Care Quality and Safety ......................................... 73

Ms Melissa Docker1, Ms Sarah Judd-Lam1 ..................................................................................................................... 73 1Carers NSW .............................................................................................................................................................. 73

Meeting growing demands on the paid care workforce by upskilling informal carers ................................................ 74

Ms Melissa Docker1, Ms Sarah Judd-Lam1 ..................................................................................................................... 74 1Carers NSW .............................................................................................................................................................. 74

Social networks, cognition and service use in long-term care .................................................................................... 75

Ms Laura Dodds1, Professor Andrew Georgiou1, Prof Johanna Westbrook1, Dr Joyce Siette1 ....................................... 75 1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation .................................. 75

A Systematic Review of Interventions to Improve Analgesic Use and Appropriateness in Residential Aged Care ...... 76

Ms Laura Dowd1, Dr Amanda Cross1, Mrs Choon Ean Ooi1, Dr Felicity Veal2, Prof John (Simon) Bell1,3 ........................ 76 1Monash University, 2University of Tasmania, 3National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing ................................................................................................... 76

End user perspectives on research and evaluation in aged care: is it time for a new model? ..................................... 77

Ms Jocelyn Small2, Prof Colleen Doyle1, Ms Bridget Howes, Dr Joan Ostaszkiewicz ...................................................... 77 1National Ageing Research Institute, 2Blue Cross ..................................................................................................... 77

Promoting evidence based aged care: Are we ready? ................................................................................................ 78

Dr Peta Drury1, Mrs Joanne Hope, Dr Kaye Rolls, Professor Victoria Traynor ............................................................... 78 1University Of Wollongong ....................................................................................................................................... 78

Psychometric properties of the assessment tools associated with discharge in general medicine: A systematic review .................................................................................................................................................................................. 79

Ms Aruska D'Souza1,2, Associate Professor Catherine Granger1,2, Ms Melanie Tomkins3, Ms Nina Leggett3, Ms Jacqueline Kay1, Associate Professor Catherine Said2,3,4 ............................................................................................... 79

1Royal Melbourne Hospital, 2University of Melbourne, 3Western Health, 4Australian Institute for Musculoskeletal Science ...................................................................................................................................................................... 79

Innovative care for older prisoners living with dementia: Perspectives of external organisations ............................. 80

Dr Sanetta Du Toit1 ........................................................................................................................................................ 80 1The University Of Sydney ........................................................................................................................................ 80

Person centred home care packages: future visions for carer recognition ................................................................. 81


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Ms Cathy Duncan1, Ms Lorraine Williams2, Dr Lukas Hofstätter3 .................................................................................. 81 1University Of Wollongong, 2Bay & Basin Community Resources, 3Carers NSW ...................................................... 81

Impact of relational continuity of primary care in aged care: a systematic review ..................................................... 82

Dr Suzanne Dyer1, Ms Jenni Suen1, Dr Helena Williams2, Assoc Prof Maria Inacio3, Professor Maria Crotty1, Assoc Prof Gillian Caughey3 ............................................................................................................................................................ 82

1Flinders Health and Medical Research Institute, Flinders University, 2Silver Chain Group, 3Registry of Senior Australians, South Australian Health and Medical Research Institute ..................................................................... 82

Factors influencing care and support for older adults with traumatic injury: A qualitative study .............................. 83

Dr Joanna Schwarzman1,2,4, Dr Aislinn Lalor1, Dr Sandra Braaf2, Associate Professor Libby Callaway1, Dr Mohammed Aburrumman1,3, Professor Belinda Gabbe2, Dr Christina Ekegren1,2 .............................................................................. 83

1School of Primary and Allied Health Care, Monash University, 2School of Public Health and Preventive Medicine, Monash University, 3Monash University Accident Research Centre (MUARC), Monash University, 4Australian Institute of Family Studies ........................................................................................................................................ 83

The challenges and opportunities of delivering a song-writing course for older adults online in 2020 ....................... 84

Assoc Prof Helen English1, Ms Cassandra Danckert, Dr Michelle Kelly, Professor Frini Karayanidis ............................. 84 1University Of Newcastle .......................................................................................................................................... 84

Digital drawing for people with dementia and their supporters ................................................................................ 85

Ms Emma Febvre-Richards1, Mr Cameron May, Ms Christelle Filleau2, Dr Alexandra König2, Dr Gary Cheung3, Ms Sarah Togher4, Ms Anne Schumacher4, Dr Susan Gee5, Ms Tracey Hawkes5 ................................................................ 85

1Massey University, 2CoBTeK (Cognition Behaviour Technology) Research Unit Université Côte d'azur Memory Clinic and Research Centre University Hospital Nice, France Institut Claude Pompidou, 3The University of Auckland, 4Dementia Wellington Charitable Trust, 5Canterbury District Health Board ........................................... 85

Predicting when an aged care service ‘fails’ its residents: How can we do this? ......................................................... 86

Prof Deirdre Fetherstonhaugh1, Prof Joseph Ibrahim2, Dr Jo-Anne Rayner1, Ms Linda McAuliffe1 ................................ 86 1La Trobe University, 2Monash University ................................................................................................................ 86

Barriers and facilitators for the provision of quality palliative care for older people: Clinicians’ perspective. ............ 87

Dr Samantha Fien1, Ms Emily Plunkett2, Assoc Prof Magnolia Cardona2,3 ..................................................................... 87 1CQUniversity, 2Gold Coast Hospital and Health Service, 3Institute for Evidence‑Based Healthcare, Bond University .................................................................................................................................................................................. 87

Human Rights in the Context of Dementia ................................................................................................................. 88

Mrs Theresa Flavin1 ....................................................................................................................................................... 88 1Opan ........................................................................................................................................................................ 88

The Song Collective: Building sustainable online music communities to support older adults wellbeing and connectedness ........................................................................................................................................................... 89

Dr Libby Flynn1, Ms Phoebe Stretton-smith1, Professor Felicity Baker1, Dr Tanara Sousa1, Dr Imogen Clark1, Assoc Prof Jenny Waycott1, Dr Katie Greenaway1, Dr Elise Kalokerinos1, Dr Peter Koval1 ............................................................. 89

1University of Melbourne ......................................................................................................................................... 89

Exploring and extending understandings of migrant ageing: A systematic review ..................................................... 90

Dr Marika Franklin1, Professor Lucy Taksa1, Professor Fei Guo1 .................................................................................... 90


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1Macquarie University .............................................................................................................................................. 90

Leveraging migrants’ ‘community cultural wealth’: An asset-based approach to migrant ageing .............................. 91

Dr Marika Franklin1, Professor Lucy Taksa1, Professor Fei Guo1 .................................................................................... 91 1Macquarie University .............................................................................................................................................. 91

Achieving active and equal co-design: Perspectives of people impacted by dementia ............................................... 92

Ms Ellen Gaffy1,2, Professor Virginia Lewis1, Dr Margaret Winbolt1, Dr Anita Goh2,3,4 .................................................. 92 1La Trobe University , 2National Ageing Research Institute, 3Melbourne Health, 4University of Melbourne ........... 92

Adapting to Adversity in Later Life through Culture ................................................................................................... 93

Ms Lena Gan1 ................................................................................................................................................................ 93 1University Of Melbourne ......................................................................................................................................... 93

Quality care: a meta-synthesis of residential aged care staffs' perspectives .............................................................. 94

Ms Stephanie Garratt1,2, Dr Andrew Gilbert1,3, Ms Leona Kosowicz1, Prof Briony Dow1,4,5, Dr Joan Ostaszkiewicz1,4 ... 94 1National Ageing Research Institute, 2The University of Auckland, School of Population Health, 3La Trobe University, 4Deakin University, School of Nursing and Midwifery, 5University of Melbourne, School of Population and Global Health ..................................................................................................................................................... 94

Predicting death – Training hospital assessment teams to identify patients nearing the end-of-life .......................... 95

Dr Katrin Gerber1, Dr Paul Yates, Dr Barbara Hayes, Ms Carol Perich, Dr Cik Lee, Dr Sarah Berriman, Mrs Karen Bodna, Mrs Jo-Anne Slee, Ms Joanne Tropea, Ms Kayla Lock, A/Prof Melissa Bloomer ........................................................... 95

1National Ageing Research Institute ......................................................................................................................... 95

‘Unprepared for the depth of my feelings’ – Capturing grief through research poetry ............................................... 96

Dr Katrin Gerber1, Dr Lidia Engel, Dr Larissa Hjorth, Ms Kayla Lock, Dr Terence Chong, Mrs Mary O'Mara, Mr Andre Catrice, Dr Kaoiri Shimoinaba, A/Prof Christina Bryant, Mrs Sarah O'Leary, Mrs Primrose White, Dr Samantha Loi, Assoc Prof Danny Hills, Assoc Prof Bianca Brijnath ....................................................................................................... 96

1National Ageing Research Institute ......................................................................................................................... 96

Uncovering gender and cultural and linguistic diversity as drivers of ageing complexity ........................................... 97

Ms Mary Ann Geronimo1 ............................................................................................................................................... 97 1Federation of Ethnic Communities' Councils of Australia ....................................................................................... 97

Approaches to navigation and evaluation: using community development principles in CALD contexts ................... 98

Ms Mary Ann Geronimo1 ............................................................................................................................................... 98 1Federation of Ethnic Communities' Councils of Australia ....................................................................................... 98

Emotional vigilance of ethnic minority families of people living with dementia ........................................................ 99

Dr Josefine Antoniades1,3, Dr Andrew Gilbert1,2, Dr Samantha Croy5, Assoc Prof Bianca Brijnath1,3,4 ........................... 99 1National Ageing Research Institute, 2La Trobe University , 3Curtin University , 4Monash University, 5Murdoch Children's Research Institute .................................................................................................................................... 99

COVID-19 and elder abuse ....................................................................................................................................... 100

Ms Anna Gillbard1 ........................................................................................................................................................ 100 1Unitingcare ............................................................................................................................................................ 100


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Elder abuse data collection: learning and strategies ............................................................................................... 101

Ms Anna Gillbard1 ........................................................................................................................................................ 101 1UnitingCare ............................................................................................................................................................ 101

Improving the health and wellbeing of older LGBTQ people: supported by the City of Sydney. ............................... 102

Mr Russ Gluyas1 ........................................................................................................................................................... 102 1ACON ..................................................................................................................................................................... 102

Home care worker perspectives on online delivery of training programs and the effects of COVID-19 .................... 103

Dr Anita Goh1,2, Prof Colleen Doyle1, Professor David Ames1,2, Dr Margaret Winbolt3, Dr Steven Savvas1,8, Dr Susan Malta2, Professor Philip Clarke2, Dr Anita Panayiotou1, Professor Claudia Cooper4, Professor Gill Livingston4, Professor Constantine Lyketsos5, Assoc Prof Frances Batchelor1, Mr Jason Burton6, Prof Lee Fay Low7, Associate Professor Samuel Scherer8, Dr Samantha Loi2, Ms Erica Wise1, Ms Esther Tan1, Ms Ellen Gaffy1, Ms Anne Fairhall9, Prof Briony Dow1,2 .......................................................................................................................................................................... 103

1National Ageing Research Institute, 2The University of Melbourne, 3La Trobe University, 4Division of Psychiatry, University College London, 5Johns Hopkins University, 6Alzheimer’s WA, 7University of Sydney, 8Royal Freemasons, 9Family carer; Project advisory group chair ....................................................................................... 103

The Royal Commission, budget, and dementia research and care............................................................................ 104

Dr Anita Goh1, Prof Pazit Levinger1, Prof Colleen Doyle1, Dr Steven Savvas1, Assoc Prof Frances Batchelor1, Ms Erica Wise1, Ms Esther Tan1, Ms Ellen Gaffy1, Mr Jeremy Dunn1, Prof Briony Dow1 ............................................................ 104

1National Ageing Research Institute ....................................................................................................................... 104

Let’s Dig In! .............................................................................................................................................................. 105 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Inverpine Residential Aged Care, 4School of Public Health & Preventive Medicine, Monash University ................................................................................................................................................................ 105

Exploring participant experience in life story work .................................................................................................. 106 1Bolton Clarke ......................................................................................................................................................... 106

Sensory Impairment and Successful Ageing in Older Adults Over Five Years ........................................................... 107

Prof Bamini Gopinath1, Prof Catherine McMahon, Prof Paul Mitchell ........................................................................ 107 1Macquarie University ............................................................................................................................................ 107

Codesigning a holistic program to prevent or alleviate the effects of frailty ............................................................ 108 1Bolton Clarke, 2Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 3Centre for Health Communication and Participation, La Trobe University, 4School of Nursing and Midwifery, Centre for Quality and Safety, Institute for Health Transformation, Deakin University, 5Centre for Quality and Safety Research Monash Health , 6Cabrini Health, 7School of Public Health & Preventive Medicine, Monash University, Alfred Hospital, 8Faculty of Health and Behavioural Sciences, The University of Queensland .............................. 108

Co-designing and implementing community approaches: learnings from POWER and Being your Best projects. .... 109

Dr Maja Green1, Dr Rajna Ogrin1, Professor Judy Lowthian1 ....................................................................................... 109 1Bolton Clarke ......................................................................................................................................................... 109

Wisdom Project Australia (WPA): An innovative wellbeing program ....................................................................... 110

Ms Gail Green1 ............................................................................................................................................................. 110


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1Wisdom Project Australia ...................................................................................................................................... 110

Connect Online- Supporting CHSP consumers engaging in Technology .................................................................... 111

Mr Nathan Hall1........................................................................................................................................................... 111 1Baptistcare Nsw/ ACT at home .............................................................................................................................. 111

Innovative Ways of Promoting Cognitive and Social Engagement for Older Adults: From Research to Practice ....... 112

Dr Celia Harris1 ............................................................................................................................................................ 112 1The Marcs Institute, Western Sydney University .................................................................................................. 112

Can we enhance video calls between grandparents and young grandchildren? ....................................................... 113

Professor Paola Escudera1, Dr Celia Harris1 ................................................................................................................. 113 1The Marcs Institute, Western Sydney University .................................................................................................. 113

Using Elaborative Reminiscing to Support Memory and Relationships in Residential Aged Care ............................. 114

Dr Celia Harris, Penny Van Bergen, Gabrielle Picard, Paul Strutt ................................................................................ 114

Dance for Thriving! - a successful intervention case study ....................................................................................... 115

Ms Gail Hewton1, Ms Julie Chenery1 ............................................................................................................................ 115 1Gold Moves Australia ............................................................................................................................................ 115

Residual impairments and recurrence following repositioning procedures for older people with Benign Paroxysmal Positional Vertigo. ................................................................................................................................................... 116

Professor Keith Hill1, Mrs Eyvonne Sim3, Associate Professor Dawn Tan2,4, Dr Yong Hao Pua2 ................................... 116 1Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, 2Singapore General Hospital, 3Curtin University, 4Singapore Institute of Technology ........................................................................... 116

A meta-analysis of factors impacting care and counterproductive work behaviours in aged care and hospitals. ..... 117

Ms Batoul Hodroj1, Dr Kïrsten Way, Dr Theresa Scott, Ms Asmita Manchha, Professor April Wright ........................ 117 1University of Queensland ...................................................................................................................................... 117

Loneliness among carers of older people: An analysis of Social Connectedness, Recognition, Wellbeing and Distress ................................................................................................................................................................................ 118

Dr Lukas Hofstaetter1, A/Prof Hugh Bainbridge2.......................................................................................................... 118 1Carers NSW, 2UNSW .............................................................................................................................................. 118

“I'm extremely worried about the future”: A qualitative analysis of older carers’ anticipated care endings ............ 119

Dr Lukas Hofstaetter1, A/Prof Emma Kirby2, Ms Giselle Newton2, A/Prof Christy Newman2, Ms Sarah Judd-Lam1 .... 119 1Carers Nsw, 2UNSW ............................................................................................................................................... 119

The impact of COVID-19 on LGBTIQ+ older people: concerns and improvements .................................................... 120

Prof Mark Hughes1, Dr Trevor Gates2, Dr Tinashe Dune3, Mx Jack Thepsourinthone3 ................................................ 120 1Southern Cross University, 2Colorado State University - Pueblo, 3Western Sydney University ............................ 120

Methodology for developing a best-practice guide for dementia in Aboriginal and Torres Strait Islander communities ................................................................................................................................................................................ 121


Page 12 of 242

Dr Jo-anne Hughson1, Mr Harold Douglas1, Dr Mary Belfrage2, Professor Dawn Bessarab3, Prof Dimity Pond4, Prof David Atkinson3, Associate Professor Dina LoGiudice1,5 .............................................................................................. 121

1University Of Melbourne, 2Royal Australian College of General Practitioners, 3University of Western Australia, 4University of Newcastle, 5Melbourne Health ........................................................................................................ 121

Implementing a comprehensive nutrition and dining experience program to reduce malnutrition in aged care homes ................................................................................................................................................................................ 122

Ms Angela Malberg1, Dr Cherie Hugo1, Ms Loretta Reiken2 ........................................................................................ 122 1The Lantern Project, 2Dignity in Dining ................................................................................................................. 122

Building and Sustaining a Community of Practice in Aged Care Nutrition and Dining Experience ............................ 123

Ms Angela Malberg1, Dr Cherie Hugo1, Nick Ryan2 ..................................................................................................... 123 1The Lantern Project, 2Lutheran Services ............................................................................................................... 123

Countering Cultural Bias in Ageing Research Methods ............................................................................................. 124

Ms Aliza Hunt1, Prof Philip Batterham1, Prof Zachary Steel2 ....................................................................................... 124 1Australian National University, 2UNSW ................................................................................................................. 124

The Australian public and the aged care system: attitudes towards care quality and future funding ....................... 125

Dr Claire Hutchinson1, Professor Julie Ratcliffe1, Mr Matthew Crocker1, Dr Sheela Kumaran1, Dr Rachel Milte1, Dr Jyoti Khadka1 ....................................................................................................................................................................... 125

1Flinders University ................................................................................................................................................. 125

'Traffic-light approach’: supporting older people and service provider participation in the development of the QOL-ACC .......................................................................................................................................................................... 126

Dr Claire Hutchinson1, Professor Julie Ratcliffe1, Ms Jenny Cleland1, Associate Professor Ruth Walker1, Dr Rachel Milte1, Dr Candice McBain2, Ms Megan Corlis3, Dr Victoria Cornell4, Dr Jyoti Khadka1 .............................................. 126

1Flinders University, 2University of Sydney, 3Australian Nursing and Midwifery Federation SA, 4ECH .................. 126

Making Australian clinical guidelines ageing-friendly: some considerations for improvements ............................... 127

Mr Kerry Hwang1,2, Dr Kirsten Moore1,5, Dr Terence Chong2,3, Ms. Sue Williams1, Assoc Prof Frances Batchelor1,2,4 . 127 1National Ageing Research Institute, 2University of Melbourne, 3St Vincent's Hospital, 4Deakin University, 5Division of Psychiatry, University College London ............................................................................................................... 127

Measuring the factors affecting healthcare barriers in older culturally and linguistically diverse Australians .......... 128

Mr Kerry Hwang1,2, Assoc Prof Bianca Brijnath1,4, Associate Professor Dina LoGiudice2,3, Associate Professor Jeromey Temple2 ....................................................................................................................................................................... 128

1National Ageing Research Institute, 2University of Melbourne, 3Melbourne Health, 4Curtin University ............. 128

Artist’s Perspective of Personalised Music Therapy in Dementia care: a Data Analysis ............................................ 129

Ms Bronte Hyams1, Dr Vivian Issac1 ............................................................................................................................ 129 1Flinders University ................................................................................................................................................. 129

ROSA: Big Data Guiding Evidence-Based Change in Aged Care ................................................................................. 130

Assoc Prof Maria Inacio1, Assoc Prof Gillian Caughey1, Dr Sarah Bray1, Ms Catherine Lang1, Assoc Prof Craig Whitehead2,3, Professor Renuka Visvanathan4,5,6, Ms Liddy Griffith7, Prof Keith Evans7, Ms Marilyn von Thien1, Ms Penelope Lello1, Prof Steve Wesselingh7 ..................................................................................................................... 130


Page 13 of 242

1Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), 2Southern Adelaide Local Health Network (SALHN), 3Flinders University, 4The Queen Elizabeth Hospital, Central Adelaide Local Health Network (CALHN), 5NHMRC CRE Frailty and Ageing, University of Adelaide, 6Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre , 7South Australian Health and Medical Research Institute (SAHMRI) .................................................................................................................................................. 130

Sharing the experience of participating in a co-design project: a senior perspective ............................................... 131

Sue Izatt, Mrs Nadine Veerhuis, Professor Victoria Traynor ........................................................................................ 131

Muscle Strengthening And Cardiovascular Fitness Activities For Poliomyelitis Survivors: A Systematic Review And Meta-Analysis .......................................................................................................................................................... 132

Dr Timothy Lathlean1, Mr Akhilesh K Ramachandran, Dr Stephen PJ Goodman, Mr Michael KJ Jackson ................... 132 1The University Of Adelaide, 2The University of New England ............................................................................... 132

Clinical staff perspectives on sedentary behaviour and physical activity in hospitalised older adults ...................... 133

Mr Unyime Jasper1, Professor Renuka Visvanathan1,2,3, Dr Agathe Daria Jadczak1,2,3, Associate Professor Solomon Yu1,2,3, Dr Joanne Dollard1,2,3 ....................................................................................................................................... 133

1Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia, 2National Health and Medical Research Council Centre of Research Excellence: Frailty Trans-Disciplinary Research to Achieve Healthy Ageing, University of Adelaide, Adelaide, SA, Australia. , 3Basil Hetzel Institute and Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia ................................. 133

A Longitudinal Study of the Prevalence and Predictors of Older Persons’ Computer Use: ALSOP Cohort ................. 134

Ms Tara Johnson1, Dr Mojtaba Lotfaliany1, Dr Natalie Hyde1, Dr Lesley Berk1, A. Prof. Mohammed Abdelrazek1, Prof. Micheal Berk1, Prof. Sharon Brennan-Olsen1, Dr Mohammadreza Mohebbi1, Prof. John McNeil3, Ms Carlene Britt3, Prof. Elsdon Storey3, A. Prof Robyn Woods3, Prof. Mark Nelson4, A. Prof. Raj Shah5, A. Prof. Lars Kayser2, Dr Sarah Hosking1 ...................................................................................................................................................................... 134

1Deakin University, 2University of Copenhagen, 3Monash University, 4University of Tasmania, 5Rush University 134

Advance Personal Planning: Proactively Preparing for the Rest-of-Life, Not End-of-Life .......................................... 135

Ms Briony Johnston1 .................................................................................................................................................... 135 1University of Technology Sydney .......................................................................................................................... 135

Enhanced Palliative Care at Home: Evaluating community-based generalist palliative care .................................... 136

Ms Georgina Johnstone1, Ms Janeen Cato2, Professor Judy Lowthian1 ....................................................................... 136 1Bolton Clarke Research Institute, 2Bolton Clarke .................................................................................................. 136

A total approach to dementia care using the Namaste Care program ...................................................................... 137

Dr Sara Karacsony1, Dr Melissa Abela1, Dr Claire Eccleston1 ....................................................................................... 137 1University Of Tasmania, School of Nursing ........................................................................................................... 137

LGBTQI ageing and the implications of past trauma on care .................................................................................... 138

Ms Robyn Kennedy1 ..................................................................................................................................................... 138 1InterPride ............................................................................................................................................................... 138

Preventing violent death in older Australians using the perspective of 15 years of data.......................................... 139

Ms Briohny Kennedy1 ................................................................................................................................................... 139


Page 14 of 242

1Monash University................................................................................................................................................. 139

Why is there a mismatch between ideal and actual practice in a GEM unit? ............................................................ 140

Mrs Farnaz Khoshmanesh1, Professor Yvonne Wells2, Associate Professor Tracy Fortune3, Dr Tamara Tse4.............. 140 1Occupational Therapy, Social Work and Social Policy, La Trobe University, 2Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, 3Occupational Therapy, Social Work and Social Policy, La Trobe University, 4Occupational Therapy, Social Work and Social Policy, La Trobe University .......................................................... 140

Socio-Economic Position across the Life Course and Disability Free Life Expectancy Trends in Australia .................. 141

Dr Richard Tawiah1, Prof Kaarin Anstey1, Professor Carol Jagger3, Dr Kim Kiely2 ....................................................... 141 1UNSW, 2NeuRA, 3Newcastle University ................................................................................................................. 141

Collaborations at the local level for ending ageism:local government, services and initiatives, and EveryAGE Counts ................................................................................................................................................................................ 142

Dr Marlene Krasovitsky, Mr Joel Pringle ...................................................................................................................... 142 1The Benevolent Society, 2EveryAGE Counts .......................................................................................................... 142

Radio relationships and well-being in older age ....................................................................................................... 143

Dr Amanda Krause1, Dr Heather Fletcher2 ................................................................................................................... 143 1James Cook University, 2The University of Melbourne ......................................................................................... 143

Emotions, singing, and well-being ............................................................................................................................ 144

Prof Jane Davidson2, Dr Amanda Krause1 .................................................................................................................... 144 1James Cook University, 2The University of Melbourne ......................................................................................... 144

Implementing Shared Decision Making in Outpatient Perioperative care: Perioperative care for Older People undergoing Surgery.................................................................................................................................................. 145

Dr Rajni Lal1, Dr Ramai Santhirapala, Dr Judith Partridge, Dr Jugdeep Dhesi ............................................................. 145 1Ryde Hospital, NSLHD ............................................................................................................................................ 145

Recruitment barriers and enablers for an Aboriginal Health Practitioner led dementia prevention program .......... 146

Mr Alex Lalovic1, Mrs Lesley Markey1, Ms Deanne Lewis1, Ms Glennette Dowden1, Associate Professor Kay Cox1, Mr Michael Bynder1, Ms Maureen Merritt1, Ms Tania Kelly1, Mr Samuel Bulten1, Professor Leon Flicker1, Professor Sandra Thompson1, Dr Rachel Milte2, Professor Dawn Bessarab1, Associate Professor Carmela Pestell1, Professor Keith Hill3, Associate Professor Dina LoGiudice4, Dr Christopher Etherton-Beer1, Dr Kate Smith1 .............................. 146

1University Of Western Australia, 2Flinders University, 3Monash University, 4University of Melbourne ............... 146

Relevance and cultural appropriateness of cognitive reserve measures in Aboriginal and Torres Strait Islander communities ............................................................................................................................................................ 147

Dr Louise Lavrencic1,2, Dr Holly Mack1,3, Mr Terrence Donovan1, Ms Gail Daylight1, Dr Wendy Allan1, Prof Brian Draper1,4, Prof G. A. (Tony) Broe1,2, Prof Kim Delbaere1,2, Dr Kylie Radford1,2 ............................................................. 147

1Neuroscience Research Australia, 2University of New South Wales, 3University of Technology Sydney, 4Prince of Wales Hospital ........................................................................................................................................................ 147

Discourses relating to people living with dementia, carers, and their socio-spatial rights. ....................................... 148

Ms Carmela Leone1, Prof Irene Blackberry, Dr Rachel Winterton ............................................................................... 148 1La Trobe University ................................................................................................................................................ 148


Page 15 of 242

Physical activity during COVID19 - results from the ENJOY Seniors Exercise Park project ........................................ 149

Prof Pazit Levinger1, Mr Jeremy Dunn1, Dr Maya Panisset1, Prof Briony Dow1, Assoc Prof Frances Batchelor1, Professor Keith Hill2 ..................................................................................................................................................................... 149

1National Ageing Research Institute, 2Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University .................................................................................................................................................. 149

Frailty within the Indigenous landscape ................................................................................................................... 150

Ms Ebony Lewis1, Ms Leanne Howard1, Assoc Prof Magnolia Cardona2, Dr Kylie Radford3, Dr Adrienne Withall1, Mr Adam Howie1, Professor Kenneth Rockwood4, Associate Professor Ruth Peters3 ....................................................... 150

1University of New South Wales, 2Bond University , 3Neuroscience Research Australia, 4Dalhousie University ... 150

A case study exploration of 24-hour functional care quality provided to older hospitalised medical patients ......... 151

Dr Lenore Ley1, Emeritus Professor Maxine Duke1, Emeritus Professor Mari Botti1 .................................................... 151 1Deakin University .................................................................................................................................................. 151

Examining the relationship between childhood adversity and mental health in older adults .................................. 152

Mr James Lian1,2, Dr Kim Kiely1,2, Prof Kaarin Anstey1,2 ............................................................................................... 152 1University of New South Wales, 2Neuroscience Research Australia (NeuRA) ....................................................... 152

FRAIL-NH for Frailty Screening in Aged Care: A Systematic Review .......................................................................... 153

Ms Shin Liau1,2, Ms Laura Dowd1, Dr Samanta Lalic1,3, Professor Renuka Visvanathan2,4, Prof John (Simon) Bell1,2 .. 153 1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 2National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, 3Pharmacy Department, Monash Health, 4Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide ........ 153

The impact of coronavirus restrictions on older people and their carers in Australia -future implications ............... 154

Dr Katarzyna Lion1, Professor Wendy Moyle1,2, Dr Monica Cations3, Dr Lihui Pu1,2, Sally Day3, Ms Jenny Murfield1,2, Professor Mark Gabbay4,5, Dr Clarissa Giebel4,5 .......................................................................................................... 154

1Menzies Health Institute Queensland, Griffith University, 2School of Nursing and Midwifery, Griffith University, 3College of Education, Psychology and Social Work, Flinders University, 4Department of Primary Care and Mental Health, University of Liverpool, 5NIHR ARC NWC ................................................................................................... 154

Negotiating balance of cultures among Chinese Australians to facilitate ageing well .............................................. 155

Assoc Prof Shuang Liu1 ................................................................................................................................................ 155 1U Of Queensland ................................................................................................................................................... 155

Understanding linguistic discordance in Residential Aged Care ............................................................................... 156

Dr Katrina Long1, Dr Shiva Vasi2, Dr Jim Hlavac3, Miss Marlene de Bruin1, Dr Joanne Enticott2,4, Mr Rob Macindoe5, Professor Terry Haines1 ............................................................................................................................................... 156

1School of Primary and Allied Health Care, Monash University, 2Department of Psychiatry, School of Clinical Sciences, Monash University, 3School of Languages, Literatures, Cultures and Linguistics, Monash University, 4Monash Centre for Health Research and Implementation, 5SEHCP Inc. (t/a enliven) .......................................... 156

ED visits by aged care residents with limited English proficiency ............................................................................. 157

Dr Katrina Long1, Professor Terry Haines1, Ms Sharon Clifford2, Professor Suresh Sundram3,4, Professor Velandai Srikanth5,6, Mr Rob Macindoe7, Ms Wing-Yin Leung8,9, Dr Jim Hlavac10, Dr Joanne Enticott3,11 ................................. 157


Page 16 of 242

1School of Primary and Allied Health Care, Monash University, 2Department of General Practice, School of Public Health and Preventive Medicine, Monash University, 3Department of Psychiatry, School of Clinical Sciences, Monash University, 4Monash Health, 5Peninsula Clinical School, Central Clinical School, Monash University, 6Peninsula Health, 7SEHCP Inc. (t/a enliven), 8Swinburne University of Technology, 9National Ageing Research Institute, 10School of Languages, Literatures, Cultures and Linguistics, Monash University, 11Monash Centre for Health Research and Implementation .................................................................................................................... 157

Non-dietary factors influencing dietary inflammatory index scores in community-dwelling older adults in the ACT 158

Ms Elizabeth Low, Assoc Prof Nenad Naumovski, Assoc Prof Stephen Isbel, Dr Nathan D'Cunha, Assoc Prof Rachel Bacon, Dr Jane Kellett ................................................................................................................................................. 158

1University Of Canberra .......................................................................................................................................... 158

Living well in residential aged care homes: Supporting meaningful activity for residents ........................................ 159

Assoc Prof Elizabeth Cyarto1,2 ...................................................................................................................................... 159 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland . 159

Why re-engage with work as mentors? The motivations of post-retirement age workers and meaningful work. .... 160

Dr Jennifer Luke1 .......................................................................................................................................................... 160 1University Of Southern Queensland ...................................................................................................................... 160

Online Deliberative Democracy to develop recommendations for an approach to reporting missing persons with dementia ................................................................................................................................................................. 161

Assoc Prof Margie MacAndrew1, Mr Dubhglas Taylor, Senior Sergeant Jim Whitehead2, Mr John Quinn, Professor Elizabeth Beattie1, Ms Katy Wyles1 ............................................................................................................................. 161

1Queensland University of Technology, 2Queensland Police .................................................................................. 161

Barriers and facilitators to cognitive screening of older adults in rural health services ............................................ 162

Dr Sean Macdermott1, Dr Rebecca Mckechnie2, Kayla Royals3, Prof Irene Blackberry2 .............................................. 162 1La Trobe University, 2La Trobe University, 3La Trobe University ........................................................................... 162

Researching aged care during Covid: Adapting to the unexpected ........................................................................... 163

Mr Sean Mack1 ............................................................................................................................................................ 163 1Charles Sturt University ......................................................................................................................................... 163

Realising research outcomes using PAR in the Art Centres: Supporting our Elders study ......................................... 164

Ms Paulene Mackell1,2, Ms Kathryn Squires1, Dr Jessica Cecil1, Dr Scott Fraser1, Assoc Prof Frances Batchelor1, Prof Briony Dow1, Dr Maree Meredith4, Ms Michelle Young5, Ms Lynley Nargoodah6, Dr Chrischona Schmidt7 ............... 164

1National Ageing Research Institute, 2RMIT University, 3Western Australia Centre for Health and Ageing, 4Poche Centre for Indigenous Health, 5NPY Women's Council, 6Mangkaja Arts Resource Agency, 7Ikuntji Artists ........... 164

Stigmatising discourses in the context of the Australian royal commission into aged care ...................................... 165

Ms Asmita Manchha1, Dr Ken Tann1, Dr Kïrsten Way1, Dr Michael Thai1 .................................................................... 165 1University Of Queensland ...................................................................................................................................... 165

Exploring the acceptability and viability of CCTV in aged care: SA Health CCTV Pilot ............................................... 166

Mrs Cassie Mason1 ...................................................................................................................................................... 166 1SA Health ............................................................................................................................................................... 166


Page 17 of 242

Intervening in resident intimate relationships: staff perspectives ........................................................................... 167

Ms Linda McAuliffe1, Prof Deirdre Fetherstonhaugh1, Dr Maggie Syme2 .................................................................... 167 1Australian Centre For Evidence Based Aged Care (ACEBAC), La Trobe University, 2Kansas State University ....... 167

Mindfulness-based art therapy reduces anxiety and increases happiness in older adults living in residential care .. 168

Dr Louise Horstmanshof1, Ms Sandra McKenny1, Dr Louise Horstmanshof2 ................................................................ 168 1Northern Rivers Psychology, 2Southern Cross University ...................................................................................... 168

Pragmatic implementation of the ‘Enabling Choices’ conversation tool: lessons from the field ............................... 169

Dr Claudia Meyer1,2,3, Dr Marissa Dickins1,4, Ms Kylie Hall1, Ms Louise Davison1, Ms Fiona MacRae1 ........................ 169 1Bolton Clarke, 2Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 3Centre for Health Communication and Participation, Latrobe University, 4Southern Synergy, Department of Psychiatry, Monash University .................................................................................................................................................. 169

'Circuit breaker': Critical interim support for community-dwelling older people without access to aged care services ................................................................................................................................................................................ 170

Dr Amber Mills1,2.......................................................................................................................................................... 170 1Brotherhood of St Laurence, 2Monash University ................................................................................................. 170

Mental wellbeing in people with dementia: A clinician's perspective ...................................................................... 171

Dr Leander Mitchell1 .................................................................................................................................................... 171 1The University Of Queensland ............................................................................................................................... 171

Governance, operations and consumer perspectives of the aged care reform impact on residential care delivery.. 172

Ms Cathy Monro1, Associate Professor Lynette Mackenzie, Associate Professor Kate O'Loughlin, Dr Sanetta Du Toit .................................................................................................................................................................................... 172

1The University Of Sydney ...................................................................................................................................... 172

Identifying mechanisms of change within a multisystem collaboration to improve the lives of older people .......... 173

Dr Kirsten Moore1,2, Professor Emeritus David Dunt3, Ms Susan Williams1, Dr Katrin Gerber1, Ms Debra O'Connor1 173 1Melbourne Ageing Research Collaboration, National Ageing Research Institute, 2Division of Psychiatry, UCL, 3School of Population and Global Health, The University of Melbourne ............................................................... 173

Homely, but not home: The spiritual meaning of ‘home’ for residents living in aged care ....................................... 174

Ms Sally Mordike1 ........................................................................................................................................................ 174 1Charles Sturt University ......................................................................................................................................... 174

Exploring the role of compassion in the psychological health of family carers of older adults ................................. 175

Ms Jenny Murfield1, Professor Wendy Moyle1, Professor Analise O'Donovan2, Professor Robert Ware3 ................... 175 1Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, 2Griffith Health Group, Griffith University, 3Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University ................................................................................................................................................................ 175

Sleep and brain health ............................................................................................................................................. 176

Ms Tergel Namsrai1, Mr Ananthan Ambikairajah1, Mr Nicolas Cherbuin1 .................................................................. 176 1Centre for Research on Ageing, Health and Wellbeing, Australian National University ....................................... 176


Page 18 of 242

Opportunities for improvement of international public policy for falls prevention in the community setting - a content evaluation of policy documents .................................................................................................................. 177

Ms Aleksandra Natora1, Jennie Oxley1, Terry Haines2, Linda Barclay3, Kelvin Taylor1, Bruce Bolam4, Milica Markovic5

.................................................................................................................................................................................... 177 1Monash University Accident Research Centre (MUARC), 2Monash University, School of Primary and Allied Health Care, 3Monash University, Department of Occupational Therapy, 4Bendigo Health, 5Department of Health ....... 177

Development of an evidence-informed education program teaching older drivers to use advanced vehicle technology ............................................................................................................................................................... 178

Mr Nicholas Neville1, Dr Kristy Coxon1, Professor Karen Liu1, Associate Professor Andy Cheng4, Professor Lisa Keay2, Associate Professor Julie Brown3 ................................................................................................................................. 178

1Western Sydney University, 2UNSW Aging Futures Institute, 3The George Institute for Global Health, 4The Hong Kong Polytechnic University ................................................................................................................................... 178

“Train Your Brain” for Cognitive Gain? A Systematic Review and Meta-Analysis of Commercial Brain-Training Programs ................................................................................................................................................................. 179

Ms Lan Nguyen1, Dr Karen Murphy1, Assoc Prof Glenda Andrews1 ............................................................................. 179 1Griffith University .................................................................................................................................................. 179

Advance Care Planning Australia: engaging communities ........................................................................................ 180

Ms Linda Nolte1, Loretta Walshe1................................................................................................................................ 180 1Advance Care Planning Australia ........................................................................................................................... 180

Assessing Reach and Influence of the Melbourne Ageing Research Collaboration (MARC) using Social Network Analysis ................................................................................................................................................................... 181

Ms Debra O'Connor1, Ms Susan Williams1, Dr Kirsten Moore1, Ms Sarah Carr1, Dr Peter Carswell2 ........................... 181 1Melbourne Ageing Research Collaboration National Ageing Research Institute, 2Synergia ................................. 181

AoP@Home for community-dwelling people living with dementia: steps to implementation ................................. 182

Dr Claire O'Connor1,2, A/Prof Roslyn G Poulos1,2, Ms Michelle Heldon1, Ms Linda Barclay1, Professor Elizabeth Beattie3, Professor Christopher J Poulos1,2 ................................................................................................................................. 182

1HammondCare, 2University of New South Wales, 3Queensland University of Technology .................................. 182

The importance of social connection: first steps in the journey through the Older Women Living Alone project. .... 183 1Bolton Clarke ......................................................................................................................................................... 183

Evolution of a community-wide approach to support wellbeing of older people through Connecting Communities to Care. ........................................................................................................................................................................ 184

1Bolton Clarke ......................................................................................................................................................... 184

Final step: taking learnings from an existing UK model to form Connecting Communities to Care. .......................... 185

Dr Rajna Ogrin1, Dr Maja Green1, Professor Judy Lowthian1 ....................................................................................... 185 1Bolton Clarke ......................................................................................................................................................... 185

Isolation in residential aged care during COVID: An ethical analysis ........................................................................ 186

Dr Maria O'Reilly1, Dr Rebecca Davis2, Prof Cheryl Monturo3, Dr Diana Sturdevant4 .................................................. 186 1CQUniversity, 2Grand Valley State University, 3West Chester University of Pennsylvania, 4University Of Oklahoma Health Sciences Center ........................................................................................................................................... 186


Page 19 of 242

A luxury we can’t afford? Injecting evidence based practice into aged care following the Royal Commission ......... 187

Dr Joan Ostaszkiewicz1 ................................................................................................................................................ 187 1National Ageing Research Institute ....................................................................................................................... 187

Working differently to integrate social and clinical aged care .................................................................................. 188

Dr Joan Ostaszkiewicz1 ................................................................................................................................................ 188 1National Ageing Research Institute ....................................................................................................................... 188

Co-designing a best practice model of continence care in residential aged care ...................................................... 189

Dr Joan Ostaszkiewicz1, Dr Jessica Cecil1, Ms Leona Kosowicz1, Ms Erica Wise1, Prof Briony Dow1 ............................ 189 1National Ageing Research Institute ....................................................................................................................... 189

Caring for Spirit Online Training for Aboriginal and Torres Strait Islander People Living with Dementia .................. 190

Mrs Lauren Poulos1, Ms Eliza Pross2, Dr Kylie Radford1 ............................................................................................... 190 1Neura, 2Ochre and Salt .......................................................................................................................................... 190

Identifying dementia risk in Parkinson’s disease: using data-driven cognitive subtyping to develop a neuroimaging biomarker ................................................................................................................................................................ 191

Ms Dana Pourzinal1, Dr Jihyun Yang1, Prof Gerard Byrne1, A/Prof John O'Sullivan2, Prof Katie McMahon3, Dr Leander Mitchell4, Dr Nadeeka Dissanayaka1,2,4 ....................................................................................................................... 191

1University Of Queensland Centre For Clinical Research, 2Royal Brisbane and Women's Hospital, 3Queensland University of Technology, 4The University of Queensland ..................................................................................... 191

Grassroots movements to end ageism ..................................................................................................................... 192

Mr Joel Pringle1 ............................................................................................................................................................ 192 1The Benevolent Society / Everyage Counts ........................................................................................................... 192

Can technologies better support people living with dementia and chronic pain? .................................................... 193

Dr Lihui Pu1, Professor Wendy Moyle1,2 ....................................................................................................................... 193 1Menzies Health Institute Queensland, Griffith University, 2School of Nursing and Midwifery, Griffith University ................................................................................................................................................................................ 193

Knowledge, confidence, attitudes & beliefs of Physiotherapists in working with people living with dementia ........ 194

Mr Stephen Quick, Dr David Snowdon1,2, Dr Katherine Lawler3, Prof Jennifer McGinley4, Mrs Sze-Ee Soh5,6, A/Prof Michele Callisaya1,2,7 ................................................................................................................................................... 194

1Peninsula Clinical School, Central Clinical School, Monash University, 2Academic Unit, Peninsula Health, 3Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, 4Department of Physiotherapy, University of Melbourne, 5Department of Physiotherapy, Monash University, 6Department of Epidemiology and Preventative Medicine, Monash University, 7Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania ........................................................................................................ 194

Characterising older adult engagement during group technology-driven reminiscence therapy. ............................. 195

Ms Madeleine Radnan1, Prof Kate Stevens1, Professor Caroline Jones1, Mr Andrew Leahy1, Dr Clair Hill1, Professor Deborah Parker2 .......................................................................................................................................................... 195

1Western Sydney University, 2University of Technology Sydney ............................................................................ 195

Age-adjusted gender variation in the length of stay at residential aged care in Australia ........................................ 196

Mr Md Mijanur Rahman1, Dr Rob Gordon1, Ms Anita Westera1, Prof Kathy Eagar1 ................................................... 196


Page 20 of 242

1Australian Health Service Research Institute, University of Wollongong .............................................................. 196

Evaluation of the Royal Flying Doctor Telehealth Specialist Services – Provider Perspectives .................................. 197

Dr Rebecca Mckechnie2, Dr Tshepo Rasekaba1, Prof Irene Blackberry2, Jocelyn Syme3, Cassie Moore3, Melanie Trivet3

.................................................................................................................................................................................... 197 1La Trobe University, 2La Trobe University, 3Royal Flying Doctor Service ............................................................... 197

Does telehealth improve access to healthcare - effectiveness of the Flying Doctor Telehealth Specialist Services ... 198

Dr Tshepo Rasekaba1, Dr Rebecca Mckechnie2, Jocelyn Syme3, Cassie Moore3, Melanie Trivet3, Prof Irene Blackberry2

.................................................................................................................................................................................... 198 1La Trobe University, 2La Trobe UNiversity, 3Royal Flying Doctor Service .............................................................. 198

Older peoples’ perceptions and experiences of community engagement in aged care ............................................ 199

Assoc Prof Helen Rawson1, Ms Kerry Rigby2, Ms Cherene Ockerby2, Dr Helen Forbes2 ............................................... 199 1Monash University Nursing and Midwifery, 2Deakin University, Centre for Quality and Patient Safety Research - Monash Health Partnership .................................................................................................................................... 199

Substituting nurses in residential aged care: findings from evaluation of two residential-in-reach services in Victoria ................................................................................................................................................................................ 200

Dr Jo-Anne Rayner1, Prof Deirdre Fetherstonhaugh1 ................................................................................................... 200 1ACEBAC, La Trobe University ................................................................................................................................. 200

Prediction of dementia: Differences between performance-based versus informant-reported measures of functional impairment .............................................................................................................................................................. 201

Dr Simone Reppermund1, Sujin Jang1, Dr Katya Numbers1 .......................................................................................... 201 1Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales ...................................... 201

Listen N Talk: developing an app to promote intergenerational language learning.................................................. 202

Dr Mark Richards, Professor Caroline Jones, Ms Josephine Lardy, Ms Helena Lardy, Ms Sarah Bock ......................... 202 1The MARCS Institute - Western Sydney University ............................................................................................... 202

Dementia Engagement Modelling Program: A novel model of aged care during COVID-19 ...................................... 203

Ms Lyn Robb1, Dr Tom Morris1, Mr Mustafa Atee1,2 .................................................................................................... 203 1The Dementia Centre, Hammondcare, 2Curtin Medical School, Faculty of Health Sciences, Curtin University ... 203

Baseline data from the PITCH study: characteristics of Home Care Workers providing dementia care .................... 204

Dr Steven Savvas1, Dr Anita Goh1, Prof Colleen Doyle1, Assoc Prof Frances Batchelor1, Ms Esther Tan1, Ms Erica Wise1, Professor David Ames1, Dr Margaret Winbolt2, Dr Susan Malta3, Prof Lee Fay Low4, Prof Briony Dow1 .................... 204

1National Ageing Research Institute, 2La Trobe University, 3University of Melbourne, 4University of Sydney ...... 204

Models for predicting fall in aged care: Systematic Review ..................................................................................... 205

Dr Joyce Siette1, Dr Kristiana Ludlow1,2, Dr Mikaela Jorgensen1, Ms Laura Dodds1, Dr Joyce Siette1, Dr Nasir Wabe1, Professor Stephen Lord3, Professor Jacqueline Close3,4, Prof Johanna Westbrook, Dr Karla Seaman ......................... 205

1Australian Institute of Health Innovation, Macquarie University, 2School of Psychology, University of Queensland, , 3Neuroscience Research Australia, UNSW, 4Prince of Wales Clinical School, UNSW ........................................... 205

Playful Placemaking with Pets around a Pandemic: Socially engaging older pet owners towards game-changing dialogues ................................................................................................................................................................. 206


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Mr Jacob Sheahan1, Ms Natalie Davey2, Ms Alicia Kennedy2, Dr Larissa Hjorth1 ........................................................ 206 1RMIT University, 2Cherished Pets Foundation ....................................................................................................... 206

Self-efficacy of migrant care workers in caring for older residents in residential aged care settings ........................ 207

Ms Sumina Shrestha1, Professor Yvonne Wells1, Dr Christine While1, Assoc. Prof. Aziz Rahman2 ............................... 207 1La Trobe University, Melbourne, 2Federation University ...................................................................................... 207

Self-efficacy of residential aged care workers in caring for older residents: A scoping review ................................. 208

Ms Sumina Shrestha1, Mr Rayan Alharbi1, Dr Christine While1, Professor Yvonne Wells1, Assoc. Prof. Aziz Rahman2 208 1La Trobe University, Melbourne, 2Federation University ...................................................................................... 208

A mixed methods study on the impact of COVID-19 in older Australians during second lockdowns ........................ 209

Dr Joyce Siette1, Dr Kristiana Ludlow1,2, Dr Joyce Siette1, Ms Laura Dodds1, Professor Viviana Wuthrich1, Dr Carly Johnco1, Prof Joanne Earl1, Dr Piers Dawes1, Dr Paul Strutt1, Prof Johanna Westbrook1 ............................................ 209

1Macquarie University, 2University of Queensland ................................................................................................ 209

The National Telehealth Counselling & Support Service In Residential Aged Care - A Reflection ............................. 210

Mr Mark Silver1, Professor Sunil Bhar, Jenny Linossier, Dr Debra Koder, Aida Brydon, Rebecca Collins, Sofie Dunkerley, Joanna Waloszek ......................................................................................................................................................... 210

1Swinburne University of Technology ..................................................................................................................... 210

The Physical Activity Pathways Model: An Evaluation ............................................................................................. 211

Dr Jane Sims1, Mr Adam Demirtel2, Ms Jo Howard3 .................................................................................................... 211 1Jane Sims & Associates, 2Merri Health, 3Sunbury and Cobaw Community Health ............................................... 211

Decision-making sub-types among older adults in the Personality and Total Health (PATH) Through Life Study ..... 212

Dr Craig Sinclair1, Dr Ranmalee Eramudugolla1, Dr Brooke Brady1, Mr Nicolas Cherbuin2, Prof Kaarin Anstey1 ........ 212 1School of Psychology, University Of New South Wales, 2Centre for Research on Ageing, Health and Wellbeing 212

Patient-reported factors influencing older adults’ cancer screening decision-making: A systematic review ............ 213

Ms Jenna Smith1, Dr Rachael Dodd1, Ms Karen Gainey1, Prof Vasi Naganathan2, Dr Erin Cvejic1, A/Prof Jesse Jansen3, Prof Kirsten McCaffery1 ............................................................................................................................................... 213

1Sydney School of Public Health, Faculty of Medicine and Health, The University Of Sydney, 2Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, 3School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University .......................................................... 213

Scoping international literature on adverse events in residential aged care: what’s happening and what’s missing? ................................................................................................................................................................................ 214

Ms Bella St. Clair1, Dr Mikaela Jorgensen1, Dr Amy Nguyen1, Professor Andrew Georgiou1 ....................................... 214 1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University ................................................................................................................................................................................ 214

Managing risk and rights in aged care: Qualitative analysis of Royal Commission data. .......................................... 215

Assoc Prof Mandy Stanley1, Dr Patricia Cain1 .............................................................................................................. 215 1Edith Cowan University ......................................................................................................................................... 215

People Living with Dementia and Redress of Structural Harms in Residential Aged Care ......................................... 216

Dr Linda Steele1, Mrs Kate Swaffer2 ............................................................................................................................ 216


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1University Of Technology Sydney, 2University of Wollongong .............................................................................. 216

What can the psychological contract theory tell us about building Australia’s aged care workforce? ...................... 217

Prof Christine Stirling1 .................................................................................................................................................. 217 1University Of Tasmania.......................................................................................................................................... 217

An international adaptation of the Australian environmental assessment tool for Singaporeans living with dementia ................................................................................................................................................................................ 218

Dr Joanna Sun1, Prof Richard Fleming2 ........................................................................................................................ 218 1University Of Tasmania, 2University of Wollongong ............................................................................................. 218

Assessment of health, wellbeing and quality of life for older persons in aged care.................................................. 219

Dr Susan Taylor1, Rebecca Walton1, Dr Angelita Martini1 ........................................................................................... 219 1Brightwater Care Group ........................................................................................................................................ 219

Perceptions of aquatic physiotherapy and health related quality of life among people with Parkinson’s disease ... 220

Miss Fleur Terrens1 ...................................................................................................................................................... 220 1Peninsula Health .................................................................................................................................................... 220

Manjimup Repair Cafe: codesign, community and sustainability ............................................................................. 221

Mrs Jacqui Tibbits1 ....................................................................................................................................................... 221 1Consultivation ........................................................................................................................................................ 221

Online yoga for seniors during COVID19: adaptations made in the SAGE trial ......................................................... 222

Assoc Prof Anne Tiedemann1, Dr Juliana Oliveira1, Professor Stephen Lord2, Professor Cathie Sherrington1 ............. 222 1Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University Of Sydney, 2Neuroscience Research Australia .................................................................................................................................................. 222

The IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) study ............... 223

Ms Joanne Tropea1,2, Professor Kwang Lim1,2, Associate Professor Caroline Brand1,2, The IMPETUS-D Working and Advisory Group ............................................................................................................................................................ 223

1University Of Melbourne, 2Royal Melbourne Hospital .......................................................................................... 223

Highlighting the Benefits and Strengths of Informal Dementia Caregivers During COVID ........................................ 224

Dr Kristen Tulloch2, Ms Trudy McCaul1, Dr Theresa Scott1 .......................................................................................... 224 1The University of Queensland, 2University Of The Sunshine Coast ....................................................................... 224

"...it's like a death": Older driver perceptions on discussing and planning for driving retirement ............................ 225

Mrs Nadine Veerhuis1, Professor Victoria Traynor1, Professor Melanie Randle1 ......................................................... 225 1University of Wollongong ...................................................................................................................................... 225

Reflections on Working and Walking Gently Together ............................................................................................. 226

Ms Sharon Wall1 .......................................................................................................................................................... 226 1Aboriginal Health And Ageing Program NeuRA ..................................................................................................... 226

By Your Side –Physiotherapist-led care worker-supported program to prevent falls ............................................... 227

Dr Willeke Walsh1, Dr Claudia Meyer2,3,4, Assoc Prof Elizabeth Cyarto2,5,6................................................................... 227


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1Bolton Clarke, 2Bolton Clarke Research Institute, 3Centre for Health Communication and Participation, La Trobe University, 4Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 5Faculty of Health and Behavioural Sciences, The University of Queensland , 6Department of Psychiatry, University of Melbourne .............................................................................................................................................................. 227

Towards an understanding of delirium using functional MRI: Preliminary results ................................................... 228

Dr Sarah Ward1,2,3, Prof Johan Van der Meer4,5, Prof Meegan Campbell4, Ms Suzie Thistlethwaite2, Dr Alice Greenwood2, Dr Kana Appadurai2, Dr Shanthi Kanagarajah2, Dr Greg Watson2, Dr Robert Adam2,3,5, Dr Eamonn Eeles3,6, Prof Michael Breakspear4,5 ............................................................................................................................ 228

1Redcliffe Hospital, 2Royal Brisbane and Women's Hospital / STARS, 3University of Queensland, 4Newcastle University, 5QIMR Berghofer, 6The Prince Charles Hospital ................................................................................... 228

Personalised Care for VR-based Reminiscence in Aged Care: A Case Study .............................................................. 229

Assoc Prof Jenny Waycott1, Mr Tony Simms2 .............................................................................................................. 229 1The University Of Melbourne, 2Dementia Consultant ........................................................................................... 229

‘Uncovering’ undue influence in instances of financial abuse of older persons. ....................................................... 230

Dr Eileen Webb1 ........................................................................................................................................................... 230 1University Of South Australia ................................................................................................................................ 230

Student nurses’ attitudes towards older adults: A scoping review ........................................................................... 231

Ms Helen Venables2, Professor Yvonne Wells1 ............................................................................................................. 231 1La Trobe University, 2Australian Catholic University ............................................................................................. 231

Maybo training to improve staff response to aggression in residential care ............................................................ 232

Dr Jacqueline Wesson1,2,3, Professor Lynn Chenoweth2, Ms Janine Grossman1, Ms Bente Ryan1, Scientia Professor Henry Brodaty2,4,1 ........................................................................................................................................................ 232

1Montefiore, 2Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, 3Health & Ageing, Faculty of Health Sciences, University of Sydney, 4Dementia Centre for Research Collaboration ......................... 232

Comprehensive Assessment - The Key To Person-Centred Service Delivery ............................................................. 233

Ms Jessica Wheatley1................................................................................................................................................... 233 1BaptistCare ............................................................................................................................................................ 233

South Australia's Adult Safeguarding Unit – Getting the Balance Right .................................................................... 234

Ms Elicia White ............................................................................................................................................................ 234

Inspiring innovative approaches to challenge loneliness and improve the experience of ageing ............................. 235

Ms Kathy Williams1, Ms Kylie Fergusen, Ms Brenda Muturi ........................................................................................ 235 1Office For Ageing Well, Dept For Health And Wellbeing ....................................................................................... 235

Designing digitally delivered health screening tools to meet the needs of Australia’s ageing prisoner population .. 236

Dr Jane Hwang1, Dr Adrienne Withall1, Professor Peter Schofield2, Mr Amanuel Kidane Hagos1, Professor Tony Butler1, Dr Natasha Ginnivan3, Mr Rhys Mantell1, Dr Kylie Radford6, Associate Professor Kylie Dingwall7, Dr Philip Snoyman4, Dr Stephen Hampton5, Mr Luke Grant4 ....................................................................................................................... 236

1School of Population Health, University Of New South Wales, 2Hunter New England Local Health District, 3School of Psychology, University of New South Wales, 4Corrective Services NSW, 5Justice Health & Forensic Mental Health Network NSW, 6Neuroscience Research Australia (NeuRA), 7Menzies School of Health Research ............ 236


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Chinese carers’ perspectives on adapting the World Health Organization iSupport for Dementia in Australia ........ 237

Scientia Professor Henry Brodaty2, Professor Julie Ratcliffe1, Assoc Prof Bianca Brijnath3, Dr Hui-Chen (Rita) Chang4, Dr Shahid Ullah1, Ms Yunrui Zhou1, Ms Mei Ye1 .......................................................................................................... 237

1Flinders University, 2The University of New South Wales, 3National Ageing Research Institute, 4University of Wollongong ............................................................................................................................................................. 237

Navigation of community-based aged care services by older people and their families: A Scoping Review ............. 238

Ms Yuchen Xie1,2, Assoc Prof Myra Hamilton3,7, Professor Carmelle Peisah4,5,6, Dr Craig Sinclair1,2, Prof Kaarin Anstey1,2,6 .................................................................................................................................................................... 238

1School of Psychology, University of New South Wales , 2Neuroscience Research Australia, 3University of Sydney, 4Capacity Australia, 5School of Psychiatry, 6UNSW Ageing Future, 7ARC Centre of Excellence in Population Ageing Research ................................................................................................................................................................. 238

Ethics of using social robots in aged care facilities: care staff perspectives .............................................................. 239

Mrs Stella Yuan1, Assoc Prof Jenny Waycott1, Professor Reeva Lederman1, Dr Simon Coghlan1 ................................ 239 1The University of Melbourne................................................................................................................................. 239

Prevalence of visual impairment in older people with dementia and its impact: A scoping review ......................... 240

Ms Wanyu Zhang1, Dr Fiona Stanaway1, Assoc. Professor Timothy V Roberts1,2,3, Professor Christopher J Poulos4,5 . 240 1The University of Sydney, 2Department of Ophthalmology, Royal North Shore Hospital, 3Vision Eye Institute, 4HammondCare , 5The University of NSW (School of Population Health) .............................................................. 240

Technologies for Social Connection in Aged Care during COVID-19: Staff Perspectives ............................................ 241

Assoc Prof Jenny Waycott1, Mr Wei Zhao1, Dr Ryan Kelly1 .......................................................................................... 241 1The University of Melbourne................................................................................................................................. 241

The design and development of interactive textiles for people living with dementia .............................................. 242

Ms Yushan Zou1,2, Dr Fanke Peng1, Dr Nathan D'Cunha1, Dr Eddi Pianca1, Associate Professor Damith Herath1 ....... 242 1University of Canberra, 2Southwest University ..................................................................................................... 242


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Proactively witnessing falls in older inpatients may not result in less serious fall related injuries Dr Sameer Abdoolakhan1, Dr Kevin Ong2

1Royal Perth Hospital, 2Armadale Kelmscott District Memorial Hospital Aims To examine the correlation between older inpatient fall outcomes and patient characteristics and environmental factors, with a view to improve preventive measures. Methods A retrospective study was undertaken of older inpatients who had a fall in a district metropolitan general hospital in Western Australia. Results We noted 321 falls occurred between December 2017 and December 2018. Of these, 222 (69.2%) falls were unwitnessed, 96 (29.9%) falls resulted in more severe outcomes, and 239 (74.5%) falls occurred in older patients (≥65‐year‐olds). The number of fall risk factors correlated with the number of falls. Polypharmacy (n = 158) was the most common easily modifiable fall risk factor. Severity outcomes did not appear to be impacted by whether a fall was unwitnessed. Fall risk assessments conducted on admission did not appear to increase the proportion of falls being witnessed or mitigate outcomes. Inpatients ≥80 years old were more likely than older inpatients <80years old to have high falls risk if their falls were unwitnessed, P<0.001. This unexpected pattern was also present if the falls resulted in non-severe outcomes, P=0.015. Conclusion Our findings extend the concept of modifying a few fall risk factors to reduce falls risks into the older inpatients’ setting. Proactive optimisation of medications on presentation might add value to routine surveillance. The later anomalies reflect relaxation of surveillance on more mobile older inpatients with high falls risk, to facilitate discharge. This was not associated with more severe outcomes. The data gathered in this study will be useful for benchmarking purposes.


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Association of Weight loss, Weight status, and Abdominal Obesity with all-cause Mortality in Older Adults Mrs Tagrid Alharbi1

1Monash University Background There may be age-related differences in the impact of obesity on health. This study aimed to examine whether weight loss, weight status (based on body mass index [BMI] categories), and abdominal obesity (based on waist circumference [WC]) were associated with 17-year mortality risk in community-dwelling older adults. Methods Data were obtained from 2017 French community-dwelling participants (aged ≥65). Mortality status was determined through death registries. The risks of all-cause mortality associated with weight loss, BMI and WC were examined using Cox proportional hazards models over a 17 years of follow-up. Results Over a median 15.5 years, 812 participants died. Self-reported weight loss at study baseline was not associated with an increased mortality risk after adjusting for health and lifestyle factors. However, in men, a baseline self-reported recent weight loss of >3kg was associated with a 52% increase in mortality risk (95% CI 1.05-2.18) in a fully adjusted model. Abdominal obesity compared to non-abdominal obesity was associated with a 49% increased mortality risk (95% CI 1.22-1.83). However, being overweight (but not obese) was associated with a 20% decreased risk (95% CI 0.66-0.97) compared to a normal BMI. Gender did not affect these associations. Conclusions Modest self-reported weight loss was not associated with all-cause mortality in community-dwelling older adults after adjusting for health and lifestyle factors. The findings of this study support the use of waist circumference, rather than BMI, as a predictor of mortality risk in older adults. Keywords weight loss; obesity; abdominal obesity; mortality; older adults


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The Effectiveness of Technological Interventions for Addressing Social Isolation and Loneliness among Older People Dr Rachel Ambagtsheer1,2, Dr Kim Borg3, Dr Louise Townsin1, Dr Maria Alejandra Pinero De Plaza2,4, Dr Michael Lawless2,4

1Torrens University Australia, 2CRE for Frailty and Healthy Ageing, 3Monash University, 4Flinders University Background Older people were disproportionately impacted by social distancing measures arising from the coronavirus pandemic, increasing their risk of experiencing social isolation and loneliness. Technology is frequently proposed to enhance social engagement; however, few reviews have addressed its efficacy among older people from a theoretical standpoint. We addressed three research questions: 1) What is the effectiveness of technology-based interventions in addressing social isolation and loneliness among older people? 2) What are the key barriers and enablers of such interventions? 3) What key theoretical frameworks have informed these interventions? Methods We conducted a Mixed Methods Systematic Review, searching PubMed, Embase, PsychInfo, Cochrane Reviews/Trials and the ACM database from inception to June 2020 using key search terms relating to older people, social isolation/loneliness and technology, including quantitative, qualitative and mixed methods primary studies with a technology-based intervention component. Two independent reviewers conducted all screening. Quality reviews were conducted using the JBI criteria for qualitative and quantitative studies. We used the Covidence online portal for screening and analysis. Results We identified 990 initial studies, subsequently removing 235 duplicates. After title/abstract screening, 632 studies were excluded. A further 57 studies were excluded after full text review, leaving 66 remaining eligible studies. As the review is ongoing at time of abstract submission, the presentation will summarise and discuss key findings. Conclusions/Implications The presentation will outline key implications and recommendations for health service providers, policy makers and researchers with an interest in developing technology-based interventions to address social isolation and loneliness among older people.


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Self-Assessed Health Status, Proprioception and Falls – how are they related? Ms Susan Antcliff1, Dr Jeremy Witchalls1, Professor Gordon Waddington1, Dr Sarah Wallwork2, Dr Marijke Welvaert3

1University Of Canberra, 2University of South Australia, 3Australian National University Proprioception is known to decline at older ages and this is likely to contribute to the increased risk of falls. This longitudinal study aimed to explore the relationships between proprioception, risk of falls and self-assessed health status. Fifty-five participants undertook repeated assessments over a year or more on a range of tests related directly or indirectly to proprioception, including active movement extent discrimination (AMEDA), Timed Up and Go (TUG) and a Sensory Organisation Test (SOT). At the final testing session, we asked participants to make a subjective assessment of their current health status. Thirty-eight (69%) of the participants suffered at least one fall during the study. However, not all falls are created equal and the incidence of different types of falls varied markedly with self-assessed health status. Similarly the type of fall was important determinant of the rhe relationship between falls and the various metrics. Lower health status was associated with poorer performance on the purely physical tests (TUG and SOT), but not the tests with a focus on cognitive performance, suggesting that participants were either not aware of or disregarded any cognitive decline in assessing their health status. The evidence from our study highlights the pitfalls in treating falls as a single category of events. It may also point to the need for a nuanced understanding of how people perceive their health and ensuring that both physical and cognitive elements are taken into account.


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Measuring incidence and risk of falls – be careful what and how you ask! Ms Susan Antcliff1, Dr Jeremy Witchalls1, Professor Gordon Waddington1, Dr Sarah Wallwork2, Dr Marijke Welvaert3

1University Of Canberra, 2University of South Australia, 3Australian National University In order to develop strategies to mitigate falls risk, we need reliable information on falls. Typically, this information has been collected through diaries and retrospective measures. The current study collected information on the incidence and characteristics of falls among a group of participants living independently in the community through daily contact via SMS or email over a period of at least 12 months. Participants undertook to a number of tests related to proprioception at the start of the study and falls events were recorded daily for 12 months. The incidence of falls was substantially higher than has been reported in studies using alternative methods of falls recording, with 69% of participants having at least one fall during the 12 months. We argue that this is partially due to recall and partially due to definitional issues of what constitutes a fall. Logistic regression analysis was used to explore how performance on the initial tests was related to subsequent falls risk. We found that risks were quite different once falls were classified by the circumstances in which they occurred and the difficulty of the activity in which the participant was engaged. For falls occurring in the least challenging circumstances, a small number of risk factors were highly predictive of increased risk. The data collected through this study affords a rich insight into the varied nature of falls and has implications for developing interventions and mitigation strategies.


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Improving resident-focused documentation and saving nurse time: evaluation of a digital system in aged care Dr Kasia Bail1, A/Prof. Bernice Redley2, Professor Diane Gibson1, Eamon Merrick3, Prof. Karen Strickland1, Alicia Hind1, Prof. Catherine Paterson1, Ass/Prof. Natasha Jojo1, Bridget Smith1, Beatrice Vann4

1University Of Canberra, 2Deakin University , 3Auckland University of Technology , 4Health Care Consumers Association Health information systems offer an opportunity to contemporaneously record care delivery, streamline documentation, and provide clinicians with access to point-of-care evidence-informed decision-making to optimise holistic person-centred care. However, many systems have not been evaluated. The aim of this study was to evaluate the deployment of Humanetix ‘ACE’ documentation and decision-support technology system into a residential aged care facility in relation to work efficiency and quality of care. A three-stage, participatory action research design, used concurrent mixed methods to collect data at three time-points over two-years. Data were collected from 65 residents/visitors, 90 staff, 7 managers/consultants and administrative databases. These included 130 pedometer readings; 59 surveys; 47 hallway interviews; 133 hours of time and motion observations; 65 documentation diaries; 27 focus group participants; 38 documentation audits on 19 resident records and 739 incident reports. Acceptability of the ACE system was demonstrated by high usability and satisfaction scores from staff and residents. Improved work efficiency was demonstrated by time saved on searching for information, with a mean 20% of nurse time saved post-ACE implementation. Qualitative data indicated staff felt able to spend more time with residents; more able to respond to resident needs; and better equipped to manage the ‘delicacies of resident dignity’ when using ACE. Quality of documentation improved, with completed resident assessments increasing from 68% to 96%. New technologies are integral to aged care and contribute to the provision of quality care. Implementation of ACE was associated with high user acceptability, improved work efficiencies and enhanced quality of resident care.


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Virtual visits: Reminiscence in residential aged care with digital mapping technologies Dr Steven Baker1, Dr Sarah Webber, Assoc Prof Jenny Waycott 1Griffith University Objective: Digital technologies can support reminiscence and lifestyle enrichment in residential aged care. This study explored potential benefits and risks of virtual visits using digital maps, tablet computers and virtual reality technologies. Methods: Reminiscence sessions were conducted with metropolitan aged care facility residents (n = 7), using digital mapping applications to ‘visit’ places of personal significance. Residents and family members (n = 4) were interviewed. Results: Some older adults found virtual visits valuable and all reminisced in various ways about personal, family and social experiences. Family members felt that virtual visits would be enriching for loved ones and that they supported sharing of life stories. Our results also highlight that VR usability improvements are needed to better suit older people. Conclusions: Virtual visits could offer valuable opportunities for positive reminiscence for some older adults in residential aged care. Digital technologies need to provide better support for older users and people who assist them.


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Elder Mediation: Reflections on Theory and Practice Assoc Prof Lise Barry1, Ms Megan Frost2

1Macquarie Law School, 2Relationships Australia In this presentation, Megan Frost, Practice Specialist in Senior Relationships Services for Relationships Australia, and Associate Professor Dr Lise Barry from Macquarie Law School, present their reflections on elder mediation as an innovative service model. Megan will outline the successes and challenges of the program “Let’s Talk - Elder Mediation and Support Service”. The services targets areas in regional and rural NSW and offers culturally adaptive work with the Chinese Community in metropolitan Northern Sydney, funded by the NSW Domestic and Violence Innovation fund. Lise will provide both a theoretical and practical perspective based on her experience in delivering elder mediation services and training. Elder mediation is gaining in popularity and has been recommended to address a range of conflicts and decisions including: end of life care, family responsibility for support, allegations of abuse and neglect, and conflicts with care providers. The presentation will discuss the challenges of introducing elder mediation into the landscape of services for older Australians and the similarities and differences of other models of family mediation. The presenters will then share their recommendations for developing future services and workforce skills. This presentation is relevant to anyone who deals with conflict about decisions by and for older people, and who are seeking new ways to train their workers to think about navigating the relational aspects of service delivery.


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Measuring quality of care in aged care Assoc Prof Frances Batchelor1,2,3, Dr Christa Dang1, Ms Anabelle Peck1, Dr Steven Savvas1, Dr Anita Goh1,2, Prof Briony Dow1,2,3

1National Ageing Research Institute, 2University of Melbourne, 3Deakin University Introduction and background The Royal Commission into Aged Care Quality and Safety has heard testimony from many about poor quality of care in both community and residential aged care. The recommendations and subsequent response from the government have highlighted the need for new models of care as well as the need to hear about the direct experience of consumers. Up until recently, quality of care has typically been measured in terms of ‘outputs’, focusing on provider metrics and mostly limited to residential aged care. Aim The aim of this presentation is to explore the issue of measurement of quality of care in aged care, and to highlight how we need to move beyond standard consumer experience surveys to a more in-depth, targeted evaluation of care, that privileges the voices of consumers. Overview This presentation will include discussion about measurement of quality of care across clinical and non-clinical domains, including a review of measures, and discussion about possible new approaches. There will also be a discussion on person-reported outcome measures, commonly referred to as patient-reported outcome measures (PROMS) and some of the challenges in obtaining PROMS from people receiving aged care, in particular, from those with cognitive impairment. Expected learning outcomes for audience members Audience members will learn about quality of care measurement in residential and community aged care, including strengths and limitations of different approaches.


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Stroke survivors admitted to GEM wards are different to those admitted to rehabilitation wards. Mrs Lucy Bell1, Mrs Ettie Ben-Shabat1, Mrs Mellisa Raymond1,2, Mr Brian Anthonisz3, Mrs Anne Holland4,5, Mrs Sze-Ee Soh6,7

1Physiotherapy Department, Alfred Health, 2College of Science, Health and Engineering, La Trobe University, 3Head of Rehabilitation Services, Alfred Health, 4Professor of Physiotherapy (Research), Monash University and Alfred Health , 5Department of Allergy, Immunology and Respiratory Medicine Central Clinical School, Monash University, 6Department of Physiotherapy, Monash University, 7Department of Epidemiology and Preventative Medicine, Monash University Introduction: Little is known about the characteristics and outcomes of stroke survivors admitted to Geriatric Evaluation and Management (GEM) wards compared to rehabilitation wards. Methods: A two-year retrospective audit (2014-2015) of all inpatient stroke admissions to a subacute hospital in metropolitan Melbourne, Australia was conducted. Charlson Comorbidity Index (CCI), Functional Independence Measure (FIM), length of stay (LOS), Allied Health (AH) therapy time (minutes/day) and discharge destination for GEM and Rehabilitation groups were compared. Logistic regression models were used to identify factors associated with discharge destination. Results: Our sample of stroke survivors admitted to GEM wards (GEM: n=70, Rehab: n=170) were significantly older (median 85 years, IQR 81-89 versus median 71, IQR 59-79), had lower admission FIMs (median 36, IQR 18-68 versus median 73, IQR 46-91), received less therapy time (median 67 minutes, IQR 52-92 versus median 136, IQR 101-162) made less functional gains (FIM change; median 5, IQR 0-22 versus median 23, IQR 10-43) and were discharged home less often (36% versus 71%) despite similar CCI and LOS. Overall, greater odds of discharge home were associated with higher admission cognitive FIM scores (OR 1.13; 95% CI 1.06, 1.22) and greater functional improvement (OR 1.05; 95% CI 1.02, 1.08), after adjusting for potential covariates. Conclusion: Stroke survivors admitted to GEM wards are older, have poorer function and poorer outcomes compared to those admitted to rehabilitation wards. New strategies are required to ensure older stroke survivors have the best opportunity for rehabilitation particularly in the context of an ageing population.


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Impact of emergency department length of stay on older persons' anxiety and comfort Prof Julie Considine1,2, Ms Debra Berry1,2, Professor Bodil Rasmussen1,3, Prof Alison Hutchinson1,4, Assoc Prof Helen Rawson6, Dr Peter Jordan5, Dr Maryann Street1,2

1School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 2Centre for Quality and Patient Safety Research – Eastern Health Partnership, 3Centre for Quality and Patient Safety Research – Western Health Partnership, 4Centre for Quality and Patient Safety Research – Monash Health Partnership, 5Eastern Health, 6Monash University Introduction: Older people frequently require emergency department (ED) care and can have long stays in the ED. The aim of this study was to determine whether there was relationship between ED length of stay (LOS) and older people’s (aged ≥65 years) anxiety, comfort and adverse events. Methods: This prospective observational study was conducted in Melbourne, Australia. Patients (n = 301) from three EDs were grouped according to ED LOS: ≤4-hours (n = 89), 4–8 hours (n = 136) and >8-hours (n = 76). State and trait anxiety and comfort were measured in ED and adverse event data were collected from medical records. LOS groups were compared using Chi-Square and Kruskal-Wallis test. Results: There was no significant between group difference in Trait Anxiety Scores. Patients with ED LOS ≤ 4-hours had lower median State Anxiety Scores (p = 0.003), were less likely to require ward admission (p < 0.001), and more likely to require short stay unit admission (p < 0.001). There were no significant between group differences in comfort whilst in the ED or adverse events during ED care or hospitalisation (for admitted patients). Conclusion: The levels of state and trait anxiety in this cohort of older ED patients was relatively low, so the impact of ED LOS on the anxiety of these older ED patients appears minimal. There was no association identified between ED LOS and comfort during ED care. Adverse events during ED care or hospital admission for admitted patients were infrequent.


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Geriatric oncology in the Instagram Era: Adopting PhotoVoice to enable empowerment and shared decision making Prof Irene Blackberry1, Dr Christopher Steer2,3, Dr Tshepo Rasekaba1, Ms Kim Young1, Ms Nicole Webb2, Mr Darren Jayasuriya3, Ms Kylie Owen1, Dr Mira Kapur3

1La Trobe University, John Richards Centre, 2Border Medical Oncology and Haematology, 3UNSW Background and aim: Multidimensional assessment of older adults with cancer results in more holistic care, better communication about age-related concerns and enables personalised, patient-centred supportive care. Geriatric assessment (GA) captures clinical, physical and psychological factors, with limited opportunity to gather information about the patient’s environment, personal contexts and priorities. Patient-centred care may be enabled using the novel intervention of PhotoVoice, a qualitative research method that utilises photographs to facilitate discussion and deeper exploration of a person’s response to cancer. We will explore patient satisfaction with communication with the oncologist regarding age-related concerns, empowerment, patient-centred care and shared decision-making informed. We also conducted a quality improvement medical records audit to examine the uptake of enhanced supportive care (ESC) before and during the use of PhotoVoice optimised ESC. Methods: A feasibility and acceptability trial of GA-guided ESC using PhotoVoice among 20 adults aged over 70 years in a regional cancer centre. A retrospective audit of 118 patient records served as baseline. Implications and conclusion: Patient-centred care is a critical element of shared decision-making. It ‘explores and validates patients’ individual experiences of illness, their needs, expectations and values; offers patients opportunities to provide input into and participate in their care; enhances partnership, shared understanding, and trust in the patient-physician relationship’. Multidisciplinary team review of findings from GA incorporating photovoice analysis may inform a management plan that reflects both the patient’s priorities and evidence-based care.


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Building an empathic workforce using virtual reality technology Dr Clare Wilding1, Ms Kim Young1, Ms Caroline Cummins2, Mr Craig Bowler3, Mr Trent Dean2, Ms Elizabeth Gill2, Ms Karen Cronin2, Dr Ali Lakhani1, Prof Irene Blackberry1

1La Trobe University, 2Mercy Connect, 3Valley General Hospital Background: If health workers have empathy for the lived experience of their clients, they are more likely to provide sensitive, high-quality, and person-centred care. Virtual reality is a technological innovation that has created a new opportunity for an immersive digital experience that enables a user to obtain a first-person perspective of someone else’s world view. We created a virtual reality experience that enables care workers to view the world through the eyes of a person living with intellectual disability. Methods: A pre and post pilot using mixed methods was completed. Our study evaluated the feasibility and acceptability of using a virtual reality application to improve empathy in personal care workers in the disability sector. Results: Quantitative results indicated an overall trend towards increased empathy following engagement in the virtual reality experience. Qualitative findings included that participants had not previously used virtual reality; they became engrossed in the virtual reality world; they felt empathy for their clients through engaging with the virtual reality world; and, they considered virtual reality to be a useful means of helping people develop understanding of living with disability. Implications: Further research about the use of virtual reality to develop empathy is warranted. There is potential that virtual reality experiences could be useful for helping care staff to develop a deeper understanding from a client’s perspective; such a first-person point of view might foster compassion in caregivers, especially with troubling behaviours, such as anger and aggression.


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Older People's Advocacy against the backdrop of the Royal Commission and Covid-19 Dr Barbara Blundell1, Mr Craig Gear2, Ms Anna Harrington 1Curtin University, 2Older Persons Advocacy Network This presentation will explore the role and importance of professional advocacy in the aged care sector against the backdrop of the Aged Care Royal Commission and the Covid-19 pandemic. Professional advocates from the Older Persons Advocacy Network (OPAN) support the rights of older people and their caregivers, building their capacity to solve their own problems, providing empowerment, and reducing the need for service intervention. OPAN provides free support to older people and their representatives to address issues related to Commonwealth-funded aged care services as well as elder abuse. The pandemic presented a range of unique rights-based concerns within aged care, whilst the Royal Commission has shone a light on an aged care system that struggles to deliver safe and quality care and, in too many instances, neglects older Australians. In a system that is failing to meet the basic human rights of older people, access to experienced and professional advocates has never been more important. A mixed-methods research project was conducted in partnership with OPAN to identify the advocacy skills, competencies, and training required to work effectively as a professional advocate. This work was undertaken at the time of the Royal Commission and the associated exposure of the events advocates support older people through. Research phases included a scoping literature review, six focus groups (n=41) with OPAN advocates around the country, and a national online workforce survey (n=67). Presenters will discuss the research findings and implications for advocacy in this sector during a time of heightened vulnerability for older people.


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In their own words: sexual health priorities of older Australians Mx Louise Bourchier1, Prof Meredith Temple-Smith2, Prof Jane Hocking1, Dr Susan Malta1,3

1Melbourne School of Population and Global Health, University of Melbourne, 2Department of General Practice, University of Melbourne, 3National Ageing Research Institute Background: Many older adults are sexually active, however, their sexual health is often overlooked. Older adults have distinct needs that may be different from younger people. To better meet these needs, the sexual health priorities of older Australians themselves must be understood. Methods: Data was collected via an anonymous online survey in April 2021. Participants were aged 60+ and living in Australia. This study examined responses to the question: “What do you feel are the most important sexual health and wellbeing issues for you?” Comments were analysed using content analysis. Results: To date, 298 responses have been recorded. 43% of respondents were aged 60-69, 42% aged 70-79, 15% aged 80-89. 61% were female, most identified as heterosexual (78%), and just over half were sexually active (52%). In the 207 comments supplied, people spoke of a variety of challenges, joys, and changes in their sexual lives. Some expressed satisfaction and hoped the status quo would continue, others shared experiences of frustration or grief, others said that sex was unimportant to them. The following themes were identified: sexual function, physical health (chronic conditions, mental health), intimacy and connection, pleasure, relational challenges (communication difficulties, infidelity), desire differences between partners, sexually transmissible infections, and wanting to be recognised as a sexual being. Conclusions: Sexual expression continues to be important for many older adults. People navigate a range of physical, emotional, and relational changes as they age. Understanding the priorities of older adults is important to adequately address the sexual health of older Australians.


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A nursing framework for early detection and management of post-operative delirium in older people Mrs Alera Bowden1, Professor Victoria Traynor2

1Illawarra Shoalhaven Local Health District, 2University of Wollongong Background: delirium is an acute and reversible confusion which presents as agitation and or lack of alertness and can be extremely distressing for the person. When older people experience a post-operative delirium they are at a higher risk of having longer hospital stays, psychotropic medication use, recurrent delirium, dementia, nursing home relocation and mortality. Currently, over 15% of older people experience a post-operative delirium with up to one third of cases remaining undetected. Currently no post-operative delirium pathways exist to assist nurses to detect and manage post-operative delirium in the post-anaesthetic care unit setting. Aim: to develop, implement and evaluate a post-operative delirium pathway in post-anaesthetic care units to increase nurses’ confidence and competence in detecting and managing post-operative delirium in older people. Methods: this is a multi-site, translational study with a pre-post quasi-experimental design. A co-design approach was used to capture nurses’ current practice and knowledge on post-operative delirium to inform the pathway design. The pathway was implemented using innovative educational techniques such as simulation and observational structured clinical examinations. Quantitative data was captured via surveys and qualitative via group workshops. Results: this presentation will share the outcomes of the pathway development and implementation stages. This will include the methods used to engage nurses in the pathway design, nurses’ simulation experiences and survey data on confidence and competence on detecting and managing post-operative delirium. Conclusion: implementation of a post-operative delirium pathway will improve nurses’ confidence and competence to detect and manage delirium in older people in post-anaesthetic care units.


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Navigating systems of care: structural burden for carers of migrants with dementia Assoc Prof Bianca Brijnath1,2,8, Dr Josefine Antoniades1,2, Dr Andrew Gilbert1,3, Dr Samantha Croy4, Dr Antonia Thodis1,5, Professor Jon Adams6, Dr Dianne Goeman7, Professor Colette Browning9,10, Professor Mike Kent2, Professor Katie Ellis2

1National Ageing Research Institute, 2Curtin University , 3La Trobe University , 4Murdoch Children’s Research Institute, 5Swinburne University of Technology, 6University of Technology Sydney, 7University of Newcastle, 8Monash University , 9Federation University , 10Australian National University Background & Objectives: Evidence suggests that informal carers of older migrants who live with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of migrant communities failing to seek formal support. Challenging this, we draw on the concept of ‘structural burden’ to explore how the complexity of health and aged systems contribute to the burden that migrant carers experience. Research Design & Methods: Semi-structured interviews with 104 family carers for migrants with dementia in Australia followed by thematic analysis of transcripts. Results: Additional to structural burdens encountered by the general older population, migrant carers also faced challenges locating culturally-appropriate care, were limited by discriminatory visa conditions, and were frequently required to translate the languages and operations health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno-specific organizations and other navigation support. Discussion & Implications: Australia’s care systems are notoriously fragmented. Subsidized home care involves a confusing array of different programs and levels, bureaucratic applications, and long waiting times. Carers’ encounters with these systems compound the challenges of providing informal care. For migrants this is further amplified by cultural and linguistic minority status. While ethno-specific services can reduce this burden, not all migrant groups are represented. Consequently, improving access to dementia care among migrant populations requires more than educating cultural perceptions of dementia. It requires entry point support that is culturally appropriate and linguistically accessible.


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Technology and Dementia: What does good technology look like from a carer's perspective? Dr Ruth Brookman1, Dr Celia Harris1

1Western Sydney University Social interaction is important for emotional wellbeing, but often remains an unmet need for people living with dementia and their caregivers. One tool utilised for the purpose of maintaining social connection, especially during a health crisis like the COVID-19 pandemic, is digital technology. However, the development of technology in dementia care has primarily focused on safety, monitoring devices, and supporting activities of daily living. Further, what people with dementia and their carers want and need most from technology is unknown and may vary with the stage of dementia. We report, therefore, on a mixed-methods study with the aim of investigating caregivers’ and people with dementia’s experience of technology, including barriers to its use, what they would like technology to do, and directions for future development. Caregivers (N=127), informal (n=102) and formal (n=25), completed an online survey. In addition, a subsample of caregivers (n = 22) and one person with dementia participated in a semi-structured interview. Findings demonstrate that caregivers want technology to be person-centered and to increase opportunities for meaningful social connection. These findings and implications will be discussed in relation to the potential use of technology to enhance, not replace, real social interactions.


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Health Equity And Wellbeing Among Older People’s Caregivers in New Zealand During COVID-19 Restrictions Prof Vanessa Burholt1, Dr Deborah Balmer1, Dr Rosemary Frey1, Moema Gregorzewski1, Dr John Parsons1, Dr Teuila Percival2, Rangimahora Reddy3, Dr Mary Simpson4, Dr Janine Wiles1

1University of Auckland, 2Moana Research, 3Rauawaawa Kaumātua Charitable Trust, 4University of Waikato Introduction: Unpaid family care has been the ‘backbone’ of health and social care provision in the community and was especially important during the COVID-19 restrictions. However, the stories of unpaid family caregivers have been invisible, and knowledge of their successes and challenges is limited. This community research aimed to investigate the challenges and rewards associated with caregiving focusing on caregivers who faced particular issues: those living in rural disadvantaged areas and Māori and Pacific caregivers. Method: Taking a participatory action research approach face-to-face interviews were conducted with Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients (15 living with dementia and 15 without). A thematic analysis of qualitative data was undertaken within a framework analysis. Results: Data were charted to provide decontextualized descriptive accounts in relation to the different levels of the human ecological model. Schematic diagrams captured commonalities of experiences across caregiver groups and at each level of the model identifying key issues relating to governmental policy, organizational processes, family, social networks and interpersonal relationships, individual characteristics and resources. Chronological explanatory summaries captured the complexity of experiences describing the interrelationship between levels of the model, caregiving roles, access and use of resources, simultaneously identifying positive aspects of caregiving alongside unmet needs and challenges. Conclusions: Results will be used in Phase 3 co-production workshops to produce short films describing caregivers’ experiences; identify a suite of culturally safe resources for use in future emergency health events and in everyday life; generate ideas to address unresolved issues.


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2020: the year of living bravely Prof Julie Byles1, Prof Deborah Loxton1

1The University of Newcastle The COVID-19 pandemic was associated with an outpouring of rhetoric about the vulnerabilities of older people, with people over 65 years being identified as most at risk of death if they were to catch the infection. These older people were also potentially affected due to increased isolation and reduced help in caring for others or to care for their own needs. However, 2020 also brought stories of resilience, kindness, and community cohesion, despite the needs for physical distancing. Over the year, the Australian Longitudinal Study on Women’s Health surveyed women across Australia every two weeks. The oldest women surveyed were aged 69-74. Compared to young women, the older women were generally less stressed and were less affected financially or in terms of housing and employment. However many older women were very concerned about self-managed superannuation funds, with how they were to care for ill husbands or disabled parents, living without interactions with their grandchildren, anxiety about the risk of infection, difficulty accessing health care, and many other matters. Women with poor mental health, and difficult social circumstances prior to the pandemic were more likely to have worse outcomes during 2020. This paper will present qualitative and quantitative data on the impacts of COVID-19 on the health and wellbeing of women in this 69-74 age group, and illustrate how the women made sense of their circumstances, with many women taking the opportunity to learn about themselves and to take stock of their lives to prioritise “what really matters”.


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I'm a gerontologist, but ... a view from the professorial to the personal Prof Julie Byles1

1The University of Newcastle I’ve spent almost half my life researching ageing. Collecting and interpreting data, and co-designing interventions to promote health and wellbeing. I’ve used data to gain insights into retirement, being widowed, to understand health and social determinants of ageing well, and to describe the pathways into and through aged care. I’ve developed and evaluated approaches to health assessments, medication reviews, and continence management. I’ve conducted trials of ways to notice and reduce pain, improve nutrition, and prevent falls among people in aged care. I’ve represented AAG on the National Aged Care Alliance, advised ministers on ageing, and the World Health Organisation. I’ve written reports on caregiving, and two of my PhD students are studying death and dying. But this time it’s personal. Over the last few years I have been helping my parents negotiate changes in their health and their abilities, and to make the big decisions about where to live, how to access care, and what sort of care they receive up to and including my father’s death … and now as mum faces life after dad. In this presentation I reflect on what I have learnt from data, and how this matches the actuality. Does the experience confirm the empirical? Does the research inform the reality? And what have I learnt, as a gerontologist, as a daughter, as a woman?


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Trauma-Informed Geriatric Care to Improve Staff Skills and Reduce Patient Distress: An Interrupted-Time Series Study Dr Monica Cations1, Associate Professor Kate Laver1, Professor Maria Crotty1,2, Assoc Prof Craig Whitehead1,2

1Flinders University, 2Southern Adelaide Local Health Network Geriatric hospital wards are highly medicalised environments with limited opportunities for choice and control, and can be distressing for older survivors of psychological trauma. While trauma-informed models of care (TIC) are effectively applied across mental health and other settings, the utility of these models in aged care settings has not been assessed. The objective of this study was to examine whether TIC can reduce challenging behaviour, chemical restraint, and improve staff skills and patient experiences in inpatient geriatric settings. Four wards participated in this hybrid implementation-effectiveness study across southern Adelaide, Australia, including 118 beds. Using a co-design method, the principles of TIC were transformed into a 10-part implementation strategy including staff training, establishment of highly trained ‘champions’ on each ward, and amending ward policies and procedures. An interrupted time series design was used to assess trends in primary outcomes, including monthly incidence of serious incidents, chemical restraint, and staff skills. A process evaluation was used to examine secondary outcomes including the acceptability, feasibility, and cost of the implementation strategy. Implementation and data collection are underway. Preliminary results suggest that staff are eager to adopt new approaches to reducing patient distress especially where environmental change is not possible. We will report data to elucidate whether screening for trauma-related needs and amending care to account for potential distress can reduce behaviour incidents and the use of chemical restraint.


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Trends in Mental Health Service Utilisation by Australia’s Older Adults Mr Jonathan David Bartholomaeus1, Mr Luke Collier1, Dr Monica Cations3, Assoc Prof Gillian Caughey2, Assoc Prof Maria Inacio2

1Registry Of Senior Australians, South Australian Health and Medical Research Institute, 2Allied Health and Human Performance, University of South Australia, 3College of Education, Psychology and Social Work, Flinders University Aim: Policy makers lack knowledge about how older Australians use mental health services, limiting planning potential. This study, therefore, examined trends in mental health service utilisation by older Australians. Methods: Time series analysis was conducted using public Medicare data for Australians aged ≥65. Trends in utilisation (Medicare groups A08, A20, M06, M07) between 01/01/2009 and 31/12/2019 were examined. Incidence rates were calculated, and incidence rate ratios estimated using Poisson regression. Results: Psychological therapy claims (M06) increased from 13.0/1000 people in 2009 to 38.8/1000 in 2019; a rate of 1.11/year (CI95% 1.10,1.13). GP mental health treatments (A20) increased from 30.1/1000 in 2009 to 78.5/1000 in 2019; a rate of 1.10/year (CI95% 1.07,1.13). Focussed psychological strategy claims (M07) increased from 26.5/1000 in 2009 to 54.8/1000 in 2019; a rate of 1.08/year (CI95% 1.06,1.09). Psychiatric attendances (A08) increased from 46.9/1000 in 2009 to 55.9/1000 in 2019; a rate of 1.02/year (CI95% 1.01,1.03). Women 65–74 reported the highest service utilisation compared to all other groups, claiming GP mental health treatments at 120.0/1000 compared to men (62.7/1000) in 2019. While men 85+ had the lowest utilisation, they showed the largest increase; psychiatric services increased from 14.1/1000 in 2009 to 22.4/1000 in 2019; a rate of 1.06/year (CI95% 1.04,1.08). Conclusions: The utilisation of mental health services amongst older Australians increased between 2009 and 2019. While women use more services than men, the highest growth was in older men. These insights provide a foundation for innovation in the provision of mental health services for Australia’s ageing population.


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Quality and Safety Indicators for Home Care in Australia Assoc Prof Gillian Caughey1,2, Ms Catherine Lang1, Dr Sarah Bray1, Assoc Prof Craig Whitehead3,4, Professor Renuka Visvanathan5,6,7, Prof Keith Evans8, Ms Megan Corlis9, Dr Victoria Cornell10, Prof Steve Wesselingh8, Assoc Prof Maria Inacio1,2

1Registry Of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), 2Allied Health and Human Performance, University of South Australia, 3Division of Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network (SALHN), 4College of Medicine and Public Health, Flinders University, 5The Queen Elizabeth Hospital, Central Adelaide Local Health Network (CALHN), 6NHMRC CRE Frailty and Ageing, University of Adelaide, 7Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, 8South Australian Health and Medical Research Institute (SAHMRI), 9Clinical and Health Sciences, University of South Australia, 10ECH Inc Aim: To develop quality and safety indicators for monitoring Australians receiving home care packages (HCP). Methods: The Registry of Senior Australians (ROSA) developed 15 quality and safety indicators to monitor individuals accessing HCP: wait-time, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium/dementia-related hospitalisations, emergency department (ED) presentations, pressure injuries, antipsychotic use, sedative load, chronic opioid use, antimicrobial use, premature mortality, home medication review and general practitioner (GP) management plan. Eight indicators used national data sources and seven used state hospitalisation records. Indicators prevalence (%, 95% confidence intervals (CI)) and geographical area (statistical level 3, SA3) variation during 2016 were examined. Results: In 2016, 86393 individuals received an HCP (72.1% levels 1-2, 27.9% levels 3-4). Of the national indicators, the three most prevalent included: antibiotic use (56.2%, 55.9-56.5%), GP management plan provision (43.1%, 44.4-43.5%), and high sedative load (30.8%, 30.5-31.1%). HCP median wait time was 134 days (interquartile-range 41-403). Geographical variation was highest in GP management plan provision (15.7% of areas outside expected rate). For the seven state indicators, the three most prevalent included ED presentations (43.1%, 42.7-43.5%), falls (13.2%, 12.9-13.4%), and delirium/dementia-related hospitalisations (10.9 %, 10.3-11.5%). The greatest geographical variation was in weight loss/malnutrition-related hospitalisations (12.7% of areas were outside expected range). Conclusions: A comprehensive and effective outcome monitoring system to monitor quality and safety of care provided to HCP recipients and its national variation has been developed. It provides a pragmatic, efficient, and low burden tool to support evidence-based quality and safety improvement initiatives for the aged care sector.


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Association of the COVID-19 pandemic and stay-at-home lockdowns on mental health in Australia Dr Marina Cavuoto1, Ms Jessica Nicolazzo1, Ms Alexandra Lavale1, Dr Rachel Buckley2, 3, 4, A/Prof Yen Ying Lim1, Matthew Pase1, 5

1Turner Institute for Brain and Mental Health, Monash University, 2Melbourne School of Psychological Sciences, University of Melbourne, 3Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 4Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, 5Harvard T.H. Chan School of Public Health, Harvard University Background The Australian experience during the COVID-19 pandemic has been unique, with low infection numbers but several restrictions on personal freedoms. We aimed to study the extent to which middle-aged and older Australians experienced deteriorating mental health during the pandemic compared to pre-pandemic, and identify predictive factors of poor mental health. Methods The study comprised 952 participants (mean age = 60 years, 80% female, 57% Victorian) from an Australian longitudinal community-based cohort. Pre-pandemic levels of self-reported depression, anxiety and stress symptoms were measured in 2017, 2018, and 2019 with the Depression, Anxiety, Stress Scale (DASS) and compared to levels during the height of the pandemic (March to September 2020) using linear mixed modelling. Linear regression was used to explore predictors of poor mental health during the lockdown period instituted in Victoria due to the pandemic. Results Compared to average pre-pandemic levels, depression (3.35 vs 7.96), anxiety (2.30 vs 3.65) and stress (5.41 vs 9.37) symptoms increased during the pandemic (p<0.001 for all). Participants endorsing at least moderate levels of depression increased from 8.9% pre-pandemic to 21.9% during the pandemic (p = .005). Experiencing a stay at home lockdown, high levels of loneliness, and worry about mental health were associated with higher levels of depression, anxiety and stress, whereas resilience was a protective factor. Conclusions/Implications Middle-aged and older Australians experienced a profound deterioration in mental health during the pandemic. Investment in mental health promotion is critical at this time, particularly in relation to boosting resilience, and minimising loneliness and worry.


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Update and validation of the Healthy Ageing Quiz Dr Jessica Cecil1, Assoc Prof Frances Batchelor1, Prof Pazit Levinger1, Ms Leona Kosowicz1, Prof Briony Dow1

1National Ageing Research Institute Introduction: The Healthy Ageing Quiz is a user-friendly self-assessment tool that has been helping older Australians increase their awareness of healthy ageing and maximise their current and future health since its release in 2010. The National Ageing Research Institute conducted an extensive update and validation process to produce a new version of the Healthy Ageing Quiz with the most recent research on healthy ageing. Method: A mixed methods approach was developed including a scoping review of evidence and guidelines published in the last 10 years, consultation with an Advisory Group of experts and an Australian wide online and mail survey of people over the age of 50. Survey participants were asked to complete the Healthy Ageing Quiz, an evaluation quiz (to collect demographic data and qualitative feedback) and a validation using pre-existing questionnaires related to the domains in the updated quiz. A subset of the participants was approached to complete the quiz again after 4 weeks to determine its test-retest reliability. Results: Significant modifications of the Healthy Ageing Quiz were required to update recommendations in line with current guidelines around physical activity, balance and falls, nutrition, weight and waist circumference, sleep and alcohol use. The quiz was revised to include new questions on sedentary behaviour, hearing loss, malnutrition and illicit drug use. Additional feedback from the Advisory Group was utilised to clarify terminology and maximise the accessibility of the quiz. Data collection for the Australia wide survey is underway and the validation results will be available to present in November.


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Rethinking Intersectionality in Social Gerontological Research: A Case Study Ms Jin Chen1

1Flinders University Since its conceptualisation by critical feminist Kimberlé Crenshaw, intersectionality as a theoretical and analytical approach has been used widely across academic fields. In social gerontology, academics have used intersectionality to examine how (old) age interacts with other minoritised identities like gender and culture. This presentation reflects on an intersectional approach through Imagining Ageing Futures, a study with multicultural LGBTQ+ people aged 50 and above. Imagining Ageing Futures emerged from a systematic review highlighting a dearth of studies on multicultural LGBTQ+ ageing in Australia and worldwide (Chen, McLaren, Jones & Shams, 2020). Drawing on feminist and participatory principles, the study uses an online form of photovoice comprising interviews, photo-elicitation and discussions with a small sample of participants across Australia. While the research criteria focused on gender, sexual orientation, culture and age, it became evident that an analysis through these identities was insufficient and limiting. In particular, asking participants to take, choose and discuss photographs allowed them to frame their experiences in ways that were important to them beyond these identities. Consequently, an intersectional approach meant taking a broader and fresh analysis outside these preidentified minority categories. Doing so uncovered the hidden importance of class, geography and community in shaping participant perspectives. These findings underscore a need to critically examine social gerontological research. Rather than framing older people’s experiences within pre-existing minority identities, researchers need to take a step back to reflect on the interaction of majority and minority identities in creating these experiences.


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Evaluating the Co-Design of Age-friendly Dining: Lessons from the Dining Co. Project Ms Jin Chen1, Dr Edoardo Rosso2

1Flinders University, 2ACH Group This presentation examines the evaluation of Dining Co., a co-designed project led by an Adelaide aged care provider in line with South Australia’s Plan for Ageing Well 2020-2025. Following a six-month co-design journey with two dining establishments, older people and local stakeholders, Dining Co. piloted dining initiatives that aimed to promote age-friendly neighbourhoods over a six-week period. The evaluation assessed dining experiences for older people and explored how dining out affected their social connectedness. The evaluation project adopted a mixed-method approach consisting of surveys of older customers, informal observations, interviews with dining establishment staff, and staff self-assessed attitudes towards older people and perceptions of age-friendly customer service. This provided an opportunity to appreciate the broad spectrum of stakeholder perspectives and embodied experiences of dining out for older people over the six-week pilot. The evaluation highlighted an overall positive experience for older customers at the venues. Older customers found the venues to be ‘age-friendly’ and positive in aspects like accessibility, pricing, menu options and staff interactions. They dined comfortably at the venues and interacted positively with one another, and at times, with the staff. The evaluation suggests a positive link between dining out at age-friendly venues, social connectedness and ageing in place for older people. It validates the co-design aim of age-friendly dining venues. More broadly, it provides a practical example for co-design projects to implement initiatives and evaluate their outcomes.


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“What Can You Expect At Your Age?!”: Older people’s experience of age discrimination in healthcare Ms. Aakriti Chhetri1, Dr Anthony Brown1, Ms. Yumi Lee2

1Health Consumers NSW, 2Older Women's Network NSW Research released in 2017 by the EveryAGE Counts campaign demonstrated that health care settings were the second most likely of places where older people reported experiencing ageism. This confirmed anecdotal reports from members of Health Consumers NSW (HCNSW) and Older Women’s Network NSW (OWN) that older people are being treated differently in healthcare because of their age. The two organisations partnered to further investigate the issue of ageism in the health care sector using a survey and in-depth interviews to determine how ageism is experienced by older people today, particularly in NSW, and what impact it has on them. This presentation will focus on older peoples' negative experiences of healthcare. Older people identified that these negative experiences stem from not being listened to by health professionals and their health concerns not being taken seriously. Many older people saw this manifested through the patronising language that medical professionals used when talking to them, and, most seriously, it also meant some older people did not receive clinically appropriate care. Resulting in negative health outcomes for the individuals. Older people reported that their care was further compromised by discrimination based on gender, Aboriginality, or being a member of LGBTIQ+ communities. This presentation will highlight these issues, focusing on the voices and experiences of older people themselves. The solutions suggested by older people will also be explored and an update given on the ongoing work of HCNSW and OWN to challenge ageism in healthcare.


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Maintaining active minds and bodies through online music reproduction and improvisation classes Dr Anthony Chmiel

Maintaining active minds and bodies through online music reproduction and improvisation classes A growing body of literature is linking engagement with music to benefits in mental health and wellbeing, social bonding, cognition, and motor function for older adults. However, as many of these studies tend to use vastly different methodologies the overall findings tend be mixed or inconsistent. Moreover, the majority of these studies with music engagement have been limited to approximately 2 or 3 months in duration, which is unlikely to be sufficient to produce meaningful results. This presentation introduces the Active Minds Music Ensemble, a longitudinal project in which 10 classes of older adult music novices (aged 65-80, N=68) undertake 12-months of music education. Across the year of learning participants are given aural-based instruction on how to reproduce well-known melodies, and also how to approach creative improvisation. This allows us to examine the impact of learning task on progress rate, cognition, wellbeing/enjoyment and self-efficacy. As learning occurs on both piano keyboard and an iPad app called Thumbjam, we are also able to examine the impact of instrument on motor function as well as creative musical possibilities. While initial classes were held in a face-to-face setting, this was disrupted by COVID-19 and from March 2020 all classes transitioned to an online-only format. This gave us a unique opportunity to hold detailed interviews with participants as they suddenly and unexpectedly transitioned to online learning. Using online apps and technology were frequently reported to be unfamiliar and daunting for many of our participants, although over time this engagement led to positive outcomes such as increased confidence. The positive and negative aspects of the online transition are discussed. Biography Anthony Chmiel is a researcher in music and cognitive psychology, with a focus on aesthetics, emotions, wellbeing, ageing, and education. At the MARCS Institute for Brain, Behaviour and Development, Anthony primarily works on the ARC Discovery Project “Maintaining active minds and bodies through older adult music education”. In addition to this he maintains teaching positions and research collaborations at UNSW Sydney, the University of Padova (Italy), and the Melbourne Conservatorium of Music.


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Opportunities for social participation in residential aged care: survey data from a Victorian, state-wide project Dr Samantha Clune1, Prof Deirdre Fetherstonhaugh2, Dr Jo-Anne Rayner2, Ms Linda McAuliffe2

1Australian Institute Of Primary Care And Ageing, 2Australian Centre for Evidence Based Aged Care Social isolation for older people is well understood in the literature and is of increasing relevance in policy creation [1]. Changes in social participation associated with advancing age has been linked with increasing incidences of unanticipated hospitalisation and premature mortality [2]. Much of the research literature focuses on social isolation for older people still living in the community [3]. However, little is understood about social participation opportunities or older people living in residential aged care. This project investigated social participation opportunities for older people living in residential aged care facilities (RACFs) in Victoria, Australia. All registered RACFs in Victoria (n = 576) were surveyed to investigate possible facilitators and barriers for social participation for current residents, with a focus on both internal (organisational) and external (community) social participation opportunities. A response rate of 26% (n = 153) was achieved, with data outlining key issues for continued social participation for older people. Funding nuances, like changes to welfare supplements upon transition into residential care, limited personal wealth, and a lack of dedicated internal funding were identified as potential barriers to social participation. Workforce issues, like a lack of carer availability and inconsistent use of volunteers were also cited as a barrier to ongoing participation. These findings form part of a larger study that will help to inform the creation of performance measures for social participation for older people living in residential care in Victoria.


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Social participation in residential aged care: what is most important for older people? Dr Samantha Clune1, Prof Deirdre Fetherstonhaugh, Dr Jo-Anne Rayner, Ms Linda McAuliffe 1Australian Institute Of Primary Care And Ageing Maintaining social participation across the lifecourse can be problematic, especially for those older people who have transitioned into residential care [4]. Often, levels of social participation enjoyed are starkly less upon transition, with demonstrated direct impact on health and wellbeing [5]. While many RACFs maintain a programme to foster and support ongoing social participation, it is unclear how effective these programmes are. This project uses a mixed method approach to investigate what is most important to older people in terms of social participation and what barriers and facilitators they may experience in optimising their social participation once they transition into residential care. Semi-structured interviews were conducted across Victoria with three groups of participants: older people living in their homes; older people living in residential care facilities; and staff of either community organisations or residential facilities responsible for facilitating social participation for older people. Data were analysed according to Levasseur’s six level taxonomy of social participation [6] for evidence of variation in levels of social participation across the two groups of older people. Findings indicate that both groups of older people valued more fundamental social participation whereby they are interacting with others but were not necessarily working toward a common outcome. Higher level social activities, like volunteering and political activities, were markedly reduced among older people living in RACFs. Access to necessary material and economic resources as well as impacts of illness and frailty were noted as key barriers for social participation both in the community as well as RACFs.


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Addressing recruitment challenges: designing enjoyable and effective data collection methods. Ms Kathy Constantin1

1Swinburne University of Technology Despite growing efforts to get people moving more, there is a global decrease in physical activity among older adults. With the ambition to cure inactivity, there is a crucial step that has been overlooked. Instead of pushing for movement through untailored recommendations, the individual motivation of people to move needs to be better understood. To explore this complex phenomenon the researcher had a strong anticipation of who needed to be involved in the study: adults over sixty, spanning a wide variety of activities and movement levels. Semi-structured interviews and a cultural probe kit to explore motivation and barriers around movement was designed. The first round of recruitment resulted in fewer volunteers than expected. Participants expressed that they were not “good enough” to be involved and the recruitment only drew four participants. Changes were made in the second round of recruitment, including a reconsidered cultural probe kit. Language shifted from movement and concentrated on an engaging experience. Activities included thought-provoking photography, reflective writing that focused on positive experiences and the individuals’ thoughts and feelings was emphasised. This approach resulted in sixteen new participants in five days. Data from the cultural probe kits increased quantitatively and qualitatively, and the participants were actively engaged with the project. The cultural probe kit captured the participants’ attention and kept them entertained in better communicating research needs and making participants think differently and creatively. This led to richer and more meaningful data that is driving the design stages of the movement motivation research.


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Re-balancing residential aged care provision: targets, trajectories, and tears Mr Mark Cooper-Stanbury1

1University Of Melbourne Introduction A needs-based planning framework has been a feature of managing supply of residential aged care places in Australia for several decades. Despite the framework, considerable variation in supply exists at the small-area level (Statistical Area 3 (SA3)). Recent reviews (including the Royal Commission) have proposed alternative approaches to allocation of places. Method Using the latest population projections, the expected number of places in each of the 340 SA3s for 2020 and 2030 was determined on the basis of the current target provision ratio (78 places per 1,000 population aged 70 and over), plus 3 alternative ratios (the equivalent places per 1,000 population aged 75+, 80+, and 85+). Results In 2020, there was a shortfall of 9,100 places against the current target ratio, but a mis-distribution of 51,600 places: 65% of SA3s required more places to meet the current target. By 2030, the projected shortfall (if no more places were to be allocated) would be as high as 121,000 (under the 80+ planning scenario): 92% of SA3s would have a shortfall, requiring a gross redistribution of 113,500 places. Conclusion The current planning regime has resulted in substantial maldistribution of places (relative to population-based targets), and this is expected to worsen over the next 10 years. Hence, any changes to allocation policies will need to be well designed and monitored to ensure equity of access at the small-area level is not further diminished.


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The role of Australian health professionals in helping people choose their home care package services Dr Victoria Cornell1, Dr Braam Lowies 1ECH Objectives: The aim of the project broadly was to explore consumer protection and choice as it relates to accessing and navigating home care services; and furthermore, to understand the trusted sources of information both in advance of, and during receipt of, home care services. Method: A CATI survey was delivered to 502 older Australians (aged 65 years and above) residing in Perth, Melbourne, Adelaide, Sydney, Brisbane, Canberra and Hobart metropolitan areas. Results: The survey found that most older Australians rely on health care professionals for trusted information on home care packages—both in the initial seeking of information, and the management thereafter. Conclusion: In spite of the above finding, there is little understanding of the confidence of health care professionals in finding the necessary information for their patients on quality and appropriate in-home care; their existing relationships with aged care providers; and if the recommendations to their patients are effective. Further research is needed to establish health care professionals levels of confidence in providing in-home care information and guidance and to establish what their needs are regarding practice resources, trainee education and continuing professional development.


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Point prevalence of frailty and pain in adult inpatients of an acute private hospital Dr Rosemary Saunders1, Dr Kate Crookes1, Dr Marcus Ang1,2, Dr Beverley Ewens1, Dr Olivia Gallagher1, Ms Renée Graham1, Ms Sue Haydon2, Dr Jeff Hughes3, Ms Debra Scaini2, Dr Joyce Siette1, Dr Christopher Etherton-Beer4

1Centre For Research In Aged Care, School Of Nursing And Midwifery, Edith Cowan University, 2Hollywood Private Hospital, 3PainChek, 4School of Medicine and Pharmacology, University of Western Australia In hospitals, frailty and pain are associated with adverse clinical outcomes and increased costs. Frailty and pain interact, such that pain can exacerbate the progression of frailty and the symptoms of frailty can make pain difficult to assess. This study aimed to determine the point prevalence of frailty and pain in an acute care private metropolitan hospital in Western Australia. An observational, single-day point prevalence study of frailty and pain of all adult inpatients (excluding day surgery and critical care wards) was conducted. Frailty was assessed using the modified Reported Edmonton Frail Scale (mod-REFS). Pain was assessed using the 0-10 numerical rating scale (NRS) and the PainChek® smart-device application that is intended for use with patients who cannot self-report pain. Demographic and clinical information were also collected. Of the 457 occupied eligible beds, 253 patients consented to participate, 94 were excluded, 87 refused and 23 were missed. The prevalence of frailty (mod-REFS score of 8 or higher) was 26.7%. Frailty prevalence differed by speciality: medical 54.7%, surgical 7.1%, rehabilitation 42.9%, mental health 28.6%. All participants were able to self-report pain. Using the NRS 68.1% of participants reported current pain (i.e., a rating greater than 0), the mean current pain score was 2.3 (SD 2.2). Frailty was highly prevalent particularly in patients admitted under medical and rehabilitation specialties but less prevalent in surgical patients. Pain was also highly prevalent across the hospital. These findings are important for hospitals to consider when allocating resources and directing potential interventions.


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Cycling Without Age 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Rowes Bay Residential Aged Care, 4Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 5Centre for Health Communication and Participation, La Trobe University, 6Southern Synergy, Department of Psychiatry at Monash Health, Monash University, 7School of Public Health & Preventive Medicine, Monash University Cycling without Age (CWA) is a program founded in Denmark in 2012 and is available in over 50 countries. Volunteers and care home staff (known as pilots) are trained to take residents for an outdoor bicycle ride on a trishaw, a cross between a rikshaw and an electric bicycle. This pilot project aimed to evaluate the experience and impact of CWA from the perspective of residents and their family, care home staff and pilots. Information about each ride (time of day and duration) was recorded in a logbook. A short description of the person’s affect and/or responsive behaviour(s) (happy/sad, or agitated/apathetic) immediately before, during and immediately after the ride was documented. Interviews were conducted with 21 participants. Transcripts were analysed thematically, using the interview questions to determine baseline categories followed by coding to describe central themes. Ride duration ranged from 30 minutes to two hours (mean = 93 minutes). Negative affect was observed pre-ride but not during or after any of the rides. Several themes emerged from the interview data. Seeing familiar places prompted residents to reminisce. For family, CWA was a novel way to be with their loved one. Experiencing the outdoors elicited positive emotions in residents, including those with cognitive impairment. CWA offered residents time away from their usual routine. CWA offered multiple benefits for residents which were corroborated by family members, staff and pilots. These included sharing stories, feeling the breeze or warmth of the sun, interacting with the wider community and experiencing something new and unique.


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Digital Wallpaper 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Galleon Gardens Residential Aged Care Technology is increasingly being used for dementia care, such as supporting residents’ access to computers/tablets/smartphones, active gaming, therapeutic robots and virtual reality. In 2018, the world’s first interactive ‘digital wallpaper’ was installed in a care home’s dementia care unit. This is a series of acrylic light panels, 4m long by 2.7m high, affixed to the wall. Technically, the wallpaper is a product called LUMES, created by ENESS a Melbourne-based multimedia design studio. The wallpaper initially featured nine ‘scenes’ such as bubbles that pop when touched and a cockatoo that flies away when touched. An evaluation was conducted during the first year of operation. Staff members were interviewed. Observations were made of structured programs and informal interactions with the wallpaper. Its light, colour and movement were meant to attract residents’ attention and prompt interaction, creativity and social interaction. Staff comments, corroborated by observations, revealed that residents walked past the wallpaper without even glancing at it. Possibly because of the lack of initial co-design with staff and residents, the scenes were only able to hold peoples’ attention for about one minute. This was despite the attempts by the staff to incorporate the wallpaper into their recreational and therapeutic programs. Bolton Clarke re-engaged with ENESS to create three new scenes for the wallpaper, focusing on physical activity, cognitive activity and reminiscence and incorporating sound and music. The new content was co-designed with staff and residents. Preliminary data indicates increased resident and staff engagement and satisfaction, with sessions continuing for up to one hour.


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General practice consultations in residential aged care facilities during the COVID-19 pandemic period Dr Zhaoli (Joy) Dai1, Mr Guilherme S Franco1, Dr Shirmilla Datta2, Dr Precious McGuire2, Professor Andrew Georgiou1

1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, 2Eastern Melbourne Primary Health Network Introduction Medical Benefits Schedule (MBS) telehealth items have been made available in Australia since March 2020 to facilitate timely healthcare delivery. This study describes the patterns of general practitioner (GP) consultations in residential aged care facilities (RACFs) during the COVID-19 pandemic. Methods Using GP electronic data covering 454 practices in Victoria and 346 practices in NSW, we identified RACF residents based on GP face-to-face MBS items specifically used in RACFs among those ≥65 years with ≥2 GP face-to-face consultations over the past two years. We calculated monthly GPs’ in-person visits to RACFs (MBS item 90001) and proportions of face-to-face, telephone, and video consultations against total claims of standard GP consultations. Results Among 15,851 residents (63.5% aged 85+y, 66.7% female) in Victoria and 6,946 residents (60.4% aged 85+y, 62.3% female) in NSW, monthly GP visits sightly increased in NSW [median (IQR): 1,279 (1,094-1,315) in 2019 and 1,417 (1,337-1,467) in 2020] but decreased in Victoria in 2020 [(4,000 (3,757-4,557) in 2019 and 3,561 (3,434-3,753)] in 2020). Face-to-face consultations declined since April 2020, with 86% and 90% in NSW and 83% and 71% in Victoria in April and August, respectively, while telephone consults increased to 13% and 10% in NSW and 14% and 26% in Victoria, respectively. Video consultations remained low (<4%) in both states. Implication Telehealth filled the gap of GP services delivery in RACFs during the COVID-19 pandemic. Future studies should examine how telehealth affects quality of care in aged care residents, including disease management, medication prescriptions, and routine laboratory testing.


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Reporting and resolution of complaints for people accessing aged care Dr Christa Dang1, Ms Anabelle Peck1, Assoc Prof Frances Batchelor1,2,3, Dr Steven Savvas1,2, Dr Anita Goh1,2,4, Prof Briony Dow1,2,3,5

1National Ageing Research Institute, 2University of Melbourne, 3Deakin University, 4Royal Melbourne Hospital, 5Australian Association of Gerontology Two nation-wide surveys on behalf of the Royal Commission into Aged Care Quality and Safety examined the proportion of concerns about quality of aged care services that were either reported or unreported by people accessing residential, home and respite care. For concerns that were reported, clients were asked to whom and whether satisfactory resolution was achieved. For concerns that were not reported, clients were asked their reasons for not lodging complaints. Surveys were completed by proxy if needed. Up to half of concerns about aged care services (31.7-48.4%) were not raised with others, whether informally or officially. The most common reasons for this included viewing concerns as “too minor”, thinking nothing would change, not knowing who to report to, lacking capacity to complain, or thinking it was not worth complaining during short stays in respite. The majority of reported concerns were made directly to staff, with very few (0-5%) raised with the Aged Care Quality and Safety Commission. Less than half of all reported complaints were satisfactorily resolved (27.4-48.1%). The results suggest that aged care clients face numerous barriers to reporting concerns. This should be addressed at multiple levels. The current system for capturing, investigating and responding to complaints is not working. Significant changes in regulatory processes are recommended by the Royal Commission, including introducing a single authority for all aged care complaints. Comprehensively capturing experiences of people accessing aged care will be crucial to allow their voices to be heard as the system undergoes significant change in the future.


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What concerns do older people have about their aged care? Ms Anabelle Peck1, Dr Christa Dang1, Assoc Prof Frances Batchelor1,2,3, Dr Steven Savvas1,2, Dr Anita Goh1,2,4, Prof Briony Dow1,2,3,5

1National Ageing Research Institute, 2The University of Melbourne, 3Deakin University, 4Royal Melbourne Hospital, 5Australian Association of Gerontology Two nationally-representative surveys were conducted on behalf of the Royal Commission into Aged Care Quality and Safety to examine the perceived quality of care for people accessing residential, home and respite aged care services. This talk will summarise the areas of concern raised by participants of these two surveys and discuss the implications for policy and practice in the context of the Royal Commission’s recommendations. 391 face-to-face interviews were conducted with individuals living in residential aged care facilities across Australia. 1223 telephone surveys were conducted with individuals either receiving a Home Care Package (HCP), or had received Commonwealth Health Support Programme respite or residential respite services. Proxy surveys were conducted as needed. Two-thirds of participants indicated having at least one concern about the care they receive. The most common concerns identified by individuals receiving HCP or respite services were related to finance and administration (lack of value-for-money, fee transparency, and coordination of services) and staff (continuity, training). People receiving residential care services were primarily concerned about staff (understaffing, under-resourcing), followed by fees and services (food, activities). These results are consistent with the Royal Commission’s findings more broadly. The delivery, funding and governance of aged care must be improved. Concerns about finance and administration reflect systemic issues in aged care governance and regulation. Concerns about staffing and training reflect major inadequacies of the aged care workforce. As recommended by the Commissioners, the aged care system is in need of substantial reform to improve the experience of those accessing aged care.


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Improving the system of home care: What needs to change? Ms Anabelle Peck1, Dr Joan Ostaszkiewicz1, Prof Colleen Doyle1,2,3, Assoc Prof Frances Batchelor1,2,4, Dr Anita Goh1,4,5, Dr Christa Dang 1National Ageing Research Institute, 2Deakin University, 3Swinburne University, 4University of Melbourne, 5Royal Melbourne Hospital Introduction and background The Royal Commission into Aged Care Quality and Safety found that the current system of home care is not working. Older people wait too long for funding to access care at home, find it difficult to navigate a complex and confusing system to access the services that they need, and often experience issues with the quality of services delivered. In their final report, the Commissioners presented many recommendations proposing fundamental change to the way in which home care is delivered, funded and governed. Government must now act to improve the system in response, but there is lack of clarity and evidence around the complex elements that need to change. Policy must be informed by the best available evidence, as well as ongoing engagement with older people, their families, and diverse stakeholders across the home care sector. Aims The aim of this presentation is to explore issues existing in Australia’s system of home care and to evaluate the Royal Commission’s recommendations as well as Government’s response to the recommendations. Overview of activities The presenter will share evidence highlighting the complex issues affecting Australia’s system of home care and invite discussion around implications of the Royal Commission’s recommendations and the Government’s response to date. Expected learning activities for audience members Audience members will learn about the implications of the Royal Commission’s final report and the Government’s response on home care, and discuss what needs to be done to improve Australia’s system of home care according to the evidence.


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Neighbourhood living for people with dementia: Could dementia villages be the answer? Dr Nathan D'Cunha1,2, Dr Jane Thompson2, Professor Diane Gibson1, Professor Sue Kurrle2,3

1Faculty of Health, University Of Canberra, 2The Neighbourhood, Canberra, 3Faculty of Medicine and Health, University of Sydney The built environment has been increasingly recognised as a critical factor contributing to quality of life among people with dementia. The use of innovative residential care models that incorporate small-scale neighbourhood designs have been recognised for their potential to improve quality of care, maintain dignity, and reduce medication use and hospitalisation. The need for safe, high-quality care that focuses on the wellbeing of residents has been highlighted by the findings of the Royal Commission into Aged Care Quality and Safety, who also identified the need for better care and innovative practices that could positively impact the lives of older people. Dementia villages offer recreational activities and services to their residents that we would expect within a community setting, including access to outdoor green spaces and to services such as a café, library, hairdresser or general store. Several examples of the village-style model are operational, including Korongee in Tasmania, De Hogeweyk in the Netherlands and Bryghuset Svendborg in Denmark. The Neighbourhood, Canberra (TNC) is a community based organisation aiming to establish a dementia village in the Australian Capital Territory which will provide a relationship-centred model of care offering people with dementia greater independence and connection with the local community. This presentation will summarise the available evidence for dementia villages, present local stakeholder opinions, and describe the dementia village proposed by TNC. Interest in dementia villages is increasing, and the evaluation of current and proposed dementia villages will assist in informing broader aged care innovation, policy and practice.


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What does trauma-informed aged care look like? Dr Lenore de la Perrelle1, Dr Monica Cations1, Associate Professor Tim Windsor1, Mr Nathan Klinge2

1Flinders University, 2RSL Care SA Background Exposure to psychological trauma across the lifespan can affect the experience of receiving aged care services in fundamental ways. Trauma-informed care is a framework applied in mental health and other settings in which the organisation has processes and staff capable of identifying when psychological trauma may be affecting a person’s experience in care, amending procedures to account for triggers, and creating an environment that maximises control for the victim. In aged care, changing routine care and behaviours can be complicated by a lack of familiarity with what changes are needed. Few examples exist of what trauma-informed models of aged care look like in practice. Aim The aim of this translational scoping project was to identify key clinical actions and behaviours that create a trauma-informed aged care setting, by observing and showcasing an existing specialist service who does this well. Methods We used an appreciative enquiry approach to document overt and covert examples of trauma-informed care in two specialist veteran residential care facilities in South Australia. Care observation, qualitative interviews, and policy/procedure audit were used to identify concrete examples of how that care is experienced by older trauma survivors. Results Data collection for this study is underway. Identified examples will be developed as a practical guide to what trauma-informed aged care looks like and what steps are needed to facilitate changes in routine care to meet the needs of older people who have experienced psychological trauma.


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Potential for relationships and engagement with pets, wildlife and nature to support older adults’ wellbeing Dr Kelli Dendle 1QUT Rising rates of loneliness and social isolation are well recognised risks to older adults’ mental health and wellbeing. These factors are likely to be exacerbated by COVID-19 physical isolation measures and subsequent changes in interpersonal and health behaviours. This convergence of unprecedented risk factors means that it is crucial to explore and expand the range of options available to reduce isolation and enhance older adults’ opportunities for meaningful engagement in daily life. This paper explores the potential for relationships and engagement with pets, wildlife and nature to provide a sense of connection and support older people’s mental health and wellbeing. Drawing on the findings of recent Australian research, it will address the evidence around older people’s engagement with the non-human world and identify potential benefits and pitfalls. Alternative approaches will be proposed for policy, planning and practice that leverage the benefits of non-human interaction and engagement to support older people’s wellbeing in a post COVID-19 world.


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Fish Feeders SA. A collaborative partnership between 5 local governments in South Australia Mr Lui Di Venuto1, Mrs Debra Whetstone 1City Of Onkaparinga, 2City of Charles Sturt Fish Feeders SA is a regional partnership project between the Cities of Onkaparinga, Charles Sturt, Marion, Holdfast Bay, and Port Adelaide Enfield. It is a social connection program enabling older people to connect through activities and shared learning focused on fishing and other opportunities for ageing well. Fish Feeders creates and activates a space that is inviting and accessible to all ages and encourages a sense of community. Through recreational fishing, participants appreciate nature and take care of the environment for the future. As the program will use existing infrastructure (jetties) participants are encouraged to rate each venue and give feedback regarding accessibility for older people, provide suggestions for improvements and advocate for change, thus ensuring connection and independence are maintained. The direct benefits for older people include: • Being part of a diverse range of social networks • Reducing the risks of isolation • Developing confidence in engaging with young people and the whole of society through a shared activity • Providing the opportunity to develop a sense of belonging and contribute to their community • Taking place in a safe, non-political and non-judgemental environment • Increasing access to other physical and wellbeing programs across councils • Identifying and nurturing innovative ideas and activities in a community environment Fish feeders SA innovates by sharing resources across Councils to develop a sustainable evidence-based model that can be used by any local government in South Australia, nationally, and potentially globally. The presentation shares the journey and outcomes using Results Based Accountability.


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Integration of Elder Abuse Services within the Orange Door (Victorian Specialised Family Violence Hub) Mrs Jenni Dickson1

1Better Place Australia Better Place Australia has been providing Elder Abuse Prevention Services for over 5years. The model of care is based 4 principles: 1. Safety and risk mitigation 2. Empowerment of older person 3. Respecting older person’s decision making 4. Enhancing family relationships. This is overlayed within a risk management context ensuring safety of the older person. Better Place has recently received funding to provide Elder Abuse Prevention Services within the Family Violence hubs - Orange Doors (OD) in Barwon, North East Melbourne, Bayside and Morwell. OD is a service for adults, children and young people who are experiencing, or have experienced, family violence and families who need extra support with care of children. This collaborative model has a Family Consultant work within the Orange Door receiving referrals and providing secondary consultations to staff working within OD. Whilst Elder Abuse is a form of Family Violence there are nuances including: • Elder Abuse has a high proportion of perpetrators being female • Elder Abuse is experienced by men (approximately 20-30%) • Elder Abuse victims frequently want to preserve relationships, particularly family members • Elder Abuse may not be as easily recognisable • Ageism in context to Elder Abuse. This presentation will highlight: • Differences providing Elder Abuse services within OD (higher number of cases with physical violence and police involvement) • Collaborative and integrated model of care • Case studies to highlight case complexities • Differences between rural areas and metropolitan Melbourne • Higher incidence of physical partner violence from OD referrals.


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When the cupboard's bare, we still find something there, harnessing resources to benefit older clients Mrs Bernadette Dimla1

1University Of Sunshine Coast Limited resources, lack of access to health care and transport encapsulates the issues facing regional, rural, and remote residents. Some regional areas rely on the State government multipurpose health facilities for health and community services due to lack of service providers, limited access to transport, and fragmented government funding. High operational costs, staff retention issues and skill shortages discourage non-government agencies to venture into sparsely populated and dispersed communities. In some cases, older people may be receiving insufficient services through Commonwealth Home Support Program or waiting on the National Prioritisation Queue. Consequently, older people may miss out on much needed care to live independently at home. Most practitioners provide additional support to fill the service gaps. However, the over-extension of service may not be necessary with an awareness and understanding of the existing local resources which could fulfill this important function. Having this knowledge could open opportunities for building partnerships and working collaboratively to optimise older people’s health. The presenter conceptualised and initiated lunch box sessions aimed at educating and raising awareness amongst clinicians within Cairns Health Service areas of the existing resources which could be harnessed in a resource scarce environment. The agencies are invited to introduce and explain their practice; discuss complex cases, challenges, ideas to fill service gaps, pathways to referrals and collaboration for joint clients. Attendees are also encouraged to ask the guests questions. The initiative hopes to support practitioners implement interventions informed by an awareness and understanding of existing resources that could fill service gaps.


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What next for carers following the Royal Commission into Aged Care Quality and Safety Ms Melissa Docker1, Ms Sarah Judd-Lam1

1Carers NSW Approximately 1.7 million Australians who are ageing require assistance with at least one everyday activity, with 70% reporting receiving this from informal carers, who are often ageing themselves. Many carers report positive aspects of their caring role however, without adequate support, carers can become burnt out and the sustainability of the informal caring relationship significantly undermined. In these cases, the people they care for may need to find alternative caring arrangements, which are often high-cost crisis solutions such as indefinite admission to hospital or premature placement in a residential facility. The Royal Commission into Aged Care Quality and Safety highlighted the inadequacies of the current aged care system in providing support for not only people who are ageing, but also their informal carers, predominantly the systemic and legislative limitations which can undermine the sustainability of carer health and wellbeing. These include limited opportunities to identify and address carer needs, inadequate support with service navigation and insufficient investment in respite options for family and friend carers. This presentation explores the carer-focused recommendations outlined in the Final Report of the Royal Commission into Aged Care Quality and Safety and the emerging opportunities to improve support for carers through the aged care system that these recommendations present. Particularly in regards to opportunities to increase and expand access respite, a key support for maintaining carer health and wellbeing. Addressing systemic barriers and increasing investment in support for carers will sustain caring arrangements and facilitate older Australians to remain living in their homes for longer.


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Meeting growing demands on the paid care workforce by upskilling informal carers Ms Melissa Docker1, Ms Sarah Judd-Lam1

1Carers NSW The Royal Commission has highlighted the ongoing challenges associated with growing aged care workforce demands, especially in regional and remote areas, resulting in an increased reliance on informal carers. Of the 1.2 million older Australians who required assistance in the 2018 Survey of Disability, Ageing and Carers, 3 in 4 received assistance from a family member or friend, rendering informal carers an invaluable yet often unrecognised part of the aged care workforce. Paid care workers receive a wage, breaks and formal training, and are protected by workplace insurance and WHS guidelines. Conversely, while many informal carers perform equivalent tasks, these supports are simply not available. This can place carers and the people they care for at risk of injury or harm and increase pressure on an already stretched paid care workforce. Most respondents to the 2020 National Carer Survey who were caring for an older person felt confident in providing care; however 1 in 4 four did not, and lack of confidence tended to coincide with higher psychological distress and lower wellbeing. The Carer and Consumer Coaching Project (3CP) introduces skills-based training to informal carers of older people to improve the quality, safety and sustainability of care at home, recognising the important role that informal carers play, and acknowledging that current demand and workforce shortages mean that they are often filling in service gaps. This contribution argues that investment in upskilling informal carers will support the future growth and sustainability of the paid care workforce.


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Social networks, cognition and service use in long-term care Ms Laura Dodds1, Professor Andrew Georgiou1, Prof Johanna Westbrook1, Dr Joyce Siette1

1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Introduction Having an abundant social network is associated with better physical and cognitive health, however the nature of long-term care can often mean older adults experience a higher risk of social isolation and negative impacts on cognitive function. This study aimed to identify the association between accessing types of services or activities within long-term care on social networks and cognition. Design and methods 96 residents from two aged care facilities/nursing homes in New South Wales, Australia participated in a cross-sectional study. Interviews by researchers with residents approached by staff measured social network structure (Lubben Social Network Scale LSNS-12), quality of life (EuroQol-5D, EQ5D5L) and cognition (Montreal Cognitive Assessment, MoCA). Residents’ demographics and service use were collected from electronic records in the facilities. Independent sample t-test, ANOVA and linear regression analyses were used to investigate factors associated with cognition. Results The average age of residents was 82.7 ± 9.4 years and 64.6% were female. Most had cognitive impairment (70.8% scored <22 in MoCA) and moderately sized social networks (27/60). Regression analyses indicated residents that were younger, completed a higher education level, and had larger social networks including family and/or friends, had significantly better cognitive performance. Service type and frequency was not associated with cognition. Discussion and Implications Among individuals in long-term care at risk of social isolation, having substantial and valuable social networks was associated with better cognitive function. However, whether psychosocial service provision within aged care facilities inhibits or enhances social networks and cognitive function over time requires further exploration.


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A Systematic Review of Interventions to Improve Analgesic Use and Appropriateness in Residential Aged Care Ms Laura Dowd1, Dr Amanda Cross1, Mrs Choon Ean Ooi1, Dr Felicity Veal2, Prof John (Simon) Bell1,3

1Monash University, 2University of Tasmania, 3National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing Background: Ensuring safe and effective analgesic use in residential aged care is challenging due to resident susceptibility to adverse drug events. Objective: To review the effectiveness of different interventions to optimise analgesic use in residential aged care. Methods: MEDLINE, Embase, PsycINFO and CINAHL were searched from inception to June 2021. Controlled and uncontrolled studies describing prospective interventions that reported post-intervention change in analgesic use and/or analgesic appropriateness were included. Data extraction and quality assessment were performed independently by two investigators. Results: Eight cluster-randomised controlled trials, six uncontrolled and two controlled pre/post interventions were included, comprising 9056 residents across 9 countries. Interventions included education (n=13), decision support (n=7), system modifications (n=6) and/or medication review (n=3). Six interventions changed analgesic use or appropriateness, all of which included prescribers, five involved multidisciplinary collaboration, and five included education. Two interventions reduced the percentage of residents reporting pain not receiving analgesics by 50-60% (p=0.03, p<0.001), and one improved analgesic appropriateness (p=0.03). One reduced nonsteroidal anti-inflammatory drugs (NSAIDs) (p<0.001), and another resulted in 3-fold higher odds of opioid prescription in advanced dementia (95%CI, 1.08-8.74). One medication optimization intervention reduced NSAID prescription (p=0.036), and another reduced as-needed opioid (95%CI 8.6-13.8) and NSAID prescription (95%CI 1.6-4.2). Conclusion: Outcomes of analgesic optimisation interventions are heterogenous and reflect changing understanding of analgesic benefits and risks in vulnerable resident groups. Interventions involving prescribers and enhanced roles for pharmacists and nurses, with a component of education, are most effective at changing analgesic use or appropriateness.


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End user perspectives on research and evaluation in aged care: is it time for a new model? Ms Jocelyn Small2, Prof Colleen Doyle1, Ms Bridget Howes, Dr Joan Ostaszkiewicz 1National Ageing Research Institute, 2Blue Cross Introduction and background The Royal Commission into Aged Care Safety and Quality Report noted the needs for quality improvement research and for aged care to be better informed by the best evidence from research. Two recommendations, 107 and 108, addressed research requirements specifically, recommending a new Aged Care Research and Innovation Fund, a new Council to oversee expenditure, better data governance and the establishment of a National Aged Care Data Asset. Aims This paper aims to provide a forum for end users to respond to the recommendations. What do aged care providers perceive as barriers and facilitators to (i) participation in externally funded research (ii) conduct of their own internally generated research and (iii) putting the results of new research into practice in their aged care settings. Overview of activities We provide a summary from our points of view as researchers and aged care providers. During the symposium we will ask end users to discuss the barriers and facilitators to the above. We propose discussion of whether participation in externally funded research is hindered by lack of co-design; whether internally generated research activities are hindered by lack of research-trained staffing and research and development units being cut in response to funding shortfalls; and whether putting the results of new research into practice may require a new model of quality improvement. Expected learning outcomes for audience members Audience members will learn about the research recommendations from the Royal Commission report and discuss new models of research participation in aged care.


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Promoting evidence based aged care: Are we ready? Dr Peta Drury1, Mrs Joanne Hope, Dr Kaye Rolls, Professor Victoria Traynor 1University Of Wollongong Introduction Although there a growing body of evidence applicable to the ageing population, four in 10 adult patients receive care that is not based on current evidence or guidelines, including ineffective, unnecessary or potentially harmful treatments. In this study we explore aged care leaders’ beliefs towards evidence based practice (EBP). Method Key leaders across the aged care sector (n=10) were invited to participate in an online interview. The interview guide was developed from the Theoretical Domains Framework (TDF). The TDF has been utilised across many studies to identify beliefs towards EBP (Michie et al., 2005). Content analysis of aged care leaders’ statements into the relevant theoretical domains was performed. Results The following key themes emerged from the interviews: a move to increase the uptake of evidence across the aged care sector will be well received; there will be negative consequences for the aged care sector if EBP is not implemented and; a more consistent approach to promote the uptake of evidence across the aged care sector is urgently needed. Conclusions Unlike prior studies, our results indicate that the aged care sector is ready to increase the uptake of evidence. Future planning is urgently required to develop a national approach to promote evidence based aged care. References Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making a psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005: 14:26


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Psychometric properties of the assessment tools associated with discharge in general medicine: A systematic review Ms Aruska D'Souza1,2, Associate Professor Catherine Granger1,2, Ms Melanie Tomkins3, Ms Nina Leggett3, Ms Jacqueline Kay1, Associate Professor Catherine Said2,3,4

1Royal Melbourne Hospital, 2University of Melbourne, 3Western Health, 4Australian Institute for Musculoskeletal Science Background and aim: Predicting discharge destination from acute hospital is an important task as it may improve length of stay and patient outcomes. The authors’ previous systematic review identified 23 assessment tools associated with discharge destination. This systematic review aimed to compare the psychometric properties of these assessment tools. Method: Four electronic databases were searched. Studies were included if they were: published in English and included adult, acute general medical or aged inpatients. Outcomes of interest were the psychometric properties: validity, reliability, responsiveness and internal consistency. Data were assessed for risk of bias quality using COSMIN tool and analysed/described descriptively. Results: Forty-one articles, assessing the psychometric properties of 18 different assessment tools, were included. Most (n=36, 88%) scored “adequate” or “very good” on the COSMIN scale. Validity was investigated in 40 studies (18 assessment tools), reliability in 7 studies (5 assessment tools), internal consistency in 5 articles (4 assessment tools) and responsiveness in 4 studies (2 assessment tools). No assessment tool had established psychometric properties across all four properties. The Alpha Functional Independence Measure (AlphaFIM), the de Morton Mobility Index (DEMMI), the Mini-Mental State Examination (MMSE) and the Blaylock Risk Assessment Screening Score (BRASS) had the most established data on psychometric properties (n=3 properties). Conclusion: Of the previously identified assessment tools, the measurement properties of the AlphaFIM, BRASS, DEMMI, MMSE have been studied in greatest detail. Clinicians and researchers are encouraged to consider these psychometric property findings in assessment tool selection. Trial registration: PROSPERO (CRD42017064209)


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Innovative care for older prisoners living with dementia: Perspectives of external organisations Dr Sanetta Du Toit1

1The University Of Sydney An increasing number of older prisoners living with dementia has compelled the search for a care continuum that adequately meets this population’s care and well-being needs. Long-standing barriers including limited resources and relevant expertise have necessitated an interdisciplinary approach and highlighted the potential of external organisations in supporting prisoners with dementia. However, little is known about their perspectives and experiences. This study aimed to explore the role of external organisations in providing care for prisoners with dementia in Australia. In this qualitative descriptive study, 27 participants from legal, health and social services rendering services in Australian prisons were recruited. Qualitative data were generated by applying the Nominal Group Technique in research group discussions. Demographic and background data were used to generate descriptive statistics through QualtricsTM. Inductive thematic analysis of qualitative data revealed challenges and opportunities for future dementia care in Australian prisons. Six research discussion groups represented participants from Victoria, Queensland, New South Wales, Western Australia and Tasmania. Identified themes included (1) Possible models of care for prisoners with dementia; (2) Uncovering the invisible issues of dementia care in prisons; and (3) Proposed next steps for improved care of prisoners with dementia. This study provided recommendations for multiple stakeholders to overcome barriers in providing dementia care to prisoners. Increased collaboration between corrective services and external organisations was recommended, with clear delineation of custodial and care priorities. External organisations highlighted the wider community’s responsibility to care for older prisoners and the need to explore emerging areas of practice in this regard.


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Person centred home care packages: future visions for carer recognition Ms Cathy Duncan1, Ms Lorraine Williams2, Dr Lukas Hofstätter3

1University Of Wollongong, 2Bay & Basin Community Resources, 3Carers NSW This paper presents a participatory action research project highlighting the importance of research partnerships with carers and aged care providers for successfully implementing person-centred care that meets the needs of care recipients and carers. A ‘Framework for Carer Recognition in the Home Care Packages Program’ was developed in collaboration with carers, care recipients, Carers NSW and Bay & Basin Community Resources (BBCR), a Home Care Package Provider. This research project, supported by data from the Carers NSW 2018 Carer Survey and 2020 National Carer Survey, demonstrates why carer recognition is a critical aspect of the implementation of person-centred care in the Home Care Packages (HCP) Program. A case study of how BBCR has incorporated carer recognition into their model for HCP demonstrates that the developed Framework is both valuable and viable in the context of the increasingly individualised; market based aged care system in Australia. Based on findings from this project the research partners co-authored submissions to the Aged Care Royal Commission (ACRC) regarding the lack of Carer Recognition in the HCP Program. This included a set of recommendations for policy change, including practices that facilitate carers as valued and respected partners in person centred care. This resulted in the ACRC consulting Ms Duncan regarding policy reform to the HCP Program. This paper provides valuable insights for carers, policy makers, researchers and service providers into how to ‘bridge the gap’ between the Commonwealth Carer Recognition Act (2010) and the HCP Program in the provision of person centred home care packages.


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Impact of relational continuity of primary care in aged care: a systematic review Dr Suzanne Dyer1, Ms Jenni Suen1, Dr Helena Williams2, Assoc Prof Maria Inacio3, Professor Maria Crotty1, Assoc Prof Gillian Caughey3

1Flinders Health and Medical Research Institute, Flinders University, 2Silver Chain Group, 3Registry of Senior Australians, South Australian Health and Medical Research Institute Aim: A systematic review of the impact of relational continuity of primary care on resource use and person-centred outcomes for people receiving aged care services in residential or home care settings was conducted. Methods: Systematic review to October 2020 which included studies which (a) aimed to increase relational primary care continuity, (b) included aged care recipients (c) had a comparator and (d) reported outcomes of health care resource use, quality of life, activities of daily living, mortality, falls or satisfaction. Cochrane Collaboration or Joanna Briggs Institute criteria were used for risk of bias; GRADE for confidence in conclusions. Results: Heterogeneity between study cohorts and settings across the five included studies precluded meta-analysis. Greater relational continuity with a primary care physician reduces hospitalisations (high vs. low continuity hazard ratio (HR); 0.94; 95% confidence interval (CI) 0.92-0.96) and ED visits (HR 0.94, 95%CI 0.92 to 0.96) in home care recipients (1 study, n=178,686). On-site primary care physicians or teams reduced hospitalisations and ED visits in retirement communities (1 study, n=2,468) or residential care (1 study, 15 homes). One study changed staff roles and reported increased falls; overall benefit was uncertain. Smaller studies examined a home-based primary care model (n=246) and primary care physician visits during hospital admission (n=335). Conclusion: Greater relational continuity with a primary care physician reduces hospitalisations and ED visits for older home care recipients (moderate certainty evidence), with the potential for significant cost savings. Studies examining the effects of increasing primary care continuity in residential aged care are needed.


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Factors influencing care and support for older adults with traumatic injury: A qualitative study Dr Joanna Schwarzman1,2,4, Dr Aislinn Lalor1, Dr Sandra Braaf2, Associate Professor Libby Callaway1, Dr Mohammed Aburrumman1,3, Professor Belinda Gabbe2, Dr Christina Ekegren1,2

1School of Primary and Allied Health Care, Monash University, 2School of Public Health and Preventive Medicine, Monash University, 3Monash University Accident Research Centre (MUARC), Monash University, 4Australian Institute of Family Studies Introduction: The average age of trauma patients is increasing worldwide and people are living longer with the impacts of injury. The aim of this study was to investigate factors influencing care and support provision for older adults with traumatic injury. Method: Semi-structured interviews were undertaken with 16 clinicians, support providers, researchers, policy makers and representatives from peak bodies in injury, ageing and disability in Australia. A thematic analysis was performed using a framework approach. Results: Themes identified included: lower expectations of recovery when the injury was sustained in older adulthood; limited accommodation options; restricted access to preventive care; siloed funding schemes; limited funding availability; the need for advocacy and improved workforce capacity; and pressures on families and carers. Certain themes identified were specific to people who were older when injured. Others related to people who were injured at a younger age, and were ageing with injury. However, most themes had relevance for both groups. Conclusion: Older adults with traumatic injury have complex needs which change over time and traverse traditional boundaries of responsibility within healthcare and support systems. This research highlights a range of cross-sector problems which impact the potential of older adults to recover from, and age well with, injury. To address these issues, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors, and improved advocacy and case management.


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The challenges and opportunities of delivering a song-writing course for older adults online in 2020 Assoc Prof Helen English1, Ms Cassandra Danckert, Dr Michelle Kelly, Professor Frini Karayanidis 1University Of Newcastle This paper discusses the challenges and opportunities of online delivery of a songwriting course for older adults. In 2020 our research group planned an extended (30 week) song-writing intervention in aged-care. This was abandoned due to the impact of COVID-19. Instead, we worked with our research students to transfer the content and delivery online. The online course was delivered as a collaboration with the aged-care provider NovaCare. It was a 6-week adaptation of the planned series of 10-week courses intended for face-to-face delivery. There were ten participants, average age of 80 years, who were divided into two groups. The effects on participants of the 6-week study were assessed through a range of measures delivered online, including self-report quality of life, social anxiety, technology experience and meaningfulness of songwriting (Baker & MacDonald, 2013). In addition, the team had access to all zoom session recordings. Demographic data was also collected, and a focus group held in the week following the course. This paper reflects on the challenges of using technology to create songs (iPads with GarageBand), and as the means of communication (via Zoom). Opportunities arising from the pilot lie in the increased accessibility that online delivery brings for many older adults who are experiencing isolation due to geographic, mobility or health constraints. While a 6-week course is not long enough to show significant changes in cognition and brain health, the focus group and Zoom session data revealed changes in musical confidence and empowerment that had impact in the participants’ everyday lives.


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Digital drawing for people with dementia and their supporters Ms Emma Febvre-Richards1, Mr Cameron May, Ms Christelle Filleau2, Dr Alexandra König2, Dr Gary Cheung3, Ms Sarah Togher4, Ms Anne Schumacher4, Dr Susan Gee5, Ms Tracey Hawkes5

1Massey University, 2CoBTeK (Cognition Behaviour Technology) Research Unit Université Côte d'azur Memory Clinic and Research Centre University Hospital Nice, France Institut Claude Pompidou, 3The University of Auckland, 4Dementia Wellington Charitable Trust, 5Canterbury District Health Board Without a cure or the ability to prevent the progression of dementia, the main management goal is to help people maintain their quality of life for as long as possible. Non-pharmacological therapies are essential for maintaining autonomy, improving outcomes and quality of life for people living with dementia and their supporters. We are designing MinDArT as a creative and enjoyable way to meet this need. MinDArT is a nature-based, sensory-focused drawing programme for people living with dementia and their supporters. In a series of 8 sessions, participants explore the principles of mindfulness through the meditative qualities of drawing, utilising natural resources and traditional drawing materials. During the MinDArT sessions, the participants are invited to explore these exercises in digital form on a tablet-based application (app). Each session has a custom designed app that complements the physical drawing exercise, allowing each participant to continue to draw with natures colours, gestures, and shapes with the added power (and limitations) afforded by digital drawing. The MinDArT digital applications are world-leading and unique to the programme. Each participant is loaned a digital tablet for the duration of the MinDArT programme to provide access to the benefits of the digital drawing programme at their own leisure until their next weekly session. In this presentation we will take you through the development of the digital drawing programme. We will discuss our cross discipline collaborative approach, how we have responded to participants’ feedback and needs, and technological challenges and how we see the programme developing.


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Predicting when an aged care service ‘fails’ its residents: How can we do this? Prof Deirdre Fetherstonhaugh1, Prof Joseph Ibrahim2, Dr Jo-Anne Rayner1, Ms Linda McAuliffe1

1La Trobe University, 2Monash University Background: Residential aged care should not ‘fail’ in its responsibility to meet the needs of older people. The care provided should be safe, of high quality, and best practice. Older people should also experience a good quality of life when living in aged care. Aim: To explore what constitutes ‘failure’ in aged care and develop a suite of performance measures to potentially predict possible ‘failure’ before it happens. Method: a comprehensive review of the literature and extensive consultation with key stakeholders to explore possible contributors to, (and extent of,) system failures; consultations with 304 stakeholders around failure, excellence, and potential performance measures; development of performance measures; ranking the draft set of measures and; shortlisting measures for piloting. Results: A new model for aged care consisting of five domains relevant to the experience of older adults living in residential aged care and focussing on residents’ opportunity to thrive, was developed and published¹. The shortlisted performance measures extend beyond clinical care and provide a means for addressing potential failures in other areas of resident need. The following draft set of performance measures are currently being piloted in six Victorian aged care services: • Use of evidence-based guidelines for clinical and aged care practices • Open disclosure, just and transparent culture (in day-to-day communication) • Capacity to manage periods of high demand • End-of-life care • Comprehensive resident review • Medication safety (especially high-risk drugs) • Dignity of risk • Responsive individualised behaviour management ¹ Ibrahim et al (2020) AJA 39(2), 148-155.


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Barriers and facilitators for the provision of quality palliative care for older people: Clinicians’ perspective. Dr Samantha Fien1, Ms Emily Plunkett2, Assoc Prof Magnolia Cardona2,3

1CQUniversity, 2Gold Coast Hospital and Health Service, 3Institute for Evidence‑Based Healthcare, Bond University Background Palliative Care is recognised as holistic patient and family-centred care to provide comfort near the End of Life when active treatment is not appropriate or recommended. Multiple primary studies have lobbied for achievement of optimal care at End of Life. We aimed to elucidate whether any practice gaps or concerns could be detected in its implementation and whether solutions could be identified by clinicians involved in caring for terminal older adults. Methods Scoping review of qualitative or quantitative evidence 2010-2019 in Medline and manual reference searching from relevant systematic reviews. Results Twelve studies published since 2010 with data from 1,659 subjects in >20 countries identified four major gaps: (1) Core clinical competencies; (2) Shared decision-making; (3) Health care system, environmental context, and resources; and (4) Organisational leadership, culture, and legislation. A clear picture emerged of poor uptake of recommendations from previous studies, highlighting the difficulties of changing the service culture to ensure provision of optimal services at the End of Life. Clinicians also perceived an inability to influence the health system’s environmental context and resourcing, and the culture of multidisciplinary collaboration. Conclusions There is room for improvement in the uptake of proposed solutions for individual and system barriers precluding the provision of good quality care at End of Life. Proactive implementation of healthcare staff suggestions based on their lived experience of how health systems operate is overdue/urgently needed.


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Human Rights in the Context of Dementia Mrs Theresa Flavin1

1Opan Australia has a comprehensive suite of legislation which protects the human rights and dignity of persons living with a disability. However there are significant gaps in understanding of dementia as a disability, and what human rights actually look like in this context. Often the term respect is used heavily. we all think we understand what that means, but often respect is understood to be a feeling, however true respect will take the form of a behaviour. By way of example, a carer may feel they are respecting a PLWD, but fail to greet them, introduce themselves or seek permission to enter their private spaces. Often permission is not sought to touch our bodies, we are not invited to choose what we eat or what time we go to sleep. Remember that each interaction with a PLWD feels like the first time for us, and often we have had lifetimes of trauma. We desperately need a reason to trust you and feel safe with you. Simple courtesy and kindness will fulfil this. Our brains are damaged, and we cannot discern how you feel, we can only see your actions in the physical world. This is even more important when a PLWD is non verbal. Often, non verbal people are considered to be 'absent' or just a shell, however research has proven that this is absolutely not the case. PLWD right up until the end stages of life have demonstrated awareness of the world around them, please show us respect always.


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The Song Collective: Building sustainable online music communities to support older adults wellbeing and connectedness Dr Libby Flynn1, Ms Phoebe Stretton-smith1, Professor Felicity Baker1, Dr Tanara Sousa1, Dr Imogen Clark1, Assoc Prof Jenny Waycott1, Dr Katie Greenaway1, Dr Elise Kalokerinos1, Dr Peter Koval1

1University of Melbourne Social isolation and loneliness are anticipated to become the biggest public health threat of our age, especially for populations where socially isolating preconditions, environmental barriers or lack of resources may impact community participation, such as for older adults (Holt-Lundstad et al., 2015; Stensæth, 2018). With COVID-19, and the associated social restrictions and public ageist discourses seen in response to the pandemic, the situation has intensified for many older adults (Brooke & Jackson, 2020). Music participation as a public health means has received increasing attention (Stensæth, 2018; Stige, 2018). Early notions of ecological practices in music therapy, focusing on health promotion and music as a social resource to form, build or sustain communities (Bruscia, 1998), have also been expanded through collaborative, participatory and strengths-based practices of community music therapy (Ansdell, 2002; Stige & Aaro, 2012) and resource-oriented music therapy (Rolvsjord, 2010). Responding to the shifting needs we are faced with on a societal level, The Song Collective is a novel program aiming to address the need to explore new and sustainable ways of offering music therapy informed co-created spaces where people are supported to explore how they can use music as a social and health resource. This paper will present the findings from a cross-cultural feasibility and acceptability study, and explore how music communities can be built in an online ‘arena’ in the context of COVID-19 to support older adults to have and maintain a sense of communality and belonging.


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Exploring and extending understandings of migrant ageing: A systematic review Dr Marika Franklin1, Professor Lucy Taksa1, Professor Fei Guo1

1Macquarie University Critical issues relating to migrant ageing remain underexplored and under-theorised in the gerontological and migration scholarship, despite the acknowledged diversity in ageing populations. Investigate these gaps, we examined the construction and representation of ‘older migrants’ and the concepts and theories applied in the literature at the ageing/migration nexus. This systematic review focused on key concepts relating to ageing, specifically the use of terms such as ‘healthy ageing’, ‘productive ageing’, and ‘active ageing’ appearing in qualitative studies published between 2000-2020. In total, thirty-two studies (from 8200 records) met the inclusion criteria for the review. Content and thematic analysis revealed vast differences and ambiguity in constructions of ‘older migrants’ as a group, and dominance of individual level concepts and theories drawn from psychological and cultural studies, which foregrounded choice, control, and individual responsibility. Socio-structural factors, including race, age, gender, and socioeconomic status, and their intersections, along with concepts of diversity, power relations and oppression were often marginalised or excluded from consideration in relation to migrant ageing. On this basis, we explore how concepts of intersectionality, life course and transnationalism can facilitate a more nuanced understanding of migrant ageing by giving greater attention to temporal and spatial/geographical factors and contexts and their impact on patterns, variations, and intersections in diverse contexts. We argue that the topic of migrant ageing and specifically, understandings and constructions of ageing ‘well’ can be enhanced through further attention to such factors, which have both tangible and intangible effects on health, wellbeing, and ageing.


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Leveraging migrants’ ‘community cultural wealth’: An asset-based approach to migrant ageing Dr Marika Franklin1, Professor Lucy Taksa1, Professor Fei Guo1

1Macquarie University Healthy and productive ageing are promoted in Western ageing policies as key strategies to address the economic and social impacts of an ageing population. Informed by human capital and rational choice theories and underpinned by neoliberal logics and economic and bio-medical frameworks, contemporary ageing policies target individual choice and behaviour as somewhat demarcated from the many aspects shaping social life. In the dominant ageing discourse, migrants tend to be monolithically positioned as disadvantaged and burdensome and this deficit framing has resulted in migrants’ assets in the form of human, social and cultural capitals, going unrecognised and unacknowledged at the research and policy level. Addressing this problem, we draw on Tara Yosso’ (2005) framework of ‘community cultural wealth’ (CCW). Yosso expanded on Bourdieu’s framing of capitals to develop an asset-based approach to understanding diversity. Encompassing the interlinked - aspirational, familial, social, linguistic, navigational, and resistant capitals, the concept ‘CCW’ attends to the assets and counternarratives of traditionally marginalised groups. While CCW has primarily been used in the field of education, we demonstrate the applicability of CCW for exploring diversity in ageing. We argue that harnessing and integrating CCW into migrants’ understandings and experiences of ageing provides a much more nuanced approach to exploring independence, choice and control than the economic and biomedically informed theories dominating the research and policy landscape. We conclude that this asset-based perspective enables us to consider health and wellbeing as a relational and socially situated process rather than an individual pursuit, as constructed in the dominant discourse.


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Achieving active and equal co-design: Perspectives of people impacted by dementia Ms Ellen Gaffy1,2, Professor Virginia Lewis1, Dr Margaret Winbolt1, Dr Anita Goh2,3,4

1La Trobe University , 2National Ageing Research Institute, 3Melbourne Health, 4University of Melbourne Involving people living with dementia and their families in developing resources, programs and services relevant to their care is key to developing effective, person-centred dementia-specific services. Co-design methodologies can facilitate this service-user interaction, and should be used to involve people living with dementia actively and equally in co-design processes. However, few studies have explored the involvement of people living with dementia across the complete co-design process, and fewer have sought the perspective of people living with dementia and family carers on how to achieve meaningful involvement as a co-design partner. This presentation reports on a constructivist grounded theory study exploring the involvement of people living with dementia in co-design, by examining the process of co-designing a dementia education program for home care workers (the PITCH project). In-depth semi-structured interviews (n=17) were conducted with people living with dementia and family carers involved in the PITCH co-design workshops and/or project advisory group, and with project staff. The findings suggest involvement is viewed as equal and active when the co-design process considers the individual needs and abilities of people living with dementia, and tailored support structures are built into the process to facilitate quality, ongoing and meaningful contribution as a co-designer. By developing an explanatory scheme of what active and equal involvement in co-design means for people living with dementia, and co-constructing a framework for meaningfully engaging people living with dementia in co-design, this study provides recommendations to guide educators, researchers and service providers on involving people living with dementia in co-design.


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Adapting to Adversity in Later Life through Culture Ms Lena Gan1

1University Of Melbourne The complex and multidimensional experience of ageing in later life is characterised by change. Change on the physical, psychosocial, social, economic, environmental and spatio-temporal levels. Shifts in overall health, mobility, vision, hearing and cognitive functionality all require adaptation. An individual’s field of action often diminishes impacting social connectivity, confidence and self-esteem. Physical changes can engender vulnerability to ageist societal stereotypes and discourses. Retirement brings a sudden loss of professional identity which for many comprises a large part of self-image and is a contributor to self-esteem, confidence, meaning and purpose in life. Priorities and the perception of time change. This presentation will examine the cases of two older people who have used a museum to adapt to adversity. One is a recent widow and the other suffers from mental health issues. Both have made capacitating adaptations to their situations. These case studies point to the potential of institutions such as museums to provide capacitating conditions characterised ‘by an abundance of potential, the endless possibility for becoming, and becoming-more, for continual replenishment and transformation through these inexhaustible potentials’ (Grosz 2017:180). And they underpin the positive findings of the existing body of epidemiological research that provides evidence of increased longevity and beneficial impacts on health and wellbeing of regular cultural attendance.


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Quality care: a meta-synthesis of residential aged care staffs' perspectives Ms Stephanie Garratt1,2, Dr Andrew Gilbert1,3, Ms Leona Kosowicz1, Prof Briony Dow1,4,5, Dr Joan Ostaszkiewicz1,4

1National Ageing Research Institute, 2The University of Auckland, School of Population Health, 3La Trobe University, 4Deakin University, School of Nursing and Midwifery, 5University of Melbourne, School of Population and Global Health Background: As places of both residence and work, what constitutes 'good quality care' in residential aged care requires consideration of both staff and residents' perspectives. Objective: To report on a meta-synthesis of the qualitative literature, which explores residential aged care staff perspectives on 'quality of care'. Methods: The PubMed, Medline/PsychInfo (OVID), and ProQuest databases were searched for articles that met the screening inclusion criteria. This meta-synthesis was informed by the PRISMA guidelines and included studies that were critically appraised using JBI SUMARI. Two independent reviewers conducted thematic network mapping and analysis of included articles, with oversight from three additional reviewers. Results: Thirty-seven articles were included, with findings summarised into four organizing themes and nine basic themes. The four organizing themes about quality care from staff perspectives include direct care, professional values and competence, the care environment, and organizational/regulatory factors. Conclusion: The provision of quality care is a complex concept for staff working in aged care settings, with multidimensional meanings and components. Staff interpret quality of care within a personal tension—the reality of providing care in context versus vocational idealism around the need to provide person-centered care. Staff have an intrinsic motivation to provide good quality care, but overly prescriptive regulations and inadequate funding can undermine this. Rules and regulations are required, but these should support and serve staff, rather than complicate and distract within an already complex healthcare environment. This research was funded by the Department of Health (Victoria).


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Predicting death – Training hospital assessment teams to identify patients nearing the end-of-life Dr Katrin Gerber1, Dr Paul Yates, Dr Barbara Hayes, Ms Carol Perich, Dr Cik Lee, Dr Sarah Berriman, Mrs Karen Bodna, Mrs Jo-Anne Slee, Ms Joanne Tropea, Ms Kayla Lock, A/Prof Melissa Bloomer 1National Ageing Research Institute Background: Predicting patients’ life expectancies is an extremely challenging task. Being able to identify when patients are at risk of dying within the next weeks is especially relevant for care pathway and aged care assessment teams in hospitals, who advise treating clinicians on whether older patients can be transferred to subacute wards or residential aged care. Aim: To train assessment teams to use a validated prognostic tool and examine the effects of the training on teams’ knowledge and confidence in identifying patients at risk of dying. Methods: We conducted a mixed-methods study focussing on translating knowledge into practice. Assessment teams in two Melbourne hospitals participated in a live, interactive, online training on recognition of dying. Teams were introduced to the Palliative Prognostic Index, a 5-item checklist that identifies patients with a life expectancy between less than 3 and more than 6 weeks. Methods included (a) pre- and post-training surveys with 50 assessment team members and (b) 31 in-depth interviews before and 3 months after the training. Interviews were analysed thematically. Results: Before the training, staff’s heavy reliance on intuition, pattern-matching and colleagues’ opinions made care pathway planning challenging. The training significantly improved staff’s knowledge and confidence regarding the recognition of dying. Staff identified barriers to using prognostic tools in hospital settings, leading to actionable recommendations on how to address these. Prognostic tools can be effective instruments for staff education, support clinical decision-making and encourage open discussions across teams. However, local champions and institutional support are needed to overcome implementation challenges.


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‘Unprepared for the depth of my feelings’ – Capturing grief through research poetry Dr Katrin Gerber1, Dr Lidia Engel, Dr Larissa Hjorth, Ms Kayla Lock, Dr Terence Chong, Mrs Mary O'Mara, Mr Andre Catrice, Dr Kaoiri Shimoinaba, A/Prof Christina Bryant, Mrs Sarah O'Leary, Mrs Primrose White, Dr Samantha Loi, Assoc Prof Danny Hills, Assoc Prof Bianca Brijnath 1National Ageing Research Institute Background: Older people are more likely than any other age group to experience the death of a loved one. However, their bereavement needs are often neglected with healthcare staff assuming that they are well prepared to deal with grief simply because they have encountered so many losses. Aim: Examine how grief affects older people’s physical and mental health, and identify the roles that primary care play in the bereavement support for older people. Methods: We interviewed 18 bereaved older people, 7 general practitioners, and 8 general practice nurses from across Australia. We used thematic analysis to identify overarching interview themes and poetic narrative analysis to capture participants’ unique experiences with grief. This is an innovative form of arts-based research that creates poems based on interview transcripts and thereby illustrates complex research findings in an emotional and instantly relatable way. Findings: Grief did not only affect older people’s wellbeing but also their physical health as pain and pre-existing medical conditions considerably worsened after a bereavement. General practitioners were gatekeepers to the healthcare system but struggled to recognise grief in older people. Many were unaware of available bereavement services. General practice nurses were an under-used resource even though they felt that they were well placed to help older people with their grief. To illustrate our findings, we will show recordings of interview participants reading their research poems. This presentation will highlight the need to invest in better grief support for older people and challenge the notion that grief has an expiry date.


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Uncovering gender and cultural and linguistic diversity as drivers of ageing complexity Ms Mary Ann Geronimo1

1Federation of Ethnic Communities' Councils of Australia This presentation argues that current policy reforms have missed two fundamental drivers that define challenges in ageing in Australia: gender and cultural and linguistic diversity (CALD). It will provide a framework for intersectional gender and lifecourse analysis to uncover these challenges and highlight policy levers to improve ageing and aged care. Ageing is gendered, with women representing the face of poverty in old age. Older women are more likely to live in income poverty¹ and are at particular risk of homelessness.² Additionally, CALD older women experience greater economic marginalisation and CALD older people are overrepresented among older people presenting for housing support.³ Additionally, aged care is provided on the back of the insecure and unpaid work of women. Women from CALD backgrounds are significantly represented as informal carers,⁴ and women of CALD background, as migrants often on temporary visas, are overrepresented in the poorly remunerated and casualised aged care workforce.⁵ We argue that current policy reforms have not acknowledged these drivers of complexity. We call for cross-silo policy approaches which go beyond the delivery of aged care to addressing gender equality and multiculturalism. The presentation is aimed at policymakers and researchers. 1.https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0011/3127664/HILDA-Statistical-Report-2019.pdf, Accessed 12 April 2021, see also https://www.sbs.com.au/topics/voices/culture/article/2017/11/24/aged-over-60-and-female-heres-why-you-might-be-risk-poverty, Accessed 12 April 2021 2. https://www.mercyfoundation.com.au/wp-content/uploads/2018/08/Retiring-into-Poverty-National-Plan-for-Change-Increasing-Housing-Security-for-Older-Women-23-August-2018.pdf, accessed 14 April 2021. 3. Housing for the Aged Action Group (HAAG). ‘Navigating aged care services with older people at risk of homelessness’, Older Persons Advocacy Network (OPAN), Webinar, 30 March 2021. 4. https://www.carersaustralia.com.au/about-carers/culturally-linguistically-diverse-carers/, accessed 29 March 2021. 5. https://www.arts.unsw.edu.au/social-policy-research-centre/our-projects/markets-migration-work-care-australia, accessed 29 March 2021.


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Approaches to navigation and evaluation: using community development principles in CALD contexts Ms Mary Ann Geronimo1

1Federation of Ethnic Communities' Councils of Australia This presentation explores new approaches to navigation programs and their evaluation, through the case study of the EnCOMPASS Multicultural Aged Care Connector. FECCA is delivering the program, funded by the Federal Department of Health until 2023, as a fundamental component of an integrated care ecosystem in multicultural communities. The Theory of Change behind the EnCOMPASS program, in which existing social capital of multicultural communities is organised, developed and leveraged for the delivery of navigation will be presented with early insights from its delivery. A realist evaluation model¹ used by FECCA to report on outcomes of the program, and which accounts for heterogenity of communities and success of different program components, will also be presented. Building on existing navigation practice, the presentation will identify and explore specific community development practices² in the EnCOMPASS program and evaluation, including community organising and empowerment and utilising place-based networks. It will demonstrate how these principles can be utilised for the delivery of navigation with older people facing additional layers of discrimination and systemic barriers to accessing services. The presentation will discuss the implications of this approach to the future of aged care navigation and the implementation of a Care Finder program. 1. https://cdn.odi.org/media/documents/9138.pdf, accessed 30 April 2021, see also Nurjono M, Shrestha P, Lee A, et al. Realist evaluation of a complex integrated care programme. BMJ Open 2018;8:e017111. 2. Ife, J. (2013). Community development in an uncertain world. Cambridge, Cambridge University Press, Westoby, P. (2014). Theorising the practice of community development. Surrey, Ashgate Publishing Limited.


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Emotional vigilance of ethnic minority families of people living with dementia Dr Josefine Antoniades1,3, Dr Andrew Gilbert1,2, Dr Samantha Croy5, Assoc Prof Bianca Brijnath1,3,4

1National Ageing Research Institute, 2La Trobe University , 3Curtin University , 4Monash University, 5Murdoch Children's Research Institute The experience of developing dementia is emotionally distressing; both for the person with dementia and others close to them. Family carers have to adapt to manage emotions within the person living with dementia as well as grapple with their own emotions. The emotional experience of dementia is interwoven with meanings of dementia and associated symptoms to the person with dementia, as well as others within their social and cultural milieu. Based on semi-structured interviews with 93 family carers for migrants with dementia in Australia, we analyzed the practices of dementia care though an approach theoretically informed by the sociology of emotions. Our analysis showed that family carers are acutely aware of and concerned with the emotional state of their relative with dementia. Carers reported that negative emotions such as shame, anger, and depression as being among the earliest signs of dementia, and they often attributed such emotions to the understandable impact that dementia symptoms had on their relative’s self-esteem and functional capacities. Often carers considered to be amplified by cultural stigma towards dementia, their relative’s anxieties about loss of social status, and fears of losing agency. Carers enacted a range of strategies to mitigate these impacts and manage the person with dementia’s emotional state, such as carefully maintaining a positive social environment. However, carers also reported that this labour could, at times, deplete them of their own emotional energies, and they sought out respite and support from others as forms of replenishment.


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COVID-19 and elder abuse Ms Anna Gillbard1

1Unitingcare The recent outbreak of coronavirus (COVID-19) was first reported to the World Health Organisation on December 31, 2019 and a pandemic was declared on March 11, 2020. COVID-19 has been described as an unprecedented crisis with more than one million deaths reported globally within nine months. The highest rate of fatalities from COVID-19 has been found among older people. Many countries (including Australia), put in place strict restrictions that only allowed people to leave their homes under prescribed circumstances. From late February onwards, there was a particular focus on older people self-isolating as a means of reducing the risk of exposure to the virus. Although Queensland has fared reasonably well (to date) in comparison to some states of Australia, the social and economic consequences have been extensive and are likely to be experienced for many years to come. There are a number of stressors related to the pandemic that may increase the likelihood of elder abuse occurring or exacerbate the situation for those already experiencing abuse. This presentation will discuss findings from an exploratory research study utilising data from UnitingCare’s Elder Abuse Helpline. Data were analysed to examine how COVID-19 may have increased the risk of abuse for older people. Findings from this study are relevant for both practitioners and policy makers.


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Elder abuse data collection: learning and strategies Ms Anna Gillbard1

1UnitingCare Elder abuse is a concerning social problem that arises from complex interactions between individual (victim and perpetrator), relational, community, and societal factors. Understanding the dynamics and drivers underlying abuse is complicated by a limited evidence base and fragmented approaches to research. For example, studies examining abuse of older people with dementia tend to focus on caregiver burden and burnout, failing to consider how factors such as caregiver personality, substance misuse, nature of the prior relationship, presence of supportive family or community members, and availability of home care may interact with the demands of caregiving to increase or decrease the likelihood of abuse occurring. Developing a knowledge base to uncover this intersectionality requires development of data collection systems and methods capable of capturing the complexity. In 2017, the Elder Abuse Prevention Unit received a one-off grant from the Queensland Government to improve data collection and reporting for their elder abuse helpline. The grant was used to fund a new, purpose-built, evidence-informed, database. This presentation will examine the capabilities of the database, challenges encountered in implementation, learnings, and strategies to improve data collection, analysis and reporting. Practical approaches to communicating with information technology experts, design principles to increase efficiency and accuracy, engagement with end users, and increasing reliability and validity of the data will be provided. Although elder abuse data collection is the focus, this presentation will be beneficial for organisations interested in data development across a variety of practice areas.


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Improving the health and wellbeing of older LGBTQ people: supported by the City of Sydney. Mr Russ Gluyas1

1ACON ACON's LGBTQ ageing initiative the LOVE Project, received funding from the City of Sydney across three years from 2020 to 2023. The initial funding submission was prior to the start of the COVID-19 pandemic. We then submitted further information regarding how we thought COVID-19 would impact our application and how we could pivot to continue delivering activities. We proposed the expansion of the LOVE Project in partnership with the City of Sydney to develop and improve the delivery of health promotion activities for older LGBTQ people. This grant would assist us in continuing the successful momentum of this project and build a strategic approach to addressing ageing related concerns and health literacy among our LGBTQ communities. The challenges facing the first generation of older LGBTQ people to be visibly ‘out’ as they age, reveals specific needs. We plan to deliver a suite of activities and events with a focus on social connection; healing from historical experiences of violence; physical and mental health challenges; future planning and legal advice; online safety and security; accessing appropriate aged care services; and building stronger social connections. We aim to deliver activities to specific older LGBTQ groups including Aboriginal and Torres Strait Islander people, people with disabilities, trans and gender diverse people, women, culturally and linguistically diverse people and people ageing with HIV. We have already successfully delivered three ½ day codesigned events with the support of our community advisory group. This presentation will highlight the strategic direction, community input and outcomes for this funding.


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Home care worker perspectives on online delivery of training programs and the effects of COVID-19 Dr Anita Goh1,2, Prof Colleen Doyle1, Professor David Ames1,2, Dr Margaret Winbolt3, Dr Steven Savvas1,8, Dr Susan Malta2, Professor Philip Clarke2, Dr Anita Panayiotou1, Professor Claudia Cooper4, Professor Gill Livingston4, Professor Constantine Lyketsos5, Assoc Prof Frances Batchelor1, Mr Jason Burton6, Prof Lee Fay Low7, Associate Professor Samuel Scherer8, Dr Samantha Loi2, Ms Erica Wise1, Ms Esther Tan1, Ms Ellen Gaffy1, Ms Anne Fairhall9, Prof Briony Dow1,2

1National Ageing Research Institute, 2The University of Melbourne, 3La Trobe University, 4Division of Psychiatry, University College London, 5Johns Hopkins University, 6Alzheimer’s WA, 7University of Sydney, 8Royal Freemasons, 9Family carer; Project advisory group chair The Promoting Independence Through quality Care at Home (PITCH) project aims to improve outcomes for people living with dementia and their paid and family carers by co-designing and testing an evidence-based training program for dementia care – the “PITCH program”. Almost 200 home care workers across Australia are currently undertaking the training program as a part of a randomized controlled trial. The PITCH program was initially co-designed to be delivered in a face-to-face format. However, as a result of the COVID-19 pandemic, and the resultant restrictions, we recognized the growing need for education and training to be more accessible via the internet. We conducted two 60-90 minute online focus groups with six home care workers in March 2021 in order to gather rich qualitative data on their preferences and opinions about online training for home care workers, and how online training programs are (and should be) delivered for this workforce. The focus groups centred on discussions around the challenges, benefits, platforms, and logistics of online training. From the home care worker perspective, the themes considered as important for online training: 1) face to face training is preferred for social contact; 2) on-line training has better flexibility and accessibility, and is more convenient with less interruptions. The main barrier noted by participants was regarding access to suitable technology. The presentation is aimed at policy makers, researchers, training and education developers, and the aged care workforce. Results inform the development of online education and training programs and interventions for home care workers.


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The Royal Commission, budget, and dementia research and care Dr Anita Goh1, Prof Pazit Levinger1, Prof Colleen Doyle1, Dr Steven Savvas1, Assoc Prof Frances Batchelor1, Ms Erica Wise1, Ms Esther Tan1, Ms Ellen Gaffy1, Mr Jeremy Dunn1, Prof Briony Dow1

1National Ageing Research Institute Introduction and background. Responding to Royal Commission recommendations, $229.4 million was allocated in the federal budget to improve the care that people with dementia receive. This is a record investment - will it be enough to drive systemic change in the aged care industry, and make conducting and using evidence-based research core business? Aims: The aim of this presentation is to highlight and stimulate discussion about the Commission’s recommendations regarding dementia care, as well as the Government’s responses, and how evidence can be gathered and used to effect reform. Overview of activities: In addition to the above, presenters will share examples of NARI’s projects that are embedded within industry. The Promoting Independence Through quality Care at Home (PITCH) project aims to improve outcomes for people with dementia in the community, and their paid and unpaid carers, by co-designing and testing an evidence-based dementia training program. Almost 200 home care workers across Australia have completed the program in a formal trial within six service providers. The ENJOY trial (Exercise interveNtion outdoor proJect in the cOmmunitY) is delivering and evaluating a sustainable physical activity program with people with dementia living in a residential aged care facility. Expected learning activities. Audience members will learn about the key findings relating to dementia from the Report, the Government’s response, and key findings and lessons from NARI’s research. It will stimulate and invite discussion about how research can be conducted/used by providers to improve the rights and quality of life of people living with dementia.


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Let’s Dig In! 1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland, 3Bolton Clarke, Inverpine Residential Aged Care, 4School of Public Health & Preventive Medicine, Monash University Therapeutic horticulture is the process of using plants and gardening activities to stimulate the senses and improve people’s physical, psychological, cognitive, and social wellbeing. Let’s Dig In! (LDI) is being conducted in a single care home, including the dementia care unit. The program, delivered in partnership with a horticultural therapist, comprises 12 weekly sessions of therapeutic horticulture. The project aims to evaluate the feasibility, acceptability and impact of the program from resident, staff and volunteer perspectives. Phase 1, conducting LDI with 10 residents from the home’s low care/high care area, was completed in 2020. Staff and volunteers were trained in therapeutic horticulture principles and supported residents during the sessions. Preliminary results show a 5-10% clinically meaningful improvement in participants’ mobility, strength and balance, with a few residents doubling their scores on the arm curl and balance tests. Interviews with residents indicated an improvement in subjective wellbeing; they felt happier and had a greater sense of purpose and achievement. Interviews with staff and volunteers suggest that LDI is feasible. In fact, the program has continued as part of the weekly schedule. Phase 2, starting LDI in the care home's Memory Support Unit, was postponed due to the COVID-19 pandemic. It is being implemented from April-July 2021, with 8 residents participating. The evaluation of Phase 2 will focus on the program’s ability to increase residents’ engagement and reduce agitation. Staff and volunteers will provide insights on the delivery of a therapeutic horticulture program in a dementia care unit.


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Exploring participant experience in life story work 1Bolton Clarke People in the later stages of their lives can experience feelings of sadness and loneliness. The transition into residential aged care services can be stressful and traumatic, leaving family members feeling worried and a sometimes a sense of guilt or loss. Life story work uses a biographical reminiscence approach to collecting stories from a person’s life. It is designed to enhance an older person’s sense of wellbeing, improve relationships between staff, volunteers, residents and family members, and improve job satisfaction for staff. However, there is a lack of empirical evidence to support the uptake of this type of work. This research explores the experience of participants in life story work conducted in residential aged care homes. It is conducted over a 12-month period and involves multiple life story work projects. A trained biographer who may be a staff member, volunteer or supervised student works one-on-one with a selected resident. The biographer collects stories and memorabilia which are used to create an eBook using photobook software. The book is printed and bound and presented to the resident to share with others. Qualitative methods are used to evaluate the project. Semi-structured interviews are conducted with all participants at the completion of each life story work project and a narrative enquiry methodology is used to explore resident experience and understand how people make sense of their lives. Early findings indicate enhanced social connection between residents, family members and biographers; and residents are displaying a sense of joy, pride and fulfilment about their lives.


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Sensory Impairment and Successful Ageing in Older Adults Over Five Years Prof Bamini Gopinath1, Prof Catherine McMahon, Prof Paul Mitchell 1Macquarie University Aim: We aimed to prospectively examine the relationship between vision and hearing loss and successful ageing in a cohort of older adults. Methods: We analysed 5-year data (1997-9 to 2002-4) from 1,085 adults aged 55+ years, who were free of cancer, coronary artery disease and stroke at baseline and who had complete data on sensory loss. Visual impairment was defined as visual acuity <20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold >25 dBHL (500-4000 Hz, better ear). Successful ageing was defined as the absence of: disability, depressive symptoms, cognitive impairment, respiratory symptoms and chronic diseases (cancer, coronary artery disease and stroke) at 5-year follow-up. Results: At 5-year follow-up, 243 (22.4%) participants had died and 248 (22.9%) had aged successfully. After multivariable adjustment, participants who had either best-corrected visual impairment or bilateral hearing impairment, versus those who did not have sensory impairment at baseline, had 37% reduced odds of successful aging after 5 years: OR 0.63 (95% CI 0.43-0.94). Concurrent vision and hearing loss at baseline was not associated with 5-year aging status. Participants with moderate and severe hearing handicap at baseline had 50% and 61% reduced odds of ageing successfully after 5 years, respectively. Conclusions: The presence of a single sensory impairment in older adults was associated with reduced odds of being disease-free and fully functional or having aged successfully, 5 years later. Objectively measured hearing loss and self-perceived hearing handicap, rather than vision loss, was more likely to negatively influence 5-year ageing status.


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Codesigning a holistic program to prevent or alleviate the effects of frailty 1Bolton Clarke, 2Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 3Centre for Health Communication and Participation, La Trobe University, 4School of Nursing and Midwifery, Centre for Quality and Safety, Institute for Health Transformation, Deakin University, 5Centre for Quality and Safety Research Monash Health , 6Cabrini Health, 7School of Public Health & Preventive Medicine, Monash University, Alfred Hospital, 8Faculty of Health and Behavioural Sciences, The University of Queensland Frailty is characterised by increased vulnerability and decline in physical and cognitive reserves. It mainly affects older people, leading to a cascade of repeated hospitalisations and loss of independence. It is modifiable with interventions including physical-exercise, cognitive-training, social-connection and improved nutrition, especially in group settings. Uptake of referrals to services following hospital discharge is sub-optimal, indicating that a person-centred approach is required. Aim: To codesign a program to support pre-frail/frail older community dwellers following hospital discharge, by increasing resilience and promoting independence. Methods: Healthcare consumers and professionals from three hospitals and a home-based nursing service in metropolitan Melbourne, Australia were engaged. We drew on Boyd et al’s theoretical framework for codesign incorporating six steps: engage, plan, explore, develop, decide and change. Findings: Twenty-three healthcare consumers and 17 healthcare professionals codesigned the Being Your Best program to incorporate a holistic approach addressing four domains of frailty supported by research evidence. Four modules: Moving Well, Eating Well, Thinking Well, and Connecting Well, aim to improve health and wellbeing while mitigating the effects of frailty through education alongside community- or home-based activities. Implications: Promoting health education together with community or home-based services for pre-frail/ frail older people has the potential to help reduce the effects of frailty and improve personal wellbeing, leading to increased resilience and independence, and less re-hospitalisations. Being Your Best is now being tested for feasibility and acceptability with recently hospitalised individuals. References 1. Boyd H et al. Improving healthcare through the use of co-design. N Z Med J. 2012;125


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Co-designing and implementing community approaches: learnings from POWER and Being your Best projects. Dr Maja Green1, Dr Rajna Ogrin1, Professor Judy Lowthian1

1Bolton Clarke We will showcase two co-designed multi-component interventions to improve wellbeing, confirming a whole of community approach is needed. (A) Peer support for Older WomEn to pRomote wellbeing and independence (POWER). Funded by Felton Bequest, managed by Equity Trustees, we describe how we harnessed the support of the community in outer South Eastern Melbourne and engaged them in developing and implementing three co-created services in practice, to improve wellbeing of older women living by themselves. 3 volunteers were trained and 5 women were enrolled when COVID-19 intervened in February 2020. Researchers identified that: trust and taking time to build trust was essential; women had multiple needs; and participants wanted to feel a part of their community. (B) ‘Being Your Best’. Funded by the MRFF, this project aims to use the principles of health assets and healthy ageing to shift the balance between vulnerability and resilience to reduce the impact of frailty in older community members after hospital discharge. We describe our approach of mapping local services in South-eastern Melbourne and codesigning the holistic intervention with older people. Being Your Best assesses the needs of older people, then links them to local services to optimise their wellbeing. Similar to the POWER project, the same issues are being identified: a) social aspects are pivotal; b) building trust in the community is essential for engagement; c) a suite of activities are needed; and d) older people want to be meaningfully engaged with their community. Reference Lowthian JA et al. (2021). BMJ Open. doi:10.1136/bmjopen-2020-043223


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Wisdom Project Australia (WPA): An innovative wellbeing program Ms Gail Green1

1Wisdom Project Australia Wisdom Project Australia (WPA) An innovative wellbeing program The Aging Royal Commission noted the high incidence of poor mental health of many older people. As an Accredited Mental Health Social Worker, the Director is well aware of mental health and wellbeing issues in this age group. She has been developing a safe and supported program to assist people over 60 to resolve issues that have occurred throughout their lives. The program is designed to work with cognitively capable people either in the community or in lifestyle and retirement villages. The central premise of the program is that resolving issues from the past will improve wellbeing and participants will have an improved sense of agency in making decisions about their future. Having resolved issues, it is proposed that participants will feel more satisfied with their lives and less prone to rumination and poor mental health. This presentation will interest policy makers and industry practitioners and will provide: • a general outline of the Level 1 program and the mental health rationale for its contents; • survey results from 2018 • the facilitator and participant workbooks • positive outcome results in villages • feedback on already conducted programs and plans to measure outcomes from future ones • identified issues to follow up. The program is designed to be safe and supportive rather than therapy, but is therapeutic in its group discussions and activities. Feedback about the impact of the program across villages will be discussed and suggestions offered about future programs.


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Connect Online- Supporting CHSP consumers engaging in Technology Mr Nathan Hall1

1Baptistcare Nsw/ ACT at home Connect Online was a Commonwealth Home Support Program (CHSP) Innovation Funding grant. Connect Online was designed to enhance the quality of life, social connections and address potential digital exclusion for a cohort of 300 recipients of CHSP services through the provision of internet-connected, easy access, and personalised ‘Breezie’ touch screen tablets, along with up to 6 months of regular one on one or group coaching. To enable consumer confidence and utilisation of the tablet for both consumer and staff, 58 Care Service Employees (CSE’S) were provided training in targeted lessons to encourage confidence in our consumers to use the device and to feel safe online. To build a supportive community for our newly trained Digital Coaches, a Microsoft Team was created so the Digital Coaches could share ideas on coaching, present good news stories and seek support from the Project team. Feedback received within this group was vital in establishing and building on new skills for staff in providing meaningful activities and enjoyment to consumers. In the sign up process an on-boarding questionnaire was developed by Breezie to assist in personalising the tablet to interests of the consumer, this could include email address, games, YouTube, and Skype. In addition the personalisation questionnaire we also included- • Personal Well-Being Index • Confidence scaling in using six targeted questions to understand consumer confidence in using a tablet, its functions and applications Midway through the project a satisfaction survey was also distributed to consumers. The project covered 7 BaptistCare regions in NSW.


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Innovative Ways of Promoting Cognitive and Social Engagement for Older Adults: From Research to Practice Dr Celia Harris1

1The Marcs Institute, Western Sydney University In this symposium, encompassing research from cognitive psychology, music psychology, and psycholinguistics, we present a range of tools and techniques for enhancing cognitive and social engagement. Across talks, with diverse approaches, methodologies, and research participants, we share an aim to enhance meaningful engagement for older people, particularly in contexts where there might be barriers to such engagement, such as social isolation, cultural and linguistic barriers, and cognitive impairment. Harris presents a study implementing a program for aged care workers to engage in richer reminiscing conversations with residents. Chmiel presents preliminary findings from a longitudinal online music education program, in which cognitively intact older adult novices learn how to play melodies and also explore aspects of creative improvisation. Escudero presents data from a survey examining how grandparents engaged with video call technology to maintain connections with their grandchildren during covid-19, and a subsequent experimental study examining engagement during virtual interactions. Radnan presents a program for using technology to enable reminiscing and connection to life history, exploring individuals’ personal histories using Google Street view. Richards presents a novel app for which can be used to support carers to engage with culturally and linguistically diverse older adults in their own language. Finally, Brookman presents findings from a survey examining what family carers, formal carers, and people living with dementia value about technology and what solutions they would like developed. Overall, we showcase novel tools and technologies to enhance engagement and wellbeing.


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Can we enhance video calls between grandparents and young grandchildren? Professor Paola Escudera1, Dr Celia Harris1

1The Marcs Institute, Western Sydney University The grandparent-grandchild relationship has far-reaching significance, with psychological and health benefits for both parties. COVID-19 made it difficult for grandparents and grandchildren to communicate face-to-face and many resorted to video calls to continue their connection, particularly for grandparents living in residential aged care. In our recent survey including 90 Australian grandparents, 40% began video-chatting with their grandkids for the first time during Covid-19. For many respondents, the video-calls have been a viable substitute for face-to-face visits. However, young children have significant difficulty in maintaining phone conversations, while grandparents face a number of technological hurdles. Older adults have issues with the lack of feedback on touch screen devices and the small size and spacing of the buttons (Barnard et al., 2013; Jin et al., 2007). Communication styles between generations are very different: while grandparents usually try to maintain a constant mental presence, grandchildren tend to engage discretely. In this talk, we present the detailed results of our survey on how grandparents use video calls to communicate with grandchildren younger than 5. Second, we present the preliminary results of study comparing interactions between grandparents and infant grandchildren (aged 6 to 24 months) that took place face-to-face in a university laboratory or via Zoom video calling. In a third condition, we redesigned the Zoom call to incorporate visual enhancers, to discover whether simple modifications to standard video call technology can lead to improved engagement. We discuss the implications of our findings for the long-term future of video calls technology in facilitating inter-generational communication.


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Using Elaborative Reminiscing to Support Memory and Relationships in Residential Aged Care Dr Celia Harris, Penny Van Bergen, Gabrielle Picard, Paul Strutt

Memories of the past are critically important as we age. For older adults in residential aged care, opportunities for reminiscing with staff may provide important cognitive and emotional benefits. Importantly, some reminiscing conversations are more supportive than others. In developmental research, a long tradition of sociocultural memory research has shown how children’s autobiographical memory is scaffolded and supported by parents during reminiscing, when parents use particular kinds of beneficial conversational techniques. In the current project, we aimed to examine whether we could enhance conversations between staff and residents within residential aged care, by teaching staff about these beneficial conversational techniques and supporting them to reminisce more often with residents. We conducted a workshop with 16 employees within a residential aged care and community care setting, and we followed this with a 4-week training and feedback session during which staff recorded their conversations with residents. Staff feedback indicated successful use of the scaffolding techniques, and that participants observed benefits as well as barriers to their use in day-to-day practice. Analysis of the conversations focused on which techniques were present and how residents responded to them. Overall, findings suggest opportunities for training to give aged care staff specific and practical tools that they can implement to improve conversations during day-to-day care.


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Dance for Thriving! - a successful intervention case study Ms Gail Hewton1, Ms Julie Chenery1

1Gold Moves Australia Encouraging seniors to adhere to exercise programs for health and wellbeing outcomes is often problematic. Dance is ‘exercise in disguise’ which can play a significant role in enticing and retaining seniors in physical activity that affords many physical, cognitive, emotional and social benefits. This case study offers a dance intervention example with a range of successful outcomes. This community practice intervention, underpinned by a relational approach and with a focus on dance for health and wellbeing, was developed through practice-based exploration supported by research evidence. Dance sessions are specifically adapted to incorporate exercise to promote falls prevention, increase range of movement, challenge cognition and engage participants socially and emotionally. Attendance over time has been analysed to indicate participant retention, and anecdotal observations by facilitator and health professionals plus participant feedback have been collated to indicate outcomes. Records across a 9 year period indicate high retention. Positive outcomes reported include fewer falls, greater range and ease of movement, lift in mood and a sense of belonging. Local Physiotherapists and Occupational Therapists (OTs) have attended and endorsed the dance sessions, and some local GPs and OTs, recommend their patients/clients attend and/or continue this program. Dance programs can be designed for different levels of mobility and ability and to meet particular needs and effect specific outcomes such as falls prevention, functional activity, emotional wellbeing and social connection. It is advantageous for those engaged in ageing programs and services to know more about this intervention in order to engage clients in effective activities.


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Residual impairments and recurrence following repositioning procedures for older people with Benign Paroxysmal Positional Vertigo. Professor Keith Hill1, Mrs Eyvonne Sim3, Associate Professor Dawn Tan2,4, Dr Yong Hao Pua2

1Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, 2Singapore General Hospital, 3Curtin University, 4Singapore Institute of Technology Background: Benign Paroxysmal Positional Vertigo (BPPV) is the commonest cause of dizziness in older adults, and has high resolution rates with repositioning manoeuvres. However, residual dizziness and recurrence have been reported in patients who had recovered. The study aims were to identify trends of residual dizziness and BPPV recurrence, and factors associated with residual dizziness, in older adults with BPPV. Methods: A longitudinal study with a six-month follow-up period was conducted, commencing one week post initial repositioning manoeuvres (T1), with follow-up at one month (T2), three months (T3), and six months (T4). Measures included positional test results; gait and vestibular function; symptom intensity rating; and self-report questionnaires (balance confidence, physical activity level, mental health, and impact of dizziness). Multilevel modelling was used to explore associations with residual dizziness. Results: Forty older people with BPPV (mean age 67.3 (7.27) years, 75% females) took part in this study. Post initial repositioning manoeuvres, 22 participants (55%) remained BPPV-positive. Half of those who tested negative reported residual dizziness. Six (15%) participants experienced BPPV recurrence, and 24 participants (60%) reported residual dizziness over six months. Age, anxiety, and depression were factors associated with residual dizziness in this group of participants. Residual dizziness was not significantly associated with gait, balance, or physical activity level; but was significantly associated with balance confidence, mental health, and quality of life. Conclusion: Residual dizziness can affect older adults with BPPV. This patient population may benefit from a holistic assessment that incorporates non-vestibular domains such as mental health (eg anxiety) screening.


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A meta-analysis of factors impacting care and counterproductive work behaviours in aged care and hospitals. Ms Batoul Hodroj1, Dr Kïrsten Way, Dr Theresa Scott, Ms Asmita Manchha, Professor April Wright 1University of Queensland Incidents of reduced quality of care, abuse, and neglect has been a global phenomenon within residential aged care that requires serious intervention. Antecedents to poor quality of care (QOC) and counter-productive work behaviours (CWBs) include increased job demands, reduced job resources, and job strain, however an integrative summary of findings in this space is lacking. Using a meta-analysis, we compared differences in the relationships between these antecedents and outcomes across residential aged care and hospital settings. We argue that differences in these settings may be explained by unique market and professional institutional logics within the residential aged care field. A market logic refers to a set of ideas, practices and policies that support individuals to pursue economic interests and embrace free-market solutions to economic and social problems. A professional logic refers to the rules and assumptions related to a network of individuals associated through professional expertise and experience. Synthesizing findings across 47 studies we found that high job demands (ρ ̅= -.19), low job resources (ρ ̅= -0.41) and job strain (ρ̅ = -.18) were negatively related to QOC and positively related to CWB (ρ ̅= .10, ρ̅ = .08, ρ̅ = .18) across both settings. The negative association between job resources, job strain, and QOC was stronger in residential aged care, suggesting that institutional logics may be impacting the design and devaluation of work in residential aged care to exacerbate the negative impact of low job resources on staff performance. Stakeholders should consider institutional logics related to the market and profession in residential aged care as these factors may also be superordinate antecedents to poor QOC in aged care.


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Loneliness among carers of older people: An analysis of Social Connectedness, Recognition, Wellbeing and Distress Dr Lukas Hofstaetter1, A/Prof Hugh Bainbridge2

1Carers NSW, 2UNSW While the relationships and social networks of care recipients are well researched, the social capital of informal carers, and the context of the wider community in which informal care is provided present gaps in the literature. This contribution discusses “loneliness” among informal carers for older people in Australia. We examine the levels of, and the relationships between social connectedness, feelings of recognition, subjective wellbeing, and psychological distress. Our analysis is based on data from the Carers NSW 2020 National Carer Survey with 7735 respondents. We find that loneliness is highly prevalent among carers of older people, adversely affecting health and wellbeing. In 2020 almost 50% of carers of people aged 65 or older were socially isolated, and 41% were classified as having high or very high levels of psychological distress. On average, carers of older people in Australia rated their subjective wellbeing very low at 60.5%, compared to 75% in the general population. A regression analysis confirms that social connectedness and recognition are decisive factors for the wellbeing and psychological distress of family and friend carers. Our research demonstrates the need for more holistic services supporting the community and social connection of carers, and for an understanding of the caring situation as being embedded in a wider social and community context.


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“I'm extremely worried about the future”: A qualitative analysis of older carers’ anticipated care endings Dr Lukas Hofstaetter1, A/Prof Emma Kirby2, Ms Giselle Newton2, A/Prof Christy Newman2, Ms Sarah Judd-Lam1

1Carers Nsw, 2UNSW When, how, and why caring ends is highly contingent, shaped by cultural and relational dynamics and structural constraints. Informal caring may end due to relinquishment, reflecting increasing care needs and admission to a formal care setting; recovery or improvement in the condition of the care recipient; or, via bereavement, following the death of the recipient or carer. Although the health and social impacts of providing care are extensively documented, how caring ends is not well understood. In this presentation, we draw on a qualitative analysis of free text responses to the 2020 National Carer Survey to discuss current and former carers’ reflections on their futures. Three themes were derived from our analysis: 1) carers’ physical decline, frailty, and concerns for the future; 2) relations of interdependence and fears for life without the care recipient; and, 3) navigating life ‘beyond’ caring. Our findings reveal the difficulties in anticipating and preparing for care endings, including challenges discussing such endings as well as a perceived lack of support or service provision for those nearing, during or beyond the end-of-care. We argue for renewed attention to the processes that enable or impede the continuation or relinquishment of care. Development of policy that foregrounds end-of-care planning and preparation is required in order to better equip carers (and recipients) to negotiate care endings.


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The impact of COVID-19 on LGBTIQ+ older people: concerns and improvements Prof Mark Hughes1, Dr Trevor Gates2, Dr Tinashe Dune3, Mx Jack Thepsourinthone3

1Southern Cross University, 2Colorado State University - Pueblo, 3Western Sydney University COVID-19 has had a disproportionate impact on older people and poses particular risks to lesbian, gay, bisexual, transgender, gender diverse, intersex and queer (LGBTIQ+) older people given the health and psychosocial disparties they face. This presentation reports on a survey on the impact of COVID-19 on 394 LGBTIQ+ people, aged 60 and over, living in Australia. It focuses on participants’ concerns about COVID-19, as well as perceptions of improvements to their lives due to the pandemic. Qualitative data were analysed thematically, involving within field coding to develop tentative categories and a constant comparative approach to refine emerging categories and themes. Less than half the sample (n = 175, 44.4%) reported concerns about COVID-19, while nearly 40% (n = 153) indicated some improvements to their lives. The main concerns were loneliness and loss of social connections, general concern for society, fear of infection, worry about work and employment, impact of travel restrictions and mental health impacts. Improvements included new opportunities to maintain relationships online, personal growth, increased wellbeing, less pressure to socialise, and a strengthening of relationships. Some improvements were seen to mitigate the effects of discrimination – for example, for some transgender people, it meant that they were not having to navigate public scrutiny as much as before. Participants' reflections on the improvements in their lives highlight the strengths and resilience of LGBTIQ+ older people and the many ways in which meaning and value can be gained in the face of adversity.


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Methodology for developing a best-practice guide for dementia in Aboriginal and Torres Strait Islander communities Dr Jo-anne Hughson1, Mr Harold Douglas1, Dr Mary Belfrage2, Professor Dawn Bessarab3, Prof Dimity Pond4, Prof David Atkinson3, Associate Professor Dina LoGiudice1,5

1University Of Melbourne, 2Royal Australian College of General Practitioners, 3University of Western Australia, 4University of Newcastle, 5Melbourne Health Introduction: High rates of dementia in Aboriginal and Torres Strait Islander populations are well documented and optimising health care in this group has become a priority health care goal. Culturally informed translation of best practice care into health pathways can facilitate this. This paper describes the development of a Best-Practice Guide to Cognitive Impairment and Dementia Care for Aboriginal and Torres Strait Islander People Attending Primary Care resource for the Let’s CHAT Dementia research project. Methods: The guide development combined orthodox Western medical epistemology and Indigenous knowledge and practice, ensuring inclusiveness and community participation. A multi-step process was utilised comprising: a planning phase, literature review, Modified Delphi process, Indigenous health peak body review, further review by the project’s Indigenous Reference Group, and final review by a clinical peak body. Results: In the planning phase principles of how to approach resource development and the delineation of domains in the dementia journey were outlined. Following this a review and synthesis of internationally accepted guidelines, Modified Delphi process with 2 rounds and 39 participants sought consensus on: guide aims, cultural principles, screening vs. case finding for detection, future planning, referral to specialist services, carer nomenclature. Further extensive review was undertaken post-Delphi by several Indigenous stakeholders to refine cultural content. Conclusion: The robust development process has produced an evidence-based and culturally focused resource, which is now publicly available as an Accepted clinical resource by the RACGP and will inform dementia care in primary care health services in Australia.


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Implementing a comprehensive nutrition and dining experience program to reduce malnutrition in aged care homes Ms Angela Malberg1, Dr Cherie Hugo1, Ms Loretta Reiken2

1The Lantern Project, 2Dignity in Dining Good food is everything, especially for older Australians. Yet about 50% of residents in aged care are malnourished and this increases care costs three-fold. Finding new ways to reduce malnutrition rates is a priority for aged care homes (ACHs). Epicure is Australia’s only industry-endorsed assessment and star rating program in aged care food, nutrition and mealtime experience. Epicure ratings are informed by consumer stories, staff input, observation and validated assessment. ACHs are beginning to utilise the Epicure program to reduce malnutrition. Over 4500 touch points are assessed at each home and generate ratings mapped against evidence-based principles across key areas of the food, nutrition and mealtime experience and the Aged Care Quality Standards. Subjective Global Assessment is used to assess malnutrition across every resident at every home. Resident, family and staff stories are captured and extensive mealtime observations conducted. Initial Epicure reports across aged care homes in Queensland and NSW provide an up-to-date and current picture of: malnutrition rates; themes of stories around food, nutrition and dining experience in aged care homes; and snapshots of what the dining experience looks like across these homes. Recommendations from Epicure rating reports generate prioritised action matrices so aged care can take ownership and control of implementing evidence-based strategies to improve residents quality of life.


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Building and Sustaining a Community of Practice in Aged Care Nutrition and Dining Experience Ms Angela Malberg1, Dr Cherie Hugo1, Nick Ryan2

1The Lantern Project, 2Lutheran Services The Lantern Project has supported and facilitated a Community of Practice around Aged Care Food, Nutrition and Dining Experience since 2013. Of over 1400 members across Australian and internationally, on average 130-150 stakeholders representing aged care CEOs, facility, clinical and catering managers, cooks and chefs, nursing staff, community providers, Aged Care Quality and Safety Commission representatives, research institutes, peak bodies, allied health and resident advocates regularly join a 90 minute collaboration meeting held monthly by videoconference. To date over 85 meetings have been held with over 7500 attendances. The diversity of membership and richness of conversations offers unique insights into the complexity of the aged care food, mealtime experience and malnutrition problem. This model supports Lantern’s Action-based Research Process and the publication of 11 research papers. Lantern’s leadership team has worked voluntarily to support and advocate for pragmatic industry-identified and industry-led solutions for reducing malnutrition rates and enhancing quality of life in aged care. In kind support, estimated at over $2.5m, has produced 3 Royal Commission submissions, 6 Lantern Annual conferences and over 100 conference presentations by leadership team members. Lantern’s website has engaged the general public by capturing over 1600 stories of dining experiences in aged care and over 23000 views of “People React to Aged care food” videos. Lantern’s monthly conversations continue to influence the Aged care Nutrition and Dining Experience narrative with “dining experience” now embedded in the Aged Care Quality and Safety Commission language and policies.


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Countering Cultural Bias in Ageing Research Methods Ms Aliza Hunt1, Prof Philip Batterham1, Prof Zachary Steel2

1Australian National University, 2UNSW Background: Adequate cultural translation and adaptation of psychiatric symptoms, disorders, and their measures is essential to ensure conceptual equivalence and comparable metric of psychiatric epidemiological estimates across diverse populations, particularly among older age groups. This paper identifies key challenges involved in the translation and cultural adaptation of mental health measures in a sample of older Indonesians aged ≥60 years. Methods: Twelve rural Indonesian villages were selected, and a full enumeration of older residents undertaken in 2015/16 (N=2526) using a survey based on HRS and SHARE methodologies (sample 1). Sample 2 re-enumerated two of these villages in 2017 (N=537). We used these data to assess the consequences of five common sources of bias that may influence transcultural ageing research. Results: Cut points of short symptom screens for mental ill-health calibrated for different populations and applied to our samples of rural ageing Indonesians, produced estimates that lacked comparability (e.g., sample 2 depression point-prevalence 3.2%-39.9%). Classical Test Theory indices and IRT item-level analysis identified scales with better (PHQ-9, K6, DQ5) and poorer (GDS, SRQ) construct validity. Significant measurement invariance was detected based on literacy, gender, and ethnicity. Items with both positively and negatively worded questions, a lack of familiarity with response formats (e.g., Likert scales) and the inclusion of many somatic distress items may have negatively impacted scale performance. Conclusions: There are multiple challenges in applying established mental health measures to an ageing population in a culturally diverse setting. The findings of the study provide recommendations for countering cultural bias in ageing research.


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The Australian public and the aged care system: attitudes towards care quality and future funding Dr Claire Hutchinson1, Professor Julie Ratcliffe1, Mr Matthew Crocker1, Dr Sheela Kumaran1, Dr Rachel Milte1, Dr Jyoti Khadka1

1Flinders University Background: The Australian aged care sector is pre-dominantly publicly funded through income tax contributions, and the recent Royal Commission has highlighted the need for significant investment in order to improve standards. It is therefore important to understand the general public’s attitudes towards aged care quality, and their willingness to contribute to increased funding to the sector. Methods: N=10,315 members of the general population participated in an online survey (stratified by age, gender, and state). Respondents were asked to indicate their knowledge of the aged care sector on a five-point Likert type scale ranging from ‘not at all’ to ‘very well’, and their attitudes towards key aged care quality characteristics. Participants were asked if, and if so how much, extra tax or personal contribution they would be willing to pay for 1) accepted quality care and 2) high quality care. Results: Regardless of the level of aged care literacy, there was consensus about what constitutes quality care, and care priorities for the sector. However, aged care literacy affected participants willingness to pay to fund a better-quality aged care system. Conclusions: The current crisis facing Australia’s aged care system demonstrates the central importance of general public support to drive quality improvements, recognising that increasing public expenditure on aged care is a necessary part of the solution. This study provides important baseline data from which to commence national conversations to consider all options for ensuring the quality, safety and sustainability of aged care now and into the future.


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'Traffic-light approach’: supporting older people and service provider participation in the development of the QOL-ACC Dr Claire Hutchinson1, Professor Julie Ratcliffe1, Ms Jenny Cleland1, Associate Professor Ruth Walker1, Dr Rachel Milte1, Dr Candice McBain2, Ms Megan Corlis3, Dr Victoria Cornell4, Dr Jyoti Khadka1

1Flinders University, 2University of Sydney, 3Australian Nursing and Midwifery Federation SA, 4ECH Background: The over-arching aim of this project is to develop a new preference-based quality of life instrument suitable for application in quality assessment and economic evaluation. Older people have been involved at every stage of the development of the QOL-ACC to ensure that the final instrument captures their perspectives and preferences. Methods: Mixed methods data was collected on draft items for the QOL-ACC across six key quality of life dimensions (mobility, pain management, emotional well-being, independence, social connections, and activities). Qualitative face validity data was collected from older people (aged 66 to 100 years) living in the community and in residential aged care via semi-structured interviews (n=59). Quantitative data was collected from older people (aged 65 to 91 years) receiving aged care services in the community via an online survey (n=313). A traffic light pictorial approach was adopted as a practical and systematic way to categorise and present data in a meaningful way that was easy for non-academic workshop members to understand and to be able to discuss the relative merits of each draft item. Results: The traffic light approach supported the involvement of older people and aged care provider representatives in the development and selection of final items. Six items were selected for the QOL-ACC instrument with one item representing each of the six dimensions. Conclusions: This methodological approach has ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers.


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Making Australian clinical guidelines ageing-friendly: some considerations for improvements Mr Kerry Hwang1,2, Dr Kirsten Moore1,5, Dr Terence Chong2,3, Ms. Sue Williams1, Assoc Prof Frances Batchelor1,2,4

1National Ageing Research Institute, 2University of Melbourne, 3St Vincent's Hospital, 4Deakin University, 5Division of Psychiatry, University College London Clinical practice guidelines distill expansive amounts of published evidence into practical advice and guidance for clinicians. Yet recent published evidence has identified limitations within current Australian clinical practice guidelines for providing clear and sufficient clinical directions to the care and management of older people. Inconsistencies within clinical guidelines can lead to healthcare practitioners practising within a “guideline-free vacuum”, and force clinicians to rely more on clinical experience and their own review of the evidence base. This may have a detrimental impact on the quality of care provided to the older person. In this paper, we present some of the considerations that go into developing guidelines (such as dementia or COPD guidelines), and explore the gaps in the suitability of Australian clinical guidelines for older people within the Australian context. Finally, we propose three actions to help ensure clinical practice guidelines address the complex clinical needs of older people. These include: 1.) Recognise and develop evidence search strategies and outcomes for distinct cohorts of older people; 2.) Include ageing subject matter experts on the development of each guideline; and 3.) Separate evidence reporting for older people within the guideline and highlight where more research is needed. The findings of this paper will help to ensure that clinical practice guidelines are relevant and appropriate for older people, which will assist in improving the clinical quality of care afforded to older Australians. Findings from this presentation will be of use to guideline developers and clinicians working with older people.


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Measuring the factors affecting healthcare barriers in older culturally and linguistically diverse Australians Mr Kerry Hwang1,2, Assoc Prof Bianca Brijnath1,4, Associate Professor Dina LoGiudice2,3, Associate Professor Jeromey Temple2

1National Ageing Research Institute, 2University of Melbourne, 3Melbourne Health, 4Curtin University Introduction: Older Australians from culturally and linguistically diverse (CALD) backgrounds face significant barriers to accessing healthcare. Although reported, the factors associated with healthcare barriers in older CALD Australians have seldomly been quantitatively measured. Understanding the extent of barriers to health care access will help to target effective strategies to optimise health care access. This paper presents preliminary measurements of the factors associated with healthcare barriers in older CALD Australians. Methods: Using the 2018-2019 Patient Experiences Survey from the Australian Bureau of Statistics, multivariable logistic regression was done to measure the factors associated with reporting different types of healthcare barriers in the past 12 months in older CALD Australians. Chi-squared tests were done to measure differences between the prevalence of healthcare barriers by birth groups. Results: Older CALD Australians have similar prevalence of reporting at least one healthcare barrier (17.53%) compared with older Australians (17.02%) and older Australians born in main-English speaking countries (16.46%). For older CALD Australians, factors associated with experiencing barriers at any healthcare service were being female (O.R: 1.83 95% C.I: 1.13-2.96) and having a long-term health condition (O.R: 1.95 95% C.I: 1.35-2.82). Unmarried females were less likely to report any healthcare barriers compared with unmarried males (O.R: 0.42, 95%C.I: 0.19-0.85). Factors that were associated with reporting dental barriers were being unmarried (O.R: 3.90; 95%C.I: 1.28-11.81), and not having health insurance (O.R:3.25; 95%C.I: 1.48-7.14). Conclusion: Marital status, gender, having a long-term health condition and having health insurance are significant factors affecting healthcare access in older CALD Australians.


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Artist’s Perspective of Personalised Music Therapy in Dementia care: a Data Analysis Ms Bronte Hyams1, Dr Vivian Issac1

1Flinders University Dementia is the second leading cause of death in Australia.¹ Behavioural and psychological changes (BPSD) such as depression, agitation, and psychosis are often seen² and cause distress for the patients and staff.² Music interventions have shown to mitigate BPSD.² Harmony in the bush is a multi-modal non-pharmacological study involving musicians in providing person-centred music for dementia residents as a component of the intervention. A secondary analysis of the musician interviews was conducted to understand their perspective on music program and their recommendations for an effective music intervention in dementia care. Group music interventions were conducted by an artist in five nursing homes (5 Musicians). Information about the patient music preferences was used to tailor the intervention. Interviews were conducted with the musicians after the 4-week intervention. Thematic analysis led to three themes being identified: positive change for residents, impact on staff and recommendations for an effective intervention. Musicians witnessed an overall positive change in challenging behaviours and improved staff morale. Some of the recommendations for effective interventions included the use of preferred music, sessions with smaller groups, reducing background noise to control ambience and incorporating physiotherapists into the intervention to help with physical improvements (such as gait). The perspective of musicians on the impact of music in dementia residents and staff is consistent with the existing literature and their recommendations are useful to improve the use of music in dementia care. ¹Dementia Australia. 2021. ²Raglio,A.,Bellelli,G.,Traficante,D.,Gianotti,M.,Ubezio,M.C.,Gentile,S.,Villani,D.,Trabucchi,M.2010. Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial. AgingMentHealth,14,900-4


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ROSA: Big Data Guiding Evidence-Based Change in Aged Care Assoc Prof Maria Inacio1, Assoc Prof Gillian Caughey1, Dr Sarah Bray1, Ms Catherine Lang1, Assoc Prof Craig Whitehead2,3, Professor Renuka Visvanathan4,5,6, Ms Liddy Griffith7, Prof Keith Evans7, Ms Marilyn von Thien1, Ms Penelope Lello1, Prof Steve Wesselingh7

1Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), 2Southern Adelaide Local Health Network (SALHN), 3Flinders University, 4The Queen Elizabeth Hospital, Central Adelaide Local Health Network (CALHN), 5NHMRC CRE Frailty and Ageing, University of Adelaide, 6Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre , 7South Australian Health and Medical Research Institute (SAHMRI) Introduction: The Registry of Senior Australians (ROSA) was established in 2017 by a partnership of scientists, clinicians, aged care providers and consumer advocates from 13 organisations seeking to improve the lives of Australians in aged care. This national resource, based at the South Australian Health and Medical Research Institute, connected siloed data from the aged care and healthcare sectors, at state and federal levels, to reveal a better picture of how >3 million people navigate these services and factors that affect their health and wellbeing. This presentation will (1) demonstrate ROSA’s value and impact over its first four years, and (2) introduce its future plans. Results: Since 2017, ROSA has delivered significant information to guide improvements for the aged care sector by: • Developing effective collaborations with the aged care industry and consumers; • Supporting the South Australian and Australian Governments in specific enquiries; • Delivering reports and making recommendations (including on quality and safety monitoring, use of psychotropic medicines, and effect of wait times for home care packages) to support the Royal Commission into Aged Care Quality and Safety investigations; Recommendations regarding quality and safety monitoring were endorsed by the Australian Senate in August 2020; • Publishing 36 studies demonstrating the utility of linked data to provide evidence on challenging areas within aged care. Between 2021-2025, ROSA will focus on: • Implementation of adequate quality and safety monitoring reporting nationally; • Areas of need for aged care users, including primary care services, mental health care, and medication optimisation.


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Sharing the experience of participating in a co-design project: a senior perspective Sue Izatt, Mrs Nadine Veerhuis, Professor Victoria Traynor

To improve the process and design of future co-design projects, lead facilitators can learn from end-user experiences. A co-design approach was used to engage multiple stakeholder groups, including senior drivers, to develop a decision aid for NSW senior drivers. One senior community advisory group member shares personal insights into the co-design process. Engagement in this project through a co-design process provided many personal benefits. These included; the opportunity to contribute to a project of personal significance and involvement through all stages of the project from conception to completion. Insight into other stakeholder perspectives and applying knowledge and experience to the development of the decision aid were other perceived benefits. To ensure ongoing engagement by seniors in the co-design process, approaches should prioritise face-to-face discussions. Clearly defined and timely timeframes are likewise just as important to ensure continuity and maintain engagement in the co-design process.


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Muscle Strengthening And Cardiovascular Fitness Activities For Poliomyelitis Survivors: A Systematic Review And Meta-Analysis Dr Timothy Lathlean1, Mr Akhilesh K Ramachandran, Dr Stephen PJ Goodman, Mr Michael KJ Jackson 1The University Of Adelaide, 2The University of New England Objective: To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors. Data sources: A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies. Study selection and extraction: Screening, data extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting. Data synthesis: A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects meta-analysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF). Conclusion: This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.


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Clinical staff perspectives on sedentary behaviour and physical activity in hospitalised older adults Mr Unyime Jasper1, Professor Renuka Visvanathan1,2,3, Dr Agathe Daria Jadczak1,2,3, Associate Professor Solomon Yu1,2,3, Dr Joanne Dollard1,2,3

1Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia, 2National Health and Medical Research Council Centre of Research Excellence: Frailty Trans-Disciplinary Research to Achieve Healthy Ageing, University of Adelaide, Adelaide, SA, Australia. , 3Basil Hetzel Institute and Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia Abstract Older adults are sedentary (sitting and lying for prolonged periods) for 99% of their time in hospital with very little physical activity (PA). The consequences are a longer length of hospital stay and poor physical outcomes. The perspectives of hospital staff regarding sedentary behaviour (SB) and PA in hospitalised older people is scarce. This study aimed to explore clinical staff perspectives regarding SB and PA in hospital. Methods Semi-structured interviews were conducted with 18 clinical staff on the orthopaedic and geriatric medicine ward at The Queen Elizabeth Hospital. The grounded theory methodology guided data collection and analysis. Results Clinicians understood SB and PA but with misconceptions. Staff were aware of the adverse physical and mental effects of SB while PA alleviates these negative consequences. Many staff perceived that older people preferred to be sedentary. Staff reported that in addition to patient’s physical condition and patient concerns about their safety, hospital processes such as lack of activities, poor communication, and uncoordinated care also influenced SB and PA. Staff stated that one primary reason for SB among hospitalised older people was that PA was not a ward priority and staff struggled with competing priorities. For example, it was quicker to assist patients with activities of daily living rather than allow patients complete these tasks themselves with supervision. Discussion/Conclusion Reducing SB and increasing PA in hospital requires attention to staff knowledge and processes of care and working with clinicians to increase buy-in that increasing PA is an essential part of clinical care.


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A Longitudinal Study of the Prevalence and Predictors of Older Persons’ Computer Use: ALSOP Cohort Ms Tara Johnson1, Dr Mojtaba Lotfaliany1, Dr Natalie Hyde1, Dr Lesley Berk1, A. Prof. Mohammed Abdelrazek1, Prof. Micheal Berk1, Prof. Sharon Brennan-Olsen1, Dr Mohammadreza Mohebbi1, Prof. John McNeil3, Ms Carlene Britt3, Prof. Elsdon Storey3, A. Prof Robyn Woods3, Prof. Mark Nelson4, A. Prof. Raj Shah5, A. Prof. Lars Kayser2, Dr Sarah Hosking1

1Deakin University, 2University of Copenhagen, 3Monash University, 4University of Tasmania, 5Rush University Background: Technology is rapidly advancing, including its role in accessing resources/services for managing everyday activities. Computers are among the most used devices in Australia. However, older adults remain less engaged with technology than their younger counterparts. Objective: To investigate the prevalence and predictors of older persons computer use over two time points. Methods: Data were obtained from the ASPREE Longitudinal Study of Older Persons. Participants aged ≥65yrs were recruited via general practice. Baseline (2010-14) and three-year data (2013-17) were used. Computer use was self-reported on a five-point scale. Analyses included participants reporting analysed variables. Predictors of computer use and its change over time were determined using a logistic regression with lasso. In sensitivity analyses, we repeated models after imputing missing values. Results: At baseline, 12,896 individuals participated (54.2% female, mean age 75.2yr) and 8,411 reported relevant variables. At both timepoints, over half of participants reported ‘Always’ using a computer (51.7%, 56.3%), with ‘Never’ the second most prevalent category (26.7%, 23.6%). Older persons significantly increased their computer use from baseline to three-year (OR:1.14 [95%CI:1.08, 1.21], P-value<0.001), although 76.3% reported no change. The top five predictors of computer use at baseline were: higher education, income and writing frequency, gender(male) and younger age. At three-year, gender was no longer predictive, being replaced by physical component summary (derived from 12-Item Short Form). Sensitivity analyses yielded similar results. Conclusions: Older persons are increasingly utilising computers; however, a considerable proportion are not engaging. This research suggests that some sociodemographic characteristics may predict older persons computer use.


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Advance Personal Planning: Proactively Preparing for the Rest-of-Life, Not End-of-Life Ms Briony Johnston1

1University of Technology Sydney Issue: Advance Personal Planning (APP) allows older adults to plan ahead for future financial, health and personal matters, ensuring their preferences are known during periods of incapacity or following death [Waller et al, ‘Increasing Advance Personal Planning: The need for action at the community level’ (2018) 18(1) BMC Public Health 1]. However a reluctance to think about end-of-life may be preventing engagement with the full suite of APP mechanisms [Rhee et al, ‘Uptake and implementation of Advance Care Planning in Australia: Findings of key informant interviews’ (2012) 36(1) Australian Health Review 98, 100]. Objective: This presentation will explore how reframing APP as a process that helps to prepare for the rest-of-life, rather than the end-of-life, may encourage older people to complete all available forms of APP [Yapp et al, ‘Planning for the rest-of-life, not end-of-life: Reframing advance care planning for people with dementia’ in Dementia as Social Experience: Valuing Life and Care (2018, Routledge)]. Outcomes: This presentation will expand on existing research to increase knowledge and shape a new perspective of APP. Participants will learn about APP processes, deficiencies in current systems, and benefits of reframing APP as an ongoing, collaborative exercise [Sudore et al, ‘Defining Advance Care Planning for Adults’ (2017) 53(5) Journal of Pain and Symptom Management 821]. The presentation will conclude with an overview of my doctoral research, as I will connect research, policy and practice through interviews and surveys with lawyers and older adults, identifying a significant opportunity for change in our approach to APP.


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Enhanced Palliative Care at Home: Evaluating community-based generalist palliative care Ms Georgina Johnstone1, Ms Janeen Cato2, Professor Judy Lowthian1

1Bolton Clarke Research Institute, 2Bolton Clarke Background High quality palliative and end-of-life services in the community allow people to die at home, supported by family, friends and services. To achieve this, care staff must be appropriately trained and supported. This project, funded by the Eastern Melbourne Primary Health Network, aimed to incorporate a general palliative approach as part of standard practice for individuals supported by an aged and community care provider, recognising and planning for an end-of-life that is person-centred, holistic, evidence-based and promotes quality of life. Method Several interlinking activities encompassing stakeholder engagement, education, and evaluation achieved the project aims in the outer eastern region of Melbourne. A mixed-method evaluation elucidated the experience of Nursing Care Managers using focus groups, including the barriers and enablers to providing a general palliative approach in the community; with data from electronic care records used to identify the impact of the project on key palliative care indicators. Results The education program increased participant knowledge and confidence in providing a general palliative approach, particularly in Advance Care Planning. There was also a greater awareness and willingness to refer to other professionals to support both staff and clients, with improved documentation in client care records. Conclusion Project findings confirm the significant role that generalist services can play when a palliative approach to care is incorporated. They also underscore the importance of collaborative working partnerships between generalist and specialist services in providing quality community-based palliative care. Investment in developing the capacity and capability of generalist services to deliver palliative care is vital.


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A total approach to dementia care using the Namaste Care program Dr Sara Karacsony1, Dr Melissa Abela1, Dr Claire Eccleston1

1University Of Tasmania, School of Nursing Care programs aimed at improving quality of life for older people with advanced dementia in Australian residential aged care facilities are limited and few interventions target this population. One such program that is dedicated to the care of older persons living with dementia as they approach end of life is Namaste Care. This program incorporates well-developed multisensory activities for people living with advanced dementia. The clear structure and opportunity to support person-centred care that Namaste Care provides is key to how and why the program works. Education on the dementia trajectory and a simulation of the multisensory experiences provided in a Namaste Care program were used to scaffold an education program for aged care staff in a Tasmanian RACF. Evaluation focused on improvements in staff knowledge, skills, attitudes and perceived self-competence in dementia care and changes to practice that the program could potentially yield.The study used a pre-test, post-test design collecting both quantitative data using three validated survey instruments and qualitative data through a focus group with Personal Care Assistants (PCAs) and interviews with key staff following the education intervention. Thirty-five participants of a large not-for-profit organisation undertook the education in Tasmania. Qualitative data indicated staffing and time were potential barriers to implementation; however, the enthusiasm of staff and management to adopt a structured program could potentially enable the delivery of Namaste Care.Staff identified the Namaste Care program as a way to offer a total approach and care experience to frail residents.


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LGBTQI ageing and the implications of past trauma on care Ms Robyn Kennedy1

1InterPride In 1970 a group of Sydney-based homosexual women and men formed an organisation called CAMP (Campaign Against Moral Persecution). These women and men took to the streets to demand their rights, spearheading a national grassroots campaign for LGBTQI equality. And once started, nothing could stop this campaign. Over time, the efforts of people like the women and men of CAMP led to sustained social change and long overdue equality. But these gains did not come without significant personal cost. Every public protest invited brutal retaliation from police and repudiation from a society that labelled protesters criminals, sinners and social deviants. Friends were lost to suicide, gay hate murders and medical interventions like lobotomies. For the first time, aged care services are presented with the challenge of responding to the needs of those who lived these experiences and are now ageing. This presentation focuses on the following themes: • the common fear among ageing LGBTQI activists that after fighting their entire lives for their identity, it will be lost in mainstream aged care • the need for aged care services to respond appropriately to the impact of decades of personal trauma on ageing LGBTQI activists • the mental health of ageing LGBTQI activists can be supported by celebrating and commemorating their role of in achieving significant change in relation to human rights • the mental health of ageing LGBTQI activists can be strengthened by creating environments that support their ongoing interest in and commitment to advancing the rights of LGBTQI communities.


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Preventing violent death in older Australians using the perspective of 15 years of data Ms Briohny Kennedy1

1Monash University Older adult homicide represents the extreme of physical elder abuse and other situational violence. Common typologies include intergenerational arguments, violent crime perpetrated by a stranger, and less frequently intimate partner homicide or mercy killing. Understanding the key characteristics of elder homicide and identifying missed opportunities for preventing these tragedies provides a window into stemming future violence and fatal assault. Known research gaps include absence of information about the interpersonal and offender characteristics, features of the homicide incident which would improve our understanding and better enable prevention efforts. This presentation describes original empirical Australian research using data from the Victorian Homicide Register, managed by the Coroners Prevention Unit at the Coroners Court of Victoria. Our research describes 15 years of homicide (2000-15) in older adults and includes a comparison with younger adult homicides. The analyses includes a high level of detail on deceased and offender factors and pre-incident events (e.g., health and mental health status and historical or proximate service contacts). Rates are calculated, and a regression analysis includes key factors identified to occur at increased odds in older adult homicide from our recent systematic review and meta-analysis. Drawing from the data, the presentation will characterise older adult homicide typologies by individual, interpersonal and incident factors. Opportunities for policy and prevention initiatives to potentially benefit a broad section of vulnerable older adults will be highlighted.


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Why is there a mismatch between ideal and actual practice in a GEM unit? Mrs Farnaz Khoshmanesh1, Professor Yvonne Wells2, Associate Professor Tracy Fortune3, Dr Tamara Tse4

1Occupational Therapy, Social Work and Social Policy, La Trobe University, 2Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, 3Occupational Therapy, Social Work and Social Policy, La Trobe University, 4Occupational Therapy, Social Work and Social Policy, La Trobe University Overview of the problem: Geriatric Evaluation and Management (GEM) is a model of inpatient care that aims to maintain or restore function, minimise risks associated with impaired function, manage common geriatric conditions, and optimise community living arrangements. The result of a recent observational study conducted in a GEM unit of a Melbourne hospital indicated that inpatients spend most of their time inactive, alone, and in hospital gowns. This result seemed inconsistent with published descriptions of GEM practice. To understand what comprises an ideal GEM practice, semi-structured interviews were conducted with GEM experts. Then, interviews with health professionals practicing in one Victorian GEM were conducted to better understand enacted practice. Interviews were transcribed. Content analysis was utilised. The problem: The findings highlighted a mismatch between literature-based descriptions of an ideal GEM unit, GEM experts’ perspectives, and enacted practice. For example, the notion of an appropriate and less appropriate GEM patient was evident in health professionals’ accounts. Participant descriptions also revealed a range of challenges to achieving an ‘ideal’ service. The main topics for discussions: Investigating possible underlying reasons for this mismatch and finding effective solutions are urgently needed. This presentation seeks to engage policy makers, researchers, and industry practitioners in a critical conversation about our findings thus far and possible future directions for GEM services. Implication: These findings demonstrate an urgent need for recommendations that can increase consistency between ideal and enacted practice and ultimately improve the quality of care delivered in GEM units.


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Socio-Economic Position across the Life Course and Disability Free Life Expectancy Trends in Australia Dr Richard Tawiah1, Prof Kaarin Anstey1, Professor Carol Jagger3, Dr Kim Kiely2

1UNSW, 2NeuRA, 3Newcastle University We report a program of research examining inequalities in Disability-Free Life Expectancy (DFLE) trends for Australia, based on two cohorts from the nationally representative Household Income and Labour Dynamics in Australia (HILDA) survey. Each cohort was aged 45+ at baseline with 7-years of annual follow-up (2001 cohort: n=6363; 2011 cohort: n=8197). Mild disability was defined a Global Activity Limitation Indicator (GALI: a self-reported limiting long-term health condition), and more severe mobility limitations were measured by the SF36 physical function subscale. Multistate models estimated disability transition rates (e.g. incidence, recovery, mortality), and DFLEs were calculated by individual markers of lifecourse Socioeconomic Position (SEP: education, occupation, home ownership) and an area-level index of social disadvantage. Overall life expectancy was greater in the 2011 cohort compared to the 2001 cohort for all SEP groups except for older women who did not own their own home, for these women there was no improvement in life expectancy. For all other women, any gains in life expectancy were comprised entirely of years lived with a GALI-disability irrespective of their level of SEP. Men with high SEP (e.g. high education, area advantage, and who owned their own home) were the only group to experience a gain in the years lived free from GALI-disability and to have no additional years lived with mobility limitations. Unlike other markers of SEP, occupational prestige did not strongly demonstrate differences in DFLE trends. These results reveal a complex picture of recent DFLE trends in Australia, highlighting gender differences and widening social inequalities.


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Collaborations at the local level for ending ageism:local government, services and initiatives, and EveryAGE Counts Dr Marlene Krasovitsky, Mr Joel Pringle 1The Benevolent Society, 2EveryAGE Counts Local government, the critical third tier of Australia’s system of governance, plays a crucial role in the daily lives of people. It provides many services to local residents and businesses and impacts on the integrity, quality, safety and amenity of much of the physical environment in which people live. Regionally-based State/Territory and/or federal services and initiatives are also close to the ground and people’s lives. This makes these levels of governance and services important allies for a campaign like EveryAGE Counts, which is committed to ending ageism and its impacts on older people. During 2020 and 2021 EveryAGE Counts has partnered and engaged with a range of locally-based bodies to raise the issue of ageism, hear the voices and experiences of older people where they live and support innovative and energetic initiatives to shift the dial on ageism. In many cases it was the local body or service that reached out to EveryAGE Counts for support to embark on these actions. This presentation will outline the collaborations and engagements; reflect on the approaches and processes used; share early review of the success of the measures; and point to the way forward from here. Participant views and experience regarding similar engagements between social change campaigns and local bodies will be eagerly invited during the session.


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Radio relationships and well-being in older age Dr Amanda Krause1, Dr Heather Fletcher2

1James Cook University, 2The University of Melbourne Community radio is known to promote psychosocial well-being for individuals and their communities. Specifically, radio broadcasting is “perfectly placed to tackle the far-reaching social issue of loneliness” (Order, 2017, p. 244) which is important as older adults, in particular, experience loneliness due to low levels of community connection. Thus, a better understanding of the social connections established between radio presenters and listeners could identify specific ways in which community and well-being in older life may be supported. This AAG-supported program of mixed-methods research investigated radio presenter behaviours to consider how their practices may be designed to facilitate their listenership’s sense of well-being. With data collection still underway, preliminary analyses suggest that radio presenters are not only recipients of well-being benefits, but are also conduits. They work with the listener in mind – scripting and delivering their presentation and content selections according to perceived audience preference. Findings will address how the behaviours of presenters relate to efforts to connect with, retain, and support the well-being of their listeners. Project findings provide an in-depth understanding of how radio relationships can promote well-being, leading to the creation of an evidence-based, user-friendly resource, designed to assist individuals and radio providers in promoting individual and community well-being. Broader implications regarding how the radio might be used in aged-care settings and healthy ageing policies will be discussed. Order, S. (2017). All the lonely people, where do they all belong: Community radio and social connection. Radio Journal: International Studies in Broadcast & Audio Media, 15(2), 243-258. doi:10.1386/rjao.15.2.243_1


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Emotions, singing, and well-being Prof Jane Davidson2, Dr Amanda Krause1

1James Cook University, 2The University of Melbourne The work of emotion where music has been used for explicit well-being outcomes has been understudied. For example, the successful use of choral singing with marginalised groups is well established, but it has been most typically reported as means of providing opportunity for improved health particularly related to physical outcomes such as improved breath control or social activity. The work of emotion in expressing and managing feelings as well as expanding sense of self in relation to maintaining and expanding social relationships has been less investigated. By focusing on emotion, the current study purposefully aimed to expand the scope of the discourse and understanding of music’s role in well-being outcomes for individuals, small groups and the broader community. Two case study choirs were explored: a same sex and gender diverse youth chorus and a community senior choir. Thematic analyses of these rich data revealed the importance of emotions as corporeal, relational, socio-political and performative experiences, and emphasised the centre role of emotions across different age groups and group contexts. The research highlights the need to consider the work of emotions in social group contexts and also the power of emotions when experienced in musical contexts in particular. The present results highlight the significant and central role of emotions in gaining at least some of the well-being benefits associated with singing. Drawing on the PERMA model of well-being as a lens to interpret the results, implications arise when considering how to design and facilitate group singing opportunities for older adults.


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Implementing Shared Decision Making in Outpatient Perioperative care: Perioperative care for Older People undergoing Surgery Dr Rajni Lal1, Dr Ramai Santhirapala, Dr Judith Partridge, Dr Jugdeep Dhesi 1Ryde Hospital, NSLHD Introduction: Shared Decision Making (SDM) is the process whereby patients and healthcare professionals work together to achieve a consensus management decision, based on best clinical evidence and patient’s preferences. No formal approach to documentation of such SDM conversations exists in setting of peri-operative medicine. The Choosing Wisely initiative aims to improve patient-clinician SDM. SDM should be considered whilst considering tests, treatment or management, in both primary and secondary setting. Aim: To assess and improve the quality and consistency of documentation regarding SDM conversations in an outpatient population and appraise the satisfaction of patients and professionals in the process of preoperative shared decision making. Methods: A five stage, mixed methods quality improvement programme was undertaken employing observational data, nominal group technique and survey methodology. The study was conducted in a geriatrician led Perioperative medicine for Older People undergoing Surgery (POPS) service, based at an inner-city teaching hospital serving a tertiary surgical referral population. Participants included clinicians of all grades and disciplines, and consecutive patients attending the clinic. Choosing Wisely UK framework – BRAN: Benefits, Risks, Alternatives and Nothing incorporated whilst discussing treatment plan. Results: Clinician interviews revealed inconsistent documentation of SDM. Codesign of a SDM documentation tool achieved rapid, sustainable uptake - 59%. Additional reminders and education sessions, led to SDM documentation to 98%. Patients were satisfied with SDM. Targeted interventions were used to improve clinician satisfaction with SDM. Conclusion: BRAN framework can be effectively used to formalise documentation of SDM in a sustainable manner and achieve patient and professional satisfaction.


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Recruitment barriers and enablers for an Aboriginal Health Practitioner led dementia prevention program Mr Alex Lalovic1, Mrs Lesley Markey1, Ms Deanne Lewis1, Ms Glennette Dowden1, Associate Professor Kay Cox1, Mr Michael Bynder1, Ms Maureen Merritt1, Ms Tania Kelly1, Mr Samuel Bulten1, Professor Leon Flicker1, Professor Sandra Thompson1, Dr Rachel Milte2, Professor Dawn Bessarab1, Associate Professor Carmela Pestell1, Professor Keith Hill3, Associate Professor Dina LoGiudice4, Dr Christopher Etherton-Beer1, Dr Kate Smith1

1University Of Western Australia, 2Flinders University, 3Monash University, 4University of Melbourne Aboriginal Australians have a high rate of dementia. A comprehensive program to target dementia risk factors in Aboriginal Australians has been developed. There are several barriers and enablers to identifying older Aboriginal participants at risk of developing dementia and recruitment into health programs. In partnership with three Aboriginal Community Controlled Health Services (ACCHS) in Western Australia, we have co-designed an Aboriginal Health Practitioner led program (DAMPAA) to target key dementia risk factors for Aboriginal people aged >45 years. Six Aboriginal researchers work closely with ACCHS, and Aboriginal community groups to recruit participants. After initial inclusion criteria are met, participants are screened for mild cognitive impairment using the Kimberley Indigenous Cognitive Assessment (KICA) tool. To date 543 people have been contacted to take part in the DAMPAA study with 426 (78.4 %) declining to participate or not meeting initial eligibility criteria. 117 participants have been screened with 24 (20.5 %) meeting the KICA eligibility criteria for the DAMPAA study. Reasons given for not taking part were; inability to commit to length of the program, full-time work, family commitments, caring for grandchildren, travel for funerals/other appointments. Recruitment enablers included employing Aboriginal researchers/health professionals, providing transport, home visits for KICA assessments and group screening sessions at and in partnership with Aboriginal community controlled organisations. Employing Aboriginal researchers and partnering with Aboriginal community controlled organisations improves recruitment of older Aboriginal people into health programs, however family, work and funeral commitments are key barriers. Barriers and enablers identified have informed program recruitment and delivery.


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Relevance and cultural appropriateness of cognitive reserve measures in Aboriginal and Torres Strait Islander communities Dr Louise Lavrencic1,2, Dr Holly Mack1,3, Mr Terrence Donovan1, Ms Gail Daylight1, Dr Wendy Allan1, Prof Brian Draper1,4, Prof G. A. (Tony) Broe1,2, Prof Kim Delbaere1,2, Dr Kylie Radford1,2

1Neuroscience Research Australia, 2University of New South Wales, 3University of Technology Sydney, 4Prince of Wales Hospital Aboriginal and Torres Strait Islander peoples are disproportionately affected by cognitive decline and dementia. Cognitive reserve (CR) refers to differences in cognitive processes that can help explain why individuals with the same underlying brain changes/pathology often have different cognitive outcomes. This study aims to investigate the acceptability/relevance of CR proxy measures for understanding potential protective factors such as work history, education and childhood enrichment to reduce dementia risk with Aboriginal and Torres Strait Islander peoples. We will conduct an online survey with collaborators (existing partners across 3 waves of the Koori Growing Old Well Study, KGOWS) to assess potential CR variables for acceptability/relevance; and develop a holistic tool for investigating CR in this population. Suitable CR proxies will then be examined for associations with cognitive impairment/decline using existing data from the longitudinal KGOWS study including Aboriginal and Torres Strait Islander people (60+ years, N=336 baseline; n=165 follow-up). Survey responses will inform variable selection for analysis. Preliminary work suggests that unskilled work history predicts cognitive decline; years of education and childhood enrichment likely play a role but have not been shown to be significant protective factors independently (Lavrencic et al., under review). CR proxies may protect against late-life cognitive decline and dementia for Aboriginal and Torres Strait Islander people; but, nuanced investigation of relationships and synergistic effects of CR proxies may be more relevant. This consultation and in-depth analysis will shed light on culturally-appropriate measures, to better understand dementia risk in this population, with implications for Australian population-level risk reduction policy.


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Discourses relating to people living with dementia, carers, and their socio-spatial rights. Ms Carmela Leone1, Prof Irene Blackberry, Dr Rachel Winterton 1La Trobe University People living with dementia and carers experience socio-spatial exclusion. While inclusive design is often viewed as a solution, negative constructions of people living with dementia (and carers) remain barriers to achieving genuine dementia-friendly environments. Furthermore, few dementia-friendly communities focus on rights. This study explores how people living with dementia, carers and their socio-spatial rights are constructed in the public news media, and in interviews with community stakeholders, and people living with dementia and carers, in the City of Greater Bendigo, Victoria. It adopts a rights-based conceptual framework to define socio-spatial rights as the rights to participation, inclusion and access, and a Foucauldian-inspired discourse analysis method to identify the influences within discourses. Results from the completed public news media analysis stage identify constructions of carers as burdened. Carers are also largely absent from discourses relating to socio-spatial rights. People living with dementia are constructed as deficient, lacking and suffering, however, in a counter discourse, they are constructed as persons who remain essentially who they are. In an emerging discourse, found in the context of dementia awareness and dementia-friendly initiatives, people living with dementia are constructed as engaged participants and members of their communities – as citizens. These counter and emerging discourses may be seen to reflect a shift away from a biomedical model of dementia towards a more social or relational model. Findings from this first stage and the interviews will inform dementia awareness-raising programs for local news media and community stakeholders, and the establishment of a genuine rights-based dementia-friendly community.


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Physical activity during COVID19 - results from the ENJOY Seniors Exercise Park project Prof Pazit Levinger1, Mr Jeremy Dunn1, Dr Maya Panisset1, Prof Briony Dow1, Assoc Prof Frances Batchelor1, Professor Keith Hill2

1National Ageing Research Institute, 2Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University The COVID19 pandemic and associated restrictions impacted on older people’s opportunities to engage in physical activity (PA). The ENJOY is a community research project where participants underwent a 12-week PA program using outdoor multimodal exercise equipment (Seniors Exercise Park, SEP) followed by a 6-month maintenance phase (independent SEP usage). A small sub-group who completed the 12-week program were impacted by the pandemic during their maintenance phase, being unable to access the SEPs for several months (public parks closure). This sub-group (n=17, age 74.8±8.2 years, 88.2% women) was surveyed between May-Sep 2020 to explore the impact on PA maintenance and their PA habits during the lockdown. PA levels (% of improvement in CHAMPS measure between program completion to the end of maintenance phase) were compared between participants (n=58) not impacted by COVID19 and this sub-group using t-test. Results: The majority (94.1%) reported doing some form of PA including walking outside (75%) and home exercises (68.7%, mainly strength (31.2%), stretching/flexibility (18.7%)). Frequency and duration were: 5.2±2.1 times per-week for 17.2±14.2 minutes and 4.3±2.3 per-week for 39.1±16.9 minutes for home exercises and outdoor walking respectively. The sub-group demonstrated lack of PA improvement (p ˂0.05) compared to those not impacted by the lockdown. Discussion: The lack of SEP access and closure of PA programs/leisure centres adversely impacted PA level, however participants maintained some level of activity. Given the importance of PA in reducing the incidence of hospitalization and COVID19-related death, older people should engage in any safe form of PA at home or outdoors.


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Frailty within the Indigenous landscape Ms Ebony Lewis1, Ms Leanne Howard1, Assoc Prof Magnolia Cardona2, Dr Kylie Radford3, Dr Adrienne Withall1, Mr Adam Howie1, Professor Kenneth Rockwood4, Associate Professor Ruth Peters3

1University of New South Wales, 2Bond University , 3Neuroscience Research Australia, 4Dalhousie University Indigenous Peoples worldwide suffer disproportionally higher levels of chronic disease, which can be attributed to the far-reaching and intergenerational consequences of colonisation. Frailty is a challenging expression of ageing and an important public health priority. Very few studies have explored frailty within Indigenous populations. We, therefore conducted a scoping review to: map what the literature reports around frailty in Indigenous adult populations, and; highlight current gaps in frailty research within the Indigenous landscape. A systematic search of English language original research focusing on frailty within Indigenous populations in settler colonial countries was undertaken in 10 databases and 8 grey literature websites in October 2020. Nine articles met our inclusion criteria. Most articles found Indigenous populations having a high prevalence of frailty. Compared to their non-Indigenous counterparts, frailty occurred more frequently at younger ages. Furthermore, females presented with higher levels of frailty. No culturally specific frailty measurement was identified. No articles included strategies for the management or prevention of frailty amongst this population. To our knowledge this is the first review to map reports of frailty within the Indigenous landscape. There was little robust data on frailty prevalence, approaches to frailty assessment using formal frailty measures, and potential points of intervention with regards to the management or prevention of frailty. Improvements in the evidence and factors contributing to higher levels of frailty including Indigenous views of frailty is urgently needed. Such studies should elicit Indigenous peoples’ participation in co-design approaches to frailty assessment.


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A case study exploration of 24-hour functional care quality provided to older hospitalised medical patients Dr Lenore Ley1, Emeritus Professor Maxine Duke1, Emeritus Professor Mari Botti1

1Deakin University Introduction: Quality 24-hour care for hospitalised elders involves focused activities to minimise functional decline. Study aims were to: 1) explore and describe the characteristics, intent and coordination of 24-hour functional care processes; and, 2) explore the ‘real world’ system and process barriers and facilitators for clinicians to provide best practice 24-hour care to optimise functional status in hospitalised elders. Methods: A single institution, multi-method case study using naturalistic observation, chart review, patient survey and clinician interviews. Forty-one patients aged 70 years and over and 20 clinicians were observed in 246 hours of non-participant observation on Day 2 of admission to a general medical ward. Functional change during hospitalization was measured using the Functional Autonomy Measurement System. Mobility type and duration was recorded continuously over 6-hour observation periods. Content analysis was used to recognise patterns and themes in the data. Results: Older people performed low mobility (Md=9.33 minutes, Q25=5.6, Q75=18) and 24.4% (n=10) functionally declined. Two overarching themes revealed: 1) lack of coordination of 24-hour activity-related care, and, 2) balancing variable and competing priorities in 24-hour nursing care. System and process barriers were identified that affected the fluency of 24-hour care provided by nurses and the resultant opportunity for patients to have periods of uninterrupted rest or to participate in function-promoting activities. Conclusion: There was a lack of coordination of 24-hour care provided by the interdisciplinary team to protect, promote and optimise the functional status of older patients. Barriers and facilitators to mobility promotion limited the quality of functional care delivered.


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Examining the relationship between childhood adversity and mental health in older adults Mr James Lian1,2, Dr Kim Kiely1,2, Prof Kaarin Anstey1,2

1University of New South Wales, 2Neuroscience Research Australia (NeuRA) Background: There is a need to understand how early adversity is linked with mental health in older adults. The aim of this study was to 1) explore the optimal way to operationalise a scale of adverse childhood experiences (ACEs) and 2) examine the association between ACEs with depression and anxiety in older adulthood. Methods: Data were from Wave 1 of the Personality and Total Health (PATH) Through Life Project (N = 7485, 51% women). Older adults aged 60-65 reported their childhood experiences of domestic adversity on a 17-item scale (e.g., abuse, neglect, poverty). Depression and anxiety were assessed using four validated screening instruments (GDS, GAS, MCS-12, PHQ-9). Three approaches to scoring the ACE scale were compared: i) cumulative risk, ii) factor analysis, and iii) latent class analysis (LCA). Linear regression models estimated associations between ACEs and mental health, adjusting for age, race, education, and gender. Results: Childhood adversity was associated with late life depression and anxiety when using the cumulative risk approach. Factor analysis produced latent factors of threat and deprivation, which were highly correlated, leading to problems with multicollinearity when estimating associations. Finally, LCA revealed three classes of ACEs: high adversity, low adversity, and parental maladjustment. High adversity and parental maladjustment were associated with higher levels of depression and anxiety symptoms compared to low adversity. Conclusion: Different approaches to operationalising childhood adversity reveal that ACE exposure is associated with depression and anxiety in older adults. Future studies will utilise these methods to investigate links with cognitive decline and dementia.


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FRAIL-NH for Frailty Screening in Aged Care: A Systematic Review Ms Shin Liau1,2, Ms Laura Dowd1, Dr Samanta Lalic1,3, Professor Renuka Visvanathan2,4, Prof John (Simon) Bell1,2

1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 2National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, 3Pharmacy Department, Monash Health, 4Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide Background: Despite the development of various frailty scales, most are designed for use in community settings. The FRAIL-NH scale is a simple and practical tool to support frailty screening in residential aged care (RAC). Objective: To investigate the prevalence of frailty, cross-sectional associations, predictive validity, concurrent validity, and cross-cultural adaptations of the FRAIL-NH scale. Methods: MEDLINE, EMBASE, CINAHL, and Cochrane Library were searched for primary studies that used the FRAIL-NH scale from January 2015 to March 2021. Articles were screened by two independent reviewers. Results: The FRAIL-NH scale was utilised in 31 studies across 14 countries, with majority being Australian studies (n=11). FRAIL-NH has been adapted into Brazilian Portuguese, Chinese, and Japanese. When using the most frequent cut-off of ≥2, frailty prevalence ranged from 15.1% to 79.4%. The scale was predictive of falls (n=2), hospitalisations (n=4), and mortality (n=8) over a median follow-up of 12 months. FRAIL-NH was compared to eight other scales, and was correlated with Frailty Index (FI), Fried’s phenotype (FP), and FI-Lab (r=0.57-0.81). FRAIL-NH had fair to moderate agreements with FI, FP, and the Comprehensive Geriatric Assessment (κ=0.33-0.55). A cut-off of ≥8 showed the highest sensitivity and specificity (94.1% and 82.8%, respectively) for classifying frailty status based on FI, while two studies reported the optimal cut-off of ≥2 using FI and FP, respectively. Conclusion: Despite the range of cut-offs, FRAIL-NH demonstrated predictive validity for falls, hospitalisations, and mortality in RAC. The association with adverse health outcomes highlights its value in guiding care for frail residents in RAC.


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The impact of coronavirus restrictions on older people and their carers in Australia -future implications Dr Katarzyna Lion1, Professor Wendy Moyle1,2, Dr Monica Cations3, Dr Lihui Pu1,2, Sally Day3, Ms Jenny Murfield1,2, Professor Mark Gabbay4,5, Dr Clarissa Giebel4,5

1Menzies Health Institute Queensland, Griffith University, 2School of Nursing and Midwifery, Griffith University, 3College of Education, Psychology and Social Work, Flinders University, 4Department of Primary Care and Mental Health, University of Liverpool, 5NIHR ARC NWC In early 2020, social service access for older adults, people with dementia and informal carers as well as visitor access into residential care were restricted by Federal and State government public health measures to reduce the spread of coronavirus infections. We aimed to explore the individual experiences of older adults, people with dementia and informal carers regarding their use of social services. Forty-eight older people, people with dementia and their informal carers took part in an online survey exploring social service use pre- and post- restrictions, and how it affected respondents’ quality of life, anxiety, and depressive symptoms. Additionally, 16 carers and two people with dementia participated in semi-structured interviews investigating individual experiences with a) social care services availability, b) contacting/visiting people living in residential care, and c) well-being of interviewees. Data analysis included statistical tests on survey responses and thematic analysis of interviews’ transcripts. The implemented changes resulted in restricted access to social services; consequently, participants experienced lower quality of life, physical and mental health deterioration. Carers reported a higher level of burden and increased care workload. Difficulties in following (and understanding) the restrictions among people with dementia increased challenges in providing care. Technology allowed the provision of some services and social interactions, but it also led to several challenges. The COVID-19 pandemic has highlighted concerns about sustainability and care quality in Australia, strengthening the importance of high-quality support and care provision. These findings can inform changes within the care system to facilitate a better quality of provided services.


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Negotiating balance of cultures among Chinese Australians to facilitate ageing well Assoc Prof Shuang Liu1

1U Of Queensland For older people of migrant background, life in their settlement country, which they call home, is always imbued with heritage and settlement cultures. The challenge is how to achieve a balance between the two cultures. Despite consistent research indicating that integration is associated with better cross-cultural adjustment and well-being among older migrants, there is limited understanding of the process through which integration is achieved. This paper reports a study that investigates the processes through which older Chinese Australians negotiate a balance between heritage and settlement cultures in Australia. Data were collected from semi-structured interviews with 18 older China-born Chinese Australians, most of whom immigrated to Australia for the sake of joining the family of their adult children in Australia. Thematic analysis identified three ways by which older Chinese Australians achieve a balance between cultures: adhering to Chinese food while incorporating western influence; preserving Chinese traditions while adjusting to Australian culture; and maintaining Chinese family relations while embracing change in traditional practice. These findings highlight the importance of cultural continuity in contributing to older migrants’ well-being. The paper argues that negotiating balance of cultures is an ongoing process for older migrants, which can positively shape their ageing experiences and improve intergenerational and intercultural relationships. The implication for policy and community services is to facilitate the continuity of heritage culture and identity, and link them to the Australian culture to enable cultural adjustment and well-being.


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Understanding linguistic discordance in Residential Aged Care Dr Katrina Long1, Dr Shiva Vasi2, Dr Jim Hlavac3, Miss Marlene de Bruin1, Dr Joanne Enticott2,4, Mr Rob Macindoe5, Professor Terry Haines1

1School of Primary and Allied Health Care, Monash University, 2Department of Psychiatry, School of Clinical Sciences, Monash University, 3School of Languages, Literatures, Cultures and Linguistics, Monash University, 4Monash Centre for Health Research and Implementation, 5SEHCP Inc. (t/a enliven) Older Australians are increasingly culturally and linguistically diverse, with approximately 17% speaking a language other than English and 5.6% reporting limited or no English proficiency. When these older Australians enter residential aged care facilities, they are likely to encounter linguistic discordance – an inability to effectively be understood & to understand others. Despite government policy highlighting the importance of providing care in residents’ first languages, and the availability of free interpreting services through Translating and Interpreting Services (TIS) National, little is known about how linguistic discordance is managed in residential aged care in Australia. This study therefore aimed to explore the experience of linguistic discordance for residents with limited English proficiency living in residential aged care in Australia, their families and facility staff. We used an exploratory, descriptive study design using inductive thematic analysis. Semi-structured interviews were conducted with five residents with limited English proficiency, eight family carers and twelve staff from two Melbourne residential aged care facilities. We identified five key themes: a hierarchy of communication strategies; a cycle of failed communication; low perceived importance of verbal language; lack of access to suitable communication strategies; and ageism. Staff relied on impromptu, non-verbal and verbally reduced communicative strategies and LEP residents felt misunderstood and disconnected, leading to feelings of isolation and disengagement. To address these findings, we recommend a campaign from TIS National to raise awareness and improve access to this free professional interpreting service.


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ED visits by aged care residents with limited English proficiency Dr Katrina Long1, Professor Terry Haines1, Ms Sharon Clifford2, Professor Suresh Sundram3,4, Professor Velandai Srikanth5,6, Mr Rob Macindoe7, Ms Wing-Yin Leung8,9, Dr Jim Hlavac10, Dr Joanne Enticott3,11

1School of Primary and Allied Health Care, Monash University, 2Department of General Practice, School of Public Health and Preventive Medicine, Monash University, 3Department of Psychiatry, School of Clinical Sciences, Monash University, 4Monash Health, 5Peninsula Clinical School, Central Clinical School, Monash University, 6Peninsula Health, 7SEHCP Inc. (t/a enliven), 8Swinburne University of Technology, 9National Ageing Research Institute, 10School of Languages, Literatures, Cultures and Linguistics, Monash University, 11Monash Centre for Health Research and Implementation Up to 55% of Emergency Department (ED) visits by residents of Residential Age Care Facilities (RACFs) are potentially avoidable. Limited English proficiency (LEP) contributes to lower quality health care and worse health outcomes for older people but has not been studied as a factor in avoidable ED visits from RACFs. This study aimed to examine if RACF residents with LEP have a higher rate of potentially avoidable ED visits compared to controls. We used a mixed-methods sequential exploratory design, comprising a quantitative matched cohort study of ED visit data from two local hospital networks in South-East Melbourne, Australia, and secondary thematic analysis of 25 interviews with LEP residents, family carers and staff from two RACFs in the same region. We found no differences in hospital admission rates between LEP cases and Australian-born English-speaking controls (Network 1, 87.1% cases, 85.6% controls, p=0.57; Network 2, 76.0% cases, 76.9% controls, p=0.41) and no direct qualitative evidence suggesting that LEP was a factor in avoidable ED presentations, despite communication difficulties being reported during the transfer process. These results indicate no deficit in treatment attributable to LEP which may be due to adequacy of existing RACF policies and procedures, staff training, the involvement of carers in residents’ care and/or other factors. However, additional research using different measures of LEP is recommended to further explore the role of a broader range of cultural and linguistic factors in both rates of avoidable ED presentations and the decision-making processes underpinning resident transfers to ED.


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Non-dietary factors influencing dietary inflammatory index scores in community-dwelling older adults in the ACT Ms Elizabeth Low, Assoc Prof Nenad Naumovski, Assoc Prof Stephen Isbel, Dr Nathan D'Cunha, Assoc Prof Rachel Bacon, Dr Jane Kellett 1University Of Canberra Background: Emerging evidence suggests a link between diet quality and inflammatory state in older persons, as measured by dietary inflammatory index scores. Evidence suggests a tendency to move to a pro-inflammatory state as a consequence of ageing. This may be influenced by dietary factors and non-dietary factors (including declining social networks). Aim: To explore non-dietary factors influencing dietary inflammatory index scores in community-dwelling adults. Method: This study was a cross-sectional pilot study of community-dwelling people aged 55 years and over living in the Australian Capital Territory. Participants attended a 90-minute interview, completing an extensive validated food frequency questionnaire. Additional data collected included assessment of risk of social isolation (Lubben Social Network Scale) and anthropometric measurements (self-reported; basic sociodemographic information). Dietary inflammatory index scores were used to assess diet quality with respect to anti-or pro-inflammatory content. Results: The study recruited 107 participants, average age of 70.1 (±8.61) years. The average dietary inflammatory index score was -1.10 (±1.21), indicating participants tended to consume an anti-inflammatory diet. Lubben score had a significant association with diet quality (b+SE:-.041 ±.012; p = .001). This was influenced by the number of people in the household with no influence between Lubben and dietary inflammatory index scores in one-person households (p > 0.05). However, there was an influence for participants in households with 2 or more people (b+SE:-.057 ±.016; p = .001). Conclusion: Social isolation may negatively impact diet quality. Living in a household with others may have a positive impact on diet quality for older persons.


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Living well in residential aged care homes: Supporting meaningful activity for residents Assoc Prof Elizabeth Cyarto1,2

1Bolton Clarke Research Institute, 2Faculty of Health and Behavioural Sciences, The University of Queensland Introduction: The number of older Australians living in care homes is increasing. It is estimated that there will be almost 1.6 million residents by 2050. Care homes have been criticised for their routinised and task-oriented focus, with staff prioritising physical care over psychosocial care needs. A meaningful daily life involves a focus on reciprocal relationships (with staff and other residents), social contributions and social engagement. Despite care homes providing structured recreational activities, residents have expressed feelings of loneliness and boredom, with many empty hours in the day. It is not surprising, therefore, that there are high rates of loneliness and depression in care homes. Residents, family members and staff have called for new and different activities to facilitate engagement, and provide meaningful social participation, especially for those living with dementia. Residents desire to feel a sense of belonging and contribute to those with whom they feel connected. They particularly express an interest in participating in more activities that take place outside the care home. Purpose and overview of activities: This symposium will report on four programs implemented within a large aged and community care organisation that were designed to optimise the psychosocial health and wellbeing of care home residents. It will stimulate discussion on diversional activities versus meaningful social opportunities. Expected learning outcomes: Participants will learn about strategies to improve or maintain residents’ mental and social wellbeing by providing purposeful and engaging activities. Participants will also learn about the challenges and benefits of implementing and sustaining such programs.


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Why re-engage with work as mentors? The motivations of post-retirement age workers and meaningful work. Dr Jennifer Luke1

1University Of Southern Queensland The immediate need for an injection of skills from older workers to strengthen workforce productivity has been promoted by Australian Government Intergenerational Reports (2015) as well as globally via agencies such as the Organisation for Economic Co-operation and Development (OECD) and the United Nations. The findings from recently completed PhD research (Luke, 2021) that focused on the motivations of post-retirement age workers re-engaging in work (paid or volunteer) as mentors will be provided in this presentation. Discussion will highlight what meaningful work meant to N=30 post-retirement aged interview participants who re-engaged with work in some capacity, their motivations as well as levels of career adaptability and generativity. Career engagement and support is important throughout an individual's career life cycle, no matter what age and field they work or worked in. Career re-engagement of post-retirement age workers has many potential shared benefits for employers and employees, including increased productivity, inter-generational knowledge sharing, and job satisfaction. The aim of this presentation is to contribute research findings and recommendations that can promote policy and professional practice conversations about the workforce, economic and social value of re-engaged post-retirement age workers as mentors, their motivations, sense of meaningful work, and the importance of career development support across the lifespan. Australian Treasury. (2015). 2015 Intergenerational Report Australia in 2055. Commonwealth of Australia. Luke, J. (2021). Transferring the knowledge: Career adaptability and generativity of post-retirement age citizens interested in becoming workplace mentors. (Unpublished doctoral dissertation).University of Southern Queensland, Toowoomba, Australia.


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Online Deliberative Democracy to develop recommendations for an approach to reporting missing persons with dementia Assoc Prof Margie MacAndrew1, Mr Dubhglas Taylor, Senior Sergeant Jim Whitehead2, Mr John Quinn, Professor Elizabeth Beattie1, Ms Katy Wyles1

1Queensland University of Technology, 2Queensland Police Introduction The Deliberative Democracy (DD) method, commonly used to inform policy change, involves bringing key stakeholders together to seek informed opinion. A DD event is traditionally face-to-face and provides participants with baseline knowledge through expert lectures followed by small group discussions to reach consensus on specific issues. The Getting Home Safely with Dementia project planned to use DD to develop recommendations for a standardised approach to reporting missing persons with dementia. Pandemic restrictions resulted in the DD process being achieved online. Method Experts developed an online learning package which participants completed before the event. Participants then attended two 2-hour same day Zoom forum sessions, one in the morning and one in the afternoon in purposively assigned groups. Two trained facilitators led the discussions, managed technology and noted points of agreement/disagreement. Four real life case studies with guiding questions stimulated discussion. Results A total of 78 people registered, 53 completed the learning package and 46 attended the online forum (police n=6, health professionals n=13, family carers n=15, general public n=12) in one of eight groups (max 8 per group). All groups had lively discussions captured through facilitators’ notes and Zoom recordings. Conclusion It was possible to replicate the critical elements of a DD event online. Attendees reported the online modules were engaging and informative and online sessions enabled more people to attend. The 32% of registered participants not completing the modules suggests this activity was burdensome for some and the education delivery element of DD is more difficult to replicate online.


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Barriers and facilitators to cognitive screening of older adults in rural health services Dr Sean Macdermott1, Dr Rebecca Mckechnie2, Kayla Royals3, Prof Irene Blackberry2

1La Trobe University, 2La Trobe University, 3La Trobe University Cognitive impairment (CI) is relatively common among hospitalised older adults and is associated with poor health outcomes including higher risk of hospital acquired complications, increased length of stay and readmission, and higher mortality. National Safety and Quality Health Service Standards recommend routine screening for all adults over 65 years but hospital screening rates are typically less than 60%, and where screening does occur it is often not done well. This qualitiative research study investigated barriers and facilitators to implementing cognitive screening in regional Victorian health services. Staff participated in focus groups and interviews which were transcribed and subjected to deductive and inductive analysis underpinned by the iPAHRIS framework. Study findings are that key facilitators of screening programs were legislation and/or organisational policy, staff buy-in, clinical experience, and interorganisational support and relationships. A collaborative implementation process, time, and workloads were also important considerations in a tertiary care setting. Potential barriers to screening programs included a lack of specialist services, patient and staff concerns regarding screening results, and a lack of workforce proficiency due to limited training and professional development opportunities. Whilst legislation is a key external driver facilitating CI screening, effective adoption of programs may require collaborative program development with staff members to ensure seamless incorporation of screening into existing practice and to maximise staff buy-in. In the absence of specialist services in rural areas, interorganisational relationships should be leveraged to facilitate referring ‘outwards’ rather than ‘upwards’, to maximise opportunities to address screening results and enhance the perceived purpose of screening.


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Researching aged care during Covid: Adapting to the unexpected Mr Sean Mack1

1Charles Sturt University This presentation will discuss the use of an online medium while conducting qualitative interviews in residential aged care during COVID-19. The research, which explores the connection between leadership and person-centredness, is phenomenological in design. Thirty-four semi-structured interviews were conducted with residents, family members, and staff, focusing on their lived experience of person-centredness – whether receiving, providing, leading or witnessing it. The original intention was to undertake in-person interviews onsite at two residential aged care facilities. However, this approach became unrealistic once health authorities imposed COVID-19-related visitor access restrictions. This necessitated another way of interacting with participants requiring creative and strategic cooperation from all involved. With appropriate consent, I recorded and transcribed the interviews using Zoom. Revisiting the discussions through the recordings, combined with the transcribing process, facilitated immersion in the data, added a deeper layer of rigour, and was valuable and rewarding. The transcribing was more time-consuming than anticipated but enabled the participants’ voices and sentiments to be accurately represented in text. Zoom’s video aspect (with visuals and sound) allowed me to re-live the conversation several times, especially while preparing the transcripts. From a phenomenological perspective, there was a familiarity and intimacy with the data that voice alone cannot provide. This presentation will describe the Zoom journey and its outcomes, including the unexpected benefits. It will also outline some of the challenges, practicalities, pitfalls, and lessons learned. It is appropriate for an audience of researchers and industry practitioners.


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Realising research outcomes using PAR in the Art Centres: Supporting our Elders study Ms Paulene Mackell1,2, Ms Kathryn Squires1, Dr Jessica Cecil1, Dr Scott Fraser1, Assoc Prof Frances Batchelor1, Prof Briony Dow1, Dr Maree Meredith4, Ms Michelle Young5, Ms Lynley Nargoodah6, Dr Chrischona Schmidt7

1National Ageing Research Institute, 2RMIT University, 3Western Australia Centre for Health and Ageing, 4Poche Centre for Indigenous Health, 5NPY Women's Council, 6Mangkaja Arts Resource Agency, 7Ikuntji Artists Research projects are frequently required to commit to producing and disseminating agreed material outputs prior to commencement, often as a condition of funding agreements and ethics procedures. However, participatory action research (PAR) methodology uses a cyclical approach whereby researchers and participants learn from each other, become co-researchers, and together generate knowledge and develop outcomes throughout the research. Art Centres: Supporting our Elders was a partnership facilitated by the National Ageing Research Institute and in collaboration with Mangkaja Arts Resource Agency in Fitzroy Crossing, Ikuntji Artists in Haasts Bluff, and Tjanpi Desert Weavers in the NPY Lands. Partners also included aged care providers and academic institutions. The research team predicted the primary output would be a written resource for art centres across Australia to use to support their Elders. Working with and being led by the three art centres redirected our thinking and actions to instead tell their story to a wider audience. Utilising this partnership process, we developed the format of video resources showing the importance of art centres in keeping their Elders and communities strong and connected. Producing the videos and a companion information leaflet used a PAR approach, where our partners determined the story told. Learning from each other also led the non-Aboriginal team members to critically engage with mainstream ways of knowing, doing, and being researchers in contemporary colonial Australia. This oral presentation will present our reflections on the ethical challenges, rewards and some key ingredients that led to producing these project outputs through a PAR methodology.


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Stigmatising discourses in the context of the Australian royal commission into aged care Ms Asmita Manchha1, Dr Ken Tann1, Dr Kïrsten Way1, Dr Michael Thai1

1University Of Queensland Background and Objectives: Societal discourses about stigma and aged care have surfaced during the Australian Royal Commission. Our study investigates ‘what stigmatising discourses has society built around aspects of aged care?’ Drawing on Systemic Functional Linguistics and Stigma Theory, we aim to introduce a framework to integrate our understanding of stigmatising discourses about aged care from multiple social groups within the context of the Royal Commission. Method: We applied a linguistics tool to analyse how stigma is socially constructed within 660 public submissions used to inform the Commission's inquiry in 2019. First, we identified the targets of stigma within the aged care field (e.g., people, work, environment). Second, we classified these evaluations in terms of attitude types (e.g., character judgment, social valuation) to distinguish between the different conceptions of stigma within the Royal Commission context. Results: Our findings revealed that stigmatizing discourses about aged care manifested across multiple levels (i.e., consumers, providers, institutions) with corresponding targets of stigma including clients, the system, workers, management, occupation, and residential care, respectively. We identified that discourses at a provider level predominantly featured negative character judgments in comparison to discourses at consumer and institutional levels, which accentuated low social valuation. Conclusions: This study raises awareness of key stigmatising discourses in aged care and provides the linguistic resources to facilitate conversations about the multiple forms of stigmatising discourses. Our framework helps identify priorities for intervention and enables industry, policymakers, and researchers to design system reforms with stigma in mind.


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Exploring the acceptability and viability of CCTV in aged care: SA Health CCTV Pilot Mrs Cassie Mason1

1SA Health SA Health is leading an Australian-first pilot to explore the acceptability and viability of using audio and visual surveillance and monitoring within aged care settings. The 12-month pilot commenced in March 2021 in two in two SA Health operated sites: Northgate House (a specialist residential mental health service) and Mount Pleasant Aged Care. The pilot involves the installation of CCTV cameras and sound recording devices (recording devices) in both common areas and bedrooms of the pilot sites, with bedroom cameras activated on an opt-in basis. The recording devices use Artificial Intelligence (AI) to detect predetermined visual and sound “triggers” such as falls or calls for help. When this occurs, the analytics in the recording device send a plain text alert to an independent monitoring centre, who immediately contact the facility to advise that an event has occurred. Footage of the event is automatically retained and stored securely in a locked server room on-site, which is reviewed by an authorised person as required. The pilot aims to assess whether such a system can promote the safety and wellbeing of residents. Given the broad interest in the use of this type of technology in aged care facilities, a comprehensive, independent evaluation of the pilot is being undertaken, which includes a range of resident experience, staff acceptability, and quality and safety improvement measures. This oral presentation will discuss the implementation and first six months of the SA Health CCTV pilot project, including lessons learned and preliminary observations from the mid-point evaluation.


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Intervening in resident intimate relationships: staff perspectives Ms Linda McAuliffe1, Prof Deirdre Fetherstonhaugh1, Dr Maggie Syme2

1Australian Centre For Evidence Based Aged Care (ACEBAC), La Trobe University, 2Kansas State University Sexuality and intimacy remain important to many people as they age, including older adults living in residential aged care, and can offer much comfort during what may be a difficult time [1]. Despite this, residents’ right to sexual freedom and expression is commonly denied in this setting. Cognitive impairment, family involvement, and fear of litigation are just some of the factors that influence staff decision-making in this domain, with a "protective" care paradigm often prevailing [2]. Compounding the problem is a notable absence of policy to guide staff in their practice and a lack of staff training, with many staff having never undertaken education in the area [3,4]. This presentation will report qualitative findings from a survey of Australian residential aged care services (N = 515). The aim of this research was to elucidate the ways staff intervene in intimate relationships between residents. Using the method of thematic analysis, the following key themes emerged from staff responses: communicating; educating; respecting; separating; redirecting; and monitoring. Staff respond to resident intimate relationships in a variety of ways and their decision-making regarding whether to and how to intervene is guided by their own personal values. These findings, and the implications for older people and the residential aged care services in which they reside, will be discussed. References 1Bauer et al. Psychol Sex 2013;4(3):296-309. 2Roelofs et al. Int Psychogeriatr 2015;27(3):367-84. 3Syme et al. J Adv Nurs 2016;72(10):2457-2467. 4McAuliffe et al. AJA 2020;39(S1):59-64.


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Mindfulness-based art therapy reduces anxiety and increases happiness in older adults living in residential care Dr Louise Horstmanshof1, Ms Sandra McKenny1, Dr Louise Horstmanshof2

1Northern Rivers Psychology, 2Southern Cross University Mindfulness-based art therapy shows promise as both a mental health treatment modality and leisure option but has not been widely studied in older adults, with mental health impacts unclear. This study aimed to examine the change in anxiety and happiness levels as well as fine motor skills acuity in adults aged 72-100 living in residential care after a mindfulness-based art therapy intervention. Participants were randomly assigned to either an experimental or care-as-usual control group. Experimental participants received at least four one-hour sessions using the Zentangle® method over eight weeks. Participants completed cognitive screening and pre- and post-intervention assessments of anxiety and fine motor skills. Happiness levels were monitored weekly over the eight weeks. The experimental group showed significant reduction in anxiety and increase in happiness, with qualitative data indicating participants with mild to moderate cognitive impairment were most likely to engage with the intervention. Seventy-one percent of experimental participants reported they would like to continue the activity on a long-term basis. Results support that mindfulness-based art therapy using the Zentangle® method can be an enjoyable leisure option for older adults living in residential aged care, particularly those with mild to moderate cognitive impairment. Positive mental health impacts include anxiety reduction and increased happiness levels, with a small but positive impact on fine motor skills as well.


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Pragmatic implementation of the ‘Enabling Choices’ conversation tool: lessons from the field Dr Claudia Meyer1,2,3, Dr Marissa Dickins1,4, Ms Kylie Hall1, Ms Louise Davison1, Ms Fiona MacRae1

1Bolton Clarke, 2Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 3Centre for Health Communication and Participation, Latrobe University, 4Southern Synergy, Department of Psychiatry, Monash University Overview/aim Implementation science is complex, yet critical to quality health and aged care. Sufficient attention on a plan to maximise systematic uptake of a tool or program into practice is crucial, yet often neglected. This implementation plan must focus on the context, be pragmatic, relevant and adaptive. This paper describes the pragmatic implementation of an evidence-informed conversation tool for people with dementia ‘Enabling Choices’, highlighting the opportunities and challenges of widespread upscale throughout a large Australian health and aged care service provider. Methods The fit-for-purpose Bolton Clarke Implementation Framework was used to develop an implementation plan, incorporating six questions of: (1) why do we need to change; (2) what do we know; (3) who will benefit; (4) who will make the change; (5) what strategies will be used; and (6) what difference are we making. Key elements of co-design and consideration of the wider socio-cultural-political context underpin the framework. Results Learnings from the implementation of ‘Enabling Choices’ include the need for: (1) clear alignment with stakeholder priorities; (2) ongoing support at executive management and grassroot levels; (3) creation of a healthy collaborative change team; and (4) appropriate measures to capture implementation rather than efficacy. Conclusion The successful implementation of the ‘Enabling Choices’ tool into practice was predicated on careful planning and co-ordination in line with the Bolton Clarke Implementation Framework. The Implementation Framework operational checklist helps ensure that all ‘the ducks are lined up’, minimising the risk of wasted time and resources.


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'Circuit breaker': Critical interim support for community-dwelling older people without access to aged care services Dr Amber Mills1,2

1Brotherhood of St Laurence, 2Monash University The Critical Interim Support (CIS) program is a two-year pilot and evaluation, funded philanthropically. The pilot addresses our observed service gap in the aged care system, working in an assertive outreach capacity with older people in vulnerable situations, and who experience deep disadvantage. We provide short to medium term intensive case management to address initial crises, guide them through the My Aged Care assessment process and link them with essential services. Intake criteria are age 65+ years; limited financial resources and social supports, and community dwelling. Clients exit the program when a home care package is in place or when a sufficient number of interim supports are in place, and the program is not time-limited. The pilot runs in the South Eastern and North Western suburbs of Melbourne around our existing service hubs and is staffed by two case managers and one program manager. The pilot connects people to services, as well as connecting services together. Preliminary results will be presented on the uptake of the program, presenting issues, time spent on the CIS program and outcomes. Results will be discussed in the context of the program aim: to address significant barriers to accessing care. Issues contributing to barriers to access aged care are complex and include: fragmented services; assumed literacy and technology skills to access online and phone portals; extreme social isolation and disconnection from friends and family; elder abuse; mental health issues; complex psychosocial issues and, self-neglect behaviours such as hoarding and squalor, poor hygiene, health and nutrition.


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Mental wellbeing in people with dementia: A clinician's perspective Dr Leander Mitchell1

1The University Of Queensland Mental wellbeing in people with dementia (outside the domain of behavioural and psychological symptoms of dementia) is an under-represented area in the literature and yet what literature is available speaks to the positive outcomes of mental health intervention. Additionally, clinicians can experience anxiety and trepidation themselves in working with people with dementia given the cognitive impact of such a diagnosis and the role that can play in undertaking intervention work with this population. Further, it is well documented in the literature that the mental wellbeing of the person with dementia plays a large role in the mental wellbeing of their carer. As such, work in this space not only improves the wellbeing of the person with dementia, but also their carer. This presentation will explore working with people with dementia experiencing mental health concerns in particular, while also highlighting strategies that would work more broadly for clinicians of other professional backgrounds working with people with dementia. Informed by an enablement, strengths-based modality, as well as by common brain changes associated with dementia, the presentation will offer clinicians an overview of how best to work with this population. The presentation will also incorporate clinical experience and case studies, as well as reflecting on the available literature in this area.


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Governance, operations and consumer perspectives of the aged care reform impact on residential care delivery Ms Cathy Monro1, Associate Professor Lynette Mackenzie, Associate Professor Kate O'Loughlin, Dr Sanetta Du Toit 1The University Of Sydney Australia has undertaken major aged care reforms since 2013 that re-focussed provisions from a service provider-driven policy approach to one based on consumer-directed-care principles. One focus of the reforms was to increase home and community-supported care by limiting care subsidies to residential aged care. As majority of residential aged care facilities in Australia are operated by not-for-profit organisations (AIHW, 2019), providers need to find new ways of delivering and maintaining quality care while ensuring financial viability of the organisation. Recent findings and extensive recommendations made by the Royal Commission into Aged Care Quality and Safety have highlighted the importance of comprehensive consideration of the many areas that are critical to the capacity in delivering high quality of care. Using a qualitative description research methodology, this study aims to gain a holistic snapshot of the extent of reform impact and related challenges in delivering quality residential aged care. It presents the governance, operations and consumer experiences of two independent, not-for-profit residential aged care providers, one located in metropolitan Sydney and the other in a regional area of New South Wales, as they navigate through the reforms. This study provides insights into the governance and operational issues that are critical to fulfilling a consumer-focused care delivery.


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Identifying mechanisms of change within a multisystem collaboration to improve the lives of older people Dr Kirsten Moore1,2, Professor Emeritus David Dunt3, Ms Susan Williams1, Dr Katrin Gerber1, Ms Debra O'Connor1

1Melbourne Ageing Research Collaboration, National Ageing Research Institute, 2Division of Psychiatry, UCL, 3School of Population and Global Health, The University of Melbourne There are growing demands that research provides evidence that can be translated into real world outcomes and actively engages with consumers and those implementing evidence into practice. The Melbourne Ageing Research Collaboration (MARC) was established in 2015 bringing together consumers, health and aged care services, researchers, government and peak groups to address these concerns. MARC’s mission is to improve the lives of older people by rapidly translating research evidence into policy and practice and to ensure an evidence base for existing practice. However, demonstrating and measuring the impact of MARC within a complex system creates many challenges. Implementation science principles argue the need to identify mechanisms of change and explain how interventions lead to outcomes. As MARC has grown and evolved, we have developed and enhanced our initial processes for assessing impact and understanding the logic of what MARC is trying to achieve. Through this process we have found that traditional academic assessments of research impact, such as journal publications and conference presentations, while important, are not the central impacts we are trying to achieve. We present systems-based and process-oriented logic models based on the templates developed by Rohwer [1] to describe the core contexts, interventions, direct effects and health outcomes as a framework for understanding and evaluating this complex collaboration. This innovative model aligns with the conference theme and participants will learn methods for evaluating complex interventions and collaborations. [1] Rohwer, AL. et al (2017). "Series: Clinical Epidemiology in South Africa..." J Clin Epidemiol 83: 37-47.


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Homely, but not home: The spiritual meaning of ‘home’ for residents living in aged care Ms Sally Mordike1

1Charles Sturt University Homely, but not home: The spiritual meaning of ‘home’ for residents living in aged care Best practice for quality aged care is a critical issue in Australia, with care providers promoting facilities as a resident’s new home. Yet what does ‘home’ actually mean? Exploring personal meanings of ‘home’ is vital to wholistically meet needs and optimise well-being for older people living in residential care. Informed by MacKinlay’s (2017) model of ageing and spirituality, a qualitative, phenomenologically-based study investigated the meaning of ‘home’ for ten older people, aged between 72 and 98, living in residential care. In-depth interviews were conducted to explore participants’ lived experiences, recognising that personal stories express what is meaningful in our lives. Findings showed that residential care could be homely, but never home. Home for these participants meant connection, and was a spiritual concept which was deeply personal and important. Two main themes of meaningful relationships and meaningful connection to place identified crucial factors for being ‘at home’, including relationship needs, family, finding friendship, childhood home, connection with physical spaces, spiritual home, and, for some, belief in an eternal home. Loss of connection and relationships wove through all participants’ narratives. Recommendations inform residential aged care providers of the value of meaningful connection in order to provide homely residences, especially through the intentional provision of spiritual and pastoral care, and the importance of good food, meaningful activities, and appropriate training for all staff. MacKinlay, E. (2017). The Spiritual Dimension of Ageing (2nd ed.). Jessica Kingsley Publishers


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Exploring the role of compassion in the psychological health of family carers of older adults Ms Jenny Murfield1, Professor Wendy Moyle1, Professor Analise O'Donovan2, Professor Robert Ware3

1Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, 2Griffith Health Group, Griffith University, 3Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University Background: The cultivation of compassion (to self, for others, from others) could help the psychological health of family carers of older adults by promoting adaptive emotion regulation. However, the current evidence-base is limited, and research is needed to explore the role of compassion in the psychological health of family carers of older adults. Methods: A cross-sectional survey was available for completion (online, verbally, paper) by family carers of adults aged 65 years of older with chronic conditions between July – December 2019. The survey included seven self-report scales (measuring self-compassion, compassion for others, compassion from others, dispositional mindfulness, depression, anxiety, stress, coping strategies, and difficulties in emotion regulation) and eight free-text boxes. Results: 141 family carers answered all survey questions, and 127 wrote 504 comments. Quantitative path analysis found that increased self-compassion and dispositional mindfulness was associated with lower psychological distress, and this was mediated by reduced difficulties in emotion regulation (explaining 64.8% of the variance in psychological distress, and 52.2% of the variance in emotion regulation difficulties). Qualitative content analysis found that family carers perceived a lack of compassion for themselves and from others, and there were several barriers to carers’ openness to receiving compassion (e.g., fears; demands of the caregiving role). Within the caregiving relationship, carers’ compassion was negatively influenced by care recipients’ (higher) level of need and behaviour. Discussion: Compassion-based approaches are a warranted focus within future family caregiving research and practice, with self-compassion and mindfulness potentially useful in reducing carers’ psychological distress via adaptive emotion regulation.


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Sleep and brain health Ms Tergel Namsrai1, Mr Ananthan Ambikairajah1, Mr Nicolas Cherbuin1

1Centre for Research on Ageing, Health and Wellbeing, Australian National University Background Dementia is a major global health problem with increasing prevalence and associated with major social and economic costs. However, there is no cure for dementia, making the identification of risk factors and development of preventive measures crucial. One emerging modifiable risk factor is sleep, although, its association with brain health remains unclear. Objectives To examine associations between sleep characteristics (including sleep duration, daytime dozing, snoring and insomnia) and brain health- (including brain volume and cognitive function), in a large cohort of middle-aged healthy adults. Methods A total of 29,545 participants (mean age = 54.65 years; 55.42% males) from the UK Biobank study with sleep measure at baseline and brain scans at follow up visits and a subset of 14,206 participants with cognitive measures were included in this study. Multiple linear regression models were used to investigate the association between sleep characteristics and brain health. Mediation analyses was conducted to test possible mediating effects of brain volume on cognitive function through sleep. Results Study participants slept 7.20 (0.93)/7.16 (1.03) hours per day at baseline and follow up visits. 20.20%/23.0% of participants have experienced daytime dozing while 72.20%/77.70% experienced insomnia at some level during both visits. Every 1-hour increase in sleep beyond 7 hours was associated with lower brain volumes (grey matter volume: 0.1%, SD=0.180 ml; white matter volume: 0.1%, SD=0.166 ml; left hippocampal volume: 0.25%, SD=0.002 ml, right hippocampal volume: 0.2%, SD=0.002 ml) while sleep duration, total grey matter, and right hippocampal volumes had negative non-linear association. Additionally, negative association between long sleep duration (>9 hours/day) and cognitive function (Visual memory=11.8%, SD=0.144; reaction time= 3.4%, SD=7.316; numeric memory= 5.6%, SD=0.093; and fluid intelligence= 6.6%, SD=0.078) was found while sleep duration, lower visual memory and worse fluid intelligence was non-linearly associated. Finally, there was not enough evidence to suggest white matter volume as the mediator of sleep duration associated decrease in cognitive performance. Conclusions: Poor sleep quality (<6 hours/day, >9 hours/day and daytime dozing) at midlife was associated with lower brain health (lower brain volumes and lower cognitive performance) compared to people with normal sleep. Therefore, midlife sleep quality could be an important target to improve brain health and cognitive function into old age.


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Opportunities for improvement of international public policy for falls prevention in the community setting - a content evaluation of policy documents Ms Aleksandra Natora1, Jennie Oxley1, Terry Haines2, Linda Barclay3, Kelvin Taylor1, Bruce Bolam4, Milica Markovic5

1Monash University Accident Research Centre (MUARC), 2Monash University, School of Primary and Allied Health Care, 3Monash University, Department of Occupational Therapy, 4Bendigo Health, 5Department of Health Background: Falls-related injury among older people living independently in the community is a persistent and growing global public health issue. Public health policy is important in achieving falls prevention goals and objectives, and directs stakeholder engagement, intervention prioritisation and resource allocation to enable political decision making for effective implementation action. The quality of policy formulation is a critical determinant of effective public health policy. Methods: International public policy documents related to falls prevention in community settings were identified through a scoping review of academic and grey literature published in the period 2005 to 2020. The content of these government published policy documents was evaluated according to internationally recommended criteria derived from two policy development guidelines, namely the World Health Organization guide to Developing policies to prevent injuries and violence (WHO, 2006) and the New Zealand Policy Quality Framework to enable good government decision making (DPMC NZ, 2019). Results: This presentation will share preliminary results of our policy document content evaluation. Of the 25 documents we reviewed, only 4 policies (16%) met at least 75% of the criteria, while 10 policies (40%) met less than 50% of the criteria. The content criteria most absent from the policies were quantified objectives and targets, ministerial/minister approval, allocated budget, identified risk and mitigation, and clear monitoring and evaluation. Conclusions/Implications: Our findings suggest that the content of many falls prevention policy formulations are deficient in several key determinants of policy action. This study may assist policy makers to improve falls prevention policy formulations in order to increase their political priority and likelihood of successful implementation. The findings also demonstrate the need for a clear and evidence-based model national policy for community falls prevention to enhance future government efforts. Acknowledgements: This PhD research is co-funded by the Monash University and the Victorian Department of Health through the Monash University Accident Research Centre (MUARC) Injury Prevention Graduate Research Industry Partnership Program (IP-GRIP).


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Development of an evidence-informed education program teaching older drivers to use advanced vehicle technology Mr Nicholas Neville1, Dr Kristy Coxon1, Professor Karen Liu1, Associate Professor Andy Cheng4, Professor Lisa Keay2, Associate Professor Julie Brown3

1Western Sydney University, 2UNSW Aging Futures Institute, 3The George Institute for Global Health, 4The Hong Kong Polytechnic University Introduction Researchers are optimistic about the potential for advanced vehicle technologies (AVT) to help older drivers drive safely for longer. Despite an increased range of vehicle technologies in vehicles, education in their use is lagging. To achieve optimum benefits of AVT for older drivers, education programs are needed. Objectives To develop and pilot an evidence-informed, expert-reviewed, AVT education program for drivers aged 70 years and older. Method Using available evidence, an AVT education program for older drivers was developed. The approach was guided by geragogy, cognitive-load and transformative learning theories. Classroom and naturalistic on-road components were included. Fifteen experts rated program content on relevance, representativeness, clarity and importance. Validity scores were calculated, and feedback analysed using content analysis. The program was piloted with eight older drivers to evaluate perceived benefit, feasibility and acceptability using pre and post-program questionnaires. Results International and local experts from academia, education, occupational therapy, including older drivers themselves, formed the expert panel. Content validity scores for individual domains ranged between 0.93-1.00 with overall content validity of 0.98. Older drivers (mean age: 75 years) in the pilot program reported an increase in AVT knowledge and confidence in its use post program. The program was deemed feasible and acceptable to participants. Conclusion An evidence-informed, expert-reviewed education program grounded in learning theory, with high content validity was developed and piloted. Occupational therapists involved in the prescription of assistive technology are ideally placed to understand the risks, benefits and therapeutic application of vehicle technology, and provide education in its use.


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“Train Your Brain” for Cognitive Gain? A Systematic Review and Meta-Analysis of Commercial Brain-Training Programs Ms Lan Nguyen1, Dr Karen Murphy1, Assoc Prof Glenda Andrews1

1Griffith University Background & Objectives In response to the rising prevalence rates of age-related cognitive impairment, there has been a surge in the number of commercial brain training programs available to the general public. Brain training companies appeal to the public’s concern of impending cognitive decline by advertising that their products can preserve and enhance memory and everyday functioning; however, researchers have voiced concerns regarding the validity of such claims. Method A systematic review and meta-analysis was conducted to evaluate whether these commercial programs could improve cognition in healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were examined (BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, MyBrainTrainer) across 43 eligible studies. Results In healthy older adults, brain training programs generally promoted small but significant improvements across cognitive domains including executive functioning, memory, and processing speed. However, when considering publication bias, only improvements in processing speed remained statistically-significant. Subjective measures of functioning (cognitive and affective) also improved with training. Brain training did not improve attention, objective measures of functioning, fluid-intelligence, or visuospatial ability. In older adults with MCI, no improvements were found for any cognitive domain. Conclusions Whilst commercial brain training may be suitable for enjoyment/entertainment purposes, there is currently insufficient evidence to support claims that these programs can preserve/improve cognition or everyday functioning. Brain training is not a ‘silver-bullet’ and should not be fixated on to restore deteriorating cognition. Instead, it is critical to encourage a balance of cognitive, physical, and social activities to maintain wellbeing and foster healthy aging.


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Advance Care Planning Australia: engaging communities Ms Linda Nolte1, Loretta Walshe1

1Advance Care Planning Australia Background Advance care planning (ACP) conversations may result in preferences for future medical care being documented and made available to inform care decisions. The goal of ACP is that people have choice and receive preference aligned care. Uptake remains low in Australia with only 14% of older Australians having an advance care directive. Studies indicate about half of the community have an awareness of ACP and fewer an understanding of its utility. Objectives To increase reach and engagement of individuals, families, the health and aged care workforce, and service providers in ACP. Secondly, to improve ACP understanding, practice, and uptake. Methods During 2017-20, Advance Care Planning Australia (ACPA) delivered national implementation and monitoring of a strategic ACP communications program and launched the ACP Week campaign. Results Over a 3-year period, ACPA’s website unique users increased by 83%, with 158,709 unique users in 2019-20. Over 3-years, ACPA’s Facebook followers increased by 89%. During this period, 2.7M social media users were reached. Over a 3-year period, the ACP Week campaign achieved an 117% increase in reached, with an audience of 3.25M reached in 2019-20. Over 3-years, there were 386 or more events, 602 media mentions and 127,800 dedicated campaign website page views. Conclusion ACPA, with Australian Government funding, was able to achieve increased reach and engagement in ACP activities for individuals, families, the workforce, and service providers. Further longitudinal research of ACP awareness, understanding, and document prevalence is required to assess improvement in understanding, practice and uptake.


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Assessing Reach and Influence of the Melbourne Ageing Research Collaboration (MARC) using Social Network Analysis Ms Debra O'Connor1, Ms Susan Williams1, Dr Kirsten Moore1, Ms Sarah Carr1, Dr Peter Carswell2

1Melbourne Ageing Research Collaboration National Ageing Research Institute, 2Synergia The Melbourne Ageing Research Collaboration (MARC), a partnership of 19 organisations from Melbourne and rural Victoria. It includes health services, aged care services, universities, advocacy groups, primary health and Victorian Department of Health. An advisory group comprised of older people with lived experience inform MARC activities. In 2021 MARC undertook a social network analysis (SNA) to gauge the strength of partnership relationships, determine the key influencers in Victorian based ageing research, and the level of engagement and reach of MARC amongst partners and beyond. The purpose of the SNA, complementing other evaluative processes, was to inform planning for strengthening and improving engagement of collaborative relationships. The MARC SNA, undertaken by independent experts, is the first to be undertaken in the field of ageing research. It involved a participatory approach including (1) Network analysis design and context phase, (2) online survey Social Network Analysis and (3) Interviews with key stakeholders. Survey responses were received from 107 individuals with connections to nearly 150 organisations. The preliminary data shows strong relationships exist between some organisations and has identified some key players within the collaboration. The data is available interactively and has enabled MARC to highlight opportunities for further reach and influence for each MARC partner as well as the Collaboration as a whole. SNA data, and how it has informed actions for stronger collaboration of MARC will be presented. The presentation will also discuss how SNA can help in understanding how a collaboration can contribute and enhance better aged care systems and practice.


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AoP@Home for community-dwelling people living with dementia: steps to implementation Dr Claire O'Connor1,2, A/Prof Roslyn G Poulos1,2, Ms Michelle Heldon1, Ms Linda Barclay1, Professor Elizabeth Beattie3, Professor Christopher J Poulos1,2

1HammondCare, 2University of New South Wales, 3Queensland University of Technology Most people with dementia live in the community and are supported by family carers (dyad). Over time, access to community services and maintaining hobbies becomes more difficult, leading to isolation and poorer quality of life for both members of the dyad. Arts on Prescription at Home (AoP@Home) is a new approach whereby professional artists come to the home to actively engage dyads in making art using the dyad’s preferred art form (e.g. visual arts, music, drama, singing). AoP@Home provides an exciting opportunity to bring joy into the homes of people impacted by dementia, and is now possible under existing Commonwealth funding sources. But more work is needed to bring AoP@Home from research into practice to make it a routinely available option. Following our pilot study that indicated AoP@Home is feasible, this project is evaluating the rollout of AoP@Home to support the wellbeing of people with dementia and their family carers. Prior to implementing the programs, it is vital to understand the implementation context. We are conducting focus groups with key stakeholders (people living with dementia and family carers, artists, community program managers and referral agency representatives) to identify barriers and enablers to referral and uptake of AoP@Home for people living with dementia in the community. We will present focus group outcomes and describe the process and experience of working in partnership with a project advisory group made up of people with dementia and family carers to shed light on the complex processes involved in moving research to implementation in practice.


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The importance of social connection: first steps in the journey through the Older Women Living Alone project. 1Bolton Clarke A report released by Lord Mayor’s Charitable Foundation in 2015 identified that older women were at increased risk of losing independence and experiencing poor wellbeing – particularly those living alone. Lord Mayor’s Charitable Foundation funded us to build a basis for co-creating new strategies to support health and well-being of older women living alone, through a multi-component, mixed-methods project. We describe our experiences in recruiting and engaging older women living by themselves and service stakeholders, where they co-created 10 activities that they thought would enable their independence and support their wellbeing. The top 3 were then prioritised as: 1) Handy Help; 2) Volunteer Drivers: 3) Exercise Buddies. While each has a task associated with them, social interaction was pivotal - the women wanted someone to relate to, engage with and socialise with. The key takeaways are how important choice, autonomy, dignity and respect are within the delivery of any support; that older women are a diverse group and have varied needs; and that social connection is key to enabling holistic wellbeing. References Dickins M et al. (2020). Ageing and Society, 1-19. doi:10.1017/S0144686X20001245 Johnstone G et al. (2020). Ageing & Society, 1-50. doi:10.1017/S0144686X19001818 Ogrin R et al. (2020). Health & Social Care in the Community, 28(2), 494-504. doi:10.1111/hsc.12882


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Evolution of a community-wide approach to support wellbeing of older people through Connecting Communities to Care. 1Bolton Clarke Introduction: Research has traditionally focused on discrete single intervention projects to improve the wellbeing of older people. However, to address social isolation, loneliness and holistic wellbeing, a suite of interventions engaging the whole community is necessary to make inroads to these complex, interrelated issues. Aim: To describe our evolution of an innovative codesigned, holistic wellbeing approach for older community members within the context of their own communities. We discuss four discrete research projects and one real world activity that culminated in the Connecting Communities to Care approach for enabling a future in which older people can flourish. Activities: We will • provide practical information about how to engage and codesign with key stakeholders, focusing on working with community partnership groups to co-design; • discuss the use of a visual collaboration platform to support an interactive experience to engage participants in contributing to our refining the core components of the Connecting Communities to Care approach; and • present the findings from our project evaluations and lessons learned. Expected learning outcomes: After this session, participants will be able to: 1. Understand the approach used to co-design services involving older people living in the community, other community members and health and social service stakeholders; 2. Recognise the issues with rolling out a new program in a region and how a whole of community approach is needed; 3. Be aware of methods to evaluate such a program running in the community; 4. Inform on feasibility and sustainability of a program.


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Final step: taking learnings from an existing UK model to form Connecting Communities to Care. Dr Rajna Ogrin1, Dr Maja Green1, Professor Judy Lowthian1

1Bolton Clarke In collaboration with health and social services in South East Melbourne, work is underway to develop an active neighbourhood that engages all community members, including older people, in a range of local activities to improve physical, mental and social wellbeing in older people with chronic conditions: Connecting Communities to Care. This work is based on UK Health Connections Mendip's model, which is associated with a reduction in unplanned hospitalisations. A site visit in early 2020 identified the multiple aspects necessary to enable a community-wide approach: raising knowledge and awareness of existing supports in the community; building networks and connections between community members – to help each other; having paid roles to support those who need help to link with these supports – and they are trusted providers; engage local GPs and other healthcare providers to formally prescribe social activities – be the trusted link to social supports – linking medical and social care. Using this as a model, existing evidence is being collated to develop core components of a local, community-wide, holistic wellbeing approach, and its evaluation. Codesign with key stakeholders is the next step, and then implementation and evaluation. We aim to discuss the core components identified in our literature review, based on the UK model, and seek input from attendees re: their thoughts on what is important to enable an effective and sustainable whole of community approach to improve wellbeing of older community members. Reference Abel J et al. (2018). British Journal of General Practice, 68(676), e803-e810. doi:10.3399/bjgp18X699437


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Isolation in residential aged care during COVID: An ethical analysis Dr Maria O'Reilly1, Dr Rebecca Davis2, Prof Cheryl Monturo3, Dr Diana Sturdevant4

1CQUniversity, 2Grand Valley State University, 3West Chester University of Pennsylvania, 4University Of Oklahoma Health Sciences Center The COVID-19 pandemic profoundly affected the care of older adults in long term care communities across the world. To date, approximately 40% of pandemic deaths globally have been linked to nursing homes, while in Australia more than 75% of deaths have occurred within residential aged care. Most nations and states have implemented strict guidelines on visitation, with many totally prohibiting visitation over an entire year. In Australia, while restrictions have largely eased, strict lockdowns have returned at various times, in response to regional cases. Well-intentioned measures to protect through isolation resulted in a profound ethical tension between safety and self-determination. This paper describes a collaborative project that examined this dilemma using the Madison Collaborative Ethical Reasoning in Action Framework. Eight key questions of fairness, outcomes, rights, responsibilities, character, liberty, empathy, and authority were applied in the context of aged care system responses in the USA and Australia. Results highlighted issues of paternalism vs empathy, regulatory vs family authority, short-term safety vs long-term distress, and agency vs protection. Issues of concern relate to facility readiness to manage pandemic conditions, education of staff, and the need for a more nuanced response as the pandemic progressed. Difficult ethical questions relate to how we protect the physical health of vulnerable populations, without causing long-term harm through enforced isolation and disengagement. Analysis of these dilemmas using an ethical framework can assist us to develop well-considered responses, which can, in turn, inform policy development and provide lessons learned for the future.


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A luxury we can’t afford? Injecting evidence based practice into aged care following the Royal Commission Dr Joan Ostaszkiewicz1

1National Ageing Research Institute Introduction and background In 2021 the Royal Commission into Aged Care Quality and Safety produced a landmark Report that deserves detailed reading, reflection and response. One of the recommendations was to fund research into, and innovation in, the delivery of aged care. Aims This symposium will stimulate discussion about the Royal Commission findings and recommendations related to research, evaluation and education in the aged care sector and whether the aged care sector should receive as much priority, funding, and prestige for these activities as in acute care. Overview of activities Five short papers will be presented to stimulate discussion on key topics from the Royal Commission Report. i. Colleen Doyle will present research findings, and question whether it is time to remodel the way research is viewed in aged care. ii. Joan Ostaszkiewicz will discuss workforce recommendations and models of aged care that integrate the social and health/clinical care needs and rights of older people in residential aged care iii. Frances Batchelor will discuss quality of care and the challenge of its measurement in aged care settings iv. Annabelle Peck will present recommendations about home care and research about factors that are important to older people. v. Anita Goh will discuss recommendations about dementia care and stimulate discussion about how research can improve the rights of people with dementia. Expected learning outcomes Audience members will learn about key points from the Royal Commission report and discuss the roles of research, evaluation and education in the delivery of aged care.


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Working differently to integrate social and clinical aged care Dr Joan Ostaszkiewicz1

1National Ageing Research Institute Introduction and background A knowledgeable, skilled, and resourced workforce is central to the safety and quality of care that older people experience. The Royal Commission into Aged Care Quality and Safety reported Australia’s aged care workforce was under-resourced, undervalued, and under-skilled and called for strategies to improve workforce leadership, development, skills and culture. In response, the Government stated it will increase resourcing for care minutes, create additional training places for existing and new aged care workers, offer recruitment and retention incentives for more nurses and personal care workers, and establish an Aged Care Workforce Industry Council. Arguably, the Government’s investment should be underpinned by the best available evidence about models of care that successfully integrate social and health/clinical care. Purpose or aim(s) The aim of this presentation is to examine research about existing models of care to answer the question of how we can work differently to integrate the social and health/clinical care needs and rights of older people in residential aged care. Overview of activities to be conducted The presenter will share evidence presented to the Royal Commission and from other research about models of care for older people in residential aged care, and invite discussion about its strengths and limitations in informing the delivery of aged care into the future. Expected learning outcomes for audience members Audience members will find out about aged care models, their evidence base, and discuss successful models that integrate social and health/clinical care.


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Co-designing a best practice model of continence care in residential aged care Dr Joan Ostaszkiewicz1, Dr Jessica Cecil1, Ms Leona Kosowicz1, Ms Erica Wise1, Prof Briony Dow1

1National Ageing Research Institute Incontinence is a significant health care problem that affects up to 77% of people in Australian residential aged care homes. Best practice recommendations call for a comprehensive assessment to identify and address potentially modifiable causes, and for behavioural interventions to optimise residents’ continence. However, these recommendations are largely predicated on the goal of cure or symptom improvement and do not fully accommodate the context of caregiving in residential aged care homes, nor what matters to residents, their families and staff. The project aim was to co-design a fit-for-purpose Best Practice Model of Continence Care in Residential Aged Care based on the best available evidence, aged care quality standards, policies and regulation, and aged care stakeholders’ expectations. A mixed methods approach was undertaken, including: (i) A scoping review of existing evidence about interventions to manage incontinence and other bladder and bowel symptoms in residential aged care homes; (ii) Identification of relevant models, clinical practice guidelines, frameworks and policy documents (iii) An online survey of 177 aged care stakeholders (iv) Qualitative interviews with 14 residential aged care stakeholders (v) Co-design workshops with 18 residential aged care stakeholders (vi) A pilot test of the draft model with aged care staff from two residential aged care homes (vii) Qualitative interviews with aged care residents to validate the components of the draft model Findings were synthesised to design a Best Practice Model of Continence Care in Residential Aged Care and accompanying knowledge translation resources to support the application of the model to practice.


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Caring for Spirit Online Training for Aboriginal and Torres Strait Islander People Living with Dementia Mrs Lauren Poulos1, Ms Eliza Pross2, Dr Kylie Radford1

1Neura, 2Ochre and Salt Dementia prevalence in Aboriginal and Torres Strait Islander peoples is 3-5 times higher than the general Australian population. With low awareness of dementia and aged care services and a relative lack of well-designed resources available to support and guide care decisions, the Caring for Spirit project addresses the need for culturally responsive dementia education. The Caring for Spirit project translated the results of current research into culturally relevant and accessible information via the development of an online training package for the Aboriginal and Torres Strait Islander health and aged care workforce. The training package contains four modules featuring a diverse collection of multimedia information, prepared and presented in a culturally sensitive and culturally researched way. The project team has worked beside and been guided by Aboriginal and Torres Strait Islander Elders, colleagues and wider networks, and our established Aboriginal community partners. Non-Aboriginal dementia content experts have also supported content co-development all with the purpose of providing dementia education in Aboriginal and Torres Strait islander communities which is relevant, accessible, culturally sensitive, evidence-based and engaging. Our hope is that it will contribute to the lessening of the high burden of dementia in this population, and enhance dementia care. These resources have been extensively evaluated and are a good source of information that will lead to better care and wellbeing for Aboriginal and Torres Strait Islander peoples impacted by dementia. This presentation will provide an overview and demonstration of the Caring for Spirit Aboriginal and Torres Strait Islander Online Dementia Training Package.


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Identifying dementia risk in Parkinson’s disease: using data-driven cognitive subtyping to develop a neuroimaging biomarker Ms Dana Pourzinal1, Dr Jihyun Yang1, Prof Gerard Byrne1, A/Prof John O'Sullivan2, Prof Katie McMahon3, Dr Leander Mitchell4, Dr Nadeeka Dissanayaka1,2,4

1University Of Queensland Centre For Clinical Research, 2Royal Brisbane and Women's Hospital, 3Queensland University of Technology, 4The University of Queensland Background: Recent application of the Mild Cognitive Impairment (MCI) concept to Parkinson’s disease (PD) has proven valuable in identifying those at risk of dementia. However, evidence has revealed that memory-impaired subtypes of PD-MCI with posterior-cortical brain dysfunction may be more susceptible to rapid cognitive decline than other subtypes. Objective: Given the link between hippocampal integrity and memory function in PD, we aimed to delineate subtypes of PD-MCI using a data-driven approach and explore differences in hippocampal functional connectivity between subtypes. Methods: To delineate subtypes, a k-means cluster analysis was performed on 10 cognitive variables derived from 85 PD patients without dementia. Resting-state functional magnetic resonance imaging data was available for a subset of patients. ROI-ROI analysis was performed comparing connectivity of bilateral hippocampus and other regions of interest between relevant subtypes. Results: Cognitively intact, frontal-impaired, posterior-impaired, and globally-impaired clusters were revealed. The posterior-impaired (N=17) subtype showed significantly decreased activation at rest between the right hippocampus and right anterior temporal fusiform gyrus compared to the cognitively intact (N=10) group (p=.013, FDR-corrected). The posterior-impaired group also performed significantly worse on a measure of semantic memory than the cognitively intact group (p=.004). Conclusion: Given that the fusiform gyrus is implicated in semantic memory, and semantic memory is an established predictor of PDD, the connection between the hippocampus and fusiform gyrus may reflect a biomarker of PDD. These results encourage further exploration of the fusiform gyrus and its dysfunction as a critical marker of rapid cognitive decline in PD.


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Grassroots movements to end ageism Mr Joel Pringle1

1The Benevolent Society / Everyage Counts This presentation outlines the underlying research and practice of building and supporting a grassroots movement to end ageism in Australia. Ageism against older people is stereotyping, discrimination and mistreatment based solely upon age. It comes from social acceptance of negative attitudes and beliefs about the value of older people and later life. According to the World Health Organisation (https://www.who.int/publications/i/item/9789240016866 pg XVI), ‘Ageism has serious and far-reaching consequences for people’s health, well-being and human rights… ageism is associated with a shorter lifespan, poorer physical and mental health, slower recovery from disability and cognitive decline’. The role of older people in combatting ageism includes: • Providing counter-information and opportunities for people to reflect on internalised ageism • Using their voice to challenge stereotypes and assumptions about what older people can and cannot do. (https://d3n8a8pro7vhmx.cloudfront.net/benevolent/pages/393/attachments/original/1538977350/Ageism_Full_Report_Final.pdf?1538977350 Pg 29) The EveryAGE Counts Campaign (https://www.everyagecounts.org.au/) aims to support the role of older Australians in positively changing community attitudes about ageing and older age. This approach includes: • Actions to build awareness of ageism amongst a target audience and recruit supporters; • Ongoing engagement and community building amongst supporters; • ‘Reframing’ methodology, and equipping our supporters with the tools to change how we think and speak about ageing and older people (https://d3n8a8pro7vhmx.cloudfront.net/benevolent/pages/393/attachments/original/1594191546/Reframing_Ageing_-_Final_Report.pdf?1594191546); • Identifying ‘key advocates’ through these activities to develop an ‘inner circle’ for the campaign. This presentation is intended for policy makers and researchers interesting in engaging community at the heart of social change, and campaign partners and supporters in understanding the EveryAGE Counts approach.


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Can technologies better support people living with dementia and chronic pain? Dr Lihui Pu1, Professor Wendy Moyle1,2

1Menzies Health Institute Queensland, Griffith University, 2School of Nursing and Midwifery, Griffith University Untreated pain in people with dementia is a public health problem. Due to the progressive cognitive decline associated with dementia, there is a limited ability to verbalise the pain experience. It is therefore challenging to accurately assess and manage pain in this population with the available pain assessment tools. This presentation will outline advancements in technology that offer new possibilities to support pain management in people with dementia. For example, our pilot research with a daily 15-minute intervention using a social robot (PARO robotic seal) significantly reduced observational pain levels and as-needed medication use in people with dementia living in residential aged care facilities (RACFs). However, the study was limited by the challenges of pain assessment in people with dementia as the commonly used pain observational tool was unable to provide reliable and valid results. To overcome such challenges, we are investigating the feasibility of the technology-based PainChek app to measure pain objectively in people with dementia. PainChek app uses facial recognition technology to detect facial cues and integrates non-facial cues (voice, movement, behaviour, activity, and body) to assess pain in non-communicative people with dementia within 5 minutes. We will report on the preconditions for its clinical application (e.g., training, acceptability, cost, implementation barriers and enablers) in RACFs and outline how innovative technologies may transform clinical practice and support care professionals to provide better pain management in dementia care.


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Knowledge, confidence, attitudes & beliefs of Physiotherapists in working with people living with dementia

Mr Stephen Quick, Dr David Snowdon1,2, Dr Katherine Lawler3, Prof Jennifer McGinley4, Mrs Sze-Ee Soh5,6, A/Prof Michele Callisaya1,2,7

1Peninsula Clinical School, Central Clinical School, Monash University, 2Academic Unit, Peninsula Health, 3Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, 4Department of Physiotherapy, University of Melbourne, 5Department of Physiotherapy, Monash University, 6Department of Epidemiology and Preventative Medicine, Monash University, 7Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania Introduction: Clinical care for people with dementia as a primary diagnosis, or as a co-morbidity, can be complex. Physiotherapists play a key role in the care of people living with dementia in multiple settings. The aim of this systematic review was to understand the attitudes, beliefs, knowledge and confidence of physiotherapists and physiotherapy students when working with people living with dementia. Methods: This was a mixed-methods systematic review that included qualitative and quantitative studies. Participants were physiotherapists working in any clinical specialty (e.g. gerontology, orthopaedic, neurological), and physiotherapy students who have completed at least one clinical placement. The phenomena of interest were attitudes, beliefs, knowledge and confidence when working with people with dementia in any setting. Eleven databases were searched. Data synthesis followed a convergent integrated approach according to Joanna Briggs Institute methodology for mixed methods systematic reviews. Results: The review found 15 studies eligible for inclusion. There were five key themes: rehabilitation potential (variable outcomes, poor potential), challenges in dementia care (communication, behaviour, cognition, risk, stress and burnout), education in dementia practice (inadequate training and knowledge, importance of experience), specialised area of practice (complexity of presentation, nuance of care, importance of time, holistic approach) and unsupportive systems (environment, time, risk aversion). Conclusion: Physiotherapists and physiotherapy students have low levels of knowledge and confidence in several areas important to working with people with dementia. With higher levels of knowledge and confidence associated with more positive attitudes and beliefs, dementia education needs of physiotherapists at all levels needs to be addressed.


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Characterising older adult engagement during group technology-driven reminiscence therapy. Ms Madeleine Radnan1, Prof Kate Stevens1, Professor Caroline Jones1, Mr Andrew Leahy1, Dr Clair Hill1, Professor Deborah Parker2

1Western Sydney University, 2University of Technology Sydney Reminiscence therapy (RT) stimulates discussion of past experiences (Woods, et al., 2018). Google Earth and Street View digital technology may support reminiscence. In this experiment, technology-driven RT was operationalized (called Time Travelling with Technology-TTT) as dynamic images panning the environment (High-Tech condition/HT) and compared with static images (Low-Tech condition/LT). Locations shown were person-specific (PS) or non-specific (NS). Independent variables were facial movement, lexical use and prosodic patterns of speech. A baseline dyadic RT interview was conducted pre-, mid- and post-experiment. Participants were nine clients (8 female, mean age: 79) at an aged care day respite facility. Using a repeated measure design, the HT and LT condition each ran for 6 weeks. Weekly group sessions of 2-4 clients ran for ~30 minutes. Sessions displayed PS and NS locations on a television. Facial movement presence and intensity greater in TTT compared to Baseline (ps<0.027). Lower presence of AU04 (brow lowerer) in LT compared to HT and Baseline (ps<0.036). Greater intensity of AU12 (lip corner puller) viewing PS compared to NS (p<0.026). Greater personal pronouns use in Baseline compared to LT and HT (ps<0.01) and greater in PS compared to NS (p<0.01). Emotional tone more positive in NS compared to PS (p<0.01). Greater utterance duration and words per utterance in Baseline compared to LT and HT (ps<0.01). Greater utterance duration viewing PS compared to NS (p<0.01). Findings show complexity in the interactions between person, environment and stimuli factors that influence engagement outcomes. Highlights the importance of a multi-dimensional approach. Cautious interpretation is needed.


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Age-adjusted gender variation in the length of stay at residential aged care in Australia Mr Md Mijanur Rahman1, Dr Rob Gordon1, Ms Anita Westera1, Prof Kathy Eagar1

1Australian Health Service Research Institute, University of Wollongong Background: Older women, with their longer later life, overwhelmingly spend more time in residential aged care facility (RACF) than men. However, there is a lack of inferential evidence around the accurate length of stay in RACF by gender and age. This study aims to estimate the predicted length of stay and how this differs by gender and age across different states/territories in Australia. Methods: The sample consisted of 57,157 older Australians who deceased at RACF between July 2019 and June 2020. The observed length of stay in RACF was measured from the date of admission to RACF and the date of death. Generalized linear model was used to estimate the predicted length of stay and the interaction effect of gender and age. Results: Almost three-fifths of the sample were women, with an average age at death 88.3 years (vs 85.2 years for men). The predicted average length of stay in RACF for women was 1155 days (95% CI: 1153-1157) vs 793 days (95% CI: 792-794) for men. Women’s increased age of death was significantly associated with a longer stay in RACF than men. One year increase in age of death was associated with a 1.7% increase in the length of stay for women than men (IRR=1.017, with 95% CI: 0.015-0.019). Conclusions: Women’s longer length of stay in RACF than men highlights the importance of RACF with increase in longevity. RACF is not a lifestyle choice, it should be considered as a place for living during the final trajectories of life.


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Evaluation of the Royal Flying Doctor Telehealth Specialist Services – Provider Perspectives Dr Rebecca Mckechnie2, Dr Tshepo Rasekaba1, Prof Irene Blackberry2, Jocelyn Syme3, Cassie Moore3, Melanie Trivet3

1La Trobe University, 2La Trobe University, 3Royal Flying Doctor Service Health professionals at the coalface of service provision for the 30% of older adults in rural and remote Australia are central to health service planning, delivery, and innovations to improve healthcare access. Since 2017/18, the Flying Doctors Telehealth Specialist Service (FDT-SS) was implemented and scaled up to mitigate specialist access challenges in rural and remote areas. This research evaluates experiences of FDT-SS healthcare providers. Eight rurally-based nurses and four metropolitan-based specialists completed semi-structured phone interviews between August 2019 - April 2020. Thematic analysis was performed following the Institute for a Broadband-Enabled Society framework. The following themes emerged: Improved access: telehealth facilitated specialist access for patients who would otherwise have travelled extensively for care, underpinning equitable healthcare access. Role of GPs: GPs are the principal referral source and therefore gatekeepers to telehealth services, providing opportunities to ‘champion’ telehealth. Multidisciplinary approach, continuity of care, patient autonomy: the collaborative, multi-disciplinary set-up of telehealth provides familiarity, promotes care continuity and patient autonomy in care decision-making. Sustainability enablers and threats: Organisational goals that align with telehealth support sustainability. High staff turnover, exclusive funding models and limited integration of document sharing threatened sustainability. Bridging gaps and future services: future service expansions to include other specialist services, e.g. wound clinics, as well as professional development. These findings suggest that FDT-SS improves access to specialists, patient autonomy, and is perceived to improve health outcomes. Normalising telehealth within practice remains a challenge, with a need to incorporate practice-related tasks within telehealth platforms, organisational policies, and inclusive sustainable funding models.


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Does telehealth improve access to healthcare - effectiveness of the Flying Doctor Telehealth Specialist Services Dr Tshepo Rasekaba1, Dr Rebecca Mckechnie2, Jocelyn Syme3, Cassie Moore3, Melanie Trivet3, Prof Irene Blackberry2

1La Trobe University, 2La Trobe UNiversity, 3Royal Flying Doctor Service Background and aim: Telehealth provides an innovative solution to addressing health service access challenges faced by rural and remote Australians, 30% of whom are older adults. Since 2017/18, the Royal Flying Doctor Service (RFDS) Victoria has scaled up the Flying Doctors Telehealth Specialist Service (FDT-SS) throughout rural and remote Victoria. The aim of this research was to evaluate the geographic reach of FDT-SS and its effect on health service utilisation. Methods: Service reach and scale up was mapped using RFDS Victoria service data. The following linkage datasets were obtained for a predominantly older adults FDT-SS cohort (Endocrinology, Cardiology, Psychiatry and Respiratory) (01/03/2018 to 31/03/2019): Medicare, Victorian Admitted Episode Dataset, Victorian Emergency Minimum Dataset and Victorian Patient Transport Assistant Scheme. Pre-post data analysis was performed using negative binomial regression. Results: FDT-SS covered 52 remote sites; 73% in postcodes classed as outer regional or remote. Incident rate for Medicare item claims (any claims including those relevant to FDT-SS specialities) was 30-50% higher post-FDT-SS, and telehealth specific claims were three times higher. There were no significant changes in hospital admissions or emergency department presentations. The rate of VPTAS claims were twice as high post-FDT-SS for any usage reason but was unchanged for reasons associated with the medical condition for accessing FDT-SS. Conclusion: RFDS Victoria’s telehealth specialist service is successfully reaching predominantly older people in rural and remote areas. There is evidence of use of other specialities for which travel is still required, therefore FDT-SS may consider expanding the breadth of specialties.


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Older peoples’ perceptions and experiences of community engagement in aged care Assoc Prof Helen Rawson1, Ms Kerry Rigby2, Ms Cherene Ockerby2, Dr Helen Forbes2

1Monash University Nursing and Midwifery, 2Deakin University, Centre for Quality and Patient Safety Research - Monash Health Partnership Background Older people should be empowered to actively participate in decisions about their care and wellbeing needs. The Aged Care Quality Standards place the consumers’ experience at the centre of planning, provision and review of care. It is important to understand the older person’s perspective and experience of community engagement in aged care. Aim To explore older peoples’ perceptions and experience of community engagement in aged care. Methods An exploratory descriptive design involving 33 people living in residential aged care (RAC) or independent living units (ILUs) from a large not-for-profit aged care provider in Victoria and Tasmania, Australia. Data collection involved individual interviews and focus group discussions. Results Four categories describe the participants’ perceptions and experiences: i) perceptions of community; ii) participating in the aged care community; iii) participation in the external community and; iv) benefits of engaging and participating in a community. For people in RAC, community was characterised by their notion of home, with their community connections centred on staff. Although useful engagement opportunities were facilitated by staff, a one-size-fits-all approach does not suit all residents and they should also have the choice to disengage. People in ILUs were not completely removed from the external community and their engagement highlighted a desire to maintain their independence and be part of that community. As such, they were creators of their own engagement opportunities. Conclusions Understanding older people’s perceptions of community in aged care can support development of strategies to promote their engagement and participation.


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Substituting nurses in residential aged care: findings from evaluation of two residential-in-reach services in Victoria Dr Jo-Anne Rayner1, Prof Deirdre Fetherstonhaugh1

1ACEBAC, La Trobe University Introduction Since 2008, residential-in-reach (RiR) services have operated in Victoria to reduce the inappropriate transfer of deteriorating residents to acute care. Between 2014 and 2018, two of these services, with different service models, were evaluated to understand what factors drive more frequent use by some residential aged care services (RACS). One RiR service was geriatrician-led and the other nurse-led. Method Using a qualitative descriptive design, semi-structured interviews were conducted with staff from RACS that use the residential in reach services, general practitioners (GP), and RiR service staff. The interview transcripts were thematically analysed. Results One hundred and forty-three participants were interviewed, including 107 staff from 17 RACS, eight GPs, and 12 RiR service staff. Reliance on the RiR services to provide timely clinical care to deteriorating residents was evident in both evaluations, irrespective of the service model. Frequent use of the RiR services related to the increased acuity of residents, and the difficulties in accessing timely and appropriate medical care. Most importantly, frequent use directly related to the reduced numbers of skilled nurses available to assess and manage deteriorating residents and policies that limit nurses’ ability to work within their scope of practice. Conclusions Providing clinical care in RACS is challenging given the increased acuity of residents, and limited access to medical care. Increasing the number of skilled nurses in Australian RACS, would support deteriorating residents to stay in familiar surroundings and reduce reliance on external services.


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Prediction of dementia: Differences between performance-based versus informant-reported measures of functional impairment Dr Simone Reppermund1, Sujin Jang1, Dr Katya Numbers1

1Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Background: Instrumental activities of daily living (IADL) are complex activities necessary for independent living, such as managing finances or medication. Informant-reports are most widely used IADL measures because of their brevity and ease of administration. However, informant-reports are prone to underestimate IADL ability because of caregiver burden or depressive symptoms. Performance-based IADL assessments offer an objective alternative, where individuals perform activities under observation of the assessor. The aims of this study were to assess whether a performance-based IADL measure can predict dementia and to compare an informant-report with a performance-based measure. Methods: We administered the performance-based measure Sydney Test of Activities of Daily Living in Memory Disorders (STAM) and the informant-reported Bayer-Activities of Daily Living Scale (BADL) to 440 community-dwelling adults aged 76-96 years with normal cognition (n=267) and with mild cognitive impairment (n=173). We used logistic regression to examine the longitudinal relationship of the two measures with incident dementia at 4-year follow-up considering several covariates. Results: Performance-based IADL impairment at baseline (OR = 0.82, 95% CI 0.76–0.89, p<.001) and decline in performance-based IADL function (OR = 0.73, 95% CI 0.66–0.80, p<.001) predicted incident dementia over 4 years. The prediction provided by the STAM was statistically significant over and above the BADL. Conclusions: A performance-based IADL measure can predict dementia over 4 years beyond that provided by an informant-report. Performance based IADL measures are promising tools for clinical practice to identify individuals at greater risk of dementia.


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Listen N Talk: developing an app to promote intergenerational language learning Dr Mark Richards, Professor Caroline Jones, Ms Josephine Lardy, Ms Helena Lardy, Ms Sarah Bock 1The MARCS Institute - Western Sydney University Australia’s elderly population is increasingly culturally and linguistically diverse; culturally inclusive and personalised service provision remains an under-met need in aged care (Australian Government, Department of Health, 2017). A free app shell developed through recent research, Listen N Talk, has potential to help address this need by supporting community language use among culturally and linguistically diverse (CALD) seniors, family and carestaff. At its broadest level, the Listen N Talk app research stems from a ‘language revitalisation’ framework, in the space of research with and by Aboriginal people to record, document, teach and learn their languages as spoken by the most elderly generation in their communities, to maintain cultural knowledge and wellbeing. According to this language revitalisation framework, the use of community languages via involvement of key seniors and their knowledge – even at the level of learning a few significant phrases in their language - is a significant undertapped resource which can support relationship building, cross-cultural inclusion and respect, as well as preserving cultural and family knowledge intergenerationally, within specific organised programs or informal intergenerational family activities. In this presentation we provide an overview of the development of the Listen N Talk app, and key features (audio recording provision, personalised learning), including a user-friendly interface for input in any language into the app. We will then discuss possible app uses in aged care settings to value and celebrate the linguistic and cultural knowledge of CALD seniors, with potential social and cognitive benefits for CALD seniors, family and carestaff.


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Dementia Engagement Modelling Program: A novel model of aged care during COVID-19 Ms Lyn Robb1, Dr Tom Morris1, Mr Mustafa Atee1,2

1The Dementia Centre, Hammondcare, 2Curtin Medical School, Faculty of Health Sciences, Curtin University The COVID-19 pandemic has significantly impacted the quality of life of aged care residents living with dementia more than any other population in Australia. The lockdown and social isolation measures necessary to safeguard residents and staff have resulted in increased social isolation, loneliness, and behaviours and psychological symptoms of dementia (BPSD). In acknowledgement of these impacts, the Federal Government created an Aged Care COVID-19 Grief and Trauma support package for aged care residents, their families and aged care staff. The Dementia Engagement Modelling Program (DEMP), operated by the Dementia Centre of HammondCare, is one initiative funded by this package. DEMP is a fully funded, first line of multimodal support for people living with dementia in aged care who have become withdrawn, frustrated or fearful and are at risk of developing BPSD due to COVID-19 restrictions. The service is delivered by a team of 10 dementia engagement specialists, modelling best practice and person-centred activities of engagement to support aged care staff in providing residents with meaningful purpose, comfort and reassurance. To maximise the benefits from the program, DEMP also provides coaching and development opportunities for staff to enhance their knowledge regarding communication and engagement. Outcomes of DEMP are evaluated through the regular administration of the Engagement in Preferred ActivitieS Scale (EPASS) and through the Goal Attainment Scale (GAS). In this presentation we will describe the DEMP model of care, activities, and outcomes and provide case examples that can guide meaningful engagement for other aged care residents living in Australia.


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Baseline data from the PITCH study: characteristics of Home Care Workers providing dementia care Dr Steven Savvas1, Dr Anita Goh1, Prof Colleen Doyle1, Assoc Prof Frances Batchelor1, Ms Esther Tan1, Ms Erica Wise1, Professor David Ames1, Dr Margaret Winbolt2, Dr Susan Malta3, Prof Lee Fay Low4, Prof Briony Dow1

1National Ageing Research Institute, 2La Trobe University, 3University of Melbourne, 4University of Sydney Older Australians with complex care needs, including people living with dementia, increasingly prefer to live in their own home. However, the front-line home care workers (HCWs) supporting these customers need additional training and support on how to deliver best-practice dementia care. PITCH (Promoting Independence Through quality dementia Care at Home) is a specialised training program for HCWs. A pragmatic stepped-wedge cluster RCT is being conducted to evaluate the PITCH program. To date, 158 HCWs from five home care providers across Australia have completed baseline measures. We report here baseline data on HCWs’ knowledge of dementia (DKAS), attitudes towards dementia (DAS), sense of competence in providing dementia care (SCIDS), and the strain in providing this care (SDCS). Dementia knowledge was positively associated with attitudes (r = 0.376) and competence (r = 0.287). Dementia attitudes were also positively associated with competence (r = 0.584). Job strain was not significantly associated with knowledge, attitudes, or competence. HCWs’ age and education level were not associated with knowledge, attitudes, competence or strain. However the HCWs’ cultural background was associated with all these measures, with non-Australian HCWs showing higher job strain (r = 0.186). In conclusion, being knowledgeable about dementia, positive attitudes to dementia, and a higher sense of competence were all correlated for HCWs. Staff strain in providing dementia care was only weakly associated with the cultural background of the HCW, suggesting that different levels of staff support may be beneficial for staff from CALD backgrounds.


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Models for predicting fall in aged care: Systematic Review Dr Joyce Siette1, Dr Kristiana Ludlow1,2, Dr Mikaela Jorgensen1, Ms Laura Dodds1, Dr Joyce Siette1, Dr Nasir Wabe1, Professor Stephen Lord3, Professor Jacqueline Close3,4, Prof Johanna Westbrook, Dr Karla Seaman 1Australian Institute of Health Innovation, Macquarie University, 2School of Psychology, University of Queensland, , 3Neuroscience Research Australia, UNSW, 4Prince of Wales Clinical School, UNSW Objective: Falls are one of the greatest concerns for older Australians. The consequences can be dramatic in terms of physical harm, a loss of confidence, as well as associated treatment costs. Those living in residential aged care facilities and receiving home-based community care are particularly vulnerable to falls. We conducted a systematic review to identify models for predicting falls, in real-time or near real-time, in these populations, which have been developed utilising routinely collected aged care data. Methods We searched empirical studies published in English between 2000–2020 in five databases. The systematic review followed PRISMA guidelines, and we extracted information on how the model was developed, what predictors it used and how it has been implemented. Results: After screening over 7,000 papers, only four met the inclusion criteria. Two in community care and two in residential care. Various techniques were used to develop the models, and each contained different combinations of predictors (e.g., previous falls, comorbidities, and medications). None of the models identified have been implemented and evaluated within an aged care setting as routine practice. Conclusion: The review identified a significant evidence gap and demonstrated a missed opportunity to leverage the potential of existing routine aged care data to drive predictive falls risk models in aged care. The technology and tools applied in other areas of health are now available to advance upon existing static falls risk models and create a dynamic model based on electronic aged care health record data. We outline how this might be achieved.


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Playful Placemaking with Pets around a Pandemic: Socially engaging older pet owners towards game-changing dialogues Mr Jacob Sheahan1, Ms Natalie Davey2, Ms Alicia Kennedy2, Dr Larissa Hjorth1

1RMIT University, 2Cherished Pets Foundation Due to the ongoing health risks and resulting lockdowns across Australia, social enterprise Cherished Pets suspended in-home community pet care and volunteer visits. This resulted in a loss of regular social contact within the membership and increased social isolation for vulnerable older pet owners. Responding to the elevated social isolation experienced by older pet owners in the Geelong community during the pandemic, a partnership between charity Cherished Pets Foundation and creative design researchers from RMIT University was formed to create a game for older adults, pet and place-making. Leveraging socially innovative and creative approaches, the project draws on the power of pets to connect people and incorporates physical and digital elements to make pet responsibility a playful, social and community activity. Pet Pals—an interactive, community-based and pet-ownership themed treasure-hunt style game—pairs older pet owners and volunteers to co-operatively complete challenges and discover local locations while dog-walking, encouraging social participation and connection by aligning with their interests, technology literacy and pet ownership. An initial prototype was developed for Cherished Pets members, resulting in a location-based game that was scaled to the wider Geelong community. Through participation in this gameplay, the community is providing safe spaces to reflect on the long-term implications of the pandemic and how to support social engagement for older residents, alongside fostering conversations and awareness around pet ownership and its benefits for healthy ageing.


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Self-efficacy of migrant care workers in caring for older residents in residential aged care settings Ms Sumina Shrestha1, Professor Yvonne Wells1, Dr Christine While1, Assoc. Prof. Aziz Rahman2

1La Trobe University, Melbourne, 2Federation University In the last decade, the number of residential aged care places in Australia increased by more than 20%. The Australian aged care workforce comprises a significant proportion of migrant care workers in recent years. The latest systematic review by Chen et al. (2020) suggested that new migrant staff often experience cultural shock and show a deficit in knowledge and skills regarding host cultures and traditions, which may influence their confidence in caring for older people of the host countries. Our study assessed the self-efficacy of migrant personal care workers (PCWs) in caring for older people in residential aged care settings and compared their self-efficacy with Australian-born care workers. A total of 286 PCWs participated in our online survey, of which 184 were born in Australia and 13 in English-speaking countries overseas. Eighty-eight participants were from non-English-speaking countries (NESCs). Migrant PCWs from the NESCs were younger, less experienced as carers, more educated, and more likely to be married than non-migrant care workers. They also experienced more discrimination in their everyday life than Australian-born PCWs. The mean score of caring self-efficacy was significantly lower in PCWs from NESC than those born in Australia or other English-speaking countries. They had more doubts and concerns regarding caring for older residents. Everyday discrimination was found to influence the caring self-efficacy of PCWs in residential aged care. This study suggests that policymakers and aged care providers should intervene to strengthen the self-efficacy of current and future migrant care workers in caring for older residents.


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Self-efficacy of residential aged care workers in caring for older residents: A scoping review Ms Sumina Shrestha1, Mr Rayan Alharbi1, Dr Christine While1, Professor Yvonne Wells1, Assoc. Prof. Aziz Rahman2

1La Trobe University, Melbourne, 2Federation University Self-efficacy in caring is an essential attribute if care workers are to develop positive attitudes towards their clients and perform their work optimally. Care workers’ self-efficacy may vary according to the context in which the care is being provided, and residential aged care is a multidimensional and challenging setting. This scoping review addressed questions on the level of and factors that influence caring self-efficacy of residential aged care workers (RACWs). It followed the Joanna Briggs Institute Reviewer’s Manual for Scoping Reviews. A systematic search performed in six electronic databases identified 41 eligible studies. All primary studies, irrespective of the study design, were included. From qualitative synthesis, we found that RACWs refer to caring self-efficacy as “being able to deal with difficult situations”, “accepting feedback”, “understanding residents”, “feeling useful”, and “having an awareness of their actions”. The self-efficacy score of RACWs’ was average or higher than the average score. It was positively influenced by access to resources, the support of supervisors and coworkers, job satisfaction, and training opportunities to increase their knowledge and skills. Work pressure and burnout negatively influenced RACWs confidence in caring for residents. Relationships with residents and their families also enhanced their confidence. Finally, RACWs with a strong sense of self-worth, intrinsic motivation, and interest in caring had higher self-efficacy. This review emphasises that aged care providers can improve care workers’ confidence level by increasing access to organisational resources and providing professional development opportunities.


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A mixed methods study on the impact of COVID-19 in older Australians during second lockdowns Dr Joyce Siette1, Dr Kristiana Ludlow1,2, Dr Joyce Siette1, Ms Laura Dodds1, Professor Viviana Wuthrich1, Dr Carly Johnco1, Prof Joanne Earl1, Dr Piers Dawes1, Dr Paul Strutt1, Prof Johanna Westbrook1

1Macquarie University, 2University of Queensland Introduction The impact of extensive second lockdown measures on older adults’ quality of life (QoL) remains unknown. Our study aimed to compare the QoL of older Australians in Victoria who experienced a second lockdown with the QoL of older Australians in other States and Territories. Methods A national cross-sectional survey study of 2,990 community-dwelling older adults measured QoL, social networks, healthcare access, and perceived impact of COVID-19 on multiple aspects of life, between July to September 2020 using a mix of closed and open questions. Tobit regression was used to measure difference in States and explore factors associated with QoL, and inductive content analysis of opened ended questions was conducted. Results Respondents’ mean age was 67.3 years [SD=7.0]. Victoria’s second lockdown had been in force for an average 51.7 days. Adjusted QoL scores were significantly higher in Victoria compared to the rest of Australia (t2,827=2.25, p=0.025) (median 0.84 vs 0.80, respectively). Individuals with pre-existing health conditions, receiving Government or aged care services, smaller social networks, and high medical needs reported lower QoL during lockdown. During lockdowns, Victorians made significantly more video calls compared other Australians (p=0.002). Respondents made more negative comments regarding the impact of COVID-19 compared to positive or mixed comments (81:6:12) and highlighted that emergency lockdown measures heightened feelings of insecurity, confusion, and emotional isolation. Conclusions Many vulnerable populations may have been adversely affected during this period, however the impact of Victoria’s lockdown did not appear to affect general older adults QoL compared to the rest of Australia.


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The National Telehealth Counselling & Support Service In Residential Aged Care - A Reflection Mr Mark Silver1, Professor Sunil Bhar, Jenny Linossier, Dr Debra Koder, Aida Brydon, Rebecca Collins, Sofie Dunkerley, Joanna Waloszek 1Swinburne University of Technology Over 50% of older adults in residential aged care experience mental health issues such as depression and anxiety, with significant loneliness. The COVID-19 pandemic has had an unprecedented impact on their lives. The Aged Care Royal Commission has highlighted the urgent need to offer more specialised training of mental health professionals. Swinburne University has had an established Wellbeing Clinic for Older Adults since 2011, providing free face-to-face counselling, digital story services and carer support group programs as well as delivering training to students and education seminars to hundreds of aged care staff, practitioners, volunteers and community members. The counselling is provided through postgraduate psychology, social work and counselling students as part of their clinical placements under the supervision of experienced practitioners. The Wellbeing Clinic also has a substantial research arm supported through community partnerships which focuses on evaluating practical clinical approaches to addressing mental health needs of older adults in residential care. In May 2020, as a response to the COVID-19 pandemic lockdowns, the Clinic developed the National Telehealth Counselling and Support Service. The service offers free telephone or video counselling to the residential aged care community to address the mental health and emotional wellbeing needs of residents, families and staff; as well as providing practicum based training to the future mental health workforce. This presentation will offer an overview and early findings of this program. Indications are that such a service can be a valuable and feasible means of mental health delivery, especially where accessibility and availability are compromised.


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The Physical Activity Pathways Model: An Evaluation Dr Jane Sims1, Mr Adam Demirtel2, Ms Jo Howard3

1Jane Sims & Associates, 2Merri Health, 3Sunbury and Cobaw Community Health Background Physical activity aids the management of many health conditions. But how can people be helped to keep going once a therapeutic program ends? The Physical Activity Pathways Model (PAPM) is a place-based, community health improvement program. Community Health Service exercise physiologists partnered with local exercise venues to organise transfer of clients to a range of tailored exercise sessions in the community, where clients are supported by qualified exercise facilitators. Methods So, what do clients think of this program and, importantly, do they continue to be active? The program was independently evaluated at three timepoints, using client surveys and stakeholder interviews. Results Trust gained in the Community Health Service aided the transition to local services: clients were reassured that they were going somewhere safe and supportive. Familiarisation and relationship building were key. Physical activity patterns and physical health remained stable. A significant improvement in mental health and wellbeing was observed. Clients were able to maintain their independence. The social engagement accompanying the physical activity sessions was critical- clients tended to stayed engaged because of this aspects. The project was challenged by the Covid-19 restrictions. However, many clients continued to exercise. The establishment of exercise goals has definitely paid off. Further, transitioning clients has enabled staff to work with new clients. Conclusions The PAPM comprises low cost, social and engaging programs which encourage client wellness and reablement. The model has built community partnerships and facilitated access to more resources and physical activity options.


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Decision-making sub-types among older adults in the Personality and Total Health (PATH) Through Life Study Dr Craig Sinclair1, Dr Ranmalee Eramudugolla1, Dr Brooke Brady1, Mr Nicolas Cherbuin2, Prof Kaarin Anstey1

1School of Psychology, University Of New South Wales, 2Centre for Research on Ageing, Health and Wellbeing Decision-making among older adults is a product of accumulated skills and experience, but can also be affected by age-related changes in cognitive and affective processes (Samanez-Larkin & Knutson, 2015), as well as neurodegenerative disease (Gleichgerrcht et al., 2010). Decision-making performance was assessed among a population-based sample of older adults from the Personality and Total Health (PATH) Through Life Study. The ‘Game of Dice’ Task is a validated behavioural measure of decision-making under explicit risk conditions (all task parameters explicitly available to participants). Based on existing literature, relevant cognitive and demographic measures were selected from the battery of PATH assessments for analysis. In study one 1,002 older adult participants (aged 72-78 years, with no neurological disease or cognitive impairment) were included. Cluster analytic techniques (k-means analysis) identified ‘advantageous’ (n=353), ‘disadvantageous’ (n=247) and mid-performing ‘switching’ sub-types (n=402). Participants who were younger, male and with higher scores on a measure of verbal learning were more likely to be in the advantageous sub-type. Participants with slower performance on a measure of executive functions were more likely to be in the disadvantageous sub-type. Inclusion of 102 older adult participants with mild cognitive impairment (MCI) from the same cohort (study two) suggested mild impairments on decision-making performance among this group, particularly among those with multi-domain MCI. Among older adult participants, decision-making performance on the Game of Dice Task appears to load primarily on executive function abilities. The implications for designing decision support interventions for use in similar contexts will be discussed.


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Patient-reported factors influencing older adults’ cancer screening decision-making: A systematic review Ms Jenna Smith1, Dr Rachael Dodd1, Ms Karen Gainey1, Prof Vasi Naganathan2, Dr Erin Cvejic1, A/Prof Jesse Jansen3, Prof Kirsten McCaffery1

1Sydney School of Public Health, Faculty of Medicine and Health, The University Of Sydney, 2Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, 3School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Background: Many older adults continue to be screened for cancer with limited knowledge of the uncertain benefit and potential harms. Aim: To summarise the patient-reported factors influencing older adults’ breast, prostate, colorectal and cervical cancer screening decisions. Methods: Studies were identified by searching databases (January 2000-June 2020) and independently assessed for inclusion by two authors. Data extraction and quality assessment was independently conducted by two authors then all decisions crosschecked and discussed where necessary. Results: The search yielded 2475 records, of which 21 studies were included. Nine studies were quantitative, eight qualitative, and four used mixed method designs. Most were conducted in the United States (17/21), and 10/21 assessed breast screening decisions only. Influential factors were synthesized into demographic, health/clinical, psychological, physician, and social/system categories. Commonly identified factors influencing the decision to undergo screening included personal/family history of cancer, positive screening attitudes, routine/habit, to gain knowledge, friends, and a doctor’s recommendation. Factors influencing the decision to forgo screening included being older, negative screening attitudes, and desire not to know about cancer. Factors with varying influence included insurance cover, living in a nursing home, prior screening experience, health problems, limited life expectancy, perceived cancer risk, risks of screening, family, and a doctor’s recommendation to stop. Conclusions: Older adults’ beliefs about cancer screening may run counter to concepts commonly incorporated in guidelines. Communication strategies are needed that support older adults to make informed cancer screening decisions by addressing screening beliefs in context with their perceived and actual risk of developing cancer.


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Scoping international literature on adverse events in residential aged care: what’s happening and what’s missing? Ms Bella St. Clair1, Dr Mikaela Jorgensen1, Dr Amy Nguyen1, Professor Andrew Georgiou1

1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University The Australian residential aged care sector has been under scrutiny throughout the Royal Commission. The release of the final report and its recommendations have shown new thinking is required to facilitate a system combining medical care with social care, one that takes a person-centred approach to understanding events which impact its users and their families. This study aimed to identify and describe adverse event research in residential aged care. A scoping review of international peer-reviewed literature was undertaken following the PRISMA Extension for Scoping Reviews Checklist. A search of databases identified 58 papers published between 2000 and 2020 which described or measured the impacts of adverse events in aged care. Of the 58 papers, 79% were quantitative (n=46), 12% were reviews (n=7) and 7% were qualitative (n=5). Australian research (n=16, 28%) plays a leading role in the knowledge base. An upward trend in adverse event literature was observed over time. Study participation was predominantly through retrospective use of residents’ data (57%, n=33), though the perspectives of residents, staff and family members are increasingly becoming more central. The majority of studies (n=39, 67%) focused on impacts on residents’ physical health, with literature on social aspects (n=10, 17%) and environmental factors (n=9, 16%) lesser acknowledged. This study highlights a need for greater focus on resident voices and social/environmental perspectives in adverse event research in aged care. Balancing this picture will help to ensure that changes in residential aged care are evidence-based and adequately address all facets of the lives of older people.


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Managing risk and rights in aged care: Qualitative analysis of Royal Commission data. Assoc Prof Mandy Stanley1, Dr Patricia Cain1

1Edith Cowan University Much attention within residential aged care is paid to minimising or mitigating risk. Multiple risks exist including risks of injury to staff and other residents, risks of medication error, falls risk, risks to skin integrity, risk of gastroenteritis outbreaks or infectious diseases and so on. Conversely, engaging in occupations that carry some potential for risk can restore dignity and enhance quality of life. The accreditation standards include the rights of residents to the dignity of risk. The Royal Commission into Aged Care brought to light many risks including the risks to quality of care of having an untrained underpaid workforce and lack of leadership yet there is little guidance as to how to manage risk with dignity and positivity. The aim of this presentation is to share the findings from our secondary analysis of the substantial data presented to the Royal Commission in relation to risk. Approximately 7000 publicly available data files from Royal Commission hearings, exhibits, and transcripts were entered into Nvivo and systematically searched using key words associated with risk. Sections of text were extracted for thematic analysis. Results indicate that risk underlies multiple layers of decisions and actions, with risk management at times proving complex and frustrating and for residents, carers, and families. These findings provide direction for ways to move forward requiring innovation in aging for the future to deliver a rights-based approach to residential aged care, one that enhances the dignity of older people and the quality of care received.


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People Living with Dementia and Redress of Structural Harms in Residential Aged Care Dr Linda Steele1, Mrs Kate Swaffer2

1University Of Technology Sydney, 2University of Wollongong Individual and structural harms experienced by people living with dementia in residential aged care systems are rarely acknowledged and redressed. Our presentation will explain the importance of redress as one aspect of a multi-faceted response to abuse and neglect of people living with dementia in residential aged care. As a verb, redress means ‘remedy or set right (an undesirable or unfair situation)’. This expansive definition of redress invites a response to individual and structural harms that focuses on the relationship between past harms and how we fix and re-shape our collective future. Taking up this approach to redress, our paper begins by introducing the importance of redress in the context of residential aged care and identifying examples of redress in analogous contexts of abuse and neglect in institutional settings. We then discuss the absence of redress from the work and recommendations of the Royal Commission into Aged Care Quality and Safety. Last, we discuss emerging findings from our Dementia Australia Research Foundation project exploring the views on redress of people living with dementia, their care partners, friends, and families and identify areas for future research and advocacy.


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What can the psychological contract theory tell us about building Australia’s aged care workforce? Prof Christine Stirling1

1University Of Tasmania After years of reviews and strategies for building the aged care workforce there are strong directions forward focused on education and technology and /innovation amid calls for improved remuneration. There is no question these are all needed but in human resource management terms they are all transactional aspects of the workforce contract. Given those in caring roles have a strong focus on relationships and the desire to belong and cooperate with both clients and colleagues (Elliot, Scott, Stirling et al. 2018) we need to ensure that changes do not diminish positive relational aspects of care work. Aged care work is about people and ignoring the relational aspects of workers contracts in the period of change ahead may bring new risks or unintended consequences for managers. This presentation reviews the recent proposed strategies for building up the Australian aged care workforce using the transactional/relational lens provided by psychological contract theory. Evidence of the importance of the relational aspects of the psychological contract for the expectations and retention of low paid or unpaid workers (Stirling, Kilpatrick & Orpin 2011) suggests this is an important consideration for managers. Elliot, K-EJ, Scott, JL, Stirling, CM, & Martin, AJ, 2018 “Developing Resilience in the Aged and Dementia Care Workforce”, Resilience in Aging: Concepts, Research, and Outcomes, B Resnick, LP et al. (ed):347-365. Stirling, CM, Kilpatrick, SI, & Orpin, P, 2011, “A psychological contract perspective to the link between non-profit organizations' management practices and volunteer sustainability”, Human Resource Development International, 14 (3):321-336.


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An international adaptation of the Australian environmental assessment tool for Singaporeans living with dementia Dr Joanna Sun1, Prof Richard Fleming2

1University Of Tasmania, 2University of Wollongong Background: This article describes the development of the Singapore Environmental Assessment Tool (SEAT), a culturally appropriate, usable, reliable, and valid assessment tool designed to evaluate the extent to which the built environment in aged care facilities is able to support the provision of high levels of care to people living with dementia. Methods: A multistage sequential mixed methods approach was carried out involving 16 raters in Stage 1 and six raters in Stage 2 using a culturally adapted English version of the Environmental Audit Tool-High Care (EAT-HC) in eight nursing homes. The first stage captured qualitative data on cultural sensitivities and the usability of the tool. The SEAT was improved based on the findings, and in the second stage, the usability and psychometric properties of the modified tool were again assessed. Usability was determined by data collected via the System Usability Scale and the Questions to Assess Barriers and Facilitators survey. Psychometric properties were examined by the calculation of percentage agreement, item-level interrater agreement was measured using Fleiss's κ, and Cronbach's α was used to measure the internal consistency of the subscale scores. Results: The culturally adapted SEAT was found to have an acceptable level of usability and a moderate level of reliability among subscales. Conclusion: The tool is reliable and valid when completed by users with knowledge of dementia-enabling environments. For the tool to be used with confidence, education in the application of principles of design and environments for people living with dementia is recommended prior to its use.


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Assessment of health, wellbeing and quality of life for older persons in aged care Dr Susan Taylor1, Rebecca Walton1, Dr Angelita Martini1

1Brightwater Care Group Background: In aged care, the focus is shifting from downstream treatment of illness to preventative health and wellbeing management. Aged care providers now need guidance on the evaluation of health, wellbeing and quality of life of older adults receiving care. To meet this need, a theoretical framework for holistic assessment in aged care was developed and validated for use with older adults accessing aged care services. Aim: This study aimed to: 1) identify domains of health, wellbeing and quality of life, 2) identify standardised assessments of the domains, 3) evaluate assessment psychometric measurement properties, and feasibility for use in residential aged care settings. Methods: A rapid review and Delphi technique were used to identify domains, and a systematic review to identify and evaluate standardised assessments. The rapid review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Delphi technique followed the guidelines for Conducting and Reporting DElphi Studies (CREDES). The systematic review followed the PRISMA, and COSMIN Guideline for Systematic Reviews of Patient-Reported Outcome Measures. Results: N=24 domains relating to health, wellbeing and quality of life were identified, and validated with N=51 panellists. N=2,104 studies were screened. The most common standardised assessments used with aged care residents were the EQ-5D, SF-36, Barthel Index, Berg Balance Scale, Geriatric Depression Scale, Mini-Mental Status Examination, and Neuropsychiatric Inventory. Evaluation of measurement properties and feasibility of identified assessments will be presented. Conclusion /Implications: Findings will be used to select a suite of best practice measures for the Brightwater Aged Care Outcomes Measurement Framework to monitor aged care residents’ general health, wellbeing and quality of life.


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Perceptions of aquatic physiotherapy and health related quality of life among people with Parkinson’s disease Miss Fleur Terrens1

1Peninsula Health Background: Enablers for people with Parkinson’s disease (PD) participating in aquatic physiotherapy have been identified, and exercise improves health related quality of life (HRQoL) but it's unclear whether all enablers and barriers for aquatic physiotherapy specific to the PD population have been explored. Objective: To describe HRQoL in people with PD who have undertaken aquatic physiotherapy, and explore their perceptions and attitudes regarding the program. Methods: Twenty-one participants who participated in a pilot trial on aquatic physiotherapy were included. Participants completed a survey regarding their experiences. The Parkinson’s Disease Questionnaire-39 (PDQ-39) and Personal Well-being Index-Adult (PWI) were used to quantify HRQoL, whilst focus groups were conducted to explore their perceptions and attitudes. Descriptive statistics were used to summarise HRQoL scores. Focus group data were analysed using the deductive coding method. Results: Most participants felt that the aquatic program was worthwhile (n=20/21, 95%). However, they had poor overall well-being (mean 41.6, SD 13.5) and HRQoL (mean 31.0, SD 13.2) as measured by the PWI and PDQ-39. Several barriers to aquatic therapy including safety when getting dressed, fatigue and transport were identified although many enablers were also identified, including an improvement in function, less falls and group socialisation. Conclusions: Aquatic physiotherapy was well-accepted. Participants felt their function improved and felt safe in the water. HRQoL is lower in individuals with PD when compared to Australian norms, thus interventions to optimise HRQoL need to be explored further.


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Manjimup Repair Cafe: codesign, community and sustainability Mrs Jacqui Tibbits1

1Consultivation Australia has an ageing population. Vulnerabilities for older Australians includes greater social isolation and feelings of loneliness worsened by ageism, systemic issues and Covid-19. Older people, however, want to remain active and healthy, connected and contributing to their communities and to be seen in positive terms. Linked to the international Repair Café movement, the Manjimup Repair Café was to provide a social setting for socially isolated people particularly seniors and people living with dementia, reconnect people with cherished items while reducing landfill, highlight skills and capabilities of seniors and improve feelings of self-esteem in older people and people living with dementia. The main topics presented will be: • Context • Codesign: using an asset-based community development (ABCD) methodology • Repair Café as a positive, age and dementia friendly strategy • Success during Covid-19: flexibility, safety, connections and hope • Project outputs, outcomes and sustainability The presentation is aimed at people working in community development and social services, those interested in healthy ageing initiatives and those wanting to contribute to a more inclusive and understanding world whether through research, policy, practice or social citizenship. References: Beard, JR & Bloom, DE 2015, Towards a comprehensive public health response to population ageing, The Lancet, vol. 385, no. 9968, pp. 658-61. Putman, R. D. (1993). The Prosperous Community: Social Capital and Public Life. The American Prospect, 4(13) Seppala, E. & Rossomando, T. & Doty, J. R. (2013). Social Connection and Compassion: Important Predictors of Health and Well-Being. Social Research: An International Quarterly 80(2), 411-430.


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Online yoga for seniors during COVID19: adaptations made in the SAGE trial Assoc Prof Anne Tiedemann1, Dr Juliana Oliveira1, Professor Stephen Lord2, Professor Cathie Sherrington1

1Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University Of Sydney, 2Neuroscience Research Australia Falls significantly reduce independence and quality of life in older age. Exercise that challenges balance can prevent falls. Yoga can provide a high challenge to balance, however the effect of yoga on falls has not been evaluated. The NHMRC-funded Successful AGEing (SAGE) yoga trial will establish the effect of a yoga exercise program compared to a yoga relaxation program on falls. Recruitment to the face-to-face classes for the trial was, however, interrupted by COVID19. This presentation outlines the key learnings regarding transitioning from face-to-face to online classes, including technology and ongoing support to engage older people. Participants (n=560) are randomised to either: (1) the SAGE yoga exercise program, involving twice-weekly supervised classes for 40 weeks or (2) a yoga relaxation program, involving 2 supervised classes and unsupervised practice. Primary outcome is rate of falls in the 12 months post randomisation. 467 participants were recruited since September 2019. Since COVID19, classes that were face-to-face are now delivered online via Zoom. The change to online classes has expanded recruitment locations and offered people in regional and remote settings the possibility to join. The public response to this opportunity has been exceptional, with 119 people recruited in 6 months pre-COVID19 and 348 people recruited in 8 months during COVID19, showing that access to supervised online physical activity is indeed welcomed and valued by older people. Providing technology support, an initial one-on-one introduction to the yoga instructor and access to class-specific Whatsapp groups to promote social connection, have all contributed to the trial’s success.


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The IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) study Ms Joanne Tropea1,2, Professor Kwang Lim1,2, Associate Professor Caroline Brand1,2, The IMPETUS-D Working and Advisory Group 1University Of Melbourne, 2Royal Melbourne Hospital Residential aged care (RAC) is a key provider of end-of-life care for people with dementia, and staff require the knowledge, skills and organisational support to provide quality end-of-life dementia care. IMPETUS-D was developed by experts in simulation and health profession education and includes 11 online modules covering key aspects of best practice end-of-life care for people with dementia living in RAC. The study aimed to evaluate the effectiveness of IMPETUS-D on reducing hospital transfers among residents with dementia; to improve staff knowledge and attitudes about palliative dementia care (qPAD) and bereaved family satisfaction with care (SWC-EOLD). A cluster randomised controlled trial with process evaluation was undertaken. 24 RAC homes were randomised to the intervention (IMPETUS-D) or control (usual training). For the primary outcome logistic regression with standard errors weighted by cluster effects was used, and linear mixed models to assess differences in qPAD scores and family satisfaction. The process evaluation assessed fidelity, dose, and reach. There were no significant group differences in hospital transfers at 6-months (odds ratio=1.14, p=0.44), staff knowledge and attitudes (mean score intervention=60.1 and control=59.5, p=0.77), or family satisfaction (mean score intervention=26.6 and control=27.0, p=0.80). Overall, 250 (25%) staff participated in IMPETUS-D. Staff participation varied across the care homes from 15-53%. Lack of time and having other training commitments were reported as main barriers. Training participation rates were lower than expected and likely impacted on outcomes. Multiple strategies to support staff to participate in training, and to then put new knowledge and skills into practice are required.


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Highlighting the Benefits and Strengths of Informal Dementia Caregivers During COVID Dr Kristen Tulloch2, Ms Trudy McCaul1, Dr Theresa Scott1

1The University of Queensland, 2University Of The Sunshine Coast Background Research into caregiving during the COVID-19 pandemic has been unsurprisingly dominated by reports of negative experiences, but for many informal caregivers, COVID-19 produced unexpected benefits. We interviewed caregivers about their perceptions of care during the pandemic. Methods Semi-structured interviews with 26 informal caregivers of people living with dementia were conducted by allied health professionals. Responses were coded with focus on strengths demonstrated, and benefits of providing care during the pandemic, coping strategies, and creative adaptation of care, and were thematically analysed. Results Seven themes were derived from during-pandemic care: (1) respecting personhood; (2) connecting with virtues and values; (3) improving relationships; (4) seeking and receiving support; (5) prioritising self-care; (6) being protective and proactive; and (7) making practical changes. Conclusions and implications Participants reported a range of benefits and positive experiences consistent with caregiving in non-pandemic times, such as respecting personhood and being protective and proactive. Findings that seemed surprising to participants included the unexpected benefits of providing care during COVID-19, such as improvements in relationships between the person living with dementia, their carepartner, and professionals, and the opportunity to connect with their own virtues and values. Many participants described changes in care strategies they hoped to retain into the future. Enforced isolation resulted in deeper connections for some informal caregivers, and caregivers will benefit from resources that facilitate continuation of adaptive care.


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"...it's like a death": Older driver perceptions on discussing and planning for driving retirement Mrs Nadine Veerhuis1, Professor Victoria Traynor1, Professor Melanie Randle1

1University of Wollongong Driving is the preferred mode of transport for many older drivers, providing mobility to maintain independence and quality of life. The loss of driving privilege has negative psychosocial consequences, including depression. Early discussions and planning for driving retirement is therefore essential. Driving retirement, however, is typically a taboo topic for older drivers and their support networks. To understand why discussions and planning about driving retirement are avoided, 43 semi-structured interviews were conducted with older drivers in New South Wales, Australia. Thematic analysis of transcripts offers insights into why discussions and planning for driving retirement are avoided or facilitated. The findings reveal many older drivers had not discussed or planned for driving retirement. Barriers to discussing and planning for driving retirement included: perceptions of loss, change, death and denial. Facilitators to discussing or planning for driving retirement included: declining health and driving confidence, medical advice age or car accident. Driving retirement in car dependent societies is a major life event, symbolising an end of life stage for some older people. To better support older drivers transition to driving retirement an understanding of the value and meaning placed on driving in the context of the individuals’ identity and lifestyle is recommended.


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Reflections on Working and Walking Gently Together Ms Sharon Wall1

1Aboriginal Health And Ageing Program NeuRA Much of the work that takes place in and across our research group is about building partnerships between Aboriginal and non-Aboriginal people. Partnerships are created between colleagues and co researchers as well as with community Elders, partnering organisations, community groups and associations. We hope to, through this small presentation, provide an opportunity to reflect on the key elements that have been reflected in our work together across cultures that lead to the development of what we consider to be enduring partnerships and collaborations in our communities and within our own team. We will further share a model which underpins these experiences and provides a framework for us to refer to and reflect upon in our work together. We will attempt to extrapolate the key elements of these relationships including the principles of being an Indigenous Ally (Summer May Finlay, 2019) all of which commit to working with shared respect, shared meaning, shared knowledge and an enriched experience of working and walking and learning together, side by side.


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By Your Side –Physiotherapist-led care worker-supported program to prevent falls Dr Willeke Walsh1, Dr Claudia Meyer2,3,4, Assoc Prof Elizabeth Cyarto2,5,6

1Bolton Clarke, 2Bolton Clarke Research Institute, 3Centre for Health Communication and Participation, La Trobe University, 4Rehabilitation, Ageing and Independent Living Research Centre, Monash University, 5Faculty of Health and Behavioural Sciences, The University of Queensland , 6Department of Psychiatry, University of Melbourne Background Falls are a major health concern for community-dwelling older people. The Otago Exercise Program (OEP) is an effective, evidence-based home program to reduce the risk of falls. Exercise participation and program adherence among older people, however, is known to be a challenge. Support by home care workers for older people to participate in exercise programs appears feasible. This pilot study evaluates the older person benefits and acceptability of a physiotherapist-led (virtual) and care worker supported OEP. Methods This mixed methods study included: (1) in-home physiotherapist tailored OEP set-up and virtual physiotherapy consultation; (2) older participant questionnaires and functional outcome measures, at baseline, 8- and 12-weeks, and interviews at 8- and 12-weeks; (3) care worker training, in-home support of OEP and interviews at 8- and 12-weeks. Results Thirteen older people, eight care workers and one physiotherapist participated. Over the 12-week program, a non-significant trend was noted for falls risk reduction, and falls efficacy, quality of life and functional improvement. Thematic analysis showed formal and informal support was valued by older people in the context of motivation for program engagement and working together to achieve benefits. Mixed methods synthesis, using a role-ordered matrix approach, indicated high variability in ongoing independent program participation. Conclusion A modified OEP via care worker support and virtual physiotherapy consultation provides a feasible and acceptable option for exercise participation for falls prevention for older people in their home.


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Towards an understanding of delirium using functional MRI: Preliminary results Dr Sarah Ward1,2,3, Prof Johan Van der Meer4,5, Prof Meegan Campbell4, Ms Suzie Thistlethwaite2, Dr Alice Greenwood2, Dr Kana Appadurai2, Dr Shanthi Kanagarajah2, Dr Greg Watson2, Dr Robert Adam2,3,5, Dr Eamonn Eeles3,6, Prof Michael Breakspear4,5

1Redcliffe Hospital, 2Royal Brisbane and Women's Hospital / STARS, 3University of Queensland, 4Newcastle University, 5QIMR Berghofer, 6The Prince Charles Hospital Aims: To determine if structural and functional magnetic resonance imaging (fMRI) brain scans in delirious geriatric inpatients are feasible and informative. To demonstrate altered neurophysiology of the default mode network (DMN) via fMRI in patients with delirium compared to matched controls. As a benchmark, comparing the value of task-free default mode integrity to altered networks underlying vigilance and response inhibition. Methods: Observational pilot study of fMRI of inpatients, in a tertiary hospital geriatric ward, diagnosed as delirious by a geriatrician. Informed consent was obtained via substitute decision makers. A novel scanning paradigm was developed testing functional networks in resting state and during a simple task of sustained attention and response inhibition. Participants underwent a structural and functional MRI protocol during an episode of delirium and as their own controls 4-8 weeks later. Results 8 participants were recruited. 2 were excluded, before scanning, no longer meeting inclusion criteria. 6 initial and 1 follow up fMRIs were obtained. Participant mean age was 81 years (range 77 – 85 years), 50% were female and co-morbidity was high. 5 of the 6 participants completed the full imaging protocol, including task engagement. Head movement during scanning, was generally within acceptable limits. Data demonstrates considerable cortical atrophy and ventricular enlargement consistent with age. Preliminary fMRI analyses show a highly variable pattern of cortical recruitment during task engagement. Conclusions: These preliminary findings show it is ethically and logistically feasible to engage elderly patients with acute delirium into a high end structural and functional imaging study.


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Personalised Care for VR-based Reminiscence in Aged Care: A Case Study Assoc Prof Jenny Waycott1, Mr Tony Simms2

1The University Of Melbourne, 2Dementia Consultant In residential aged care, many technology-based activities have been introduced to provide clients with opportunities to connect to the world and engage in new experiences. An innovative example is the use of immersive virtual reality (VR), which enables people to virtually “travel” to other places by viewing a realistic 3D world through a VR headset. Virtual reality can be especially powerful for reminiscence. With programs such as Google Earth, aged care clients can revisit places that were significant in their childhood or early life, such as the village where they grew up. Using immersive VR in aged care, however, requires careful one-to-one facilitation. This study aims to understand what works well when facilitating VR reminiscence in aged care. We conducted a case study that examined the practices of one caregiver who has used immersive VR for reminiscence with people living in aged care. Examples from the caregiver’s practice suggest that VR reminiscence can be valuable: aged care clients revisited places and experiences from their past and then shared stories about their experiences with family members. To achieve this outcome, the caregiver spent considerable time with each client to understand their individual needs and to create a personalised VR experience. The case study highlights the care involved in designing personalised VR experiences for individual aged care clients. We conclude that for VR reminiscence to be powerful and enriching for aged care clients, those facilitating the activity need to adopt a personalised care approach and involve clients in co-designing the experience.


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‘Uncovering’ undue influence in instances of financial abuse of older persons. Dr Eileen Webb1

1University Of South Australia Detecting financial abuse or exploitation is complex and even experienced practitioners can find it difficult to distinguish ‘an unwise but legitimate financial transaction from an exploitative transaction resulting from undue influence, duress, fraud, or a lack of informed consent. (Hafemeister, 2005) Furthermore, this form of abuse rarely becomes apparent until considerable sums of money or property have been misappropriated and the older person finds themselves in dire financial circumstances. A remedy may be available to the older person through legal proceedings (McFarlane v McFarlane [2021] VSC 197) but this is a long, expensive and worrisome route. Our presentation ponders how we can identify and address such instances of financial abuse at an earlier stage, before too much damage is done. This presentation examines the efficacy of undue influence screening tools in identifying financial abuse of older people. Implementation of such tools are proving effective in the Unites States to assist field officers from Adult Protective Services identify older people at risk of financial abuse or exploitation through insidious practices such as undue influence, duress or coercive control. Although certainly not a ‘silver bullet’, the tools are proving useful in investigations of financial abuse and our presentation ponders the scope for such tools in Australia.


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Student nurses’ attitudes towards older adults: A scoping review Ms Helen Venables2, Professor Yvonne Wells1

1La Trobe University, 2Australian Catholic University Introduction: Nurses can expect to care for more older adults than patients in any other age group, and it is essential that nursing students enter the workforce with the diverse competencies required to work with this population. However, student nurses generally favour technical or acute areas of nursing practice, rather than working with older adults. Factors associated with student nurses’ attitudes, and educational interventions to improve attitudes to older people, are important topics for research. Method: Two related scoping literature reviews were performed, to (1) map factors associated with nursing students’ attitudes to older adults and (2) assess the evidence on whether attitudes to older people could be improved. Ten databases were searched. A systematic approach included four stages: title and abstract review; full text review; data extraction, and data summary. Findings: Sixteen studies were identified on predictors of student nurses’ attitudes towards older people and a further 10 studies on interventions to improve these attitudes. Few demographic variables were associated with student nurses’ attitudes, but attitudes, such as experience with older family members and willingness to care for older patients, emerged as consistent predictors. It is possible to improve student nurses’ attitudes towards older people, given a careful, structured approach. Conclusion: Results highlight the importance of intentionally providing student nurses with education designed to improve their attitudes towards older people and willingness to care for them.


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Maybo training to improve staff response to aggression in residential care Dr Jacqueline Wesson1,2,3, Professor Lynn Chenoweth2, Ms Janine Grossman1, Ms Bente Ryan1, Scientia Professor Henry Brodaty2,4,1

1Montefiore, 2Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, 3Health & Ageing, Faculty of Health Sciences, University of Sydney, 4Dementia Centre for Research Collaboration Background People living with dementia in residential care can demonstrate aggressive behaviour that can escalate to high-risk situations for staff and others. Staff exposure to physical violence ranges from 50 – 90% (Bostrom et al 2011; Banerjee et al 2012). Maybo training focuses on personal safety for the person and staff, covering communication, risk-reduction, de-escalation and physical intervention skills. Aims To evaluate the effectiveness of Maybo training on staff attitudes, confidence and skill in responding to people living with dementia who show physical aggression, and to examine staff’s training needs and benefits, physical aggression frequency and severity. Method Staff confidence, skill and attitudes (pre/post self-report questionnaires), written reflections post training, and observational data (3 months post-training) will explore changes in staff’s application of Maybo content. Consistency between self-report and observational data, and organisational aggression frequency and severity statistics, will be examined. Results Despite COVID-19 disruption, 128 consented staff (careworkers, nurses, allied health, cleaning/ catering, managers) from four dementia units completed baseline questionnaires, two-day face-to-face education and online training; they had smartphone access to resources. Organisational-level aggression incidence data involving people with dementia have been collated. Re-assessment is scheduled for June 2021 followed by data analysis. Conclusions Maybo training could be an appropriate education program for aged care staff and equip them with skills in positive behaviour support, avoiding aggression, potential restraint and restrictive practices. This study is the first Maybo program evaluation in Australian residential care.


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Comprehensive Assessment - The Key To Person-Centred Service Delivery Ms Jessica Wheatley1

1BaptistCare The agonies of long Home Care Package waiting lists are well known, with individuals waiting up to two years to commence their assessed package level. With the health status of the older person potentially having changed considerably by the time they commence with a provider, the initial ACAT assessment may be well out of date and fail to paint an accurate, comprehensive picture. To address this issue, BaptistCare at home have embedded Health and Well-Living (HWL) Consultants into our care management teams. These positions are held by Occupational Therapists or Physiotherapists with extensive community aged care experience. Upon package commencement, the HWL Consultants undertake a comprehensive, holistic assessment of the consumer. Along with a review of the client’s physical, social, cognitive and psychological status and contributing factors, the Consultants also guide Care Managers and Care staff on how to incorporate a wellness and reablement approach in ongoing service delivery. The Consultants also act as a key resource for Care Managers when they require advice on how to effectively respond to consumer need when their circumstances change, medical conditions worsen or level of function declines. The presentation will provide an overview of the role of the HWL Consultant and demonstrate how this innovation has been instrumental in enhancing the quality of service delivery, ensured timely responsiveness to consumer’s changing needs, optimised their level of function and safety, and ultimately enabled them to remain living at home. This presentation will be relevant to policymakers, aged care service providers and assessment agencies.


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South Australia's Adult Safeguarding Unit – Getting the Balance Right Ms Elicia White

We know that one in 20 older Australians experiences some form of abuse, often by someone they know and trust. The complex nature of abuse, particularly in families requires a flexible and responsive approach, tailored to meet the needs of each individual. The Ageing and Adult Safeguarding Act 1995, which establishes an Adult Safeguarding Unit, fulfilled the South Australian Government’s commitment to progressing legislation to create a rights-based legal framework for the prevention of abuse and neglect of vulnerable adults. The South Australian Adult Safeguarding Unit commenced operations on 1 October 2019 with an initial remit to respond to reports of abuse of older people. In 2020, the Unit’s legal mandate broadened ahead of schedule to include people living with a disability. Anyone with concerns or suspicions about abuse of an older person or a person living with a disability can report their concerns to the Unit. Once a report has been received, the Unit has a statutory responsibility and accountability to respond. The focus of the Unit is to work with a person to develop a safeguarding plan which takes into consideration the needs and wishes of the person. Given the complex family dynamics that exists in many families, the Unit has a strong focus on working positively with and for the vulnerable adult to preserve the relationships that are important to them. This oral presentation will reflect and discuss the types of reports that the Unit has received since commencement and will draw on case scenario's to demonstrate the value of such a service. It will reflect on emerging themes, considerations for balancing a person’s right to safeguarding with their right to autonomy and challenges of the first 2 years. It will comment on the priorities for the coming year as the Unit expands to include all adults vulnerable to abuse, and the ongoing considerations for the development of a rights-based service delivery model.


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Inspiring innovative approaches to challenge loneliness and improve the experience of ageing Ms Kathy Williams1, Ms Kylie Fergusen, Ms Brenda Muturi 1Office For Ageing Well, Dept For Health And Wellbeing South Australia’s Plan for Ageing Well 2020-2025 identifies Meaningful Connections as one of three strategic priorities for ageing well, informed by conversations with older South Australians and other stakeholders. Social connections are a key enabler to ageing well. Australians experiencing higher levels of loneliness have significantly worse physical and mental health than those experiencing lower levels of loneliness (Australian Loneliness Report). Office for Ageing Well, SA Health, in partnership with a range of community organisations, is leading a broad range of initiatives to understand and reduce loneliness. One example is the Loneliness Warriors pilot project, a partnership between Office for Ageing Well and Community Centres SA, which aims to move awareness closer to action through the recruitment, training and roll out of ‘Loneliness Warriors’. Local residents feeling lonely or isolated will be able to find and access trusted volunteers (Loneliness Warriors) with active listening skills, and caring and empathetic natures, to support them to find pathways to connection, meaning and purpose. Through the Meaningful Connections, Stronger Communities initiative, Office for Ageing Well is partnering with Wellbeing SA and COTA SA The Plug-in to conduct consumer engagement to gain insights into the drivers that improve social connectedness and wellbeing, and reduce loneliness and social isolation among older people living in regional South Australia. Both of these initiatives commenced in March 2021. This presentation will discuss these and other initiatives being undertaken in South Australia to understand and address loneliness and the outcomes achieved to date.


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Designing digitally delivered health screening tools to meet the needs of Australia’s ageing prisoner population Dr Jane Hwang1, Dr Adrienne Withall1, Professor Peter Schofield2, Mr Amanuel Kidane Hagos1, Professor Tony Butler1, Dr Natasha Ginnivan3, Mr Rhys Mantell1, Dr Kylie Radford6, Associate Professor Kylie Dingwall7, Dr Philip Snoyman4, Dr Stephen Hampton5, Mr Luke Grant4

1School of Population Health, University Of New South Wales, 2Hunter New England Local Health District, 3School of Psychology, University of New South Wales, 4Corrective Services NSW, 5Justice Health & Forensic Mental Health Network NSW, 6Neuroscience Research Australia (NeuRA), 7Menzies School of Health Research Older prisoners aged 50+ are the most rapidly expanding prison population worldwide, with growth outpacing the ageing of the general population. Older prisoners are believed to experience ‘accelerated ageing’, with complex, age-related care needs (e.g. frailty, dementia) that often go undetected or untreated. Financial constraints compounded by a lack of appropriate assessment tools contribute to a lack of adequate data on the health of older inmates. These health issues place older prisoners at risk both in prison and upon release. We present the findings from the first stage of the ASCAPE study (Audio app-delivered Screening for Cognition and Age-related health in PrisonErs), which will develop and validate a novel, digital health screening tool using serious game and audio-delivered technology to collect important health, medical and cognitive data. Interviews will be conducted with 30 older, current or ex-prisoners (including Aboriginal and Torres Strait Islander people) to understand their experiences of health care in prison, use of technology and perspectives on collecting health data via innovative game-based methods. Findings to be presented include barriers in adequate health screening for this population and how new technologies may be used to facilitate this process in an efficient, acceptable, culturally appropriate, and cost-effective way. A focus on inclusive co-design processes, and future steps for tool development will also be presented. It is expected that this technology will provide equitable screening opportunities to a range of populations, such as those with intellectual disability or from culturally and linguistically diverse backgrounds, or contexts like primary health clinics.


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Chinese carers’ perspectives on adapting the World Health Organization iSupport for Dementia in Australia Scientia Professor Henry Brodaty2, Professor Julie Ratcliffe1, Assoc Prof Bianca Brijnath3, Dr Hui-Chen (Rita) Chang4, Dr Shahid Ullah1, Ms Yunrui Zhou1, Ms Mei Ye1

1Flinders University, 2The University of New South Wales, 3National Ageing Research Institute, 4University of Wollongong Background: Caring for a relative living with dementia at home is more common in culturally and linguistically diverse (CALD) communities in Australia. However, education interventions for this group of carers in the language of their choice are scarce. The World Health Organization has developed iSupport for Dementia, an online self-learning education program for informal carers. Aim: The aim of this study was to work with informal and professional carers from Chinese background in Australia to modify a generic Chinese iSupport for Dementia program developed through an international collaboration and to co-design implementation strategies. Methods: This study applied a qualitative description study design. Focus group with informal and professional carers from Chinese background was applied to collect data. Thematic analysis was used in data analysis. Results: In total, 18 informal carers and 17 professional carers participated in the study. Most informal carers were spouses of people with dementia. Professional carers were employed by a Chinese ethno-specific community aged care provider. Main themes identified from data include: (1) Enhancing self-help in dementia care using Chinese iSupport; (2) Building the iSupport program in the Chinese culture in Australia; (3) Strengthening peer support for carers in the program; (4) the need for professional carers to engage in the program; (5) and expectations for user friendly program. Conclusions/Implications: Findings from the study informed the revision and implementation of Chinese iSupport for Dementia program in Australia. This study has implications for CALD communities in Australia to adapt multilingual versions of iSupport program through international collaboration.


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Navigation of community-based aged care services by older people and their families: A Scoping Review Ms Yuchen Xie1,2, Assoc Prof Myra Hamilton3,7, Professor Carmelle Peisah4,5,6, Dr Craig Sinclair1,2, Prof Kaarin Anstey1,2,6

1School of Psychology, University of New South Wales , 2Neuroscience Research Australia, 3University of Sydney, 4Capacity Australia, 5School of Psychiatry, 6UNSW Ageing Future, 7ARC Centre of Excellence in Population Ageing Research Introduction: As older people increasingly use community-based aged care services, it is critical to ensure that consumers (i.e., care recipients and their families) can smoothly navigate the aged care system and obtain adequate resources and services. Improving access to and navigation of the aged care system has been a focus of peak bodies (e.g., The Council on the Ageing) and was highlighted in the 2021 Budget. We use a scoping review methodology to explore and map emerging themes in relation to access to and navigation of community-based aged care. Methods: A scoping review was conducted using the established framework of Arksey and O’Malley. A comprehensive search was performed in three electronic databases (PubMed, Scopus, and ProQuest) and the Grey Literature (Google/Google Scholar and AAG Grey Literature Library) to identify relevant literature. All members of the research team reviewed the extracted data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Results: Preliminary results suggest emerging themes include system or structural-level factors such as service design and socio-economic status, and individual-level factors such as knowledge of the complex systems, caregiver identity, advocacy, family relationships and technology use, albeit with considerable overlap. Conclusions: This paper demonstrates that structural and individual level factors, and the interactions between may impact consumers’ access to resources and services. Further examination of the literature will elucidate key enablers of and barriers to aged-care navigation to inform future research and policy.


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Ethics of using social robots in aged care facilities: care staff perspectives Mrs Stella Yuan1, Assoc Prof Jenny Waycott1, Professor Reeva Lederman1, Dr Simon Coghlan1

1The University of Melbourne Background: It is important to consider the ethical challenges around the use of social robots designed to help care for older people. While ethical concerns have been raised by philosophers in previous literature, some stakeholders’ perspectives are missing. Our objective is to investigate care staff perspectives on ethical issues associated with using robots in aged care facilities, based on their real-world experiences. Methods: We conducted semi-structured interviews with ten staff who have direct experience of employing robots in aged care homes. Interview questions included asking about the benefits and challenges of using robots, and participants’ opinions on the issues of dignity, deception, and emotional attachment for older residents. Results: We found a mismatch between prior theoretical work and stakeholders’ reflections on the ethical issues. Participants perceived robots as effective tools to enhance their job satisfaction and supplement human care rather than as threats to their jobs. Participants disagreed robot use would cause deception, and did not consider robots undignified, but noted some residents and family members had the concern that robot use infantilized residents. Participants had mixed views on the issue of emotional attachment: they acknowledged attachment to robots could reduce loneliness for residents, but noted the challenges of removing robots from residents who became strongly attached. Conclusion: Our findings suggest that staff perceived ethical issues may be related to how robots are deployed, the benefits of robots, and residents’ relationships with robots. We suggest more empirical studies are needed to complement existing theoretical discussions.


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Prevalence of visual impairment in older people with dementia and its impact: A scoping review Ms Wanyu Zhang1, Dr Fiona Stanaway1, Assoc. Professor Timothy V Roberts1,2,3, Professor Christopher J Poulos4,5

1The University of Sydney, 2Department of Ophthalmology, Royal North Shore Hospital, 3Vision Eye Institute, 4HammondCare , 5The University of NSW (School of Population Health) Objectives Visual impairment and dementia both increase with age, and it is likely that many older people will suffer from both conditions. This scoping review aims to investigate the prevalence and types of visual impairment among older people with dementia, and the impact of visual impairment on older people with dementia and their carers. Setting and participants This scoping review used Arksey and O’Malley’s methodological framework. Studies in any setting involving people with dementia and some assessment of either visual impairment, eye diseases causing visual impairment or the impact of visual impairment were included. Results Thirty-one studies investigating the prevalence of visual impairment among older people with dementia were included with estimates ranging from 19.7% to 51.6%. Only ten studies reported on impacts of visual impairment on older people with dementia, including increased use of hospital services, increased disability and dependency, reduced social engagement, negative emotions, increased abnormal behaviours, loss of hobbies, difficulty in using visual aids or memory aids, and greater Neuropsychiatric Inventory symptoms. Only one study reported on impacts on carers and found increased conflict and physical exhaustion. Conclusion Visual impairment is common in older people with dementia and is associated with negative impacts on those with dementia and their carers. However, heterogeneity between studies in terms of setting and method for assessing VI make it difficult to compare findings between studies and further research is needed, particularly assessing the impact on carers.


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Technologies for Social Connection in Aged Care during COVID-19: Staff Perspectives Assoc Prof Jenny Waycott1, Mr Wei Zhao1, Dr Ryan Kelly1

1The University of Melbourne Communication technologies such as video-conferencing and social media have the potential to keep older people connected and engaged with society. The need for digital connection and engagement has increased since the outbreak of COVID-19 when lockdowns and distancing policies meant that people could not meet in person. However, knowledge of how digital technology can be used effectively to meet older adults’ social needs remains limited, particularly in aged care settings where older adults are more likely to be isolated and frail with complex health conditions. This research aims to understand how various technologies were used for social connection in aged care during COVID-19 restrictions. It further aims to identify the benefits and challenges of using such technologies in residential and community care settings. We conducted interviews with aged care workers and technology providers to investigate their experiences of designing or deploying technologies in aged care, and to understand how the pandemic affected the way technologies were designed and deployed. We found that during COVID-19 restrictions, digital technologies were used creatively to keep older adults connected to their loved ones and engaged with online communities and activities, such as by providing online exhibitions, concerts, and exercise classes. However, there were challenges in deploying these technologies, including difficulties in adapting to individual needs, lack of technical support, barriers to providing training over distance, and issues in engaging older adults from culturally and linguistically diverse backgrounds. This presentation highlights lessons learned to inform future effective use of technologies for communication in aged care.


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The design and development of interactive textiles for people living with dementia Ms Yushan Zou1,2, Dr Fanke Peng1, Dr Nathan D'Cunha1, Dr Eddi Pianca1, Associate Professor Damith Herath1

1University of Canberra, 2Southwest University Multisensory therapy has the potential to improve mood and reduce the behavioural and psychological symptoms of dementia due to its sensorial qualities and physical properties. The latest technological developments in textile materials and technology make it possible to provide multisensory experiences for people with dementia that stimulate their senses of touch, olfactory, light, and sound. This review reports on recent advances in interactive textiles that can provide sensorial interaction for people with dementia, and highlights the potential of textile technology in dementia care. In total, 21 case studies were identified published between 2011 and 2021 that focused on interactive textiles for dementia, include thermochromic textile, optical fibre, textile with long-lasting fragrance, and traditional textile. The evidence suggests that sensory textile interventions have a positive impact on mood and behaviour, and reduce behavioural and psychological symptoms of dementia, and may therefore improve quality of life. The fabrication methods, construction, and applications of the textiles were also reviewed, and various design methods for incorporating functionality into textiles for people with dementia were identified, such as knitting, weaving, embroidery, and coating. Based on this review, a theoretical framework is proposed to enable the design of potential interactive textile solutions for sensory application specifically for dementia care. Interactive textiles can assist in providing pleasant tactile sensations and engaging experiences for people with dementia. The richness of textiles and the diverse possibilities for their use offer vast opportunities for sensorial exploration and experience for people with dementia.

AAG DIGITAL EVEN Oral Presentations - Australian ...

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