Aged Care: Neglect!

A couple of weeks back, I attended the community forum in Newcastle, for Australia’s Royal Commission into Aged Care Quality and Safety. I was close to tears as I listened to people’s harrowing stories of their experiences in relation to the aged care sector. So, this month, I can’t go past this particular publication. Sure, it’s not a journal article, but it’s of equal importance, in my humble opinion, particularly to Australians.

The Foreword of the Commission’s Interim Report (2019), titled: Neglect, opens with: “It’s not easy growing old. We avoid thinking and talking about it….The Australian community generally accepts that older people have earned the chance to enjoy their later years…Yet the language of public discourse is not respectful towards older people. Rather, it is about burden, encumbrance, obligation and whether taxpayers can afford to pay for the dependence of older people.” As many of the forum’s speakers stated, once a person is being cared for by the aged care sector, it’s often “out of sight, and out of mind”.

I attended because I’m concerned about my own ageing; because I’ve been troubled about the care given to elderly members of my family; and because of the stories I’ve heard and investigated in the pre-prescribed care many therapists are trained to provide to residents of Aged Care facilities. Understandably, commission may raise more questions than it answers, but, at this celebratory time of the year for many, I leave you with the question the attending Commissioner, Ms Lynelle Briggs AO, asked asked us, in her closing comments: “Where’s the joy?”

Out of interest, I’ve just searched publications in the last 2 years, for evidence relating to older people and joy. Although findings are limited, one study sheds some light on this. Rinnan et al (2019) set out to find “new approaches to increase positive health and well-being” in residents aged care facilities in Norway. The researchers found “joy of living” was associated with “positive relations, a sense of belonging, sources of meaning, moments of feeling well, and acceptance”. I look forward to a day when quality aged care is the norm, and not the exception. I look forward to a day when the concept of Old People’s Home For 4 Year Olds is just one of many examples of quality aged care; again, the norm and not the exception.

It’s not easy growing old. As Commissioner Briggs asked us to do, I ask you to read the Interim Report, tell people about the report, and talk with family and friends about our aged care. Let’s make sure older Australians are not “out of sight, and out of mind”.

Reference: Rinnan E, André B, Drageset J, Garåsen H, Arild Espnes G, Haugan G (2018) Scandinavian Journal of Caring Sciences, 32(4), 1468-1476, https://doi.org/10.1111/scs.12598

Know’vember!

In celebration of five years of successes, CPDLife® is celebrating with its “Know’vember” promotion. During all of November 2019, all Self Directed courses offered through CPDLife® website are at half price! This means that our “flag-ship”, 8 hour courses are only $110! But this promotion only applies during this months, so get in quick as there’s only a couple more weeks to go.

Stroke Recovery & Rehab

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October 2019: Bernhardt, Borshmann, Kwakkel et al (2019) Setting the scene for the second stroke recovery and rehabilitation roundtable. International Journal of Stroke, 4(5), 450-456, DOI ttps://doi.org/10.1177/1747493019851287

It’s hugely, hugely encouraging to hear about the work of international collaboratives like this one. I’ve been involved in one of the sub-groups and again, this is also hugely encouraging and energising. After all, why not approach stroke recovery from an international perspective; taking what is done best in one country and applying it in another, and learning lessons from the less effective practices and models of care? When it comes to improving outcomes for those directly affected by stroke, an international “team” approach should be underpinning the clinical practices of every local team. To stay up-to-date on what is happening at an international level, this is the team to follow.

As the authors rightly state, this team includes those who are working with people recovering from stroke right through to researchers like Andrew Clarkson, who are investigating animal models of stroke. This broader perspective and collective provides a richer source of what is, and is not, the very best practice that we can deliver to those directly affected. It also provides the broadest platform on which future research and change can occur. If you have a professional and/or personal interest in stroke recovery and rehabilitation, I commend the work and output of this group to you. If we liken stroke recovery to a ship sailing international waters, this group acts as the rudder mechanisms directing and plotting its course.

This article is freely available. Although it is not reporting original research, it is nevertheless an important publication for those with an interest in stroke recovery.

Exciting News!

Today is the first day of my new CPDLife® website. It’s not only full of beautiful, Australian landscape photography, it now proudly boasts the following:

  • New suite of Self Directed course options, which, for the 8-hour courses, are priced at only AUD$220
  • Completely updated Neuroplasticity course, with a new, Self Directed option
  • Completely updated Educating Online (3hr), Stroke in 30 and Evidence in 30 courses, which are still complimentary!
  • My new, Self Directed, 3-hour Understanding Evidence course, priced at only AUD$88
  • My new Blog, with posts Health Care, Professional Development and Online Learning, which I’ll add to regularly. (I’ll still keep doing Journal Club on this website, I promise!)

If you’d like to receive CPDLife® updates, go to the Courses page, scroll down and submit your name and email address.

PS. I’m still updating my Stroke Recovery course, and, if all goes according to plan, an Educator Led and Self Directed option will be available in October 2019.

Carers’ Unmet Needs

July 2019: Denham et al (2019) “This is our life now. Our new normal”: A qualitative study of the unmet needs of carers of stroke survivors. PLoS ONE 14(5): e0216682. https://doi.org/10.1371/journal.pone.0216682

Its always special to reference an article published by authors I have some connection with. This article, which incidentally, is open access, provides unique insight into the care needs of those who care for people recovering from and/or living with stroke. The authors introduce their research reflecting on the fact that stroke is a “family disease”. They’re right, aren’t they? It’s not just the survivor who is directly affected, but those who they share their lives with – hence the “family” description. What’s unique to this study, is its investigation of the unmet needs of carers across diverse settings. Previous research has mainly focussed on the rehabilitation phase of care. Although this study used qualitative methods and the majority of responders were female, it nevertheless provides unique insights into these members of our communities. You’ll find the abstract under Journal Club 2019 and “humble opinion” as a comment to this post.

Post-stroke Function: First 5 Years

June 2019: Rejnö et al  (In Press) Changes in functional outcome over five years after stroke. Brain and Behaviour https://doi.org/10.1002/brb3.1300

As the authors rightly claim, there is little evidence about the long-term, functional outcomes in survivors of stroke; which, when you think about it, is surprising! Stroke is a chronic disease, one that survivors will live with for the rest of their lives, yet we know very little about its long-term, functional impact. What I also find very surprising, is the lack of ongoing support that those with stroke, receive in the long-term. Australian researcher, Dr Jeni White, found that, once discharged, many feel “abandoned” by the healthcare system. So, its timely that we review an article about the long-term needs of people living with stroke. This article is freely available. Please find the abstract under Journal Club 2019, and my “humble opinion” attached as a comment to this post.

Stroke and Prolonged Grief

May 2019: Large et al (In Press) A changed reality: Experience of an acceptance and commitment therapy group after stroke. Neurophsychological Rehabilitation, DOI: 10.1080/09602011.2019.1589531

The honesty and frankness of Stephen Jenkinson, a “grief monger”, is refreshing. He’s currently touring Australia, but please assume this is not a promotion of his tour and that I’m not a beneficiary. I refer to him because his ideas interest me. In an interview with the ABC in 2016, he stated: “Every solution to dying that we come up with preserves the fear of it while claiming to absolve us of it.” Hmmm… is it time to talk about this?

Of course, I’m not suggesting that stroke is synonymous with dying, but up to one third die within the first year. However, stroke is synonymous with the experience of prolonged grief. In my search for studies investigating post-stroke grief in the past 2 years, I found only one! Large et al (In Press) investigated the efficacy of Acceptance and Commitment Therapy (ACT) after stroke, and found the main difficulty survivors face is “accepting the changed reality”. Do the clinical practices associated with stroke recovery include time and interventions targeting prolonged grief and the “accepting the changed reality”; or, is most of what we do as professionals, an avoidance of this?

To find Large et al’s abstract, please go to the Journal Club 2019 page. This article is not publicly available, so you may need to purchase it or ask your facility’s librarian. Please find my “humble opinion” as a posted comment.