Kitwood (1997) proposed that “Person Knowledge” is a necessary pre-requisite for Person-Centred Care, that is, knowing the person behind the dementia diagnosis. This “Person Knowledge” encompasses residents’ life history, culture, personality, family traditions, preferences, and needs. The international literature clearly establishes the importance of Person Knowledge as a mechanism for improving Person-Centred Care. However, the literature provides little detail on the processes, strategies and relationships involved in gaining this Person Knowledge.
Aim
The current study explored how Australian aged care staff gain and share Person Knowledge for aged care residents with dementia. The study focuses on how staff engage with Person Knowledge in the absence of special interventions and within the limits of their usual resources.
Method
Interviews and focus groups were conducted with staff in six residential aged care homes in ACT and rural NSW. Managers, lifestyle staff, nurses, and personal care assistants (PCAs) were included. Interviews and focus groups were transcribed and analysed using thematic analysis.
Results
Results will outline the key strategies and sources of information staff use to get to know residents with dementia, both initially and as residents change over time. There will be a focus on the ways staff communicate Person Knowledge to one another and update this knowledge over time. Barriers and enablers for attaining and sharing Person Knowledge will be outlined.
Conclusions
Implications for how aged care organisations can facilitate staff getting to know residents with dementia and provide more person-centred care as part of business as usual will be discussed.

Staying at home is an important goal for many older people. However, the ability to stay at home is often dependent on the availability of in-home care services provided by a skilled and dedicated workforce. In response to a high and increasing demand for care workers, the Home Care Workforce Support Program (HCWSP) was established by the Australian Government to attract, train, and retain an additional 13,000 workers nationwide to support the growing demand for consumer access to home care. Six programs were established, using various approaches to meeting the program goals, and our team were engaged to evaluate the program operating across Queensland. This presentation will include qualitative and quantitative data on the recruitment of over 2500 workers through HCWSP Queensland.

Our evaluation demonstrated the ability to attract large numbers of people interested in aged care work, busting the myth that people don’t want to work in aged care. The program was also able toto speed up the time from inquiry to employment. We also identified a barriers to recruitment and retention, a need for broader thinking about workforce diversity and skill base, as well as a need for different ways to support and train workers once they are employed. We will share insights as to what worked, what didn’t, and what the home care landscape could look like if some or all of the recommendations from our evaluation could be implemented.


HCWSP QLD is led by COTA Queensland, Skills Hubs and Skils Generation.

Background: Asking individuals about their unmet needs can be a valuable approach at both an individual and population level. However, people with dementia are often not asked directly about their needs and the needs of carers can go unnoticed. In this study we aimed to identify the prevalence and type of unmet needs present in this population.
Methods: We developed an Unmet Needs Instrument for Dementia (UNI-D, 26 items) and Unmet Needs Instrument for Carers of People with Dementia (UNI-C, 80 items) using a mixed methods approach. The self-report instruments were administered to a cross-sectional group of people with dementia living in the community in Australia and their carers.
Results: Overall, 85% of participants with dementia (total n=95) and 87% of carers (n=196) reported at least one unmet need. The median number of needs reported was 4 (IQR=8) for people with dementia and 16 (IQR=24) for carers. In both groups, those with symptoms of depression reported more unmet needs. For people with dementia the most frequently endorsed unmet needs were associated with managing memory problems, accessing dementia-specific information, and participating in meaningful activities. The most frequently endorsed unmet needs of carers were related to their own emotional wellbeing, accessing appropriate services and activities, and managing apathy in the person they support.
Conclusions: Our study found that unmet needs are highly prevalent in this population. There is a need to develop and rigorously test the effectiveness of innovative approaches to meet the most commonly reported unmet needs.

Place of death is a valuable indicator of quality end-of-life care. While most Australians express a preference for dying at home, the reality is that less than 15% of people do so. For frail older adults, decisions about end-of-life care often arise during health crises resulting in hospitalisation or transfer to residential aged care. The key to fulfilling personal preferences is preparation. However, planning for dying at home is not established practice. This study explored the perspectives of clients, informal carers, and home care workers to identify the key needs and concerns surrounding planning for end-of-life care at home. To capture a broad view, semi structured interviews were conducted with three clients receiving aged care in the home, seven informal carers, and five community care workers. The interview transcripts were analysed using descriptive thematic analysis. Participant concerns centred on the necessity for all involved parties to feel confident and be prepared. Emotional and relational confidence around having end-of-life conversations was important for everyone while carers expressed concerns about the practical aspects of daily care. There were notable knowledge gaps regarding what services could and could not be provided in the home. Participants expressed a desire for shared resources that would offer clear guidance and assist in managing the responsibilities of the situation while honouring the dignity and wishes of the older person. Findings indicate the need for meaningful consumer lead information and education programs to better facilitate end-of-life care preferences.

Driven by necessity, telehealth services escalated during the COVID-19 pandemic. Yet, instigating a virtual model of care within a large aged and community care organisation requires prioritisation and planning. This pilot study co-designed a virtual model of care to deliver allied health services in aged care supported by Personal Care Workers (PCWs); and will evaluate acceptability, feasibility, and potential effectiveness.

The development and implementation of a virtual model of care in Far North Queensland, involving a client-allied health professional video consultation supported by a PCW in the client’s home, was driven by the executive team of an aged care organisation. Consultation was prioritised by all key stakeholders and organisational consensus was achieved around scope of practice, risk mitigation, and meeting business imperatives while ensuring clinical safety and quality. Structured interviews and focus groups with 10 PCWs and 9 consumers revealed all could see the potential benefits of telehealth, and identified that PCWs require training, clients need provision of devices, and where possible, clients should be familiar with the PCW.

Approximately 20-25 aged care recipients, family members, and about 20 aged care staff (e.g., Occupational Therapists, PCWs) will participate in a mixed-methods evaluation of the service. The evaluation will incorporate self-reported questionnaires examining frailty and falls risk; an audit of aged care records evaluating impact on service outcomes, adoption, and reach; alongside individual and focus group interviews.

The findings will be discussed in the context of utilising innovative models of care to best meet the needs of older Australians.

Background
People with dementia and their care partners can face a challenging post-diagnostic journey to navigate the health and aged care systems, and adapt their lifestyle. The Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) Program is delivered over twelve-weeks by allied health practitioners in groups of up to seven people with dementia and their care partners, who both live in the community. This study aimed to provide an in-depth analysis of the experiences and perspectives of participants who completed SPICE during 2022-2024.

Methods
Semi-structured interviews were audio recorded and transcribed with people with dementia (n=49) and care partners (n=46). Transcripts were grouped together by participant type and underwent content analysis. The line of enquiry prompted self-reported changes from engagement in the program's various components and perspectives about its structure and style.

Results
People with dementia shared themes of ‘enjoyment’, ‘meeting people’ and that SPICE was ‘useful’, particularly the exercise sessions. Care partners observed positive changes in their loved one with themes of ‘connection’, ‘enjoyment’, ‘being understood’, as well as enhancements in physical and social capacity. Care partner self-reflections involved themes of ‘belonging’, ‘social connection', and increased understanding about dementia itself, and feeling equipped with strategies and support. A majority of participants would recommend SPICE and found value in the program components. Some participants recommended scheduling changes due to the intensity of sessions.

Conclusions
Findings support growing evidence for wider availability of early post-diagnostic care that can improve quality of life for people with dementia and their care partners.

The Independent Health and Aged Care Pricing Authority (IHACPA) plays a pivotal role within the aged care sector to provide costing and pricing advice to the Australian Government. IHACPA’s aged care cost collections provide evidence-based data for IHACPA’s annual aged care pricing advice to the Minister for Health and Aged Care.
IHACPA completed two major cost data collection projects in 2022-2023, the Residential Aged Care Costing Study (RACCS23) and the Support at Home Costing Study (SAHCS23). These were the first of many cost data collections IHACPA will carry out to better understand the costs of delivering aged care services in residential and in-home settings.
Recommendations from RACCS23 and SAHCS23 highlighted the need for future costing studies to increase sample representativeness and adopt a flexible approach when engaging with specialised populations such as Aboriginal and Torres Strait Islander residents and providers, homelessness, residents living with dementia and under-represented jurisdictions and rural and remote areas.
To address these recommendations, IHACPA aims to better collaborate and engage with provider groups to ensure their challenges are heard and understood, to reduce participation barriers, and to maintain interest from providers throughout the year to be involved in IHACPAs work in an evolving and dynamic aged care landscape.
This presentation details IHACPA’s learnings from RACCS23 and SAHCS23, cost collection plans for 2024, and how IHACPA will continue to refine and improve upon its future cost data collections to ensure they remain representative of the aged care sector.

Background: Advance care planning (ACP) is underutilised. This cross-sectional study explores associations among health literacy, depression, anxiety, decisional conflict, and ACP engagement and the mediating role of the decisional conflict in these associations.
Methods: The study included 262 -dwelling older adults in Australia. Data were collected using the Health Literacy Screening Questions (Chew et al., 2004), Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983), Decisional Conflict Scale (O'Connor, 1995), and ACP Engagement Survey (Sudore, Heyland, et al., 2017). General linear modelling was used for data analysis.
Results: Anxiety and decisional conflict were directly associated with ACP engagement even after controlling for potential confounders. Decisional conflict partially mediated the association between anxiety and ACP engagement.
Conclusion: Increased anxiety and decisional conflict could reduce ACP engagement, even among community-dwelling older adults with higher levels of education and health literacy.
References
Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588–594.
O’Connor, A. M. (1995). Validation of a Decisional Conflict Scale. Medical Decision Making, 15(1), 25–30.
Sudore, R. L., Heyland, D. K., Barnes, D. E., Howard, M., Fassbender, K., Robinson, C. A., Boscardin, J., & You, J. J. (2017). Measuring advance care planning: Optimizing the advance care planning engagement survey. Journal of Pain and Symptom Management, 53(4), 669-681.e8
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

Background: Data overload is a substantial challenge in aged care, with complexity related to data volume, system varieties, and functional limitations related to real-time prioritisation and staff delegation. User-friendly systems effectively leveraging data collected to facilitate informed decision-making has the potential to care quality.

Aim: To develop and test a digital alert dashboard that draws data from existing collections to support staff in providing clinical alerts in a non-clinical environment. This system aims to enable care escalation and triaging for early intervention of potentially preventable complications in residential aged care settings.

Methods: Co-design was developed with a three-stage process: 1. data mapping; 2. selection of priority areas informed by theoretical nursing frameworks; 3. decision trail for trigger escalation pathways. Qualitative participatory action research was then employed using a simulation trial of the dashboard with focus groups of care home staff and external nurse experts.

Results: Co-design created a framework for care escalation based upon the fundamental and clinical domains of nursing informed by nursing theory and nursing staff in a 67-bed residential aged care home. Data collection and analysis will occur in May/June.

Conclusions: The digital alert dashboard has the potential to improve aged care staff satisfaction of visibility of resident needs, ability to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care, and reduce preventable complications. The use of an evidence-informed nursing framework to inform digital alert dashboard has the potential to be widely implemented by other software providers and other facilities nationwide.

OBJECTIVES: This study aims to explore fall-related gait characteristics in older adults with higher-level gait disorders using Inertial Measurement Units (IMUs) and their association with cognitive impairment. METHODS: A descriptive cross-sectional study with two groups: older adults with higher-level gait disorders and an age and gender matched non-gait disorder group. Both groups received gait assessments using IMUs under different walking conditions and cognitive assessments. RESULTS: In comparison to the non-gait disorder group, those with gait disorders showed worse cognitive performance assessed by MoCA, Stroop, SDMT and TMT B-A; worse gait performance with reduced speed (gait speed, stride length, foot strike angle and toe off angle), increased postural instability (double support %GCT), and increased gait variability (CoV% of stride length). Medium strength of the association was shown in between all the gait variables and cognitive variables except large effect size between SDMT and gait speed, stride length and double support, and small effect size between CoV% of stride length and LEMOCOT and TMT B-A. All these associations were statistically significant at .05 level. CONCLUSION: It is feasible to conduct gait assessment using instrumented wearable systems (IMUs) in the natural home environment as well as cognitive assessment in older adults with higher-level gait disorders. Individuals with higher-level gait disorders exhibit diminished gait performance, characterised by decreased gait speed, increased postural instability and gait variability; decreased cognitive performance in attention, processing speed, motor planning and cognitive flexibility. There is association between gait performance and cognitive performance.

Background: Co-design holds promise for improving transitional care. To date, co-design has not been applied to address the education needs of culturally diverse informal carers (carers) and older adults undergoing care transitions. Transitional care includes a patient’s transition from hospital to home including discharge and follow-up in the community.
Aim: To describe the co-design approach employed to develop storyboards for creating educational resources about transitional care for carers and older adults from Australian Greek, Italian, Mandarin, and Cantonese backgrounds.
Methods: Qualitative data were gathered during workshops and interviews with carers and staff from multicultural community-aged care organisations across Australia. Data were analysed for content, with data and themes incorporated into draft storyboards. The storyboards were presented back to the same participants for review. A Carer Advisory Group, comprising carers, community and inpatient providers, also provided feedback. Interpreters were used to support data collection.
Findings: A total of 27 participants were recruited. All participants expressed a preference for the educational resources to be in short form videos and booklets available in both their first language and English. Storyboards were developed for each culturally diverse group. Storyboards highlighted key advice and tips for other carers and older adults during transitional care.
Conclusion: The presentation provides an example of one co-design storyboard approach to develop culturally appropriate educational resources that address the information needs of carers and older adults during transitional care. The educational videos and booklets developed will be disseminated online.

Introduction
One third of adults over 60 will have a fall each year, which can lead to injuries and affect health and quality of life. Physical activity focussing on balance and strength can reduce the risk of falling, however existing fall prevention exercise programs are not always popular. Our previous research has demonstrated a tailored dance program for fall prevention and wellbeing is well attended and highly engaging, but there is not yet evidence that dance prevents falls.
We will conduct a pilot randomised controlled trial with a waitlist control group to assess the acceptability, feasibility and impact of a tailored dance intervention for people aged 65 plus.
Method
Forty community-dwelling individuals aged 65 plus will be recruited and randomised to either the intervention or control group. The intervention is a 10-week, twice-weekly group-based program of dance classes, each 1 hour 15 minutes duration. The control group receive the same program after the data collection period. All participants will complete a survey and a simple functional assessment before and after they participate in the classes.
Outcome
Primary outcome will be participant satisfaction with the program. Secondary outcomes are feasibility of the study methods, impact of the intervention on balance and health and wellbeing measures, and potential adverse events.
Implications
Preliminary results are expected in December 2024, and will guide the design of a larger RCT. If proven effective, findings will allow us to recommend tailored dance programs as a widely accessible and enjoyable strategy for preventing falls in older adults.

Introduction: The task of stewarding a system of aged care that is fit for purpose and supports older Australians’ quality of life is a complex challenge. The Australian Royal Commission into Aged Care Quality and Safety recommended that the Department of Health and Aged Care improve its stewardship of the aged care system. This literature review was conducted to assist the Department understand this challenge better.
Method: A scoping review using systematic methods was conducted in 2023 to: develop an understanding of stewardship; describe how stewardship has been implemented internationally; and identify the conditions associated with successful implementation and its impacts on systems, staff and clients.
Results: We identified 76 peer-reviewed articles and nine grey literature sources. Common descriptions of stewardship included taking responsibility for something, identifying strategic directions, managing resources, and ensuring that all components of the system work together in a resource-constrained environment. However, the literature review also identified inherent contradictions in the concept. Few articles identified impacts of introducing system stewardship or conditions associated with successful implementation. Studies showed that activities to engage local communities and stakeholders were positively received, but resource restrictions could prevent effective implementation of stewardship.
Conclusions: Those charged with the role of stewardship must develop new ways of working that will vary in response to local conditions, in a system that has unclear boundaries, with a concept that encompasses contradictory notions. Evaluation of the implementation of regional stewardship in aged care will be a valuable addition to the literature.

Introduction: Malnutrition is a key area for improvement identified in the 2021 Royal Commission into Aged Care Quality and Safety, linked to a wide range of adverse events in older adults, including increased falls, infections, pressure injuries, and overall health service utilisation. Yet malnutrition is under-detected due to challenges of implementing existing screening tools. Using routinely collected data could enable automated screening. This study aimed to develop and internally validate a malnutrition screening tool based on routinely collected data in the long-term care setting.

Methods: This was a diagnostic prediction model development and internal validation study for an automated malnutrition screening tool (AutoMal). Eight candidate variables identified through expert consultation were extracted from routinely collected data at 10 Australian residential aged care facilities. Backward stepwise logistic regression using the Subjective Global Assessment as the reference standard was conducted. Internal validation was conducted using bootstrapping.

Results: 539 residents were included. Body mass index and weight change % over 6-months were selected into the AutoMal model. AutoMal demonstrated excellent discrimination of malnutrition, with Area Under the Curve of 0. 8378 (95% confidence interval 0.80-0.87). Youden’s Index value was 0.37, resulting in sensitivity of 78% (95% confidence interval 71-83%) and specificity of 77% (72-81%). Optimism-corrected Area Under the Curve was 0.8354.

Conclusions: AutoMal demonstrates excellent ability to differentiate malnutrition status. It makes automated identification of malnutrition possible by utilising two variables commonly found in electronic health records. This may be useful for clinically identifying malnutrition for management or as a quality monitoring indicator.

As individuals age, pain-causing conditions become increasingly prominent reasons for seeking healthcare and being admitted to hospital. In Australia in 2022-2023, patients aged 65 and over accounted for 23% of Emergency Department (ED) presentations. Additionally, the prevalence of dementia is on the rise (Australian Institute of Health and Welfare [AIHW], 2023). Studies have shown that a significant proportion of people living with dementia regularly suffer from some degree of pain (Corbett et al., 2012; Sampson et al., 2015). Cognitive impairment complicates pain assessment and management. Research conducted in Australia found that patients aged 75 and older were more likely to experience a delay in analgesia administration than other age cohorts (Arendts & Fry, 2006). Another Australian study noted double the median time to analgesia for cognitively impaired patients, compared to their cognitively intact counterparts (Fry et al., 2014). Despite the availability of observational tools, there is no national clinical care standard for pain assessment of patients with cognitive impairment. A review of health service policies demonstrated a lack of clear guidelines for pain assessment of cognitively impaired older adults. An audit was undertaken to describe nurses’ pain assessment practices for older adults with cognitive impairment presenting to a large tertiary ED in Western Australia. The digital medical records of this cohort presenting to the ED in November 2023 were reviewed. Descriptive statistical analysis of the data was undertaken. Audit results detailing methods and outcomes of pain assessment practices and pain management initiation in the ED will be presented.

While existing literature covers fall prevention in healthcare (hospital and residential care) settings, there remains a significant gap in understanding effective interventions and strategies for managing the immediate aftermath of falls to minimise hospital transfers and mitigate injuries. This scoping review identifies interventions implemented within healthcare settings aimed at enhancing post-fall management.
A literature search was completed in Medline, EBSCO CINAHL, PsychINFO and Scopus to identify studies that described interventions or strategies used in the immediate post-fall period. Full-text articles were assessed by two independent reviewers. The data extraction tool was used to identify recurring themes and facilitate a narrative synthesis.
Seventeen studies were included. Post-fall interventions were categorised as (i) assessment tools (n = 9, 52.9%); (ii) structural post-fall protocols (n = 4, 23.5%); (iii) post-fall huddles (n = 2, 11.8%); and (iv) multifactorial approaches (n = 2, 11.8%). The structured protocols provided promising results in reducing unnecessary hospital transfers from residential care. However, there is no conclusive and consistent evidence for the assessment tools, protocols, and huddles, highlighting the need for further research at a larger scale and of greater methodological rigour.
This scoping review highlights the various post-fall interventions used in different healthcare settings. However, there is uncertainty about how to systematically manage older adults after a fall in these settings. This review lays the groundwork for developing tailored interventions to improve care immediately after a fall, with relevance for the various interdisciplinary team members promoting better communication and patient safety.

Background: Sensory impairments affect over 70% of people receiving home care services and it is estimated that around 80% have cognitive impairment. Hearing and vision impairments exacerbate the impact of cognitive impairments and sensory support is thus a critical component of home care services.

Aim: This project aims to understand the preferences of Australians for sensory support services in home care packages compared to alternative services, such as help with domestic services, personal care, physical and mental health services as well as social support. We are particularly interested in the role of cognitive impairment in decision-making and preference heterogeneity between care recipients, caregivers, and care managers.

Methods: Informed by a literature review and expert opinions, we will administer a discrete choice experiment to a sample older Australians who receive home care services (n=200), caregivers (n=300), and care managers (n=100). In an online survey respondents will be presented with a series of hypothetical choice tasks presenting each two alternative bundles of home care services with varying levels of comprehensiveness. Survey respondents will be asked to choose between the two alternatives in each choice set.

Results: Responses to the choice tasks will allow us to understand the relative importance and trade-offs between service types. A cost attribute in choice sets will enable us to estimate the relative and overall willingness-to-pay for sensory support services.

Background: Whilst there is a drive to increase diagnosis rates in dementia, there is a lack of attention is being paid to getting a correct and timely diagnosis. For people with a rarer subtype of dementia, getting the correct diagnosis, and subsequent care, might be more difficult than for people aged 65+ presenting with the more common symptoms of Alzheimer’s disease dementia. The aim of this mixed-method systematic review was to synthesise the evidence base on misdiagnosis of dementia.

Methods: Misdiagnosis in dementia was defined as either receiving an initial incorrect dementia subtype diagnosis, or receiving an incorrect non-dementia diagnosis. Post-mortem assessments of subtype diagnosis were excluded. Nine databases were searched in June 2023, with screening of titles and abstracts and consequent full texts completed independently by two researchers.

Results: Twenty studies were included. Studies were categorised into four themes: Factors associated with delayed diagnosis or misdiagnosis; Difficulties related to the diagnostic process; Economic consequences of misdiagnosis; and Experiences of delayed diagnosis or help-seeking. People with Lewy Body dementia or behavioural variant fronto-temporal dementia were found to experience longer diagnosis times and often incorrect initial diagnoses. Whilst evidence is limited regarding the economic impacts, evidence from the US points towards increased economic costs of misdiagnosis.

Conclusions: There is an urgent need to investigate the rates and emotional and economic impacts of misdiagnosis on people with dementia, their carers, and the health and social care system. Advancing the evidence base is crucial to reduce misdiagnosis and inform clinical practice.

Introduction. Engagement with life is central to ageing well. There is currently a lack of flexible programs for promoting engagement that tailor to the unique interests, capacities, and life circumstances of individuals. We designed and evaluated a new program for promoting engagement with later life based on principles of behavioral activation.
Methods. A total of 135 adults aged 65 and older who scored at or below the median on the Life Engagement Test were randomly assigned to either a 6-week behavioral activation program (n = 66); or a 6-week well-being program based on brief positive psychology interventions (the active control; n = 69). Participants completed assessments at baseline, 1-week follow-up and 3-month follow-up. The primary outcome was engagement with life, and secondary outcome measures included social network characteristics, measures of mental health, well-being, and psychological and self-regulatory resources.
Results. Participants in both conditions showed improvements in engagement with life post-intervention that were sustained at 3-months. Post-intervention improvements in both conditions were observed across most secondary outcomes; however, for several outcomes, participants with more limited functional and cognitive resources benefitted from participation in the positive psychology (active control) condition, but not the treatment condition.
Conclusion. Similar levels of improvement in engagement with life and well-being were evident for participants who completed a behavioral activation-focused intervention, compared with participants who completed a positive psychology focused intervention. The positive psychology approach may confer greater benefits for emotional well-being among those with poorer functional and cognitive abilities.

Introduction: Aged care staff and doctors frequently highlight consumers’ role in antibiotic treatment decisions. However, few studies include consumers.

Objective: To investigate consumer perspectives on antibiotic use in residential aged care.

Methods: A search across six online databases yielded 3373 studies, with five meeting inclusion criteria. Participant quotes, themes, statistical analyses, and authors’ interpretive summaries in the included studies were inductively coded and refined to generate themes.

Results: Three themes emerged: perception of benefits and risks of antibiotics; perceived role in antibiotic treatment decision-making and information-communication needs. Consumers held positive attitudes towards antibiotics, did not associate antibiotics with the exclusive treatment of bacterial infections, and had limited awareness of potential risks, such as antibiotic resistance. Studies showed diverse perceptions regarding resident’s involvement in antibiotic treatment decision-making with some residents actively seeking antibiotics and others trusting healthcare professionals to decide. Only one study explored the resident’s family members' role in antibiotic treatment decisions and suggested that while families trusted healthcare providers, they sought greater involvement when they lacked confidence in the standard of care provided. Studies also described the need for effective provider-consumer communication and information sharing which was affected by contextual barriers such as motivation, preferences, available information resources, and provider attitudes.

Conclusion: Limited literature is available on consumer perspectives on antibiotic use in aged care. The review highlights that consumer needs and preferences are more complex than simply wanting an antibiotic. Antimicrobial stewardship programs should target consumer awareness, beliefs and provider-consumer communication to enhance antibiotic use in aged care.

Background
In April 2023, quality of life (QOL) and quality of care experience (QCE) were introduced as mandatory indicators in Australian residential aged care facilities (RACFs) to measure wellbeing and consumer experience, respectively. This study examines four months of post-introduction data to describe QOL and QCE scores, explore related factors and assess variations by completion mode and facility.
Method
A retrospective cohort study involving 1,772 residents across 22 Sydney-based RACFs. QOL was measured by the Quality of Life-Aged Care Consumer (QOL-ACC) scale, and QCE by the Quality of Care Experience-Aged Care Consumer (QCE-ACC) scale, both through three completion modes: self, interviewer-facilitated and proxy completion. We used propensity score matching to compare QOL/QCE differences by completion mode; multilevel ordinal logistic regression to investigate QOL-/QCE-related factors; and funnel plots to explore facility-level score variations.
Results
Of 1,772 residents, 1,706 completed the QOL-ACC survey and 1,686 the QCE-ACC. Median score was 21 (IQR 18–24) for QOL and 23 (IQR 20–24) for QCE, both indicating ‘excellent’ outcomes. Leisure activities component of QOL, and social relationships and complaint lodging of QCE, were rated lower than other dimensions. Self-completion yielded significantly higher scores than other modes. Substantial variations in scores between RACFs were also evident. Longer stays and fall history correlated with lower QOL, while visual impairment and fall history correlated with reduced QCE.
Conclusions
We found high QOL and QCE across the 22 RACFs. Enhancing residents’ leisure activities, social relationships, and addressing specific needs (e.g., visual impairment and fall history) may enhance QOL and QCE.

Background: People living with dementia face barriers in accessing rehabilitation, including stigma and a lack of health professional knowledge about dementia rehabilitation. A recent co-design process identified that health professionals need opportunities to learn about dementia rehabilitation, and that training should challenge stigma.

What we did: An online “Introduction to Dementia Rehabilitation Course” was developed over an eight month period. Efforts to maintain an anti-stigma orientation included: learning from research about anti-stigma approaches relating to dementia and other stigmatised groups; critically appraising and carefully choosing images and language; incorporating virtual social contact through videos; incorporating participant self reflection; and engaging with living experience experts to review and improve course modules before launch. The course was piloted with health workers - including allied health professionals, practice nurses, Aged Care Assessors, and case managers - in Eastern and South Eastern Melbourne.

What we learnt: Challenging stigma through online training requires careful consideration and a multi-pronged approach. Time needs to be dedicated to content development, content review, and importantly to critical self-reflection by course developers. Engaging with and listening to people with diverse perspectives and expertise is essential at every stage of the process.

Where to next: Course outcomes will be evaluated to identify changes in participant attitudes, confidence and knowledge. This evaluation, together with feedback from living experience experts, will assist in updating the course for longer term access. Options for making a version of the course accessible to the wider community, including people living with dementia, will be explored.

[Background] In recent years, drones have been used for a variety of purposes owing to their advantages such as autonomous flight, provision to equip cameras, and the ability to perform surveys using specialized analysis software.
[Purpose] Assessing walking ability is crucial for evaluating health risks and rehabilitating independent walking. This paper presents a pilot study on gait analysis using a drone.
[Method] A drone was used to record a comfortable 10-m straight walk from an upright position. Gait analysis involved spatial coordinates digitized with AR markers and posture-estimation technology.
[Results and Discussion] In the study, image analysis was performed on a gait event of approximately 7 m. To capture the scene effectively using a fixed-point camera, the entire walking path and the subject must be included within the field of view. For this, various conditions need to be considered to ensure a long shooting distance, even if the subject appears small. Despite using a wide-angle lens, distortion can have a substantial impact. To address these issues, a DX was created to adjust the angle enlargement when photographing subjects with a drone and analyzing their gait using skeletal information. Consequently, the scale and marking of body parts were simplified, which served as the analysis standards and confirmed the potential of gait analysis using drones.

Hoarding disorders and squalor are increasingly prevalent with age and exacerbated by physical and cognitive decline. Management is ongoing and complex; for services, tensions arise amidst significant health and safety risks impacting care delivery whilst upholding older people’s rights.
An environmental scan aimed to examine the under-researched profile and management of hoarding and squalor in home care, using three methods: desktop audit (RiskMan incident data, client records/lists), semi-structured interviews with allied health staff and management (n=4), and case study documentation.
The audit identified 47 clients (53% with hoarding behaviours, 23% squalor, 23% both), with most referred for wound, medication and/or diabetes management. Two-third of clients had mental health concerns, and half cognitive issues. Marked engagement with allied health services was evident (social work: 62%; occupational therapy: 55%; physiotherapy: 38%), with 75% having a fall-related incident. In interview data, trauma-informed, person-centred approaches were noted as critical, existing staff knowledge and education were deemed inadequate, and sufficient time and resources were vital to care provision. Case studies reinforced this complexity and the need for a long-term focus with extensive inter-service collaboration.
This study demonstrates the complexity of hoarding and squalor presentation within home care, which is overlaid on extensive clinical needs, creating a reinforcing loop requiring coordinated, collaborative and integrated service responses. The role of Allied Health in care is under-recognised, with appropriate training recommended. Existing funding and service models must accommodate flexible long-term approaches to management which ensure safety and rights for all involved.

Introduction: A recent survey of 10,518 Australians (Royal Commission into Aged Care Quality and Safety) identified that community perceptions of life in residential aged care homes (RACHs) are somewhat negative, perceiving residents as often lonely and unhappy and lack control over their lives. The “Ciao! Program”, commenced in Italy in 2020, was developed to provide live, online opportunities for interaction and engagement, and has demonstrated positive experiences for older adults in RACHs. Our study aims to explore the feasibility of its implementation within an Australian context.
Methods: Pre-post 6-month study in six RACHs. Four participants at each site (Manager, Wellbeing/Lifestyle Coordinator, resident, and relatives) will participate in pre- and post-interviews, monthly surveys, and activity audits from February-November 2024 to evaluate the project.
Results: Preliminary pre-data (n=16 interviews) indicate the need to strengthen connections and a sense of community across RACHs. Staff indicate demand for program activities that enable cognitive stimulation (e.g. gardening, current affairs), as well as catering for residents with cognitive impairment (e.g. virtual travel). Residents and relatives report physical exercise to be of high priority and a preference for physical-activity-based options (e.g. chair-based yoga). Additional results of program implementation will be reported.
Conclusion: The “Ciao! Program” will support opportunities to enhance the sense of belonging to a community and improve social inclusion and resident enjoyment. Further, it offers the possibility of optimising resource utilisation and reducing staff burden by sharing meaningful interactive resident-centred activities across multiple homes, making it potentially scalable nationally.

A Churchill Fellowship awarded in 2020 explored Cognitive Stimulation Therapy (CST), an evidence-based, small group intervention designed to stimulate and engage people with mild to moderate dementia. The fellowship report recommended the formation of a network of professionals to create opportunities for the expansion of CST in Australia. The challenge was to identify who had completed facilitator training, where and how CST was being delivered, and if there was potential for other organisations to be involved in a collaboration.

While work was undertaken in 2014 to adapt CST to the Australian setting, without coordination, facilitator training or support for facilitators, CST has had limited traction. The absence of a network of professionals has prevented collaboration and led to missed opportunities for advocacy to government and dementia stakeholder groups. As a result, there has been no engagement of facilitators, limited expansion of CST, and a lack of input into consultation processes, collaboration in research activities and applications for funding of CST projects.

This presentation will share the process of establishing a CST community of practice for professionals interested in, delivering or researching CST in Australia. With support from the International CST Centre, CST facilitators and organisations delivering CST were identified and contacted. By engaging Master Trainers from New Zealand and appointing an Australian trainer, CST facilitator training has been established. The process undertaken to engage individuals, the successes, challenges and lessons learned will be shared in the presentation for professionals or advocates wishing to establish a community of practice.

Background. Aged care recipients with communication support needs are at an increased risk of being excluded from conversations about their care. Delivering communication partner training (CPT) to aged care workers may improve care recipients’ well-being and autonomy. However, existing CPT programs are disorder-specific, and do not account for the broad spectrum of communication challenges experienced in aged care settings.



Aims. To identify and describe evidence-based CPT programs that are relevant to older adult populations.



Methods. Scoping review conducted in alignment with PRISMA-SCR reporting guidelines. Journal articles were systematically identified from five databases (PubMed, PsyINFO, Embase, Cochrane, CINAHL). Articles were independently screened by two authors and were included if they reported CPT programs or communication skills training relevant to aged care populations. Data were extracted using the Intervention Taxonomy (ITAX) and an author-developed tool. Extracted data were analysed using frequency counts and qualitative content analysis.



Findings. A total of 90 articles, reporting 48 different CPT programs, met our inclusion criteria. Most programs were designed for staff working with people with dementia (30%) or aphasia (30%) and were delivered in person by either a speech pathologist or allied health professional. Competency tools typically measured acquired knowledge and confidence.



Conclusion. The findings from our review offer valuable insight into the delivery modalities, methods, and outcome measures commonly used in evidence-based CPT programs, relevant to older adult populations. This scoping review is the first step in developing a fit-for-purpose CPT program for the Australian aged care workforce.

Humbugging – Cultural Obligation vs Elder Abuse

Cultural obligation involves First Nations Elders caring for families, their communities and extended family. However, a delicate balance co-exists between cultural obligations and respect for First Nations Elders.

The act of humbugging is unreasonable and repeated demands placed on a First Nations Elder by a family member, for money, accommodation or payment of goods and services. Humbugging occurs as a result of a range of factors, including socio-economic and cultural obligations of First Nations communities.

Aged Rights Advocacy Service (ARAS) Aboriginal Advocates are raising awareness of the issue of Humbugging through the provision of culturally safe resources that ask the question, “Is this happening to you or someone you know?”

They provide advocacy support that offers safeguards and options to resolve concerns but also aim to preserve family connections and relationships through linking First Nations Elders and their families to culturally appropriate supports.

The aims of this poster are to:
• raise awareness of the issue of Humbugging,
• distinguish between cultural obligations and Humbugging,
• look at the cultural context of forms of abuse,
• explore the barriers that prevent Elders from accessing safeguards,
• increase knowledge about culturally safe community resources that can support First Nations Elders and their families.

Participants will gain an understanding of Humbugging. The target audience is service providers and community members. The poster is relevant to the conference theme as it is groundbreaking work in the area of Humbugging and how it impacts First Nations Elders.

The aged care sector plays a crucial role in supporting older Australians to age well. However, the sector has been facing significant challenges meeting the needs of older Australians due to workforce shortages. Projections indicate that to meet the growing demand for aged care, the workforce will need to triple in size over the next three decades. The Aged Care Royal Commission highlighted the need to embrace flexibility and adopt innovative strategies to effectively meet workforce needs into the future.
Family and friend carers provide a unique opportunity for growing the aged care workforce. Through their caring role, carers often develop skills and experience that make them well suited to paid caring roles. Carers also experience higher levels of unemployment and under-employment than other Australians, making them more likely to be looking for work. While Carers NSW research indicates that many carers do not want to work in paid direct care roles, some carers do. Carers, however, face unique barriers to employment associated with their caring role. Innovative approaches are needed to attract and enable interested carers to enter and sustain employment in aged care.
This presentation, aimed at policy makers and industry practitioners, will report findings from Carers NSW research and consultations with carers, aged care providers and workforce experts aimed at identifying and overcoming barriers or deterrents to aged care employment for family and friend carers. It will highlight key policy and practice opportunities to attract and enable family and friend carers to enter the aged care workforce.

People with dementia identify quality of life for themselves and their families as amongst their highest priorities. Access to active interventions that enhance social participation and physical and cognitive function can assist with maintaining quality of life.

Carers play a critical role in the wellbeing of people with dementia, however they experience high rates of psychological morbidity and social isolation. Furthermore, time constraints and lack of access to alternative care arrangements are barriers to carers accessing support. Tailored programs which support the wellbeing of people with dementia and their carers concurrently require evidence to inform practice.
This presentation describes a multicomponent program delivered in a community setting which aims to maintain the quality of life of people with dementia and their carers. People with dementia participate in twice-weekly group cognitive stimulation therapy over seven weeks. Cognitive stimulation therapy is an evidence-based psychosocial intervention that uses themed activities to help maintain cognitive and verbal skills. At the same time, their carers engage in once-weekly group education focussed on peer support, stress reduction, and skill development.

The program's development and preliminary results will be reported. This includes carer self-efficacy and mental well-being, and cognitive function and quality of life of people with dementia. Qualitative data on the experiences of participants and the perspectives of the clinicians who implemented the program will also be presented. The results will inform future iterations of the program and inform clinicians, researchers, and policymakers on implementing a tailored intervention for people with dementia and their carers.

Climate-related challenges and consequences are exaggerated faced by vulnerable groups including older people. Understanding their climate challenge and resilient strategy is crucial for informing policy and planning efforts to protect older individuals in the face of climate change.
The aim of this study is to explore local understandings of older people living in Eastern Indonesia, and capacity around, strengthening climate resilience, focusing on health, wellbeing, and future-proofing communities and environments.
A qualitative study design using Focus Group Discussion (FGD), in-depth interview and ethnographic observation was used in this study. Participatory action research (PAR) approach was employed to ensure collaboration between researchers and impacted communities to contribute valuable insights and knowledge.
Six FGDs and 30 interviews with older people, government and non-government stakeholders were undertaken. Initial finding of this study indicates the significant negative impact of climate change toward older people in Eastern Indonesia on their health and wellbeing and socio-economic condition. Some factors such as socio-economic status, community-based activity available, health care support, social networks and intergenerational relations (with both conflicts and solidarity between generations) play a role in influencing resilience adaptation strategies employed by older people in the community in Eastern Indonesia
This study highlights the importance of recognising and supporting the resilience strategies to climate change impacts by older people, particularly in building social capital and support networks among older people. This research provides valuable insight for policymakers and stakeholders seeking to promote climate resilience and sustainable development in vulnerable communities including older people in Eastern Indonesia.

Connection and communication become more challenging as the dementia journey progresses but remain imperative for compassionate care and individual wellbeing. Communication through supported songwriting stimulates fresh thinking in this space, co-creating opportunities which support authentic connection and communication between people who have dementia and those around them.

During a recent online songwriting project for people with dementia and their care partners, participants created 36 original songs. The facilitated songwriting opportunity offered a space and medium for communicating and connecting differently, through storytelling in song. The creative products (songs) expressed a range of perspectives, histories and day-to-day concerns and events. These creative works offer rich insights, through sharing of deeply personal experiences of living with and alongside dementia.

This presentation explores what people with dementia and their care partners chose to communicate through their song lyrics. Discoveries made through song lyric analysis delivered a renewed appreciation of each person’s capacity and identity; characteristics sometimes subsumed by diagnoses and/or ableist assumptions. We discuss the value of this novel musical approach in giving voice and visibility to those whose stories, ideas and opinions might otherwise be missed.

Attendees will be challenged to consider music-based engagement in creating fresh opportunities for communication and connection with people who have dementia, as part of contemporary care and best practice, reconsidering possible assumptions around capacity. We challenge the notion that people with dementia can’t, won’t or don’t communicate effectively while reaffirming that each person’s story is valuable, and may be accessed and expressed through shared creative activities.

Background The strengthened aged care standard 5.5.7 focuses on oral health. There are many barriers that limit the provision of, and access to, oral health care, oral health assessments and care plans, and referrals for dentistry. Barriers include shortages in the dental workforce, lack of transport, cost, and 1-2 year waiting lists for public dentistry.

A new approach or fresh thinking needs to be applied to the practice of oral health care for persons living in care homes.

Aim: This ARIIA funded research project aims to optimise oral health awareness, education, and screening by linking clinical decision making and responsibility by a dentist through a digital health platform, Smilo, at Blue Care’s Nowlanvil residential care facility in Ipswich, Queensland.

Intervention: Staff were trained in the principles and practices of good oral hygiene and the use of the Smilo digital health platform; residents and family members were engaged in a recruitment strategy; and customisation of Smilo based on the co-design feedback occurred as required.

Method: A participatory action model and co-design framework utilising qualitative resident journeys and quantitative pre and post education surveys was used to evaluate oral health knowledge and practice with participants.

Results: Results from surveys and resident journeys will be presented that focus on outcomes that strengthen aged care standard 5.5.7. Data presented includes the strengths and barriers to success.

Conclusions Results will inform the debate around whether a digital health platform can improve the practice of oral health care for persons living in care homes.

The advent of new diagnostics and therapies provides an opportunity to reconstruct the care systems for dementia. To disrupt the paradigm of care requires understanding the current care paradigm to identify where there are opportunities for change.
We explored the current care systems for dementia from the perspective of patients and significant others (spouse/partner, adult child, friend).
A qualitative exploratory study was conducted consisting of online interviews and a River of Life storytelling activity. A consumer advisory group reviewed the data collection process. We asked participants to reflect on their diagnosis journey and share key elements of the journey across care systems. Thematic analysis was conducted.
Thirty-seven interviews were conducted with patients and significant others. Five typical gatekeepers were identified across the dementia diagnosis pathway: the person; significant others; GP; specialist and after diagnosis workforce. These gatekeepers were positioned above the community, health system and aged care systems. Participants described whirlpools at each gatekeeper point where a person may become trapped before either progressing, regressing or stalling through the pathway. The care systems impacted the person throughout the dementia diagnosis pathway, where the awareness, recognition, responses and resources for dementia at the community, healthcare, aged and social care levels where important overarching themes going across the gatekeepers and care systems.
Through this work we have highlighted various factors, barriers and facilitators along the dementia diagnosis pathway and have identified opportunities for organisational, healthcare system and population-level improvements for rural, regional and urban Australians.

Objectives. The gerontological nursing competency (GNC) program is effective and acceptable to mid-career nurses working in Australian aged care settings. This research investigated whether the course, when implemented as a new graduate transition to practice program, positively impacted on participant knowledge and experience.
Methods. The GNC program was delivered as a transition to practice program across Australia 2021-24, providing a 6-month evidence-based personalised mentoring program to support nurses build their gerontological knowledge, skills and attitudes. A cross-sectional survey design was used, at the beginning and end of the program for each participant cohort, with mixed methods approach including open ended questions regarding the impact of the. Key areas of knowledge highlighted in the Royal Commission were examined using established tools: ageism, nutrition, dementia and palliative care.
Results. 216 nurses participated in the research from six states and territories of Australia. Preliminary analysis shows promising impact. The rich qualitative responses highlight a dedicated workforce responsive to investment in their knowledge and training, but ongoing concerns about workload and workforce. The cohort reported challenges regarding changing and fragile work circumstances, complex personal circumstances (including international carer responsibilities), and increased responsibilities (including infection control leadership and regulatory responsiveness of their organisation).
Conclusions. The gerontological nursing competency program supports transition to practice in new graduate nurses entering aged care, and could be constructed as part of micro-credentialling to further expand the specialisation of this emerging workforce. The individually tailored mentoring program, providing external peer review and support, was a crucial element of successful delivery.

Globally there are ongoing concerns about the ‘nursing shortage’. Arguably this is related to inadequate ‘supply pipeline’ on the one hand and the loss of experienced registered nurses (RN) on the other, creating a complexity/experience gap. While problems of attraction, recruitment and retention mounted over the past 40 years, they were exacerbated with COVID-19, compounded by 24/7 RN requirements, resulting in industry leaders ‘crying foul’ that there just aren’t the nurses to recruit. This is in the face of erosion of the nursing role in aged care: through disabling RNs from working to their full scope, minimising the recognition of the role to focus only on ‘technical skills’, allowing the marketisation of aged care replace RNs with less qualified staff, and role creep. It will take years to address the shortage.

Our ‘dangerous idea’ is to focus on ensuring that gerontological nursing is recognised as a positive career choice and a high-value skill-set. Older people need care in almost all places care is delivered: the highest users of hospital beds, highest consumers of health services, and aged care is the largest ‘principal area’ for nurses’ reported workplace. We propose four key areas to improve efficiency, increase satisfaction, and build and sustain the next generation of nurses to respond to the ageing population: 1. Promote the speciality of gerontological nursing; 2. Healthy work environments; 3. Effective digital systems including comprehensive care and nurse sensitive outcome measures; 4. Involve the public in deciding what care to ration.

This study examines the relationship between self-reported poor sleep and cognitive performance across various age groups. We found that individuals in their 20s and 60s experiencing poor sleep reported reductions in subjective sleep duration by approximately 26.45 and 50.73 minutes, respectively. Additionally, sleep latency increased notably in the 20s group, with mixed results observed in the 40s.

In the 20s, poor sleep at earlier waves was predicted poorer immediate recall in later waves, especially in females, highlighting the impact of poor sleep on cognitive performance.
In the 40s, lower performances in SDMT (indicative of decreased attention), mean simple reaction time, and mean complex reaction time (both reflective of slower processing speed), as well as impaired immediate recall, were predictors of poor sleep in subsequent waves. These findings suggest a predominant effect of cognitive decline on sleep quality, with some evidence of bi-directional influences.

In the 60s age, superior SDMT scores, worse immediate recall, and higher spot the word scores predicted poorer sleep later, pointing to the change of direction and influence of cognition on sleep quality.

These results underscore the significance of sleep quality as a public health issue. Poor sleep is a critical predictor of reduced processing speed, attention, memory, and verbal intelligence, particularly in early adulthood, which changes in older adults. The implications extend across the lifespan, stressing the need for interventions to enhance sleep quality to preserve cognitive health.

There has been a rapid increase in technological solutions aiming to optimise older people’s health, dignity and quality of life. However, engaging end-users in the development, feasibility and acceptability is limited.

We tested and evaluated feasibility and acceptability of the novel Conversation as Therapy Pin (CaTPin). CaTPin is a wearable device aiming to capture and identify whether time spent in conversation is linked to loneliness in older people.
The prototype CaTPin device was initially tested by older people over a 1-week period, with evaluation of acceptability, feasibility, validity and reliability conducted through interviews. Following adaptation, the device was trialled with two groups of participants ≥65 years (a) experiencing loneliness or (b) not experiencing loneliness. Participants’ perspectives of the CaTPin were obtained through interviews at 2 weeks and thematically analysed.

Prototype testing with three participants (2 Male) identified key device design and data collection content issues, leading to adjustments. A total of 23 participants (15 female) consented to the trial, mean age 72 ±6.8 years, including 7 experiencing loneliness. Although the concept was considered positively (albeit not for the participants themselves), device functionality and design hampered participants fully integrating the device into their lifestyle, despite the initial modifications.

Use of novel technology can likely enhance the lives of older people. Sufficient initial investment in codesigning prototypes is essential to enhance user-friendliness and function; thereby providing appropriate data to build the evidence base.

Motivated by novel therapeutics and diagnostics, dementia diagnosis and management are entering a new dawn which will require early recognition of possible dementia signs and symptoms. Despite global impetus for earlier diagnosis, the majority of research focuses on diagnosis or the period thereafter, with little focus on the symptoms leading to diagnosis. In addition, due to poor general knowledge of dementia, many misunderstand it to be an inevitable part of ageing, with memory loss as the initial symptom.

A qualitative exploratory study was conducted to systematically account for the varied pre-diagnostic symptom profiles from the perspective of people who had experienced dementia signs and symptoms and significant others (spouse/partner, child, sibling, friend).

Thirty-three semi-structured interviews were undertaken, data was analysed by applying an integrative bio-psycho-social model, the International Classification of Functioning and Disability (ICF). Key signs and symptoms ranged across ICF domains and included changes to: mental and sensory functions, communication, mobility, and ability to perform familiar tasks that were noticed in the context of daily life, workplaces, and relationships. Common themes emerged including the significance of retrospect in recognising symptoms, and the gap between the threshold for recognition and the threshold for help seeking.

This study produces public health priorities: raising awareness of the array of pre-diagnostic dementia symptoms on an individual, interpersonal, and community scale; and equipping organisations and communities to recognise and support dementia. Informal identification of the early signs and symptoms of dementia could help improve disease outcomes and facilitate timely interventions and future care preparations.

Aims: This study explored functional changes in culturally and linguistically diverse (CALD) older adults living in community settings.
Design: A cross-sectional design examined cognitive status, frailty, and depression levels among CALD older adults.
Methods: The study involved 221 older individuals from two community organisations offering services and activities. Assessment tools included the Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ) for daily functions, the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) for cognitive changes, the FRAIL Scale for physical frailty, and the Geriatric Depression Scale-5 (GDS-5) for depression levels. Data descriptive was applied to report our findings.
Results: The average age of participants was 75.31 years, with 149 (67.4%) reporting chronic diseases. The primary languages were Chinese (65.6%), Arabic (29%), and others including Armenian, French, Vietnamese, and Indonesian (4.1%). HBA-FAQ results showed notable changes in sleep, memory, and emotional aspects, with mean values of 0.78, 0.79, and 0.81, respectively. The average AD8 score was 2.37, suggesting likely cognitive impairment, while the FRAIL score indicated a pre-frail status (average 1.06) and GDS score showed a normal depressive state (average 1.24).
Conclusion: The study highlights functional decline and increased frailty among CALD older adults, illustrating the complexities of aging in these communities. Deteriorations in cognitive and physical health underscore the need for tailored interventions.
Implications: The findings provide insights for developing strategies to enhance the quality of life and well-being of CALD older adults. Future research should identify access barriers to health services for CALD older adults to improve health outcomes.

Residential aged care facilities commonly host undergraduate health students during clinical placement experiences. Evaluation of these programs often focus on outcomes for students but there is limited literature focused on the residents’ experiences of students working and learning in these settings.
This research is focused on the social and emotional impacts of placing university students in aged care facilities from the perspective of the residents. Using an interpretive phenomenological design, the research intends to explore resident experiences of having undergraduate students in their home. Data will be collected using interviews with residents at a rural aged care facility that hosts large numbers of health student clinical placements.
By using the resident as the consultative focus we can potentially design new and innovative engagement strategies that meet the residents’ need for social and emotional connection whilst also promoting valid student learning experiences.
As a project in-progress, this presentation will discuss the concepts of social and emotional wellbeing as reliant on connection, inclusivity, and consultation. The presenter will discuss the research design and preliminary results of the interpretive phenomenological analysis.
The results have potential to influence the design and structure of health student placement programs, as well as the nature of student-resident interactions in these settings. The presentation is targeted towards tertiary education providers, industry practitioners and

Background: Functional ability is an essential component of healthy aging, yet current assessment tools often evaluate basic and instrumental activities of daily living separately. With Indonesia experiencing rapid aging population growth in Southeast Asia, there's a pressing need for a comprehensive, standardized functional assessment tool in the Indonesian language.

Aims: To translate the HBA-FAQ into Indonesian and assess its content validity in Indonesian settings.

Methods: The HBA-FAQ was initially translated into Indonesian by a gerontologist. This version underwent review by five nursing experts for accuracy, followed by a back-translation into English by a linguistics expert to ensure fidelity. To assess the instrument's practical applicability and content validity, a pre-test was conducted with ten elderly participants from suburban areas. Additionally, ten nurses and gerontologists evaluated the relevance and clarity of each item within the Indonesian context.

Results: The pre-testing of the tool revealed that the older adults’ daily functions ranged from no change to moderate change. The older adults reported the most moderate change in financial affairs and the slightest change in self-care. A few items did not apply to older adults in suburban Indonesian settings, such as driving and using mobile phones, computers, or other digital devices. All the HBA-FAQ items were clear and relevant (Mean CVI 0.98; CVR 0.97).

Conclusion: The findings suggest that while the HBA-FAQ is largely clear and relevant, modifications are needed to enhance its applicability and readability for the Indonesian elderly population. The next steps include revising specific items based on this feedback.

The introduction of human-centred design in aged care facility projects highlights the need to balance nursing practice and the built environment. Yet, project management, which is essential for delivering successful projects, is often overlooked in this field. Given the condition of many aged care facilities in Australia, renovation is often a more cost-effective way to update the built environment. However, there is limited understanding of the potential gap between the intended therapeutic design in aged care facility renovations and the actual results that have been delivered.

To determine whether such a gap exists, it is crucial to have a comprehensive understanding of the interrelationships between the therapeutic design in residential aged care facilities, renovation project management and the decision-making process. Questionnaires with 327 respondents and 14 semi-structured interviews were conducted with project managers, aged care providers and designers from November 2023 to March 2024. It is expected that large organisations tend to have more experience with their own departments in dealing with designers and project managers, while smaller organisations with less or no experience in projects heavily rely on external consultants. Additionally, the level of informativeness before engaging with any experts aligns with these results. From the perspective of aged care providers, a shared understanding of certain terms affects decision-making efficiency. In addition to agreeing with this opinion, project managers and designers also mention that the level of information available could also be a key factor driving final decisions.

Dementia may well challenge us all because of the fundamental complexity of the condition, however, within the complicated domain of understanding behaviour, it may be considered beneficial to always appreciate the world through the lens of the person with dementia.

Stereotypes based on cognitive assumptions become part of how we think, and how we consider others should act or behave.
Subjective terminology such as "challenging behaviour", "behaviours of concern", "BPSD", “inappropriate”, “attention seeking” and “problematic”, are negative labels that are dehumanising, demeaning and derogatory, perpetuating prejudicial bias towards people with dementia and changed behaviour.

We should instead consider that changes in behaviour are most often a response to, and result from expressing and communicating unmet need.

By successfully capturing the origins of changed behaviour we may effectively remove the triggers from a person’s life, in turn addressing the issue related to that specific behaviour.

This enables us to design positive and supportive approaches incorporating a thorough understanding of care responsive to a person’s cognitive capabilities, lowered stress thresholds, life story, and factoring in person-centred physiological, emotional, bio-psychosocial, and environmental interventions.

This would then provide increased possibilities to enable people with dementia to live a life free of the constraints that society place upon people that are different.

“Care partners who understand a person’s cognitive boundaries and provide care respecting the preferences of the person with dementia, in ways that least exhausts their capabilities, are best able to minimise or avert behavioural expression and the negativity associated with it”. (Bisiani, 2011).

AIMS: This published study utilised a single case study examining the effect of providing a doll as a therapeutic tool on the behaviour of a person with dementia in a Residential Aged Care Facility. Specifically, the research examined doll therapy and associated it with observed past attachment needs. It was anticipated that by meeting past attachment needs, doll therapy may potentially reduce/prevent changed behaviour, improving wellbeing of the participant.

METHOD: A single case study, female participant, with moderately advanced Alzheimer’s disease, was the subject of this research. The case study used both qualitative and quantitative research design and methodology in data collection and analysis. For the purposes of this paper, the data was grouped under three logical categories: physical, emotional, and psycho/social behaviour.


RESULTS: The results demonstrated that doll therapy was a positive intervention for the person with dementia in this research. The findings indicated a reduction in changed behaviour related to the need for attachment and a considerable decline in anxiety and agitation.
There was extensive ongoing improvement in social interaction, communication, mobility, and intake.
Crucially, this study advances understanding of (a) the use of a doll as a therapeutic tool to reduce changed behaviour of a person with dementia; (b) meeting the long-term attachment needs of the participant to reduce/prevent behaviour; and (c) the effect of therapeutic interventions on wellbeing.
This research extends an understanding of how individualised complementary therapies may inform professional practice, promoting opportunities for the exchange of knowledge, stimulating research, and promoting best practice.

Elder abuse is one of the most heinous and vilest indicators of ageist discrimination within our current civilization.

Chemical restraint, one of the manifestations of elder abuse, remains an extremely contentious and provocative topic.

In the residential aged care sector, federal law stringently forbids the use of chemical restraint for reasons such as convenience, castigation, or any non-medical motive.

It has been indicated for years that management of changed behaviour displayed by people with dementia, relies essentially on medications that sedate.

This is despite significant data that establishes these types of pharmaceuticals have inadequate usefulness and are often the source of substantial negative and mortiferous side effects.

The prevalence and overuse of psychotropics still appears to be utilised with a worrying, and predictable intent to chastise, or suppress a person’s right to speak up, conveniently justified under a concealed, rationalised, and shameful guise that suggests it is a ‘reasonable’ necessity.

Accountability is now required.
Approaching a restraint free culture includes:
• Mandatory training in understanding care responsive to people with dementia.
• Provision of information systems, and services, to health professionals and the community.
• Recommendations and rigorous frameworks, review processes and preventative models of care.

As a collective, humankind must be motivated to transform their penchant for fearmongering, partisan intolerance, and conditioned, preconceived bigotry towards people with dementia, thus uphold a integrated voice of activism that defends individual autonomy, supports well-being, and acknowledges each person’s right to equality and “Freedom of Expression”.

Residential respite care is a form of short-term care provided by Residential Aged Care Facilities (RACFs) for community dwelling older people needing care when their day-to-day carer is unavailable. Research has identified the need for urgent interventions to improve quality of care for people accessing residential respite care and their carers. Consumer engagement has also highlighted several concerns including challenges with communication, medical management, and information quality and access. The 3C Program aims to respond to these concerns by addressing the following key areas during respite care admission: comprehensive assessment, care planning and clinical communication. The program will be implemented with respite seekers and their carers during admission to RACFs across Victoria. Comprehensive assessment will involve a suite of validated health assessments to identify key risks and needs for both the respite seeker and carer. The findings will facilitate production of a person-centred care plan. The care plan will be complemented by readily accessible video vignettes that support effective clinical communication during respite care handover. These will highlight important information about the person’s needs and function, and assist frontline respite care staff, enhancing information exchange between the respite seeker, carer, and staff. This presentation will discuss development of the materials and methods of the 3C Program with a focus on the processes involved in the production of video vignettes, and the rationale for the novel use of video technology to enhance clinical communication throughout handover to respite care. Preliminary feedback and findings from participants and key stakeholders will be presented.

Background
Falls are a common problem and people with Parkinson’s disease (PwPD) fall often due to their associated motor and non-motor impairments. Promoting safer mobility behaviours may reduce falls, however this concept is poorly articulated in the literature. The aim of this scoping review was to map out the concept of safe mobility behaviour to draw implications for PwPD.

Methods
The Joanna Briggs Institute methodology for scoping reviews was followed1. Studies involving older adults (aged ≥ 65 years) and/or people with neurodegenerative conditions (including PwPD) that sought to define, describe, and/or explain this concept were included.

Results
Of the 21,563 records retrieved, 135 publications were included. Although safe mobility behaviour was not explicitly defined, its performance was described as a combination of observable actions and cognitive processes. Mobility behaviour was influenced by an interaction between the person, environment, and task performance. Furthermore, person-related factors that shaped these behaviours involved an interaction between physical, cognitive, and affective domains.

Conclusion
We propose a definition for safer mobility behaviour as any protective action and associated functional cognitive process used to prevent falls. It is unique to each person and occurs across a spectrum of safer to riskier behaviour through interactions with the environment and tasks performed. Safer mobility behaviour is important for PwPD due to additional impairments that further influence these interactions. Future research should focus on assessment of and intervention targeting safer mobility behaviour overall and in PwPD.


References
1. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis: JBI; 2020.

People who have sustained a fall are the most common call for service to the Queensland Ambulance Service (QAS). Falls related incidents represented 8.7% of all incidents attended by QAS paramedics following a Triple Zero (000) call in the 2020 and 2021 calendar years. Falls disproportionally affect the older adult population (aged 65 years and older). Across the Brisbane metropolitan region, this cohort represents approximately 67% of the people who fall requiring the assistance of the QAS.

The QAS Falls Co-Response Program is a pilot program run in partnership between the QAS and Queensland Health providing a multi-tiered, multidisciplinary response to Triple Zero (000) calls where a patient’s condition relates to a fall. This is the first falls co-response service to be provided by an ambulance service in Australia.

Two units operate in the Brisbane metropolitan region, each comprising a two-member crew of a paramedic and allied health practitioner (occupational therapist or physiotherapist). These units provide an accelerated assessment, management and disposition planning service for falls incidents received to the QAS.

This initiative facilitates greater integration between the post fall follow-up and referral pathways, by providing comprehensive assessment of the patient in their environment to inform falls assessment and management plans in a timely manner.

Patients assessed by the QAS Falls Co-Response Program are transported to an Emergency Department significantly less frequently than those seen by standard acute paramedic crews (49% vs 77%), and response time is quicker (41 minutes vs 58 minutes).

While previous aged care funding relied on the Wage Cost Index 9 (WCI-9) indexation method that was not tailored to a specific sector, the Independent Health and Aged Care Pricing Authority (IHACPA) provides annual pricing and costing advice to the Australian Government (Government) informed by sector specific indexes and the actual costs of delivering care. This advice includes recommendations for the Australian National Aged Care Classification (AN ACC) price and the national weighted activity unit weightings that determine the relative prices of different AN-ACC classes.

IHACPA is committed to a consultative, transparent and evidence-based approach in the development of its residential aged care and residential respite care pricing advice.

Annual consultation is the primary mechanism for stakeholders to provide input into the development of IHACPA’s Pricing Framework for Australian Residential Aged Care Services (the Pricing Framework). The Pricing Framework sets out IHACPA’s policy approach, methodology and principles governing its residential aged care pricing advice.

This presentation will outline the policy context in which IHACPA is operating, including IHACPA’s use of the 2023 Residential Aged Care Costing Study and the methodology behind developing IHACPA’s pricing advice to Government, with a particular focus on IHACPA’s data driven approach, indexation methodology, and the adjustments IHACPA included to prospectively account for known cost increases to the sector in the short term.

Introduction:
Delirium is distressing and is the most common hospital acquired complication for older people in hospital. It is associated with an increased risk of other adverse events including falls, malnutrition, and pressure injuries. Delirium can be prevented in 30-40% of older patients. The application of non-pharmacological multicomponent interventions targeted at risk factors is recommended.

Method:
A qualitative document analysis was undertaken of 32 documents including publications, fact sheets, online resources and brochures. The framework method was used for data analysis to identify key themes. Focus groups with health care professionals and researchers with delirium expertise were held to deepen the understanding of the findings and its applicability in clinical practice. This research is informed by a patient safety framework and is the qualitative component of an mixed methods exploratory sequential study.

Results:
Non pharmacological multicomponent interventions are recommended to be provided to all older people at risk of delirium. The role of nursing in intervention delivery and within the multidisciplinary team is lacking definition which requires further examination.

Resourcing and empowering people to age in place is shaping service provision through the allocation of funding in Australia. The reablement model of care is one intervention designed to support older people as they age within the community. With its person-centred, holistic approach to supporting independence the complexities inherent in reablement are reflected in how its services are designed, delivered and evaluated. People are at the core of all stages of the reablement model yet consensus from within academic literature highlights an underrepresentation of the voices of lived experience. Understanding how older people ageing in the community and their families experience reablement is vital and forms the basis of a current PhD project being undertaken in Northwest Tasmania. This presentation will share the initial stages of this PhD summarising the key considerations in the design, delivery, and evaluation of reablement based community care services for older people, their families.

Title: Co-creating a person-centred program to enhance the clinical placement experience for nursing students in rural aged care: A pilot study
Background: Nursing students continue to perceive aged care clinical placements to be of lesser value and providing limited contribution to their development as Registered Nurses when compared to acute nursing experiences (Cooke et al., 2021; Hunt et al., 2020). With the mandated 24/7 Registered Nurse staffing requirements from the Australian Royal Commission, and the challenges residential aged care facilities (RACFs) continue to face in recruiting Registered Nurses (Campbell, 2023), addressing their perceptions is essential.
Aim: This study aims to identify methods to enhance the clinical placement experience for nursing students in rural aged care through the development of a co-created person-centred program involving collaboration with aged care stakeholders and nursing students.
Methods: The study will be conducted within a rural South Australian RACF. Participants include staff, residents, and their families from the RACF, nursing clinical facilitators and undergraduate nursing students. A mixed methods approach, including surveys, interviews, and focus groups will be used to gather various perspectives informing the co-created program. Subsequently, a workshop using a nominal group approach will be held with participants to reach a consensus on the content of the rural aged-care placement program to be piloted with first-year nursing students at the participating RACF.
Results & Conclusions: The project is in the data gathering stage. Preliminary findings for the focus groups with aged care stakeholders and the survey with nursing students will be shared.

Background: Montessori for Dementia and Ageing [MDA] can be used in residential aged care [RAC] to promote person-centred care [PCC] and dignity of risk [DoR]; key aged care standards and recommendations for practice. This study aimed to develop an MDA-Education-Program for RAC staff (direct and indirect-care workers) to support PCC, DoR and meaningful engagement with residents.
Methods: Drawing on academic literature and key consumer websites the MDA-Education-Program was developed and comprised of: (1) MDA-Goals: independence/choice/memory/mobility/skills/purpose; (2) MDA-Approaches: meaningful engagement/purposeful roles/task-breakdown/memory-visual cues/physical-cognitive ability (e.g-multi-sensory-stimulation); (3) MDA-Environmental-Modifications (e.g-activity stations/sensory-walls). The MDA-Education-Program was pilot-tested in two large RAC homes mid-2023 comprising: Phase-1: all direct (e.g-nurses/personal-care-attendants) and indirect (e.g-lifestyle/kitchen) care staff participated in one 30-minute interactive group training session led by MDA-trained-facilitator; Phase-2: upskilling MDA-Champions (n=55) via 4-hour workshop to support embedding of MDA; Phase-3: MDA-trained-facilitator supporting staff during 6-month trial-period. To evaluate the MDA-Education-Program, semi-structured interviews were conducted 6-months post-implementation with direct/indirect care staff at both pilot homes. Inductive/deductive analysis approaches were applied.
Results: Sixty-staff working morning/mid-day/afternoon shifts were interviewed. Overwhelmingly, staff felt the MDA-Education-Program provided practical approaches to support their staff-resident interactions, DoR and PCC. Most staff believed MDA-approaches can be used in everyday practice, with ‘meaningful/purposeful activity’ and ‘multi-sensory-stimulation’ being most commonly applied. Main barrier to applying MDA included embedded task-based practice and the cultural shift required to change this. Main enabler included the education component reinforced by resources/staffing and MDA-trained-facilitator.
Conclusions/Implications: The MDA-Education-Program will be implemented across the provider's 14 remaining RAC homes, with this evaluation informing the implementation approach.

Aim
Ageing is widely recognized as the primary risk factor for dementia, although its deterministic role remains debatable. This population-level study aims to assess the nuanced impact of ageing on dementia incidence rate (DIR) globally.

Methods and Results:
Ageing was a significant contributor to DIR, but not as important as previously assumed. Ageing explained 58.05% of DIR variance, the third strongest correlation among the statistical relationships between ageing and each of the top ten chronic diseases leading to death. Further analysis of the ageing-DIR relationship showed that, after removing the competing effects of economic affluence, genetic background, total fertility rate, and urbanization, ageing only explained 5.95% (less than 6%) of DIR variance. Enter multiple regression analysis identified that ageing was a significant predictor of DIR, and stepwise multiple regression analysis identified total fertility rate as the most influential predictor of DIR, with ageing ranking second. Economic affluence, genetic background, and urbanization were deemed statistically insignificant.

Conclusions
This study challenges the deterministic view of dementia as an inevitable consequence of biological ageing. While age remains a significant risk factor for dementia, ageing alone accounts for less than 6% of dementia incidence variance.

Implications
This study underscores the complexity of dementia as a multifaceted condition, necessitating a comprehensive approach within the framework of healthy ageing strategies. The term "senile disease" may have emerged due to the noticeable nature of dementia symptoms, manifested as behavioural abnormalities that profoundly affect the quality of life for both affected individuals and their caregivers.

Introduction: General practitioners (GPs) in primary care are the first point of contact in the health system for a person experiencing signs and symptoms of dementia. The GP assessment then determines whether the person receives a referral for specialist care, and hence GPs are gatekeepers to specialist assessment.
Aim: To identify, from the perspective of people with signs and symptoms of dementia and/or their significant others, the facilitating and impeding actions to accessing specialist assessment for dementia in primary care.
Methods: A descriptive qualitative study with semi-structured interviews conducted online using zoom. The interview guide asked people to reflect on their dementia diagnosis journey from the recognition of signs and symptoms to navigation through the health and social care system across primary care, specialist care, and aged care. The Candidacy Framework was used to guide analysis.
Results and conclusion: Thirty-seven people who had experienced the Australian dementia diagnosis process as a patient and/or significant other (partner/spouse, adult child, sibling, friend) participated in the interviews. Key themes were identified and mapped to the candidacy framework: the threshold for symptom identification; the value of having a regular GP; ability to communicate need for medical assistance; GP’s prompt or delayed provision of a specialist referral; collaboration between patients, significant others, and GPs; inadequate GP dementia-specific knowledge; and time and workload constraints. The dynamic interaction of patients, significant others, and GP’s facilitating and impeding actions influenced access to specialist dementia assessment.

Introduction: Well-designed exercise programs can reduce falls in community-dwelling older adults but adherence to falls prevention programs are low. Technology may overcome some barriers to improve engagement although less is known on adherence to this delivery mode. The aim of this systematic review was to synthesize evidence for adherence to remote-delivered technology-based falls prevention programs.
Methods: A systematic literature search of nine databases was undertaken. Studies were included if they were randomized trials of remote-delivered technology-based falls prevention programs in community-dwelling adults over 60 years. Pooled adherence rates were calculated using random-effects meta-analysis, and meta-regression was used to examine the factors associated with program adherence.
Results: Eleven trials with 569 participants (mean average age 75 years) were identified. A variety of technology including apps, exergames and online synchronous classes were used to deliver the falls prevention programs, and there were no serious adverse events for studies reporting this information (n=8). There was substantial variability in the way adherence data were reported. For studies that reported the mean number of completed exercise sessions, the pooled estimate of adherence was 82% (95% CI 0.68, 0.93), however, no association was observed between program characteristics (e.g. exercise duration or telephone follow-up) with exercise adherence.
Conclusions: Whilst the use of remote-delivered technology may confer some benefits for the delivery of falls prevention programs, better reporting of adherence is needed. There is an opportunity to reimagine how technology can be used to support older adults’ adoption of falls prevention programs into their daily life.

Introduction:
Allied health services are a fundamental part of the aged care sector to support functional reablement in older people. However, the growth of the allied health workforce in aged care has not kept up with demand. As such understanding how we can address recruitment and retention challenges is critically important.
Methods:
The aim of this scoping review was to identify the enablers and barriers for allied health professionals (AHPs) to engage in the aged care sector. The review used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Six databases and grey literature were searched, and a thematic analysis was conducted.
Results:
Of the 1369 records screened, 14 studies were identified in the review. Four themes were identified that highlighted the key enablers and barriers of recruitment and retention of AHPs in aged care: 1) Supporting clinicians to work in diverse and complex environments; 2) Developing the pipeline to build workforce capacity; 3) Navigating system wide challenges; and 4) Appreciating the added complexity of rural practice.
Discussion:
This review brings together an understanding of the enablers and barriers for AHPs to work in the aged care sector. It highlights complexities that are commonly faced particularly with varying funding models and organisational structures, which often don’t align to person centred care.
Conclusion:
Further research on exploring effective strategies to increase and sustain AHPs within aged care is required to ensure we have an adequate workforce to meet the needs of an ageing population.

Purpose: The ageing population has driven an increased demand for residential aged care services. To date, however, there is a dearth of knowledge in relation to the activity behaviours (e.g., sedentary time) of older adults in this setting. This study aimed to examine the activity behaviours of older adults residing in aged care facilities and potential determinants of prolonged sedentary time.
Method: An observational cross-sectional study design was used. Participants ( 60 years, independently ambulant +/- walking aids) were recruited from four residential aged care facilities in metropolitan Adelaide, South Australia. Wrist-worn accelerometers (7d/24h protocol) were used to measure activity behaviours. Mood and cognition were measured using the Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-30), respectively. Data were analysed descriptively, and linear regression was used to identify predictors of prolonged sedentary time (≥ 30 mins).
Results: The sample comprised 50 residents aged 71-96 years (Mage = 86.6 ± 6.1 years, 56.0% female). Residents spent most (87%) of their waking wear time sedentary (12.8 hr/d; 766.8 ± 95.7 min/d), and this time was largely (73.1%) accrued in prolonged uninterrupted bouts (≥ 30 mins). The regression analyses showed that neither cognition nor mood emerged as predictors of prolonged sedentary time.
Conclusion: Older adults in residential aged care settings spend much of their time sedentary, and this sedentary time is prolonged and uninterrupted. Ongoing efforts to develop and implement strategies to reduce prolonged sedentary time in aged care residents are necessary.

Background: Mealtimes should be designed and delivered in a way to support the goals of care for the setting they are provided in. It is also important to consider patient and staff perspectives in the creation of mealtime design, to ensure they are fit for purpose. Currently, little is known about patient and staff perspectives on the ideal mealtime delivery for the rehabilitation setting.
Aim: To explore patient and staff perceptions about how mealtimes should be delivered in the rehabilitation setting.
Method: This qualitative descriptive study conducted semi-structured interviews with 9 previous and current rehabilitation patients and 10 rehabilitation staff. Data were analysed using qualitative content analysis methods.
Results: Two concepts were explored, including 1) role of mealtimes in patients’ rehabilitation, and 2) the ideal mealtime. Mealtime roles were either to facilitate recovery, social interaction, rest, and routine, or represented a time of frustration and challenges resulting from their impairments or service limitations for patients undergoing rehabilitation. The ideal mealtime involved creating a therapeutic experience, defining key considerations for mealtime processes to support rehabilitation, providing options and flexibility to tailor mealtimes to individual needs, enhancing mealtime care through interdisciplinary collaboration, and using supportive mealtime care practices.
Conclusion: The ideal mealtime in rehabilitation is based on principles of flexibility and adaptability, and ensuring supportive systems and processes are embedded at each stage of the mealtime. By delivering a mealtime based on these principles, mealtimes can become a positive influence on patients recovery and well-being and minimise challenges they may face.

Despite widespread proliferation of digital media, older people often struggle with one-size-fits-all digital services, leading to increased social isolation irrespective of their socioeconomic status. During the COVID-19 pandemic, as societies embraced a "new normal" dominated by digital technologies, vulnerable groups remained disadvantaged. These digital inequalities are associated with discriminations in access, use and efficacy of digital resources, which is critical to be minimized for sustainable digitalized societies (Imran 2022a).

Older migrant adults in Australia are particularly at high risk of digital exclusion due to a multitude of complex individual and institutional factors as identified by Imran et al (2022b).

This research aims to uncover issues surrounding digital inequality among older Australians of culturally diverse backgrounds in ACT (as a pilot study) and explore the suitability and validity of the model using the newly developed survey instruments (Imran et al, 2024). The results are expected to shed light on critical gaps and likely socio-technical solutions for Home based as well institutional age care for diverse ethnic communities.

References

Imran, A. (2022a). Why addressing digital inequality should be a priority. The Electronic Journal of Information Systems in Developing Countries. https://onlinelibrary.wiley.com/doi/full/10.1002/isd2.12255

Imran, A., Quimno, V., & Gregor, S. (2022b). Factors Influencing Digital Inequality: A Scoping Review. Proceedings Annual Workshop of the AIS Special Interest Group for ICT in Global Development, Copenhagen, Denmark.

Imran, A., Shahriar, F., & Haque, M. (Accepted). Survey instruments for measuring Digital Inequality at the individual level. 16th IFIP TC9 Human Choice and Computers Conference. Thailand, 8-10 Sep 2024

Objectives. To investigate barriers and facilitators to nurses creating and implementing behaviour support plans in an acute care ward for people with dementia.

Methods. The research involved semi-structured interviews with staff members employed at geriatric wards of a tertiary education hospital. Reflexive thematic analysis, aligned with a constructivist paradigm, was used to derive themes from interview data. Additional descriptive statistics on the characteristics of the ward were gathered.

Results. Ten staff members participated in the research. Five themes were generated, including (1) Nurses understand the primary tenants of positive behaviour support; (2) Staff have the knowledge, skill, and attitude to support BSPs; (3) Nurse leadership in initiating creating and leading BSPs; (4) Making key information accessible would assist nurses in managing responsive behaviours and working with BSPs; (5) Maximising resources would assist nurses in managing responsive behaviours and working with BSPs.

Conclusions. Findings from this study indicate that nurses are well-suited, knowledgeable, and willing to engage in positive behaviour support, however, require additional support to do so. Nurses would benefit from increased education, documentation aids, and organisational support to better facilitate BSPs. This research endorses nursing practice involving a designated nursing coordinator responsible for driving positive behaviour support as well as the utilisation of nursing support staff including volunteers and activity coordinators.

Background:
Following a dementia diagnosis, there are opportunities for healthcare providers to facilitate active interventions, rehabilitation, and care. Maximising social independence, engagement, remaining at home, maintaining functional capacity, and physical safety are common goals expressed by people with dementia and their care partners. However, there is limited evidence about the effectiveness of multidisciplinary services to maximise quality of life and empower people with dementia and their care partners.

Purpose:
This symposium will share evidence from multidisciplinary post-diagnostic dementia programs that aim to provide social, physical and cognitive engagement for people with dementia and support for care partners. We will showcase these foundational research projects and promote fresh thinking for clinicians, researchers, and policymakers.

Overview of activities:
The first three presentations will report on a twelve-week multicomponent program developed in the ACT from the perspectives of clients, an occupational therapist, and a dietitian. Similar programs in NSW and Victoria will be presented by a nurse and occupational therapist, respectively. A common intervention in each program is Cognitive Stimulation Therapy (CST). The final presentation will report on developing a community of practice designed to increase the uptake of CST across Australia. Each presentation will be twelve minutes, and the convenor will finish with a summary and lead a question and answer session.

Expected learning outcomes:
Audience members will gain a better understanding of the implementation of post-diagnostic dementia care services being delivered in Australia from a multidisciplinary perspective and how they might incorporate similar initiatives in their own context.

Background & Aims
Pain prevalence increases with increasing age, with significant impacts on older adult’s well-being and quality of life. Given the global population ageing, a better understanding of the prevalence and incidence of pain is crucial if we are to promote healthy ageing and reduce pain burden. This highlights the importance of data collection on pain across various resources, particularly from longitudinal cohort studies. To provide an overview of pain data availability and gaps, we identified and systematised ageing cohorts across the globe.

Methods
We searched for ageing cohorts across the globe that included participants aged 60+ at baseline. We extracted data availability on pain in each cohort study, as one of the intrinsic capacity domains that shape older adult’s healthy ageing.

Results
We found 287 ageing cohort studies globally, spanning Europe (n=82), Oceania (n=25), Asia (n=68), North America (n=90), South America (n=8), the Middle East (n=8), and Africa (n=7). Over 80% of cohort studies from Oceania collected at least one pain-related data, followed by 75% in South America, 71% in Africa, 67% in Europe, about 60% in the Middle East and Asia, and <50% in North America.

Conclusions
These results underscore current wealth of data, which can be used to provide evidence-based information with the goal of reducing the prevalence of pain and its consequences. However, overall data availability remains limited in South America, the Middle East, and Africa, which needs to be addressed. This project represents a novel/comprehensive synthesis of ageing cohort studies to inform better research.

A significant advance in the field of cultural gerontology in recent decades has been the growing level of contributions from academics and practitioners in health gerontology. At least two major journals in geriatric medicine have instituted sections on geriatric medical humanities, and similar sections in gerontology journals have included contributions from health gerontology.

There are many commonalities and a significant potential synergy for cultural gerontology arising from the long history of the analogous field of health humanities, while there are differences of emphasis in definition, and balance between scholarship and education.

This presentation will explore synergies and barriers to joint working, including authorship profiles from original bibliometric research in both health humanities and cultural gerontology.

In a pattern similar to health humanities, from a survey of 5 relevant journals covering cultural gerontology, over four-fifths were written by single authors, 42% gerontology/age-studies, 29% arts/humanities/social sciences and 23% of uncertain affiliation: only 6% had a clear indication of joint working across disciplines. In the two geriatric medicine journals, authorship was almost exclusively from geriatric medicine/gerontology.

Cultural gerontology and health humanities share origins, similarities and synergies but also display significant differences that if approached with a collaborative spirit will allow for mutual learning and growth. This presentation will point to encouraging signs of growth and interest in what the shared space cultural gerontology and health gerontology. has to offer to our understanding of ageing and optimal pathways to provide care for our future selves.

Introduction
A prior hip fracture can increase the risk of readmission within 30 days after discharge from hospital. Although readmission-related healthcare reforms have shifted their focus from all-cause readmission to potentially preventable readmissions (PPRs), little is known about risk factors associated with PPR within 30 days after discharge from hospital (30-day PPR) among older adults in residential aged care facilities (RACFs). This study identified factors associated with 30-day PPR for residents of RACFs to inform improvements in transitional care between hospital and RACF.
Methods
A retrospective cohort study using the linked hospital admission and mortality data in New South Wales, Australia of older adults aged ≥65 years admitted after a hip fracture and discharged between January 2014 to February 2023. PPR was identified according to 22 conditions selected by the Australian National Health Care Agreement, and 4 conditions (fall-related injury, pressure injury, dehydration, sepsis). Multivariable logistic regression examined factors predictive of 30-day PPR.
Results
Among 13,234 older adults, 827 (6.2%) experienced 30-day PPR. The odds of 30-day PPR for older adults with one and ≥2 Charlson comorbidities were 1.19 times (95% CI: 1.01-1.41) and 1.31 times (95% CI: 1.05-1.64) higher, respectively than those with no Charlson comorbidities. Older adults with injury mechanisms excluding falls (OR: 0.34, 95% CI: 0.16-0.69) and those who had hip fracture-related surgery (OR: 0.65, 95% CI: 0.53-0.80) had a decreased risk of 30-day PPR.

Conclusions
Care planning prior to discharge could aid in reducing PPRs for residents of RACFs with factors associated with 30-day PPR.

Imagine a hermit in a cave – the most ‘alone’ archetype we have. But even this hermit relies on the connections they have developed: with themselves, the weather, and the animals and insects who live alongside or become their meal.

Connection is a human requirement, no matter how extroverted or introverted we are.

Exploring our sense of self and what connections we value most (and those we don’t) does not just provide us with critical information for our ageing well, but the process itself can allow us to learn more about those who we seek to build relationships with.

In Bruce Rumbold (Ed.), Spirituality and palliative care: social and pastoral perspectives (2002), Paver highlights the issues that people face when their lives are not ‘integrated’, which reinforces the notion that wellbeing is linked to connectedness. Paver says that life ‘is a dynamic journey which illustrates the interconnectedness of physical, social and emotional issues with the spiritual issues that confront people facing illness and death.’

This oral presentation will show industry practitioners how the ConnecTo and Connect-Explore models can be used in aged care and community group settings to further integration and self awareness – and by extension meaning, hope and contentment.

This innovative group use of the model has been designed, against the background of increasing levels and experiences of loneliness, to encourage growth, learning and relationship building in the aged care resident groups who participate.

Aims
This review aimed to identify the type, direction, and association between psychological and psychosocial factors and important health outcomes in older adults with low back pain (LBP).

Methods
This scoping review followed Arksey and O’Malley’s five stage framework. Databases searched included Medline, CINAHL, Embase, and PsycINFO. The included studies involved participants ≥ 65 years old with LBP, reported psychological or psychosocial factors, health outcomes (falls, polypharmacy, pain, activities of daily living (ADLs), frailty or time in hospital) and used quantitative, qualitative, or mixed methods study designs.

Results
The search yielded 5,027 citations, with 776 progressing to full text review. The included studies encompassed various designs, including cross-sectional, qualitative, and prospective cohort studies. Psychological factors were evaluated using the Geriatric Depression Scale, and Pain Catastrophizing Scale. Additionally, fear avoidance beliefs, kinesiophobia, anxiety and fear of falling were assessed, along with some psychosocial factors, including marital and living status, loneliness, social support and stigma. Health outcomes predominantly focused on ADLs, such as mobility or gait speed, while there was limited reporting on falls, polypharmacy, pain concurrent with LBP, or frailty. No included studies reported the health outcome related to time spent in hospitals.

Conclusion
This scoping review identified research highlighting the association between psychological factors (such as depression, anxiety and catastrophizing) and the performance of ADLs (such as mobility) in older adults with LBP. It is critically important to understand these associations in the context of LBP in older age to better manage this underserved population.

A knowledge of cultural interaction and religious values in the elderly care sector plays a significant role to reduce discrimination among immigrant caregivers. To understand the implications of cultural changes in the care workforce, this study query, what are religious and cultural considerations affecting Muslim care professionals in delivering practical care at in care homes? What are the obstacles and challenges for Muslim care professionals in this sector? How are immigrant caregivers involved in negotiating their cultural and religious norms in their working place? What should be done to ensure the wellbeing of Muslim immigrant caregivers? With this in mind, this study adopts cultural competence theory with religious values as an analytical framework. By identifying gaps in intercultural competence and challenges, this study has the potential to promote the wellbeing of immigrant caregivers in the elderly care sector in the Nordic countries.

Background:
Communication is a vital but neglected element of ageing: underlying individual decisions about health and aged care; the delivery of personalised aged care funding, supports and services; the (complaints-based) regulation of the aged care sector; and safeguarding of older people from neglect and abuse.

Aim:
This paper is an exploratory study of lived experiences of communication support needs in community and residential aged care.

Method:
60 in-depth interviews, 2 focus groups, and 4 participant observations were conducted with people using community and residential aged care services; their significant others; and front-line aged care staff about communication and aged care. Thematic analysis identified core issues.

Findings:
Communication support was identified as a significant unmet need within aged care. At the individual level, occasions of in-home support, personal care, or other direct support may not allow for the time, space, and skills needed for effective communication. At the service level, the need for better communication supports when interacting with service organisations was identified, as well as during transition into and out of services at different stages of a person’s aged care journey. At the system level, participants felt communication was not prioritised in aged care funding, complaints and regulation processes, or between aged care and other systems such as healthcare and income support.

Implications:
Recognition of the impact of communication support needs in individual interactions, inside services and residences, and in the aged care system itself is essential to providing effective interactions, quality aged care services, person-centred care, and support.