Nurse-Led Innovations for Optimising the Quality and Safety of Care for the Older Person in Residential Aged Care: A Warrant for Action.

Aim: To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.

Gait characteristics in older adults with higher-level gait disorders during normal, dual-task, and destabilising walking conditions at home and their association with cognitive impairment.

Background: Gait disorders are common among older adults and contribute to falls and immobility. This study aimed to explore gait characteristics in older adults with higher-level gait disorders during normal, dual-task, and destabilising walking conditions at home, and their association with cognitive impairment.

Methods: A cross-sectional study was conducted in the community with two groups (n = 60): older adults with higher-level gait disorders and an age- and gender-matched non-gait disorder (control) group.

Developing a Novel Digital Tool for Personalised Antipsychotic Prescribing in People Living With Dementia: The Views of Australian Clinicians.

Optimising antipsychotic prescribing in people living with dementia is important to manage symptoms and avoid adverse events. Clinical decision support tools that predict therapeutic response based on individual patient characteristics can help personalise prescribing and complement decision-making by prescribers. The aim of this study is to investigate the views of Australian prescribers on the development and use of a digital antipsychotic prescribing support tool in dementia.

Potentially High-Risk Antipsychotic Use in People With Dementia: A National Data Linkage Study.

Objectives: To investigate the prevalence of and sociodemographic factors associated with potentially high-risk antipsychotic use in people living with dementia in Australia.

Design: Retrospective cross-sectional study using national linked data from the 2021 Census and the Pharmaceutical Benefits Scheme.

Setting And Participants: All people aged ≥65 years who responded to the 2021 Census, self-reported a diagnosis of dementia and/or were dispensed an acetylcholinesterase inhibitor or memantine, and purchased ≥1 antipsychotic subsidized by the Pharmaceutical Benefits Scheme between August 1, 2021, and October 31, 2021, were included.

Prevalence and Risk Factors for Psychotropic Medication Use in Older Adults in Australia: A Nationwide Data Linkage Study.

Background And Objectives: Psychotropic medications are associated with an increased risk of adverse drug events in older adults, yet national data on their use in Australia remain limited. This study aims to estimate the prevalence of psychotropic medication use among older Australians and to examine the sociodemographic factors associated with their use.

Methods: A retrospective cross-sectional study was conducted using national linked data from the 2021 Census and the Pharmaceutical Benefits Scheme (PBS).

Post-diagnostic support in Australia: Perspectives of people recently diagnosed with dementia and their carers.

Timely post-diagnostic support is necessary to help people with dementia and those who provide care adapt to the diagnosis and optimise independence and quality of life. However, evidence from people with dementia and carers regarding the support they need is scarce. To explore the perspectives of people with dementia and their carers regarding the support they had been offered, barriers and facilitators to accessing such support, and support they viewed as desirable or ideal.

Predictors and Moderators of Hospitalisation and Mortality in People with Dementia Using Antipsychotics: Systematic Review.

Background And Objectives: Antipsychotics are used to manage behaviours and psychological symptoms of dementia. While antipsychotics have been associated with increased risk of adverse outcomes, factors associated with these outcomes have been understudied. Thus, the aim of this study was to identify factors associated with risk of hospitalisation and mortality in older people living with dementia using antipsychotics.

Exploring Factors for Inclusive Occupational Therapy for People With Dementia in Australia: A Qualitative Study.

Importance: Occupational therapy interventions are a crucial part of dementia care and have been shown to be effective in research trials. However, the acceptability and inclusivity of occupational therapy interventions to treat dementia for people from diverse groups are unclear.

Objective: To explore factors contributing to the delivery of acceptable and inclusive community-based occupational therapy interventions for people with dementia from diverse groups in Australia.

Interpreter Communication Quality in Cognitive Assessments for Dementia: The MINDSET Randomized Clinical Trial.

Importance: With increasing dementia prevalence due to population aging, interpreters are needed to facilitate timely dementia diagnosis by supporting the complex verbal and nonverbal interplay between clinicians and patients during cognitive assessments. However, to our knowledge, no randomized clinical trials have previously evaluated interventions to improve interpreter communication during cognitive assessments for dementia.

Objective: To assess whether online training codesigned by interpreters, clinicians, and multilingual family carers improves the quality of interpreter communication during cognitive assessments for dementia.

Effectiveness of the Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence of people living with dementia: a multicentre, pragmatic, randomised, open-label, controlled trial.

Background: We investigated the effectiveness of an Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence, health and well-being of people with dementia, family carer outcomes and costs.

Method: A multicentre pragmatic parallel-arm randomised controlled trial compared I-HARP to usual care in community-dwelling people with mild to moderate dementia and their family carers in Sydney, Australia (2018-2022). I-HARP is a 4-month, home-based, dementia rehabilitation model delivered by an interdisciplinary team.

Developing, implementing, and evaluating the first national Memory and Cognition Clinic Guidelines in Australia.

Introduction: A lack of national consensus on the roles and responsibilities of Australian memory and cognition clinics contributes to the large variability seen across services. The introduction of guidelines and a quality assessment framework could facilitate greater harmonization and quality improvements.

Methods: We used a modified Delphi process to develop the guidelines.

Embracing Reablement as an Essential Support Approach for Dementia Care in the 21 Century: A Position Paper.

The World Health Organization (WHO) recognizes the right of individuals with dementia and their family caregivers to access interventions that enhance their participation in society. Reablement is an approach that enables older people to participate in meaningful daily and social activities. Over the past decade, a growing body of evidence has underscored reablement as a promising approach within dementia care, including positive outcomes for people with dementia and their family caregivers, and cost-effectiveness.

Development of a model of help-seeking for dementia diagnosis by the person experiencing changes and family supporters.

Objectives: This paper aimed to develop a model to describe help-seeking for dementia diagnosis. The practical model is intended to guide public health interventions to increase help-seeking.

Method: The model was developed by our multidisciplinary team based on qualitative semi-structured interviews in English ( = 33) and Chinese ( = 8) with older people, people with dementia and carers.

Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): protocol for a stepped-wedge cluster randomised controlled trial.

Background: The health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses' accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources.

The Right to Rehabilitation for People With Dementia: A Codesign Approach to Barriers and Solutions.

Introduction: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation.

Promoting Independence Through Quality Dementia Care at Home (PITCH): An Australian Stepped-Wedge Cluster Randomised Controlled Trial Evaluating a Dementia Training Program for Home Care Workers.

Objectives: The primary aim of this pragmatic stepped-wedge cluster RCT was to determine the efficacy of a co-designed dementia specialist training program (the PITCH program) for home care workers (HCWs) to improve their confidence and knowledge when providing care for clients living with dementia.

Methods: HCWs who provided care to clients with dementia were recruited from seven home care service provider organisations in Australia between July 2019 and May 2022, and randomised into one of 18 clusters. The primary outcome was HCW's sense of self-competence in providing care services to people living with dementia at 6 months post PITCH training measured by the Sense of Competence in Dementia Care Staff (SCIDS) Scale.

Moving forward with dementia: an explorative cross-country qualitative study into post-diagnostic experiences.

Objectives: This explorative cross-country qualitative study aims to describe experiences of receiving a dementia diagnosis and experiences of support following a diagnosis in Australia, Canada, the Netherlands and Poland.

Method: Qualitative study using projective techniques during online focus groups, online and telephone interviews with people with dementia and caregivers.

Results: Twenty-three people with dementia and 53 caregivers participated.

Development of a method and an assessment construct for person-centered translation of dementia public stigma scales.

Background: With the number of people with dementia dramatically increasing over time and dementia becoming a major health concern worldwide, scales have been developed to assess the stigma socially attached to this neurodegenerative disorder. There are, however, almost no available methods and assessment constructs for person-centered translation of dementia public stigma scales.

Objective: To develop such a method and such an assessment construct by translating the Dementia Public Stigma Scale (DPSS) into standard written Chinese.

The Effectiveness of Dance Interventions on Psychological and Cognitive Health Outcomes Compared with Other Forms of Physical Activity: A Systematic Review with Meta-analysis.

Background: Physical activity is known to improve psychological and cognitive outcomes. Learning dance sequences may challenge cognition, partnered or group dance may benefit social interactions, and the artistic aspect may improve psychological wellbeing. Dance is an equally effective form of physical activity compared with other structured physical activities to improve physical health, but it is unclear how effective dance could be for psychological and cognitive outcome measures.

Enhancing post-diagnostic care in Australian memory clinics: Health professionals' insights into current practices, barriers and facilitators, and desirable support.

Introduction: Providing integrated and evidence-based support to individuals and families following a diagnosis of dementia is essential in order to optimise their quality of life and assist them to live well. Memory clinics provide multidisciplinary services specialising in the assessment and post-diagnostic treatment of people with dementia. This study sought to identify current practices, barriers and facilitators to provision of postdiagnostic support and to obtain health professionals' opinion of ideal post-diagnostic support to be offered in Australian memory clinics.

Forward with Dementia: process evaluation of an Australian campaign to improve post-diagnostic support.

Background: Forward with Dementia is a co-designed campaign to improve communication of dementia diagnosis and post-diagnostic support.

Methods: Webinars, a website, social and traditional media, and promotions through project partners were used to disseminate campaign messages to health and social care professionals (primary audience) and people with dementia and carers (secondary audience). The campaign ran between October 2021 and June 2022, with 3-months follow-up.

Frameworks for cultural adaptation of psychosocial interventions: A systematic review with narrative synthesis.

Introduction: Psychosocial dementia interventions may be less effective when used with populations for whom they were not initially intended. Cultural adaptation of interventions aims to increase effectiveness of interventions by enhancing cultural relevance. Use of theoretical frameworks may promote more systematic cultural adaptation.

The MINDSET Study: Co-Designing Training for Interpreters in Dementia and Cognitive Assessments.

There is a growing demand for interpreter-mediated cognitive assessments for dementia. However, most interpreters lack specialist knowledge of dementia and cognitive assessment tools. This can negatively affect the way instructions and responses are conveyed between clinicians and patients, undermining clinicians' ability to accurately assess for cognitive impairment.

A Preliminary Exploration of the Impact of Aged Care Reforms on the Governance of Two Australian Residential Care Facilities.

Australia's ongoing aged care reforms have re-focused service provisions from a provider-driven policy approach to a consumer-directed care focus and redirected residential care subsidies. This study aimed (i) to identify the experiences and perceptions of people involved in the governance of residential care facilities about their management of changes due to new accreditation requirements and funding mechanisms, and (ii) to describe their strategic responses to aged care reform changes. A qualitative description design used interviews exploring perspectives of Board Chairs, Board Directors, and Chief Executive Officers of two NSW-based residential care organizations.