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Aim: This study aimed to explore what constitutes brilliant aged care.
Background: Although many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care-practices that exceeded expectation.
Design: The methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning.
Methods: This study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency.
Results: According to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise.
Conclusions: This study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation.
Relevance To Clinical Practice: For those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms.
Patient Or Public Contribution: The nominees, who included carers, were invited to participate in workshops with other carers and older people to co-design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data.
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http://dx.doi.org/10.1111/jocn.16789 | DOI Listing |
JAMA Netw Open
September 2025
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Importance: As obesity rates rise in the US, managing associated metabolic comorbidities presents a growing burden to the health care system. While bariatric surgery has shown promise in mitigating established metabolic conditions, no large studies have quantified the risk of developing major obesity-related comorbidities after bariatric surgery.
Objective: To identify common metabolic phenotypes for patients eligible for bariatric surgery and to estimate crude and adjusted incidence rates of additional metabolic comorbidities associated with bariatric surgery compared with weight management program (WMP) alone.
JAMA Netw Open
September 2025
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Importance: Patients with advanced cancer frequently receive broad-spectrum antibiotics, but changing use patterns across the end-of-life trajectory remain poorly understood.
Objective: To describe the patterns of broad-spectrum antibiotic use across defined end-of-life intervals in patients with advanced cancer.
Design, Setting, And Participants: This nationwide, population-based, retrospective cohort study used data from the South Korean National Health Insurance Service database to examine broad-spectrum antibiotic use among patients with advanced cancer who died between July 1, 2002, and December 31, 2021.
JAMA Netw Open
September 2025
Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City.
Importance: Advances in diagnostics have enabled the detection of more gastrointestinal pathogens, but misuse of diagnostics can lead to inappropriate antibiotic use and excess financial burdens. Ensuring appropriate use of diagnostics is crucial for optimizing patient care and promoting stewardship of health care resources.
Objective: To elicit parents' and clinicians' perspectives on expectations for care of pediatric diarrhea with a focus on diagnostic testing and to evaluate the potential for an electronic clinical decision support tool (ECDST) to improve appropriate use of diagnostics.
JAMA Netw Open
September 2025
Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada.
Importance: Caregivers of community-dwelling older adults play a protective role in emergency department (ED) care transitions. When the demands of caregiving result in caregiver burden, ED returns can ensue.
Objective: To develop models describing whether caregiver burden is associated with ED revisits and hospital admissions up to 30 days after discharge from an initial ED visit.
Age Ageing
August 2025
Department of Nursing Health Services Research, Graduate School of Health Care Sciences, Institute of Science Tokyo, Yushima, Bunkyo-ku, Tokyo, Japan.
Background: Little is known about how ambulatory care sensitive condition (ACSC)-related readmissions can be reduced in acute care settings.
Objective: This study examined the association between transitional care for hospitalised older patients with ACSC and ACSC-related readmissions.
Methods: This retrospective observational cohort study included patients aged 65 years and older admitted with ACSC as the primary diagnosis from 1 April 2022 to 31 January 2023, using linked data from the Diagnosis Procedure Combination and the medical functions of the hospital beds database.