Skip to main content
Top
Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Care | Research

What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context

Authors: Mark I. Hohenberg, Najwa-Joelle Metri, Rubab Firdaus, David Simmons, Genevieve Z. Steiner

Published in: BMC Geriatrics | Issue 1/2021

Login to get access

Abstract

Background

The aim of this study was to inform the development of a Community Geriatrics Service (CGS) that addressed the healthcare and social needs of community dwelling older people in an Australian context.

Methods

Stakeholders (N = 108) took part in a ‘needs assessment’ involving 30-min semi-structured interviews with general practitioners (GPs; N = 49), and three 2-h focus groups (community engagement meetings; N = 59) with older people, informal caregivers, allied healthcare workers, and nursing home directors. Data were transcribed and thematically coded, mapped to source and weighted to the frequency that the theme was raised across sources.

Results

Five themes informing CGS development and delivery emerged: active health conditions (management of behavioural and psychological symptoms of dementia, falls, multimorbidity, and other relevant conditions), active social challenges (patient non-compliance, need for aged care social workers, caregiver stress, elder abuse, social isolation, and stigma), referrals (availability of specialists, communication, specialist input, and advance care directives), access (lack of transport options, and inaccessibility of local geriatrics clinics and specialists), and awareness (lack of awareness, knowledge, and resources).

Conclusions

The CGS will need to address access, referral processes and health system navigation, which were perceived by stakeholders as significant challenges. These findings warrant the development of a CGS with an integrated approach to aged care, pertinent for the health and social needs of the elderly.
Literature
1.
go back to reference Australian Bureau of Statistics. Census of Population and Housing: Reflecting Australia - Stories from the Census, 2016. Ageing population, 2016. Canberra: ABS; 2017. Australian Bureau of Statistics. Census of Population and Housing: Reflecting Australia - Stories from the Census, 2016. Ageing population, 2016. Canberra: ABS; 2017.
2.
go back to reference Ingham B, Chirijevskis A, Carmichael F. Implications of an increasing old-age dependency ratio: the UK and Latvian experiences compared. Pensions. 2009;14(4):221–30.CrossRef Ingham B, Chirijevskis A, Carmichael F. Implications of an increasing old-age dependency ratio: the UK and Latvian experiences compared. Pensions. 2009;14(4):221–30.CrossRef
3.
go back to reference Australian Bureau of Statistics. Australian demographic statistics. In: vol. ABS cat. no. 3101.0. Canberra: ABS; 2015. Australian Bureau of Statistics. Australian demographic statistics. In: vol. ABS cat. no. 3101.0. Canberra: ABS; 2015.
4.
go back to reference Healy J, Healy J. The benefits of an ageing population. Canberra: Australia Institute Canberra; 2004. Healy J, Healy J. The benefits of an ageing population. Canberra: Australia Institute Canberra; 2004.
5.
go back to reference Hugo G. Australia's ageing population: some challenges for planners; 2003. Hugo G. Australia's ageing population: some challenges for planners; 2003.
8.
go back to reference Day P, Rasmussen P. What is the evidence for the effectiveness of specialist geriatric services in acute, post-acute and sub-acute settings. N Z Health Tech Assess. 2004;7(3):1–149. Day P, Rasmussen P. What is the evidence for the effectiveness of specialist geriatric services in acute, post-acute and sub-acute settings. N Z Health Tech Assess. 2004;7(3):1–149.
9.
go back to reference Korc-Grodzicki B, Tew W, Hurria A, Yulico H, Lichtman S, Hamlin P, et al. Development of a geriatric service in a cancer center: lessons learned. J Oncol Pract. 2017;13(2):107.CrossRef Korc-Grodzicki B, Tew W, Hurria A, Yulico H, Lichtman S, Hamlin P, et al. Development of a geriatric service in a cancer center: lessons learned. J Oncol Pract. 2017;13(2):107.CrossRef
11.
go back to reference District SESLH: Integrated skin Cancer clinic. 2016. District SESLH: Integrated skin Cancer clinic. 2016.
12.
go back to reference Braun KL, Rose CL. Geriatric patient outcomes and costs in three settings: nursing home, foster family, and own home. J Am Geriatr Soc. 1987;35(5):387–97.CrossRef Braun KL, Rose CL. Geriatric patient outcomes and costs in three settings: nursing home, foster family, and own home. J Am Geriatr Soc. 1987;35(5):387–97.CrossRef
14.
go back to reference Cohen L, Manion L, Morrison K. Research methods in education: routledge; 2013.CrossRef Cohen L, Manion L, Morrison K. Research methods in education: routledge; 2013.CrossRef
16.
go back to reference Simmons D, Weblemoe T, Voyle J, Prichard A, Leakehe L, Gatland B. Personal barriers to diabetes care: lessons from a multi-ethnic community in New Zealand. Diabet Med. 1998;15(11):958–64.CrossRef Simmons D, Weblemoe T, Voyle J, Prichard A, Leakehe L, Gatland B. Personal barriers to diabetes care: lessons from a multi-ethnic community in New Zealand. Diabet Med. 1998;15(11):958–64.CrossRef
17.
go back to reference Perry M, Melis R, Teerenstra S, Drašković I, van Achterberg T, Van Eijken M, et al. An in-home geriatric programme for vulnerable community-dwelling older people improves the detection of dementia in primary care. Int J Geriatr Psychiatry. 2008;23(12):1312–9.CrossRef Perry M, Melis R, Teerenstra S, Drašković I, van Achterberg T, Van Eijken M, et al. An in-home geriatric programme for vulnerable community-dwelling older people improves the detection of dementia in primary care. Int J Geriatr Psychiatry. 2008;23(12):1312–9.CrossRef
18.
go back to reference Madureira MM, Takayama L, Gallinaro A, Caparbo V, Costa R, Pereira RM. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(4):419–25.CrossRef Madureira MM, Takayama L, Gallinaro A, Caparbo V, Costa R, Pereira RM. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(4):419–25.CrossRef
19.
go back to reference Kamińska MS, Miller A, Rotter I, Szylińska A, Grochans E. The effectiveness of virtual reality training in reducing the risk of falls among elderly people. Clin Interv Aging. 2018;13:2329.CrossRef Kamińska MS, Miller A, Rotter I, Szylińska A, Grochans E. The effectiveness of virtual reality training in reducing the risk of falls among elderly people. Clin Interv Aging. 2018;13:2329.CrossRef
20.
go back to reference Sinaki M, Lynn SG. Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study. Am J Phys Med Rehabil. 2002;81(4):241–6.CrossRef Sinaki M, Lynn SG. Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study. Am J Phys Med Rehabil. 2002;81(4):241–6.CrossRef
21.
go back to reference Macfarlane S, Atee M, Morris T, Whiting D, Healy M, Alford M, et al. Evaluating the Clinical Impact of National Dementia Behaviour Support Programs on Neuropsychiatric Outcomes in Australia. Front Psychiatry. 2021;12(367). Macfarlane S, Atee M, Morris T, Whiting D, Healy M, Alford M, et al. Evaluating the Clinical Impact of National Dementia Behaviour Support Programs on Neuropsychiatric Outcomes in Australia. Front Psychiatry. 2021;12(367).
22.
go back to reference Steiner GZ, George ES, MacMillan F, McBride KA. Ageing Australians. In: Williams TDR, McLeod K, editors. Culture, Diversity and Health in Australia: Towards Culturally Safe Health Care. Crows Nest: Allen & Unwin; 2021. in press. Steiner GZ, George ES, MacMillan F, McBride KA. Ageing Australians. In: Williams TDR, McLeod K, editors. Culture, Diversity and Health in Australia: Towards Culturally Safe Health Care. Crows Nest: Allen & Unwin; 2021. in press.
24.
go back to reference Maneze D, Everett B, Astorga C, Yogendran D, Salamonson Y. The influence of health literacy and depression on diabetes self-management: a cross-sectional study. J Diabetes Res. 2016;2016. Maneze D, Everett B, Astorga C, Yogendran D, Salamonson Y. The influence of health literacy and depression on diabetes self-management: a cross-sectional study. J Diabetes Res. 2016;2016.
25.
go back to reference Osuagwu UL, Flack J, Piya M, Wong V, Simmons D. Prevalence of diabetes mellitus and risk factors in South Western Sydney WHERE ARE WE NOW? Penrith: Western Sydney University; 2020. Osuagwu UL, Flack J, Piya M, Wong V, Simmons D. Prevalence of diabetes mellitus and risk factors in South Western Sydney WHERE ARE WE NOW? Penrith: Western Sydney University; 2020.
26.
go back to reference Arlt S, Lindner R, Rösler A, von Renteln-Kruse W. Adherence to medication in patients with dementia. Drugs Aging. 2008;25(12):1033–47.CrossRef Arlt S, Lindner R, Rösler A, von Renteln-Kruse W. Adherence to medication in patients with dementia. Drugs Aging. 2008;25(12):1033–47.CrossRef
27.
go back to reference Ivry J. Aging in place: the role of geriatric social work. Fam Soc. 1995;76(2):76–85.CrossRef Ivry J. Aging in place: the role of geriatric social work. Fam Soc. 1995;76(2):76–85.CrossRef
28.
go back to reference Netting FE, Williams FG. Can we prepare geriatric social workers to collaborate in primary care practices? J Soc Work Educ. 1998;34(2):195–210.CrossRef Netting FE, Williams FG. Can we prepare geriatric social workers to collaborate in primary care practices? J Soc Work Educ. 1998;34(2):195–210.CrossRef
29.
go back to reference Haley WE, Zelinski E. Progress and challenges in graduate education in gerontology: the US experience. Gerontol Geriatr Educ. 2007;27(3):11–26.CrossRef Haley WE, Zelinski E. Progress and challenges in graduate education in gerontology: the US experience. Gerontol Geriatr Educ. 2007;27(3):11–26.CrossRef
30.
go back to reference Fruit D. Are graduates of bachelor's degree programs in gerontology employed? A report of a national survey. Educ Gerontol. 1985;11(4–5):237–45.CrossRef Fruit D. Are graduates of bachelor's degree programs in gerontology employed? A report of a national survey. Educ Gerontol. 1985;11(4–5):237–45.CrossRef
31.
go back to reference Holosko MJ. Inclusion of gerontology content in undergraduate social work curricula in Australia and New Zealand. Gerontol Geriatr Educ. 1995;15(4):5–19.CrossRef Holosko MJ. Inclusion of gerontology content in undergraduate social work curricula in Australia and New Zealand. Gerontol Geriatr Educ. 1995;15(4):5–19.CrossRef
32.
33.
go back to reference Son J, Erno A, Shea DG, Femia EE, Zarit SH, Parris Stephens MA. The caregiver stress process and health outcomes. J Aging Health. 2007;19(6):871–87.CrossRef Son J, Erno A, Shea DG, Femia EE, Zarit SH, Parris Stephens MA. The caregiver stress process and health outcomes. J Aging Health. 2007;19(6):871–87.CrossRef
34.
go back to reference Aranda MP, Knight BG. The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. Gerontologist. 1997;37(3):342–54.CrossRef Aranda MP, Knight BG. The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. Gerontologist. 1997;37(3):342–54.CrossRef
35.
go back to reference Zannettino L, Bagshaw D, Wendt S, Adams V. The role of emotional vulnerability and abuse in the financial exploitation of older people from culturally and linguistically diverse communities in Australia. J Elder Abuse Neglect. 2015;27(1):74–89.CrossRef Zannettino L, Bagshaw D, Wendt S, Adams V. The role of emotional vulnerability and abuse in the financial exploitation of older people from culturally and linguistically diverse communities in Australia. J Elder Abuse Neglect. 2015;27(1):74–89.CrossRef
36.
go back to reference DiGiacomo M, Green A, Delaney P, Delaney J, Patradoon-Ho P, Davidson PM, et al. Experiences and needs of carers of Aboriginal children with a disability: a qualitative study. BMC Fam Pract. 2017;18(1):96.CrossRef DiGiacomo M, Green A, Delaney P, Delaney J, Patradoon-Ho P, Davidson PM, et al. Experiences and needs of carers of Aboriginal children with a disability: a qualitative study. BMC Fam Pract. 2017;18(1):96.CrossRef
37.
go back to reference Cooper C, Selwood A, Livingston G. The prevalence of elder abuse and neglect: a systematic review. Age Ageing. 2008;37(2):151–60.CrossRef Cooper C, Selwood A, Livingston G. The prevalence of elder abuse and neglect: a systematic review. Age Ageing. 2008;37(2):151–60.CrossRef
38.
go back to reference Morgan KJ, Eastwood JG. Social determinants of maternal self-rated health in South Western Sydney, Australia. BMC Res Notes. 2014;7(1):51.CrossRef Morgan KJ, Eastwood JG. Social determinants of maternal self-rated health in South Western Sydney, Australia. BMC Res Notes. 2014;7(1):51.CrossRef
39.
go back to reference Sundström A, Adolfsson AN, Nordin M, Adolfsson R. Loneliness increases the risk of all-cause dementia and Alzheimer’s disease. J Gerontol B. 2019;75(5):919–26.CrossRef Sundström A, Adolfsson AN, Nordin M, Adolfsson R. Loneliness increases the risk of all-cause dementia and Alzheimer’s disease. J Gerontol B. 2019;75(5):919–26.CrossRef
40.
go back to reference Hwang T-J, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020:1–4. Hwang T-J, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020:1–4.
41.
go back to reference Corner L, Brittain K, Bond J. Social aspects of ageing. Psychiatry. 2007;6(12):480–3.CrossRef Corner L, Brittain K, Bond J. Social aspects of ageing. Psychiatry. 2007;6(12):480–3.CrossRef
42.
go back to reference Johnston K, Preston R, Strivens E, Qaloewai S, Larkins S. Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging Ment Health. 2020;24(8):1183–95.CrossRef Johnston K, Preston R, Strivens E, Qaloewai S, Larkins S. Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging Ment Health. 2020;24(8):1183–95.CrossRef
43.
go back to reference Esteve-Matalí L, Vargas I, Sánchez E, Ramon I, Plaja P, Vázquez M-L. Do primary and secondary care doctors have a different experience and perception of cross-level clinical coordination? Results of a cross-sectional study in the Catalan National Health System (Spain). BMC Fam Pract. 2020;21(1):135.CrossRef Esteve-Matalí L, Vargas I, Sánchez E, Ramon I, Plaja P, Vázquez M-L. Do primary and secondary care doctors have a different experience and perception of cross-level clinical coordination? Results of a cross-sectional study in the Catalan National Health System (Spain). BMC Fam Pract. 2020;21(1):135.CrossRef
44.
go back to reference Chow JS, Gonzalez-Arce VE, Tam CWM, Warner K, Maurya N, Mcdougall A. Creating a successful health pathway to support the integration of patient care. J Integr Care. 2019;28(2):171–82. Chow JS, Gonzalez-Arce VE, Tam CWM, Warner K, Maurya N, Mcdougall A. Creating a successful health pathway to support the integration of patient care. J Integr Care. 2019;28(2):171–82.
45.
go back to reference Kang M, Bernard D, Booth M, Quine S, Alperstein G, Usherwood T, et al. Access to primary health care for Australian young people: service provider perspectives. Br J Gen Pract. 2003;53(497):947–52.PubMedPubMedCentral Kang M, Bernard D, Booth M, Quine S, Alperstein G, Usherwood T, et al. Access to primary health care for Australian young people: service provider perspectives. Br J Gen Pract. 2003;53(497):947–52.PubMedPubMedCentral
46.
go back to reference Vandervoort A, Houttekier D, Vander Stichele R, Van der Steen JT, Van den Block L. Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study. PLoS One. 2014;9(3):e91130.CrossRef Vandervoort A, Houttekier D, Vander Stichele R, Van der Steen JT, Van den Block L. Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study. PLoS One. 2014;9(3):e91130.CrossRef
47.
go back to reference Brodaty H, Thomson C, Thompson C, Fine M. Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry. 2005;20(6):537–46.CrossRef Brodaty H, Thomson C, Thompson C, Fine M. Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry. 2005;20(6):537–46.CrossRef
48.
go back to reference Davey JA. Older people and transport: coping without a car. Ageing Soc. 2007;27:49.CrossRef Davey JA. Older people and transport: coping without a car. Ageing Soc. 2007;27:49.CrossRef
49.
go back to reference Buys L, Snow S, van Megen K, Miller E. Transportation behaviours of older adults: an investigation into car dependency in urban Australia. Australas J Ageing. 2012;31(3):181–6.CrossRef Buys L, Snow S, van Megen K, Miller E. Transportation behaviours of older adults: an investigation into car dependency in urban Australia. Australas J Ageing. 2012;31(3):181–6.CrossRef
50.
go back to reference Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;26(5):309–13.CrossRef Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;26(5):309–13.CrossRef
52.
go back to reference Steiner GZ, Ee C, Dubois S, MacMillan F, George ES, McBride KA, et al. “We need a one-stop-shop”: co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers. BMC Geriatr. 2020;20(1):49.CrossRef Steiner GZ, Ee C, Dubois S, MacMillan F, George ES, McBride KA, et al. “We need a one-stop-shop”: co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers. BMC Geriatr. 2020;20(1):49.CrossRef
Metadata
Title
What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context
Authors
Mark I. Hohenberg
Najwa-Joelle Metri
Rubab Firdaus
David Simmons
Genevieve Z. Steiner
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02553-8

Other articles of this Issue 1/2021

BMC Geriatrics 1/2021 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.