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Help-seeking and service use for dementia in Italian, Greek and Chinese Australians
- Authors:
- LOW Lee-Fay, et al
- Journal article citation:
- Aging and Mental Health, 15(3), April 2011, pp.397-404.
- Publisher:
- Taylor and Francis
This article examines racial differences in help-seeking and the acceptability of different services for dementia. The study explored the pattern of help-seeking and the acceptance of different services among Italian, Greek and Chinese Australians compared to third generation Australians. A cross-sectional telephone survey of 350 Italian, 414 Greek, 437 Chinese and 500 third generation Australians was carried out. Participants were asked how they would seek help for a character in a vignette with dementia and what aged care services they would use. The most frequently reported sources of help for all participants were general practitioners (55%), community organisations (27%) and family (26%). Significantly more racial minority participants reported that they would seek help from their families (32%) than did third generation Australians (13%). The percentage of participants who reported they would use aged care services were 96% for day activities, 95% for community nursing, 93% for bus outings, 91% for home help with housework, 88% for carer's support groups, 83% for nursing home care, 78% for one-week respite and 67% for Meals-on-Wheels. Racial minorities were equally or more likely to say that they would use some community-based services than third generation Australians and less likely to use residential respite. Italians were less likely to use permanent residential care. Acculturation parameters were inconsistently associated with help-seeking and service acceptability.
A systematic review of different models of home and community care services for older persons
- Authors:
- LOW Lee-Fay, YAP Melvyn, BRODATY Henry
- Journal article citation:
- BMC Health Services Research, 11(93), 2011, pp.1-15. Online only
- Publisher:
- BioMed Central Ltd
Background: Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia. Methods: A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results. Results: Thirty five papers were included in this review. Evidence from randomised controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomised trials, showed that integrated care increases service use; randomised trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent. Conclusions: The outcomes of each model of care differ and correspond to the model’s focus. Combining key elements of all three models may maximise outcomes. (Edited publisher abstract)