The Australian Ageing Research Agenda – the researcher perspective

Rhonda Nay Professor/Director Gerontic Nursing Clinical School and ACEBAC La Trobe University /BECC

How are we defining ‘Policy’?

• Are we assuming practice guidelines are policy?

• If not – practice/care again the poor third cousin!

Where is Care?

• Funding – – not age-related – Bio-medical – Healthy ageing – BUT what about CARE?

Care research

• Aged care – – up to 56% acute bed days – Approx 20% formal care – Approx 5% high care/ 25% will experience and rising – ? SRSs – Insufficient health professionals – collaboration essential – BUT research models and outcomes??

Care and Policy

• Policy is important to care – Who will provide – Under what circumstances – Skills mix – In what environment – Who will fund!

Care and Policy

– Across the continuum • Impact on providers; • Appropriate educational preparation • Funding to support • New employment structures and roles • Collaboration essential

Ageing and Practice Issues

• • • • Most Systematic Reviews demonstrate paucity of evidence to inform nursing/care How can care be evidence-based if no evidence??

Research/funding essential Good care can reduce acute admission/readmission/ from home or RACF; decrease LOS; reduce adverse advents, reduce RACF admissions; costs etc etc AND improve QoL in any environment.

Re-defining evidence

• Drug effectiveness for dementia – RCT – Maybe?? Co-morbidities • The experience of dementia for the person, family and staff – qualitative • Getting policy and practice - relevant evidence and changing practice – action research.

• Qualitative research - synthesis

How to get the evidence

• • • • Broad range of practitioners and policy makers involved in setting research agenda and funding processes Must be relevant to current and anticipated need Must be accessible – academic journals not necessarily read by practitioners Implementation and evaluation of research findings

Research

• Research teams that reflect rhetoric of holistic care – eg Virtual faculty (G. Andrews) – BUT of ALL aspects of AGEING population and people. – Policy impacts real people not bits of them. – Advice from end-users to researchers and funders.

Research into care

• Most older people will require care –Do we remember the drugs?

–Machines?

–NO – the care that made it bearable and kept us feeling human!

So:

• • • • Understanding cause, prevention, cure; maintenance therapies essential BUT So is care Rhetoric of consumer participation and holistic approaches not matched by research priorities and funding

Care

• • Specialisation = fragmentation Chronic illnesses; dying major challenges – Collaboration – Use of IT - Communication across disciplines/ between client and provider.

– Ethics of care decisions • The need for understanding good care has never been greater

Selected references

• • • • • A Report to the Australian Health Ministers' Conference from Australian Health Care Agreement Reference Groups September 2002 http://www.health.gov.au/haf/ahca.htm

Flemming K. EBN Notebook: Asking answerable questions.

Evidence Based Nursing

1(2):36-37 .

1998; Kitson A. Recognising relationships: reflections on evidence-based practice.

Nursing Inquiry

2002; 9(3):179-186.

Koch, W and Tiaziani, A (forthcoming) Current and Future Trends in Gerontic Nursing Research. In Nay, R and Garratt, S

Nursing Older People: Issues and Innovations

, Elsevier: Sydney.

Pearson, A. (forthcoming) Evidence based practice – quality through research. In Nay, R and Garratt,

S Nursing Older People: Issues and Innovations

, Elsevier: Sydney.