Factors influencing care and support for older adults with traumatic injury in Australia: a qualitative study.

PURPOSE: To investigate factors influencing provision of care and support to older adults with traumatic injury in Australia, from a health service and policy perspective. METHODS: Semi-structured interviews were undertaken with 16 clinicians, support providers, researchers, policy makers, and representatives from peak bodies in Australia, who had experience across injury, ageing, and disability sectors. A thematic analysis was performed using a framework approach. RESULTS: Themes identified included prolonged injury recovery in older adults, limited accommodation options, restricted access to preventive care, escalating care needs over time, issues with siloed funding schemes and funding availability, and the need for advocacy to coordinate care across different schemes. Certain themes were specific to people who were older when injured. Others related to people who had acquired an injury at a younger age and were ageing with injury. However, most themes had relevance for both groups. CONCLUSIONS: For older adults, this research has highlighted a range of cross-sector problems which impact upon the potential to recover from injury and to age well with injury. To improve the lives of older adults with injuries, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors, and improved advocacy and case management.Implications for rehabilitationTo address the lack of long-term, multi-disciplinary preventive care for age-related conditions and secondary complications in people with injuries, older adults may need more prolonged, or individualised, care following injury, episodic health checks, and a greater focus on long-term health care.Accessible and well-coordinated specialist housing and support responses, that offer timely access to health care professionals and carers trained in both ageing and disability, and enable greater support for "ageing in place", are required to manage changing care needs of people ageing with injury.There needs to be greater involvement of geriatricians, nurses, and allied health care professionals within the aged care sector in order to care for people with complex needs, including older adults with injury-related disability.To reduce gaps in care and support for injured older adults, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors.

What Are the Restraint Practices, Preferences, and Experiences When Australian Parents Travel with Their Children in a Rideshare Vehicle?

This study aimed to explore the preferences, experiences and restraint practices of Australian parents travelling with their children in rideshare vehicles. Six hundred and thirty-one participants completed an online survey (M = 39.2 years, SD = 10.5, Range = 18.0-70.0 years; Female: 63.4%). Most participants (59.1%) reported that they had not travelled in a rideshare vehicle with their youngest child (M = 7.2 years, SD = 5.2, Range = 0.0-17.0 years; Male: 54.2%). Participants who reported that they have travelled with their youngest child in a rideshare vehicle tended to: be younger, identify as male, have completed an Undergraduate or Postgraduate degree, reside in the Australian Capital Territory, earning a higher yearly household income, and were involved in an at-fault crash in the past two years. In addition, these participants were: less likely to have a 'younger' youngest child, less likely to 'always' wear a seatbelt while travelling in their private motor vehicle, and also less likely to 'always' restrain their child in an appropriate restraint while travelling in their private motor vehicle. Prohibitive reasons for not travelling in a rideshare vehicle included: cost (29.3%), concerns over driver safety (27.5%), concerns over travelling with children in a rideshare service (24.8%), or inconvenience (24.3%). Participants who reported that they had travelled in a rideshare vehicle with their youngest child reported lower rates of appropriate restraint use within the rideshare vehicle (57.3%) than when travelling in their private motor vehicle (85.6%). Reasons associated with inappropriate restraint use within the rideshare vehicle included: unavailability of a child restraint (39.6%), travelling a short distance (33.0%), were not required to use one in this situation (33.0%), or the parent did not have a restraint with them (26.4%). Given the increasing popularity of rideshare services in Australia, and globally, the urgent adaption of rideshare-specific policy, legislation, education, and design in relation to child restraint requirements is needed to ensure the safety of child occupants.