Evaluating the Co-design of an Age-Friendly, Rural, Multidisciplinary Primary Care Model: A Study Protocol.

In the context of increased rates of frailty and chronic disease among older people, there is a need to develop age-friendly, integrated primary care models that place the older person at the centre of their care. However, there is little evidence about how age-friendly integrated care frameworks that are sensitive to the challenges of rural regions can be developed. This protocol paper outlines a study that will examine how the use of an age-friendly care framework (the Indigo 4Ms Framework) within a co-design process can facilitate the development of models of integrated care for rural older people within the Upper Hume region (Victoria, Australia). A co-design team will be assembled, which will include older people and individuals from local health, aged care, and community organisations. Process and outcome evaluation of the co-design activities will be undertaken to determine (1) the processes, activities and outputs that facilitate or hinder the co-design of a 4Ms integrated approach, and (2) how the use of the Indigo 4Ms Framework within a co-design process contributes to more integrated working practices. This protocol contributes to the development of a field of study examining how rural health and aged care services can become more age-friendly, with an emphasis on the role of co-design in developing integrated approaches to health care for older adults.

Age-friendly care for older adults within rural Australian health systems: An integrative review.

OBJECTIVES: To identify the core elements of interventions and models that facilitate age-friendly care for older adults within rural Australian health systems, and assess the extent to which these align with core elements of the Institute for Health Improvement's (IHI) Age-Friendly Health Systems 4Ms Model. METHODS: Peer-reviewed journal articles examining core elements of Australian rural geriatric care models were collected and analysed using an integrative review methodology. RESULTS: Identified models and interventions addressed all four core elements of the IHI model-what matters, medications, mobility and mentation. There was more evidence relating to mobility and mentation, with lesser evidence relating to medications and what matters. A series of core elements not aligned with the model were also identified. CONCLUSION: The IHI 4Ms Model appears to be applicable in the rural Australian context. More high-quality, systematic evidence is needed to investigate the core elements of age-friendly care across diverse rural contexts.

How Can the Lived Environment Support Healthy Ageing? A Spatial Indicators Framework for the Assessment of Age-Friendly Communities.

The Age-Friendly Cities and Communities Guide was released by the World Health Organization over a decade ago with the aim of creating environments that support healthy ageing. The comprehensive framework includes the domains of outdoor spaces and buildings, transportation, housing, social participation, respect and inclusion, civic participation and employment, communication and information, and community and health services. A major critique of the age-friendly community movement has argued for a more clearly defined scope of actions, the need to measure or quantify results and increase the connections to policy and funding levers. This paper provides a quantifiable spatial indicators framework to assess local lived environments according to each Age-Friendly Cities and Communities (AFC) domain. The selection of these AFC spatial indicators can be applied within local neighbourhoods, census tracts, suburbs, municipalities, or cities with minimal resource requirements other than applied spatial analysis, which addresses past critiques of the Age-Friendly Community movement. The framework has great potential for applications within local, national, and international policy and planning contexts in the future.

Co-creating a Peer Education program to improve skin health in older people from diverse communities: An innovation in health promotion.

OBJECTIVE: Chronic wounds, debilitating and costly to manage, are more common in older people. Prevention is possible through improving skin health. We developed, implemented and evaluated an innovative health promotion program to improve skin health of older adults. METHODS: A one-hour, peer education program was co-created and delivered to culturally diverse community-dwelling older people. A mixed-methods evaluation approach comprised objective measures of skin health and barrier function at commencement and six weeks posteducation, and focus groups posteducation. RESULTS: Seventy-three participants participated in the study (mean age 74.38 ± 11.80 years). Hydration significantly improved at follow-up for English speaking participants (t(27) = -2.90, P = 0.007). The majority of participants reported the education to be informative and useful in supporting behaviour changes. CONCLUSION: The peer education program improved skin hydration in older English speaking individuals. Peer education may effectively deliver health promotion information in some groups.

Living alone with dementia.

This paper details the findings of an exploratory study undertaken in 2009 into the older population who live alone with dementia, as part of a wider study into the phenomenon of living alone in older age with a cognitive impairment or early stage dementia. Interviews were undertaken with 19 older people who live alone with cognitive impairment or early stage dementia, and field notes were taken during interview visits. Throughout this paper, older people who live alone with a cognitive impairment or dementia who participated in the study will be referred to by pseudonym. Overall, the findings give insight into the lives of these people and how they remain connected to and supported by others. These findings will contribute to the knowledge of this group, which may be considered in future research and service delivery.

Community wellbeing in an unwell world: trends, challenges, and possibilities.

This essay explores the changing nature of the concept of community wellbeing and the richness of the concept for enhancing measurement of societal progress beyond the use of indicators focused more narrowly on economic growth. Beginning with the history of the concept of wellbeing in several disciplines, the authors pursue an integrated and ecological understanding of community wellbeing and present examples of recent developments and applications of community wellbeing indicators in international settings and in Australia.