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Biomedical subjects

A L Howe

Publications and source records attributed to A L Howe.

14 recordsLinked to original sources
PubMed2001

Recent developments in aged care policy in Australia.

A series of major reforms implemented through the mid 1980s sought to contain residential care and expand community care in Australia's long-term care system. While this goal has been maintained, a number of new policy initiatives followed the change of federal government in 1996. This article presents a systematic account of current policy objectives, implementation measures, and outcomes in three major policy areas: changing the balance between residential and community care, targeting in community care, and support for family caregivers. This analysis shows that while there have been shifts in emphasis from time to time, concerted policy efforts over the last 20 years have contained the growth of expenditure on long-term care and realized significant change in the service system.

Aged↗
PubMed1997

From states of confusion to a national action plan for dementia care: the development of policies for dementia care in Australia.

The release of Australia's National Action Plan for Dementia Care in 1992 was the culmination of more than a decade of policy development over which the federal government assumed an increasing role, and the participatory approach fostered under its Social Justice Strategy promoted collectivist and political attempts to address the issues of dementia care. This article begins with an account of four phases of policy development, with the transition from one to the next marked by changes in thinking about dementia care being incorporated into policy and then expressed in programmes and in care practices. In the second part of the article, the goals and structure of the National Action Plan are outlined and its implementation and outcomes discussed. Continuation of the policy climate in which the National Action Plan was formulated is a crucial, but uncertain, factor for future development.

Aged↗
PubMed1997

Caregiving: a common or uncommon experience?

The analysis reported here aims to establish the household prevalence of caregiving in Australia, drawing on a large scale, longitudinal survey conducted as part of the Victorian Carers Project. Comparisons are made with a national survey conducted by the Australian Bureau of Statistics and with Canadian and U.K. findings. Three aspects of caregiving are investigated: reported household prevalence, taking account of differences in definitions used in various surveys; the extent of intergenerational exchanges involved in caregiving; and the time dimensions of caregiving, in terms of duration and patterns of cessation of caregiving over time. A high degree of consistency is found in prevalences of caregiving and implications for the development of policies and programs to support caregivers are raised concerning levels of caregiving, approaches to identifying carers, targeting of services and promotion of caregiving, and the spread of the experience of caregiving across the lifecycle and between generations.

Australia↗
PubMed1996

Older women in an aging world: achieving health across the life course.

This article, based on a report (Women, aging and health: achieving health across the life span) prepared for the WHO Global Commission on Women's Health under the guidance of WHO's Aging and Health Programme, presents demographic data that clearly demonstrate the need for recognition of the health of aging women as a global issue of major public health concern. The authors show that, while female life expectancy at birth is significantly different in developed and developing countries (because of high infant and maternal mortality in the latter), these differences tend to decrease for women in developing countries who reach middle age. The authors review the various facets of the "gender transition" brought about by demographic and epidemiological transitions, drawing attention to contrasts between the situation in developing countries in Asia and Latin America and that in Eastern Europe, for example. The role of older women as care-givers is discussed, as is the likelihood of a future increase in the proportion of older women living alone in the developing world (a factor which renders them particularly vulnerable in many socioeconomic and health respects). Suggestions are made on methodologies for monitoring health trends in aging women, and on the role of WHO in this respect. A basic goal for global strategies relating to the health of older women is formulated: reduction of the inequities in life expectancy between developed and developing countries.

Adolescent↗
PubMed1989

The old old or the new old? Part 2--health status and trends of the population aged 80 years and over.

"This paper is the second part of a study of the old old population, those aged 80 years and older, in Australia. It poses the question, as the experience of advanced old age becomes increasingly the norm, are more people living longer because of better health, or surviving longer in poorer health? Three aspects of population health are examined: patterns and trends in mortality, the morbidity implications of these findings, and service utilization. The study identifies a need to integrate analyses of mortality, morbidity and service use, and to develop a methodology able to express the diversity of the old old population."

Adult↗
PubMed1989

Monitoring regional geriatric assessment teams: analysis of client flows and outcomes.

The Commonwealth Government funding of the Geriatric Assessment Program began in 1984. The Program included an evaluation component, and this paper reports findings for three Regional Geriatric Assessment Teams (RGATs) in Victoria focusing on (1) the identification of different starting points in the flow of clients to the RGATs, (2) the relationships between different starting points and (3) recommended care plans, and the relationships between (2) and final outcome, particularly whether or not this involved admission to nursing home care. The role performed by RGATs is reviewed in the context of introducing mandatory assessment, the success of which will depend on the effectiveness of RGATs not only in differentiating need for and securing admission to nursing home care but also in assessing for, accessing and initiating alternative services.

Aged↗
PubMed1986

Analysing access to nursing home care.

The aim of this study is to investigate access to nursing home care in selected regions of Australia, Canada and the United States, and to examine the common ways in which nursing homes are used. Firstly, a review of methodological considerations in measuring access to nursing home care is made. Secondly, patient turnover patterns are interpreted with a view to showing differences in nursing home use among the countries studied; aggregate turnover rates, length of stay and outcomes are compared. Thirdly, groups of patients who differ in demographic and morbidity characteristics and in their use of nursing homes are discussed. Finally a number of distributive implications of these results are raised and a framework is outlined for considering redistributive consequences of changes in the use of nursing homes. It is concluded that the rate of flow of patients through nursing homes is as important a determinant of access to nursing home care as the level of bed provision and that adoption of this dynamic view of access indicates considerable scope for redistributing use of resources within the nursing home systems of all three countries.

Aged↗
PubMedDate not supplied

Rearranging the compartments: the financing and delivery of care for Australia's elderly.

Aged care policy in Australia underwent rapid change following the 1996 change of federal government, although continuing to emphasize changing the balance of aged care away from residential care toward community-based care and improving quality of care. This paper examines these policy directions with reference to two specific areas: the differentiation of funding arrangements for the care and accommodation components of residential care, and the targeting of services in community care. In both cases, funding arrangements have been used as a prime mechanism for redrawing the boundaries between different components and levels of care. This process of compartmentalization appears likely to increase the diversity of the Australian aged care system in the future.

Aged↗