Louise Horstmanshof

Creating the conditions for self-fulfilment for aged care residents

In 1991 the United Nations General Assembly adopted the Principles for Older Persons as a framework for international policy responses to population ageing. These principles promote independence, participation, care, self-fulfilment and dignity as legitimate entitlements of all older people. Although these principles, or variations of them, are embedded in standards of best-practice in residential aged care facilities, the literature shows that in reality institutional care can deny older people opportunities to exercise some of these entitlements. More specifically, residential aged care facilities can deprive older people of access and support to pursue opportunities for the full development of their potential, i.e. their entitlement to self-fulfilment. This discussion article explores the influence of institutional care on older people’s ability to exercise their entitlement to self-fulfilment. We identify the characteristics of a ‘good life’ in institutional care, according to aged care residents themselves. The Eden Alternative™ is presented as a model of aged care that aims to create the conditions for a ‘good life’ and self-fulfilment for aged care residents.

The management of loneliness in aged care residents: an important therapeutic target for gerontological nursing

Social engagement and meaningful relationships are critical determinants of the quality of life of older people. Human beings have an intrinsic need for social connections and an engagement with the social environment. Deficits in the quality of these social relationships lead to feelings of isolation and loneliness in older people. Loneliness can have serious physiological and health implications. It is well established that loneliness is a risk factor for poor physical and mental health, comparable in size to obesity, a sedentary lifestyle and possibly even smoking. The aim of this article is to present an argument for the management of loneliness in aged care residents as an important therapeutic target in gerontological nursing. To date little is known about the effectiveness of intervention strategies designed to alleviate loneliness in aged care residents. Nurses can address this deficit in our understanding by evaluating the impact of loneliness intervention strategies.

A scaffolded approach to Discussion Board use for formative assessment of academic writing skills

Mastery of academic writing skills remains one of the greatest challenges for university students, especially in the first year. Amongst the reasons offered for the challenges are lack of clarity about the university’s expectations and low levels of teacher feedback on work submitted, a failure to engage, and low levels of contact with teaching staff and other students. Academic staff are challenged by increased class numbers and increased student diversity in classes and university policies to adopt a wide range of information technologies into teaching modes. In this paper, we offer one attempt at addressing these three important contemporary academic challenges: use of information technology to provide timely feedback through formative assessment to help students with a range of abilities to acquire the academic writing skills necessary to succeed in higher education. Early indications show that students find this form of formative assessment very useful. They value the timely and focused feedback from the lecturer and are developing collegiality as they learn from each others’ writing and feedback. We believe that this strategy is sustainable and can be adapted to facilitate academic and social integration for students across many disciplines.

Hearing loss and its impact on residents in long term care facilities: A systematic review of literature

&NA; The prevalence of age‐related hearing loss is high among older adults. Growing longevity and the older profile of aged care residents is likely to result in an increasing incidence of hearing loss among this cohort. This review reports on the findings of a systematic search of the academic databases CINAHL, Medline, PsychInfo and Scopus undertaken to investigate the hearing experiences of residents of aged care facilities. Twenty‐two studies met the inclusion criteria. Our analysis revealed clear barriers and facilitators to optimal hearing experiences and indicated the importance of the physical and social environment for effective communication. Under‐detection of hearing loss and underuse of hearing aids were prevalent. The findings highlight the importance of addressing these issues for this cohorts quality of life. Future trends that may impact on training needs are considered and recommendations are made.

Clinical exercise physiology students learning with older adults: an innovative simulation-based education programme

In this paper, we report on a series of placements for clinical exercise physiology students in a simulation-based education environment with older, independent adults. The purpose of these placement opportunities was to help prepare students to work confidently and competently with older adults in primary healthcare settings. The effectiveness of these placements was measured through semi-structured interviews with the students, their supervisors and the volunteer patients, and also by analysing the content of the students’ written reflection assignments. A combination of directed content analysis, informed by the research objectives and imposed upon the data, and conventional content analysis, in which codes were developed from themes emerging from the data, was adopted. Coding was based on units of meaning. Overall, the placement aims were met. Students reported increased confidence in communicating with older adults and in using the tools of their trade. This innovative simulation-based education experience helped students gain an understanding of their developing professional identities. However, the data show that some students still failed to recognise the value and importance of communication when working with older adults. The older adults reported that they enjoyed interacting with the students and believed that they had helped the students gain a positive impression of the cognitive and physical abilities of older adults. These older adults had also gained insight into the benefits of exercise physiology in terms of their own wellbeing.This paper demonstrates the benefits of engaging community support in developing healthcare workers and provides guidelines for replication of these innovative simulation-based education experiences. The paper is limited to reporting the social and community engagement benefits for older adults and the learning opportunities for the clinical exercise physiology students. Further research is needed to demonstrate the health gains for older adults who participate in such programmes.