Sue Malta

Caring for people with dementia in residential aged care: successes with a composite person-centered care model featuring Montessori-based activities.

Person-centered models of dementia care commonly merge aspects of existing models with additional influences from published and unpublished evidence and existing government policy. This study reports on the development and evaluation of one such composite model of person-centered dementia care, the ABLE model. The model was based on building the capacity and ability of residents living with dementia, using environmental changes, staff education and organizational and community engagement. Montessori principles were also used. The evaluation of the model employed mixed methods. Significant behavior changes were evident among residents of the dementia care Unit after the model was introduced, as were reductions in anti-psychotic and sedative medication. Staff reported increased knowledge about meeting the needs of people with dementia, and experienced organizational culture change that supported the ABLE model of care. Families were very satisfied with the changes.

The initiation and progression of late-life romantic relationships

This research explores the initiation and progression of new late-life romantic relationships among older Australians (60 years plus). Our research found that older adult romantic relationships were meaningful, important and sexually intimate. However, few led to cohabitation or marriage, with these older adults preferring to date or to maintain separate households (living-apart-together, LAT). In line with Giddens’ ideal of ‘pure’ relationships, our research indicates that older adults are looking for egalitarian relationships based on emotional and sexual equality, albeit not necessarily based on cohabitation or monogamy.

The Sex, Age, and Me Study: Recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population

Abstract Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult’s understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study’s recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.

The adverse mental health of carers: Does the patient diagnosis play a role?

OBJECTIVES The adverse mental health effects of caring have been studied, frequently in carers of people with dementia. Less is known about the mental health of carers of people with other conditions. This study compared depression and burden in older carers looking after people with a variety of conditions. DESIGN, METHODS AND MEASURES Over 200 older carers interested in participating in the Improving Mood through Physical Activity in Carers and Care-recipient Trial were included in this cross-sectional study, using the Geriatric Depression Scale (GDS) and Zarit Burden Inventory (ZBI). RESULTS Overall there were 43% of carers who were depressed and a quarter of them reported moderate-to-severe burden. Carers of people with physical conditions had the highest levels of depression and burden. Patient diagnosis, hours spent caring, and burden were associated with depression, while hours spent caring and carer depression were associated with burden. These factors contributed approximately 25-30% of the variance of depression and burden, respectively. CONCLUSIONS The diagnosis of the patient was a factor associated with depression, and older carers of people with physical conditions were at the highest risk. It is important for clinicians to assess the mental health of all carers, regardless of the patient diagnosis.

Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices

Objective: Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older peoples knowledge of STIs and safer sexual practices.

The Importance of Sex and the Meaning of Sex and Sexual Pleasure for Men Aged 60 and Older Who Engage in Heterosexual Relationships: Findings from a Qualitative Interview Study.

That many older individuals continue to engage in various forms of sexual expression well into later life is now well established in the literature. To date, however, only a small body of qualitative research has examined older men’s experiences and understandings of sex in later life. Likewise, the ways in which older men’s discussions on sex may be used as an avenue for “doing” masculinity remain underexplored. Older men are particularly interesting in this regard, as they inhabit an increasingly subordinated position in relation to hegemonic masculine ideals because of their age. To what extent might this limit or, alternatively, open up the possibilities for sexual expression and subjectivity in later life? Drawing on a subset of findings from Sex, Age, and Me: A National Study with Australian Women and Men Aged 60 and Older, data from qualitative interviews with 27 Australian men were explored in this article. The first Australian study of its kind, we argue that older men who engage in heterosexual relationships draw on a diverse and complex array of discursive positions regarding sex, relationships, and masculinity in making sense of their experiences of sex in later life. Older men are a heterogeneous group, and their experiences and understandings of sex do not simplistically follow “decline” or “success” narratives of aging. The findings of this research build upon and extend emerging research illustrating the centrality of intimacy to older men’s sexual lives, while simultaneously highlighting the ways in which the body and discursive constructions of sex intersect to shape older men’s sexual subjectivities.

Using Online Methods to Interview Older Adults about Their Romantic and Sexual Relationships

Structural ageing of populations has been accompanied by a move towards a greater understanding of the long-term health care and housing needs of older adults. Unfortunately, however, their status and value to society remains in question. In Western cultures, at least, old age is typically viewed in a negative light (Birren & Schaie, 2006, p. 389), and ageing is seen as a process of ‘inevitable decline and deterioration’ (Friedan, 1993, p. 9), or as a time of ‘decline, retreat, and withdrawal’ (Dychtwald, 2005, p. 17). Ageism refers to negative generalisations and perceptions about older adults and is a fact of life for many older people (Age Concern, 2006; Gething et al., 2003). As a group, older adults have become used to being typecast as frail, confused and a ‘burden’ on society (de Vaus et al., 2003, p. 19; Hoyer, 1997, p. 39) thereby leading to research that further problematises the lives of older people and focuses on ways of ‘dealing’ with the burden of a growing ageing population.

Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection.

BACKGROUND Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. METHODS A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n=805, 38%). RESULTS Less than one in three reported a STI test in the past 5 years (n=241, 30%) while 6% (n=51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. CONCLUSIONS STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients.

Factors associated with depression in older carers

Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated.

Mental health and well-being in older people: Butler's three constructs of ageism in Australasian Journal on Ageing.

In much of the Western world, old age is viewed negatively [1], and ageing is regarded as a process of unavoidable and predictable ‘decline and deterioration’ [2]. The term ‘ageism’ was initially proposed by Robert Butler, the founding director of the National Institute on Aging in the United States of America (USA) [3]. Ageism is typically expressed as discrimination against people on the basis of their age [4] and is manifested through negative stereotypes and perceptions about older adults [5] and, unfortunately, is a fact of life for many older Australians [6].