Yvonne Wells

To Continue, Modify or Relinquish Driving : Findings from a Longitudinal Study of Healthy Ageing

Background: The number and proportion of drivers among people entering later life continues to rise. More information on patterns of driving for older adults is required to improve service provision and traffic planning. Objectives: To map the changes in driving status for a sample of drivers aged 65 years or older over the period 1994–2000, and to identify factors associated with older people continuing, modifying or relinquishing their status as drivers. Methods: The 752 participants were drawn from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) program, a longitudinal study of people aged 65 years and older living in the community. Participants were interviewed or contacted for follow-up in 1994, 1996, 1998 and 2000 on a range of topics including their health, functional independence and driving status. Results: Although the number of recent drivers was smaller as participants died or were admitted to nursing homes over the 6-year data collection period, relatively few participants relinquished driving while remaining in the community. Many drivers reported modifying their driving habits over time, including decisions to restrict their driving to their local area during daylight only. Relationships were explored between driving status and the key variables of age, gender, marital status, instrumental activities of daily living (IADL) independence and self-rated measures of income, health, eyesight and hearing. Multivariate analyses indicated that drivers were more likely to modify their driving habits if they were older, dependent in IADL, and rated their eyesight as poor. Similar factors predicted relinquishing driving, but in addition, women were three times more likely to relinquish driving than men (even when health and disability were taken into account) and people who rated their incomes as ‘comfortable’ were more likely to relinquish driving than those with lower incomes. Conclusions: This study confirmed previous evidence that older drivers self-regulate by modifying their driving behavior as they age. However, since few drivers voluntarily relinquish driving, further research is required to identify ways of supporting older drivers to continue to drive safely.

Evaluation of a Special Nursing Home Unit for Dementia Sufferers: A Randomised Controlled Comparison with Community Care

Applicants for a newly opened special unit for dementia sufferers were randomly allocated to full-time care in the unit or placed on a waiting list and offered periodic respite care in the meantime. All applicants were living in the community at the time of random assignment. Both groups were followed up for three months to assess the effects on the dementia sufferers and on their family care-givers. Care-givers initially had a high level of psychological symptoms, which was greatly reduced after admission of the dementia sufferer to full-time care. By contrast, the care-givers of the community care group of sufferers continued to have a high level of symptoms. Dementia sufferers continued to deteriorate with both forms of care, with little difference between the two groups. Admission of dementia sufferers to full-time care in a special unit appears to be of great benefit to the psychological health of their care-givers and has no adverse effects on the dementia sufferers themselves.

When choice in retirement decisions is missing: Qualitative and quantitative findings of impact on well-being

Objectives:  To explore the importance of choice in retirement decisions for subsequent well‐being.

Empirical aspects of record linkage across multiple data sets using statistical linkage keys: the experience of the PIAC cohort study

BackgroundIn Australia, many community service program data collections developed over the last decade, including several for aged care programs, contain a statistical linkage key (SLK) to enable derivation of client-level data. In addition, a common SLK is now used in many collections to facilitate the statistical examination of cross-program use. In 2005, the Pathways in Aged Care (PIAC) cohort study was funded to create a linked aged care database using the common SLK to enable analysis of pathways through aged care services.Linkage using an SLK is commonly deterministic. The purpose of this paper is to describe an extended deterministic record linkage strategy for situations where there is a general person identifier (e.g. an SLK) and several additional variables suitable for data linkage. This approach can allow for variation in client information recorded on different databases.MethodsA stepwise deterministic record linkage algorithm was developed to link datasets using an SLK and several other variables. Three measures of likely match accuracy were used: the discriminating power of match key values, an estimated false match rate, and an estimated step-specific trade-off between true and false matches. The method was validated through examining link properties and clerical review of three samples of links.ResultsThe deterministic algorithm resulted in up to an 11% increase in links compared with simple deterministic matching using an SLK. The links identified are of high quality: validation samples showed that less than 0.5% of links were false positives, and very few matches were made using non-unique match information (0.01%). There was a high degree of consistency in the characteristics of linked events.ConclusionsThe linkage strategy described in this paper has allowed the linking of multiple large aged care service datasets using a statistical linkage key while allowing for variation in its reporting. More widely, our deterministic algorithm, based on statistical properties of match keys, is a useful addition to the linkers toolkit. In particular, it may prove attractive when insufficient data are available for clerical review or follow-up, and the researcher has fewer options in relation to probabilistic linkage.

Health, Lifestyle, and Gender Influences on Aging Well: An Australian Longitudinal Analysis to Guide Health Promotion

A primary societal goal for aging is enabling older people to continue to live well as long as possible. The evidence base around aging well (“healthy,” “active,” and “successful” aging) has been constructed mainly from academic and professional conceptualizations of mortality, morbidity, functioning, and psychological well-being with some attention to lay views. Our study aims to inform action on health promotion to achieve aging well as conceptualized by qualitative research identifying what older Australians themselves value most: continuing to live as long as possible in the community with independence in daily living, and good self-rated health and psychological well-being. Multivariate survival analyses from the Melbourne longitudinal studies on healthy aging program found that important threats to aging well for the total sample over a 12-year period were chronological age, multi-morbidity, low perceived social support, low nutritional score, and being under-weight. For men, threats to aging well were low strain, perceived inadequacy of social activity, and being a current smoker. For women, urinary incontinence, low physical activity and being under-weight were threats to aging well. The findings indicate that healthy lifestyles can assist aging well, and suggest the value of taking gender into account in health promotion strategies.

Developing a comprehensive approach to risk management of musculoskeletal disorders in non-nursing health care sector employees

This study of selected jobs in the health care sector explored a range of physical and psychosocial factors to identify those that most strongly predicted work-related musculoskeletal disorders (WMSD) risk. A self-report survey was used to collect data on physical and psychosocial risk factors from employees in three health care organisations in Victoria, Australia. Multivariate analyses demonstrated the importance of both psychosocial and physical hazards in predicting WMSD risk and provides evidence for risk management of WMSDs to incorporate a more comprehensive and integrated approach. Use of a risk management toolkit is recommended to address WMSD risk in the workplace.

Australian Baby Boomers Face Retirement During the Global Financial Crisis

This paper examines the impact in Australia of the global financial crisis on the baby boom cohort approaching later life. Data from national focus groups of people aged 50 to 64 years (N = 73), conducted in late 2008, found widespread but variable concern and uncertainty concerning work and retirement plans and experiences. A national survey (N = 1,009) of those aged 50 to 64 years in mid-2009 reported lower levels of financial satisfaction compared with other life domains; many planned to postpone retirement. Findings are interpreted in the context of policies and markets that differed significantly from those in the United States, notwithstanding the global nature of the financial crisis.

Psychological Resources and Successful Retirement

Abstract Although most people eventually make a satisfactory adjustment to retirement, some people experience difficulties in managing the transition. While measures of wellbeing are frequently included as outcomes in studies of retirement, few studies have examined the impact of retirement on health behaviours. Further, the contribution of psychological resources such as self-efficacy and sense of coherence in coping with transitions has largely been ignored. Data from the Health Status of Older People project were used to test the hypothesis that psychological resources would moderate the relationship between retirement and changes in health behaviours and wellbeing. People who had retired within the previous 5 years were compared with three other groups: those who were still working, those who were partly retired, and those who had been retired for between 6 and 10 years. Recently retired people were found to be more likely than other groups to have experienced recent reductions in physical and social ...

The role of Psychologists in fostering the wellbeing of older Australians

The United Nations International Year of Older Persons (IYOP) in 1999 prompted the Australian Psychological Society (APS) to review its responsibilities and to consider the contribution of psychological research and practice to the wellbeing of older Australians. This article reports a series of recommendations for public policy, research, training and psychological practice, drawn from a larger Position Paper that addressed a spectrum of issues. The aim is to encourage psychologists to turn a critical gaze on themselves and to examine ways in which psychology can be used to promote successful ageing. The article begins with a definition of “successful ageing”. This is followed by an examination of ageism and how this affects community expectations of older people and the quality of aged care services. Attention also is given to the low visibility of psychologists in service planning and delivery and to the overemphasis of much psychological research and practice on deficits and decline in later years. The International Year of Older Persons has come and gone, but the true test of its effectiveness will lie in evidence of longer-term changes in attitudes, policies and practices. Psychologists have much to contribute to these changes and to enhancing the wellbeing of older Australians.

Effects of Pet Ownership on the Health and Well-being of Older People

Objective: To examine the view that having a pet is good for the health and well‐being of older people, particularly those who are socially isolated.