The Australian Ageing Research Agenda – the researcher perspective

1. The Australian Ageing Research Agenda – the researcher perspective Rhonda Nay Professor/Director Gerontic Nursing Clinical School and ACEBAC La Trobe University /BECC

2. How are we defining ‘Policy’? • Are we assuming practice guidelines are policy? • If not – practice/care again the poor third cousin!

3. Where is Care? • Funding – • not age-related • Bio-medical • Healthy ageing • BUT what about CARE?

4. Care research • Aged care – • up to 56% acute bed days • Approx 20% formal care • Approx 5% high care/ 25% will experience and rising • ? SRSs • Insufficient health professionals – collaboration essential – BUT research models and outcomes??

5. Care and Policy • Policy is important to care • Who will provide • Under what circumstances • Skills mix • In what environment • Who will fund!

6. Care and Policy • Across the continuum • Impact on providers; • Appropriate educational preparation • Funding to support • New employment structures and roles • Collaboration essential

7. Ageing and Practice Issues • Most Systematic Reviews demonstrate paucity of evidence to inform nursing/care • How can care be evidence-based if no evidence?? • Research/funding essential • Good care can reduce acute admission/readmission/ from home or RACF; decrease LOS; reduce adverse advents, reduce RACF admissions; costs etc etc AND improve QoL in any environment.

8. Re-defining evidence • Drug effectiveness for dementia – RCT • Maybe?? Co-morbidities • The experience of dementia for the person, family and staff – qualitative • Getting policy and practice - relevant evidence and changing practice – action research. • Qualitative research - synthesis

9. How to get the evidence • Broad range of practitioners and policy makers involved in setting research agenda and funding processes • Must be relevant to current and anticipated need • Must be accessible – academic journals not necessarily read by practitioners • Implementation and evaluation of research findings

10. Research • Research teams that reflect rhetoric of holistic care – eg Virtual faculty (G. Andrews)– BUT of ALL aspects of AGEING population and people. • Policy impacts real people not bits of them. • Advice from end-users to researchers and funders.

11. Research into care • Most older people will require care • Do we remember the drugs? • Machines? • NO – the care that made it bearable and kept us feeling human!

12. So: • Understanding cause, prevention, cure; maintenance therapies essential • BUT • So is care • Rhetoric of consumer participation and holistic approaches not matched by research priorities and funding

13. Care • Specialisation = fragmentation • Chronic illnesses; dying major challenges • Collaboration • Use of IT - Communication across disciplines/ between client and provider. • Ethics of care decisions • The need for understanding good care has never been greater

14. Selected references • A Report to the Australian Health Ministers' Conference from Australian Health Care Agreement Reference Groups September 2002 http://www.health.gov.au/haf/ahca.htm • Flemming K. EBN Notebook: Asking answerable questions. Evidence Based Nursing 1998; 1(2):36-37. • Kitson A. Recognising relationships: reflections on evidence-based practice. Nursing Inquiry 2002; 9(3):179-186. • Koch, W and Tiaziani, A (forthcoming) Current and Future Trends in Gerontic Nursing Research. In Nay, R and Garratt, S Nursing Older People: Issues and Innovations, Elsevier: Sydney. • Pearson, A. (forthcoming) Evidence based practice – quality through research. In Nay, R and Garratt, S Nursing Older People: Issues and Innovations, Elsevier: Sydney.