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Purpose: Quality disability support is fundamental to the lives of many adults with acquired neurological disability. However, little is known about the factors that influence the quality of paid support. This study is part of a larger project to develop a holistic understanding of quality support, grounded in the experience of people with acquired neurological disability, close others, and disability support workers. The current study focuses on the support worker perspective. Methods: Following constructivist grounded theory methodology, interviews were conducted with 12 support workers. Grounded theory analysis was followed to develop themes and subthemes and build a model of quality support. Results: Five key themes, with fifteen subthemes emerged to depict factors influencing the quality of support. The five themes are: being the right person for the role, delivering quality support in practice, working well together, maintaining and improving quality support, and considering the broader context. Findings emphasise the importance of the support worker recognising the person as an individual and respecting their autonomy. Conclusions: Critical to quality support is centring the needs and preferences of people with disability, improving support worker working conditions and supporting people with disability and support workers to build effective, balanced working relationships. [ABSTRACT FROM AUTHOR]

Over 4500 people under 65 years of age live in residential aged care (RAC) in Australia, and they experience poorer quality of life than people with similar disabilities in other settings. Governments have long aimed to reduce admissions of young people to RAC, but in 2019, for the first time, the Australian Government adopted target dates for resolving the issue. The targets include reducing admissions of young people to near zero by 2022 and ensuring almost no one remains in RAC beyond 2025. The national strategy focuses mostly on housing and support needs being met via the National Disability Insurance Scheme. The present study drew on quarterly data from the National Aged Care Data Clearinghouse to examine progress toward these targets. Significant progress was evident in terms of young people entering RAC: admissions reduced each quarter between September 2018 and July 2020, halving over two years. No progress was evident in terms of young people leaving RAC for better arrangements; the trend neither increased nor decreased. Prospects for achieving the targets are discussed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine use of electronic assistive technology for social networking by people with disability living in shared supported accommodation (SSA), and compare participants' Electronic Social Networking (ESN) integration with Australian ESN normative data. Method: Telephone surveys and the ESN subscale of the Community Integration Questionnaire-Revised (CIQ-R) were administered with SSA managers. Surveys gathered demographic data, and data on Internet access, technology use and ESN integration, of 91 people with disability who were identified technology users and living in SSA. Participant ESN data were then matched with existing CIQ-R ESN normative data (N = 359). Relative risk of reduced ESN integration was calculated. Results: This study identified that, despite access to mainstream technologies, people with disability living in SSA experience low ESN integration, and use ESN for social contact less than other Australians. This group were 210% more likely to report reduced ESN integration than the matched normative sample when key demographic variables were held constant. Conclusions: Factors related to disability, including high care and support needs and greater time spent completing essential activities of daily living (such as personal care), may explain the low electronic social networking integration for people with disability living in SSA identified in this study. Further research that examines factors that influence ESN access and use following disability is necessary to inform practice to bridge the digital divide that exists between this group and other Australians. [ABSTRACT FROM AUTHOR]

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation: Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals. [ABSTRACT FROM AUTHOR]

Introduction: People with severe acquired brain injury often require lifetime support, sometimes received from paid workers if living in shared supported accommodation. Electronic assistive technology may offer a less intrusive method of support that can enable autonomous participation and deliver cost savings. However, research on rates, barriers, and facilitators of electronic assistive technology uptake is lacking. This study aimed to identify electronic assistive technology types used by people with acquired brain injury living in shared supported accommodation, assess user satisfaction and psychosocial impact of electronic assistive technology, detail the impact of technology use on respondents' participation and support needs, and describe barriers and/or facilitators to electronic assistive technology uptake and ongoing use. Method: Participants were identified electronic assistive technology users with acquired brain injury living in shared supported accommodation in Australia (N=22). Mixed methods data were collected using semi-structured interviews and published measures of support need, electronic assistive technology satisfaction, and psychosocial impact. Results: Participants reported satisfaction with the devices they used, and positive psychosocial outcomes. Areas impacted by electronic assistive technology, key facilitators and barriers to electronic assistive technology use, and implications for occupational therapists working to deliver electronic assistive technology solutions were identified. Conclusion: Electronic assistive technology use by this group can positively influence both everyday functioning and participation. Skilled prescription and ongoing support services are necessary to maximise uptake and use. [ABSTRACT FROM AUTHOR]

The article offers brief information on the Housing Toolkit software from the organization Summer Foundation.

Objectives: To examine the sociodemographic and diagnostic factors associated with a discharge from hospital to residential aged care (RAC) for younger people (aged 15-64 years) with neuropsychiatric disorders., Design: An exploratory case-control study using a historic cohort of people with neuropsychiatric disorders. Cases were people transferred to RAC on hospital discharge during the study period. Controls were people not transferred to RAC on discharge during the study period., Setting: Public and private hospital admissions in New South Wales (NSW), Australia., Participants: People aged 15-64 years with a neuropsychiatric disorder hospitalised in NSW between July 2002 and June 2015 (n=5 16 469)., Outcome Measures: The main outcome was transferred to RAC on discharge from hospital. We calculated ORs for sociodemographic and diagnostic factors to determine factors that may impact discharge to RAC., Results: During the period of data capture, 4406 people were discharged from hospitals to RAC. Discharge to RAC was most strongly associated with diagnoses of progressive neurological and cognitive disorders. Acute precipitants of RAC transfer included a broad range of conditions and injuries (eg, Wernicke's encephalopathy, stroke, falls) in the context of issues such as older age, not being partnered (married or de facto), living in areas of lower socioeconomic status, functional issues and the need for palliative care., Conclusions: There are multiple intersecting and interacting pathways culminating in discharge from hospital to RAC among younger people with neuropsychiatric disorders. Improved capacity for interdisciplinary home care and alternative housing and support options for people with high support needs are required., Competing Interests: Competing interests: Dr Di Winkler is the Chief Executive Officer of the Summer Foundation. No other disclosures., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Despite the number of older people and people with disabilities increasing in Australia, it is unclear which housing design features are needed to support physical housing accessibility for people with and without disabilities across the lifespan., Objective: This study drew upon the experience of occupational therapists to investigate accessible housing design features and home modifications to support aging in place and discharge from hospital to home., Methods: A cross-sectional online survey exploring housing design features and home modifications was completed by 144 Australian occupational therapists over six weeks in 2021. Descriptive quantitative and qualitative data analyses were used., Results: For both aging in place and hospital discharge, the most important housing design features included step-free access to the dwelling, large step-free showers, and bathroom and bedroom space on the ground floor. Qualitative findings also highlighted the importance of preparing for home modifications, such as reinforcing bathroom walls to support the post-build installation of grab rails. The most frequently needed modifications were for bathroom features, while structural changes to the dwelling were the most time-intensive modifications, requiring more than six weeks to be completed., Conclusions: External access to the home and internal access to bedroom and bathroom facilities can support aging in place and hospital discharge and mitigate the need for costly and time-intensive home modifications. While this study was conducted in Australia, the findings have relevance outside of this context, and are important for ensuring equitable accessibility for people with and without disabilities across the lifespan., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective Over the past decade, various programs and reforms have targeted the issue of people aged <65 years living in 'permanent' residential aged care (PRAC). As context for ongoing policy discourse, the aim of this study was to evaluate trends in rates of young people entering and leaving PRAC from 2008 to 2018. Methods Counts of people aged <65 years entering, remaining in and exiting PRAC were obtained from the National Aged Care Data Clearinghouse. Age standardisation was used to control for changes in the age and size of the Australian population. Annual age-standardised rates of admissions (subtracting transfers) and exits to the community were calculated. Linear regression models tested for a sustained increase or decrease in age-standardised rates nationally and within state and age subgroups. Results Notwithstanding year-to-year variation, neither admissions (subtracting transfers) nor exits to the community showed statistically significant increasing or decreasing trends in the national age-standardised rates. Admission rates varied by age and state. Conclusions Many more young people are admitted to PRAC each year than return to community living, with no sustained change between 2008 and 2018 at the national level. Age standardisation is crucial for evaluating systemic population-level change regarding younger people in PRAC. What is known about the topic? As at June 2018, over 6000 people aged <65 years still live in PRAC in Australia. Previous research has demonstrated that this cohort experiences a much poorer quality of life on average than people of similar age and disability who reside in other community settings. Various strategies for improving outcomes have been trialled, many aiming to reduce the number of younger people living in aged care; the National Disability Insurance Scheme (NDIS) also has this among its aims. What does this paper add? This paper reports trends in the number of young people entering and exiting aged care, after statistically controlling for changes due to population growth and aging. The paper highlights that national admission rates did not increase or decrease in a sustained manner, and that most of those admitted never return to community living before turning 65 years of age. What are the implications for practitioners? Programs and policies aimed at reducing the number of young people in aged care must grapple with the scale of the issue and its apparent resistance to amelioration over the past 10 years. The results of this study provide a benchmark against which to judge the future impact of the NDIS.